Expert Discusses Immunotherapy's Promise in Hodgkin Lymphoma

Opdivo had promising response rates in a recent trial testing the treatment in patients with relapsed or refractory Hodgkin lymphoma.
Regardless of previous treatment with Adcetris (brentuximab vedotin), patients with relapsed or refractory Hodgkin lymphoma who had autologous stem-cell transplant (ASCT) and then were treated with Opdivo (nivolumab) had high response levels, according to the latest data from the phase 2 CheckMate-205 trial.

In the study, 77 percent of enrolled patients had stage III or higher disease. The overall response rate was 65 percent in ADCETRIS-naïve patients, 68 percent in patients who received ADCETRIS after ASCT, and 73 percent in patients who received ADCETRIS before and/or after ASCT. The complete response (CR) rates were 29 percent, 13 percent, and 12 percent, respectively.

“We have found the dosing is quite manageable and this is generally the type of treatment that patients can continue being on for the rest of their lives,” said lead study author Michelle A. Fanale, M.D.

In May 2016, the FDA granted Opdivo accelerated approval for the treatment of patients with classical Hodgkin lymphoma that has relapsed or progressed after autologous hematopoietic stem cell transplantation and post-transplantation ADCETRIS, based on findings from the CheckMate-205 and CheckMate-039 trials.

In an interview with CURE, Fanale, associate professor, Department of Lymphoma/Myeloma, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, discussed the latest CheckMate-205 data and the next steps with Opdivo in Hodgkin lymphoma.

Can you discuss the phase 2 study?

This was a phase 2 registrational trial of Opdivo for patients who have relapsed classical Hodgkin lymphoma or had already previously undergone ASCT. There were different cohorts of certain patients who had previously received Adcetris, whereas other patients had not previously received Adcetris.

How do these results impact the treatment landscape?

These results are very applicable for seeing patients and taking care of them on an everyday basis. Opdivo was approved in the United States in May 2016 for the relapse/refractory patient population who have classical Hodgkin lymphoma or need a fourth-line of treatment. 

What was seen from this registrational trial, which is also similar to the Keytruda (pembrolizumab) phase 2 trial, was that both of these drugs work well, even for patients who previously had been resistant to Adcetris or had progressed after Adcetris treatment.

What was seen across the board was that the drug works very well overall. It saw a 70 percent response rate and the CR rate ranged anywhere from 15 percent up to almost 30 percent for the patients who were Adcetris naive.

What are the next steps following this research?

The next steps are to potentially look at Opdivo in combination with Adcetris. There are a couple of updates being presented here at the meeting. There is the phase 2 second-line pre-ASCT and there is a data update that will be given by Dr Alex Herrera. There is also the ECOG trial, that looks at Adcetrisplus Opdivo as a doublet that includes patients who are third-line and greater.

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