An exploratory update on the ECHELON-2 study was recently published in the journal Annals of Oncology. An analysis of 5-year progression-free survival (PFS) per investigator in the intent to treat (ITT) analysis group was reported.
The clinical outcomes with current frontline treatment (cyclophosphamide, doxorubicin, vincristine, and prednisone [CHOP] or CHOP-like therapy) for peripheral T-cell lymphoma (PTCL) patients are pretty poor. The ECHELON-2 study evaluated the combination of antibody conjugate, brentuximab vedotin to CHP (A+ CHP) as a frontline treatment for patients (pts) with systemic anaplastic large cell lymphoma (sALCL) or other CD30+ PTCL versus CHOP alone.
The double-blind, multi-centre, phase-III, placebo-controlled, ECHELON-2 study randomly assigned (1:1) 452 patients to either receive six to eight cycles of A+ CHP (n= 226) or CHOP (n=226). The study’s primary endpoint was PFS; it was assessed per independent central review in the primary analysis and per investigator in the current exploratory subgroup analysis. The ECHELON-2 study was neither powered nor designed to compare treatment efficacy within individual histologic subtypes other than sALCL.
After a median follow-up of 47.6 months, a higher 5 year PFS rates were observed in patients treated with A+ CHP (51.4%, 95% confidence interval [CI]: 42.8% to 59.4%) in comparison to those on CHOP treatment (43.0%, 95% CI: 35.8% to 50.0%, hazard ratio = 0.70). Also, the 5-year overall survival rates were higher in patients on A+CHP versus CHOP treatment (70.1% vs 61.0%). Peripheral neuropathy was resolved or improved in 72% of patients in the A+CHP arm and 78% in the CHOP arm. In relapsed patients, the objective response rate with brentuximab vedotin treatment after either A+CHP or CHOP treatment was 59% and 50%, respectively.
The ECHELON-2 study demonstrates consistent treatment benefits with A+CHP over CHOP treatment across subgroups and the ITT population.
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