Nivolumab and brentuximab vedotin (BV)-based, response‐adapted treatment in children, adolescents, and young adults (CAYA) with standard-risk relapsed/refractory classical Hodgkin lymphoma (R/R cHL): Primary analysis.

Authors

Peter Cole

Peter D. Cole

Rutger’s Cancer Institute of New Jersey, New Brunswick, NJ

Peter D. Cole , Christine Mauz-Körholz , Maurizio Mascarin , Gérard Michel , Stacy Cooper , Auke Beishuizen , Kasey J. Leger , Loredana Amoroso , Salvatore Buffardi , Charlotte Rigaud , Markus Puhlmann , Stephen Francis , Mariana Sacchi , Richard A. Drachtman , Paul David Harker-Murray , Thierry Leblanc , Stephen Daw , Kara M. Kelly

Organizations

Rutger’s Cancer Institute of New Jersey, New Brunswick, NJ, University Hospital Justus Liebig University, Giessen and Medical Faculty of the Martin Luther University Halle-Wittenberg, Halle, Germany, IRCCS Centro di Riferimento Oncologico, Aviano, Italy, Hôpital de la Timone, Marseilles, France, Johns Hopkins Hospital, Baltimore, MD, Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands, Seattle Children's Hospital, Seattle, WA, IRCCS Istituto Giannina Gaslini, Genoa, Italy, Santobono-Pausilipon Hospital, Naples, Italy, Gustave Roussy Cancer Campus, Villejuif, France, Seattle Genetics, Bothell, WA, Bristol-Myers Squibb, Princeton, NJ, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, Children's Hospital of Wisconsin, Milwaukee, WI, Hôpital Robert-Debré APHP, Paris, France, University College Hospital, London, United Kingdom, Roswell Park Comprehensive Cancer Center, Buffalo, NY

Research Funding

Pharmaceutical/Biotech Company
Bristol-Myers Squibb

Background: Outcomes for younger patients (pts) with R/R cHL are poor, particularly for those without complete metabolic response (CMR) before autologous transplant (auto-HCT). Nivolumab + BV has shown 67% CMR and a high 2-y PFS rate as first salvage in adults with R/R cHL. CheckMate 744 (NCT02927769) is an ongoing phase 2 study for CAYA with R/R cHL, evaluating a risk-stratified, response-adapted approach using nivolumab + BV and, for pts without CMR, BV + bendamustine. In the initial analysis of the standard-risk cohort (R2), the regimen was well tolerated with high CMR rates before consolidation with high-dose chemotherapy plus auto-HCT. We report data from the primary analysis. Methods: Pts were aged 5–30 y and had first-line treatment (tx) without auto-HCT. Risk stratification has been described previously (Harker-Murray, ASH 2018). Pts received 4 induction cycles of nivolumab + BV; pts without CMR by blinded independent central review (BICR) received BV + bendamustine intensification. Pts with CMR at any time could proceed to consolidation off study. Response was per Lugano 2014 criteria. Primary endpoint: CMR rate (Deauville ≤3) per BICR any time before consolidation. Results: At database lock, 44 pts were treated in R2 (median follow up: 20.9 mo); 43 received 4 induction cycles and 11 received intensification. Median age was 16 y (range 9–30); 24 (55%) pts had primary refractory cHL and 20 had relapsed cHL. CMR rates and ORR any time before consolidation and after induction are shown in Table. 1-y PFS rate by BICR was 91% (90% CI 77–96). During induction, 8 (18%) pts experienced grade (G) 3–4 tx-related adverse events (TRAEs); the most common any grade TRAEs were nausea and hypersensitivity (20% each). 1 TRAE led to discontinuation (G3 anaphylaxis). Most tx-related immune-mediated AEs were G1–2 (1 pt had 2 G3 infusion-related reactions). Conclusions: This risk-stratified, response-adapted approach offers a well-tolerated salvage strategy with high CMR rates and no new safety signals for CAYA with R/R cHL. Most pts avoided alkylator exposure prior to consolidation. Further follow up may confirm durability of disease control. Clinical trial information: NCT02927769.

CMR and ORR per BICR and investigator (INV) in response-evaluable pts.

BICRINV
Any time before consolidation
     n4344
     CMR, n (% [90% CI])38 (88 [77–95])39 (89 [78–95])
     ORR, n (%)42 (98)43 (98)
After 4 cycles nivolumab + BV induction
     n4444
     CMR, n (%)26 (59)29 (66)
     ORR, n (% [90% CI])36 (82 [70–91])39 (89 [78–95])

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Abstract Details

Meeting

2020 ASCO Virtual Scientific Program

Session Type

Poster Discussion Session

Session Title

Hematologic Malignancies—Lymphoma and Chronic Lymphocytic Leukemia

Track

Hematologic Malignancies

Sub Track

Hodgkin Lymphoma

Clinical Trial Registration Number

NCT02927769

Citation

J Clin Oncol 38: 2020 (suppl; abstr 8013)

DOI

10.1200/JCO.2020.38.15_suppl.8013

Abstract #

8013

Poster Bd #

346

Abstract Disclosures