On day two of the 2022 American Society of Clinical Oncology (ASCO) Annual Meeting, Thanos Zomas, MD, Global Medical Lead, Lymphoma and Leukemia, and Global Medical Lead, Adcetris Program, Takeda Oncology, discusses updated results from the ECHELON-1 study, which show a significant improvement in mortality risk and 6-year survival rate with the addition of brentuximab vedotin to first-line chemotherapy.
Can you discuss the unmet needs of patients with newly diagnosed classical Hodgkin lymphoma?
Hodgkin’s lymphoma is a relatively rare form of lymphoma. There are over 100 different types of lymphoma, and Hodgkin’s lymphoma is one of them. It was considered, fortunately, to be a very curable disease, but despite this, there is a percentage — perhaps in the order of 20% to 30% — of these patients who unfortunately relapse after their initial treatment. And so they require additional processing. Most of the time, this treatment is more intensive and repetitive. And there is an unmet medical need there that requires better treatments early on.
Why is it so important to find an optimal first-line treatment in these patients?
The majority of these patients are relatively young. The average age of patients with Hodgkin’s lymphoma is between 35 and 40 years old, although we have seen patients at a much earlier and very late age. They are in the most productive phase of their life, so it is very important to cure as many of them as possible with the first cycle of chemotherapy in order to avoid additional treatment, which is also associated with a very negative impact on their quality. of life. as very unpleasant secondary side effects, including secondary malignancies, fertility problems and cardiovascular side effects.
Can you discuss the design and endpoints of ECHELON-1?
So the ECHELON-1 study was truly an international study that included many countries around the world. This was a fully randomized phase 3 study that compared the standard of care therapy in the first-line treatment, called ABVD (doxorubicin [Adriamycin]bleomycin, vinblastine and dacarbazine), with a new treatment regimen called A+AVD (brentuximab vedotin [Adcetris]doxorubicin, vinblastine and dacarbazine), and which essentially replaced one of the weaker drugs in the ABVD regimen, bleomycin, with the targeted anti-CD30 agent called brentuximab vedotin.
This trial began enrolling patients in 2012 and completed enrollment in 2016. It has generated a lot of excitement because the disease is relatively rare. So the fact that ECHELON-1 included a very large number of patients, around 1400 patients, created a lot of expectations and hopes.
What do the 6-year results of ECHELON-1 show?
In this Congress, for the first time, we report the first formal overall survival analysis from the ECHELON-1 study, which shows a fairly significant survival advantage in favor of the Adcetris arm, the A+AVD regimen, over treatment standard. This regimen has shown very clearly, and for the first time in the past 20 years, that adding targeted agents to the first-line Hodgkin’s lymphoma regimen can reduce the risk of death by 41%. This corresponds to a very high survival rate, at 6 years of median follow-up, approaching 94%.
And, again, that can seem like a very difficult target to hit in many other types of lymphoma, as well as other types of cancer. So it’s very important to have that overall survival advantage in young people, because they can go back to their families, go back to their normal lives, and continue to live and enjoy their lives with their family and friends.