ASCO 2020 – R/R Hodgkin lymphoma: pembrolizumab tops brentuximab for PFS in phase 3


  • Deepa Koli
  • Oncology Conference reports
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Takeaway

  • In patients with relapsed or refractory classical Hodgkin lymphoma, pembrolizumab significantly improved PFS vs brentuximab vedotin across all subgroups. 

Why this matters

  • Pembrolizumab can become the new standard of care in these patients.

Study design

  • Phase 3 KEYNOTE-204 trial.
  • 304 patients with relapsed/refractory classic Hodgkin lymphoma were randomly assigned to receive either pembrolizumab or brentuximab vedotin.
  • Funding: Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA.

Key results

  • Median follow-up: 24.7 months.
  • Pembrolizumab significantly improved primary PFS vs brentuximab vedotin (median, 13.2 vs 8.3 months; HR, 0.65; P=.00271). 
    • 12-month PFS rates were 53.9% vs 35.6%, respectively.
  • PFS benefit was observed in all subgroups:
    • No post-autologous stem cell transplant (HR, 0.61).
    • Primary refractory disease (HR, 0.52).
    • Prior brentuximab (HR, 0.34).
    • Brentuximab naive (HR, 0.67).
  • Secondary PFS significantly improved with pembrolizumab (median, 12.6 vs 8.2 months; HR, 0.62; 95% CI, 0.46-0.85).
  • In the pembrolizumab vs brentuximab vedotin group:
    • Objective response rate was 65.6% vs 54.2%.
    • Median duration of response was 20.7 vs 13.8 months.
    • Grade 3-5 treatment-related adverse event (TRAE) rate was 19.6% vs 25.0%.
  • 1 death was reported because of TRAE in the pembrolizumab group.
  • Pneumonitis was more frequent with pembrolizumab.

Limitations

  • Open label.