Brentuximab vedotin or physician's choice in CD30-positive cutaneous T-cell lymphoma (ALCANZA): an international, open-label, randomised, phase 3, multicentre trial

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art_PRINCE_Brentuximab_vedotin_or_physicians_choice_in_CD30positive_cutaneous_2017.PDF (683.25 KB)
Citações na Scopus
449
Tipo de produção
article
Data de publicação
2017
Editora
ELSEVIER SCIENCE INC
DOI
Indexadores
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Autores
PRINCE, H. Miles
KIM, Youn H.
HORWITZ, Steven M.
DUMMER, Reinhard
SCARISBRICK, Julia
QUAGLINO, Pietro
ZINZANI, Pier Luigi
WOLTER, Pascal
ORTIZ-ROMERO, Pablo L.
Autor de Grupo de pesquisa
ALCANZA Study Grp
Editores
Coordenadores
Organizadores
Citação
LANCET, v.390, n.10094, p.555-566, 2017
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Background Cutaneous T-cell lymphomas are rare, generally incurable, and associated with reduced quality of life. Present systemic therapies rarely provide reliable and durable responses. We aimed to assess efficacy and safety of brentuximab vedotin versus conventional therapy for previously treated patients with CD30-positive cutaneous T-cell lymphomas. Methods In this international, open-label, randomised, phase 3, multicentre trial, we enrolled adult patients with CD30-positive mycosis fungoides or primary cutaneous anaplastic large-cell lymphoma who had been previously treated. Patients were enrolled across 52 centres in 13 countries. Patients were randomly assigned (1:1) centrally by an interactive voice and web response system to receive intravenous brentuximab vedotin 1.8 mg/kg once every 3 weeks, for up to 16 3-week cycles, or physician's choice (oral methotrexate 5-50 mg once per week or oral bexarotene 300 mg/m(2) once per day) for up to 48 weeks. The primary endpoint was the proportion of patients in the intention-totreat population achieving an objective global response lasting at least 4 months per independent review facility. Safety analyses were done in all patients who received at least one dose of study drug. This trial was registered with ClinicalTrials.gov, number NCT01578499. Findings Between Aug 13, 2012, and July 31, 2015, 131 patients were enrolled and randomly assigned to a group (66 to brentuximab vedotin and 65 to physician's choice), with 128 analysed in the intention-to-treat population (64 in each group). At a median follow-up of 22.9 months (95% CI 18.4-26.1), the proportion of patients achieving an objective global response lasting at least 4 months was 56.3% (36 of 64 patients) with brentuximab vedotin versus 12.5% (eight of 64) with physician's choice, resulting in a between-group difference of 43.8% (95% CI 29.1-58.4; p<0.0001). Grade 3-4 adverse events were reported in 27 (41%) of 66 patients in the brentuximab vedotin group and 29 (47%) of 62 patients in the physician's choice group. Peripheral neuropathy was seen in 44 (67%) of 66 patients in the brentuximab vedotin group (n=21 grade 2, n=6 grade 3) and four (6%) of 62 patients in the physician's choice group. One of the four on-treatment deaths was deemed by the investigator to be treatment-related in the brentuximab vedotin group; no on-treatment deaths were reported in the physician's choice group. Interpretation Significant improvement in objective response lasting at least 4 months was seen with brentuximab vedotin versus physician's choice of methotrexate or bexarotene.
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https://observatorio.fm.usp.br/handle/OPI/21870
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Coleções
Artigos e Materiais de Revistas Científicas - FM/MDT
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - LIM/53
Artigos e Materiais de Revistas Científicas - ODS/03