Association of PET4 response with outcomes of BV-CHP vs CHOP in the ECHELON-2 trial in CD30+ peripheral T-cell lymphoma

In the phase 3 ECHELON-2 trial, brentuximab vedotin, cyclophosphamide, doxorubicin, and prednisone (BV-CHP) significantly improved progression-free survival (PFS) and overall survival (OS) compared with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) in patients with CD30+ peripheral T-cell lymphoma, benefits that were maintained at 5 years. Interim positron emission tomography (PET) scan can be used to assess prognosis and risk-stratify patients. The prognostic value of interim PET was assessed in this post hoc exploratory analysis from ECHELON-2, evaluating interim 18F-fluorodeoxyglucose PET scans after cycle 4 (PET4) and end-of-treatment-based response, and correlated with PFS per investigator and OS. PET4 response was determined by Deauville score (scores of 1-3 were considered negative [PET4-negative] and 4-5 positive [PET4-positive]) by independent review. Overall, 452 patients were randomized 1:1 to the BV-CHP (n = 226) and CHOP (n = 226) arms. Of these, 32 in the BV-CHP arm and 41 in the CHOP arm were not evaluable for PET4. In both arms, PET4-negative status was associated with improved PFS (BV-CHP: HR, 0.36; 95% CI, 0.19-0.66; CHOP: HR, 0.26; 95% CI, 0.17-0.41) and OS (BV-CHP: HR, 0.38; 95% CI, 0.18-0.78; CHOP: HR, 0.24; 95% CI, 0.14-0.41) compared with PET4-positive status. Among patients with systemic anaplastic large cell lymphoma, PET4-negative patients had improved PFS (BV-CHP: HR, 0.28; 95% CI, 0.14-0.60; CHOP: HR, 0.31; 95% CI, 0.17-0.56) and OS (BV-CHP: HR, 0.38; 95% CI, 0.16-0.94; CHOP: HR, 0.25; 95% CI, 0.12-0.55) compared with PET4-positive patients. In this exploratory analysis, PET4-negative status by Deauville score was associated with improved long-term PFS and OS in both the BV-CHP and CHOP arms. This trial was registered at www.ClinicalTrials.gov as #NCT01777152.

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Publication Details

Journal
Blood Advances
Published
2025-08-19
DOI
https://doi.org/10.1182/bloodadvances.2024015282
Citations
2
Primary Topic
CAR-T cell therapy research
Type
article
Field-Weighted Citation Impact
2.09

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article

Association of PET4 response with outcomes of BV-CHP vs CHOP in the ECHELON-2 trial in CD30+ peripheral T-cell lymphoma

Giuseppe Gritti, Tatyana A. Feldman, Evelyn Rustia, Kerry J. Savage et al.
2 citations
Blood Advances
CAR-T cell therapy research
2.09
article

Association of PET4 response with outcomes of BV-CHP vs CHOP in the ECHELON-2 trial in CD30+ peripheral T-cell lymphoma

Giuseppe Gritti, Tatyana A. Feldman, Evelyn Rustia, Kerry J. Savage, Eva Domingo‐Doménech, Swaminathan P. Iyer, Keenan Fenton, June‐Won Cheong, Franck Morschhauser, Ranjana H. Advani, Neha Mehta–Shah, David Belada, Vincent Camus, Nancy L. Bartlett, W. Kim, Michelle A. Fanale, Ilseung Choi, Önder Alpdoğan, Sarah McCue Horwitz, Pier Luigi Zinzani, Giuseppe Rossi, Jacob Haaber Christensen, Jiří Mayer
article en
2 citations

Abstract

In the phase 3 ECHELON-2 trial, brentuximab vedotin, cyclophosphamide, doxorubicin, and prednisone (BV-CHP) significantly improved progression-free survival (PFS) and overall survival (OS) compared with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) in patients with CD30+ peripheral T-cell lymphoma, benefits that were maintained at 5 years. Interim positron emission tomography (PET) scan can be used to assess prognosis and risk-stratify patients. The prognostic value of interim PET was assessed in this post hoc exploratory analysis from ECHELON-2, evaluating interim 18F-fluorodeoxyglucose PET scans after cycle 4 (PET4) and end-of-treatment-based response, and correlated with PFS per investigator and OS. PET4 response was determined by Deauville score (scores of 1-3 were considered negative [PET4-negative] and 4-5 positive [PET4-positive]) by independent review. Overall, 452 patients were randomized 1:1 to the BV-CHP (n = 226) and CHOP (n = 226) arms. Of these, 32 in the BV-CHP arm and 41 in the CHOP arm were not evaluable for PET4. In both arms, PET4-negative status was associated with improved PFS (BV-CHP: HR, 0.36; 95% CI, 0.19-0.66; CHOP: HR, 0.26; 95% CI, 0.17-0.41) and OS (BV-CHP: HR, 0.38; 95% CI, 0.18-0.78; CHOP: HR, 0.24; 95% CI, 0.14-0.41) compared with PET4-positive status. Among patients with systemic anaplastic large cell lymphoma, PET4-negative patients had improved PFS (BV-CHP: HR, 0.28; 95% CI, 0.14-0.60; CHOP: HR, 0.31; 95% CI, 0.17-0.56) and OS (BV-CHP: HR, 0.38; 95% CI, 0.16-0.94; CHOP: HR, 0.25; 95% CI, 0.12-0.55) compared with PET4-positive patients. In this exploratory analysis, PET4-negative status by Deauville score was associated with improved long-term PFS and OS in both the BV-CHP and CHOP arms. This trial was registered at www.ClinicalTrials.gov as #NCT01777152.

Blood AdvancesVol. 9(23)
Cancer Prevention Institute of California (US), Hackensack University Medical Center (US), Memorial Sloan Kettering Cancer Center (US), The University of Texas MD Anderson Cancer Center (US), University of British Columbia (CA), Thomas Jefferson University (US), Inserm (FR), Pfizer (United States) (US), Yonsei University (KR), Washington University in St. Louis (US), Université de Lille (FR), Odense University Hospital (DK), Spinal Cord Injury BC (CA), Samsung Medical Center (KR), Lille’s Cardiology Hospital (FR), National Hospital Organization Kyushu Cancer Center (JP), University Hospital Brno (CZ), Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia (IT), Ospedale Papa Giovanni XXIII (IT), Institut Català d'Oncologia (ES), Stanford Medicine (US), University Hospital Hradec Králové (CZ), University of Washington Bothell (US), Laboratoire National Henri Becquerel (FR), Duran i Reynals Hospital (ES), Centre Henri Becquerel (FR), Université de Rouen Normandie (FR), University of Bologna (IT), Stanford University (US)
Bristol-Myers Squibb, Pfizer, AstraZeneca, Sanofi, Gilead Sciences, Celgene, Memorial Sloan-Kettering Cancer Center, BeiGene, Celltrion, Seagen, Eisai, Kyowa Hakko Kirin, MorphoSys, National Institutes of Health, Genentech, Chugai Pharmaceutical, Takeda Oncology, Kite Pharma, National Cancer Institute, Daiichi Sankyo Europe
Good health and well-being
Openalex Percentile: Top 11%
CAR-T cell therapy research
2.09
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