Brentuximab Vedotin for Hodgkin Lymphoma in North America
See article by Ramchandren et al., p. 1718
Classical Hodgkin lymphomas have long been treated with a combination of doxorubicin, vinblastine, dacarbazine, and bleomycin (ABVD). Although this combination has worked well overall, roughly one-third of patients with advanced disease will ultimately develop resistance and relapse. Ramchandren and colleagues describe results from the ECHELON-1 phase III trial, comparing the ABVD regimen with A+AVD (doxorubicin, vinblastine, dacarbazine, and brentuximab vedotin (ADCETRIS), an CD30-directed antibody-drug conjugate). In the North American cohort assessed in this article, A+AVD improved modified progression-free survival and reduced the risk of disease progression or death. Although adverse events were common on A+AVD, fewer patients needed to discontinue participation in the study than patients treated with ABVD. Overall, these results support the continuation of the A+AVD regimen for patients with advanced classical Hodgkin lymphoma.
Haplo-HSCT Is Superior to Chemotherapy for Int-risk AML CR1
See article by Lv et al., p. 1737
Patients with intermediate risk acute myeloid leukemia (int-risk AML) have a high rate of relapse and a poor overall survival. The preferred treatment for int-risk AML has been allogenic hematopoietic stem cell transplant (allo-HSCT); however, haploidentical hematopoietic stem cell transplant (haplo-HCST) has been proposed as a suitable postremission therapy for patients lacking a matching donor. Lv and colleagues describe the results of a prospective trial in which int-risk AML patients received either chemotherapy or underwent halplo-HSCT after the first complete remission. Haplo-HSCT significantly improved 3-year disease-free and overall survival compared with chemotherapy. These results suggest that, in the absence of a matched HSCT donor, haplo-HCST is an effective treatment strategy for int-risk AML postremission.
DWI to Decrease Breast MRI False Positives
See article by Rahbar et al., p. 1756
While early detection of breast cancer has been improved by advances in imaging, even MRI, the most sensitive known imaging modality for breast cancer detection, can yield false positive results, leading to unnecessary biopsies. To determine the efficacy of noncontrast diffusion weighted imaging (DWI) in reducing breast MRI false positives, Rahbar and colleagues performed a prospective, multicenter phase II trial. This trial confirmed that DWI is efficacious in discriminating benign from malignant pathologies to potentially reduce the number of unnecessary biopsies. Furthermore, the trial identified quantitative DWI-based apparent diffusion coefficient thresholds that could be validated in future phase III trials to facilitate further clinical translation of this novel early detection strategy.
Combination Therapy Using Anti-EGFR and Anti-CDK4/6 for TNBC
See article by Foidart et al., p. 1838
Triple-negative breast cancers (TNBC) carry the worst prognosis of all breast cancer subtypes, in part because no effective therapies have been identified. Foidart and colleagues have identified a combination of markers to serve as predictive biomarkers to targeted therapies. Specifically, MT4-MMP+/EGFR+/RB+ TNBC patient-derived xenografts showed greater sensitivity to a combination of anti-EGFR (erlotinib) and anti-CDK4/6 (palbociclib). The authors estimate that half of TNBC express this combination of markers. Further study of the combination of erlotinib and palbociclib in this population will therefore determine the utility of this biomarker combination in clinical settings.