Novel Brentuximab Vedotin Combination Therapies Show Promising Activity in Highly Refractory CD30+ Non-Hodgkin Lymphoma: A Case Series and Review of the Literature

Non-Hodgkin lymphomas (NHLs) are a heterogeneous group of hematologic malignancies which typically respond to standard first-line chemoimmunotherapy regimens. Unfortunately, patients with refractory NHL face a poor prognosis and represent an unmet need for improved therapeutics. We present two cases...

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Main Authors: Wilfred Delacruz, Robert Setlik, Arash Hassantoufighi, Shyam Daya, Susannah Cooper, Dale Selby, Alexander Brown
Format: Article
Language:English
Published: Wiley 2016-01-01
Series:Case Reports in Oncological Medicine
Online Access:http://dx.doi.org/10.1155/2016/2596423
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author Wilfred Delacruz
Robert Setlik
Arash Hassantoufighi
Shyam Daya
Susannah Cooper
Dale Selby
Alexander Brown
author_facet Wilfred Delacruz
Robert Setlik
Arash Hassantoufighi
Shyam Daya
Susannah Cooper
Dale Selby
Alexander Brown
author_sort Wilfred Delacruz
collection DOAJ
description Non-Hodgkin lymphomas (NHLs) are a heterogeneous group of hematologic malignancies which typically respond to standard first-line chemoimmunotherapy regimens. Unfortunately, patients with refractory NHL face a poor prognosis and represent an unmet need for improved therapeutics. We present two cases of refractory CD30+ NHL who responded to novel brentuximab vedotin- (BV-) based regimens. The first is a patient with stage IV anaplastic large cell lymphoma (ALCL) with cranial nerve involvement who failed front-line treatment with cyclophosphamide, doxorubicin, vincristine, etoposide, and prednisone (CHOEP) and second line cyclophosphamide, vincristine, doxorubicin, dexamethasone alternating with high-dose methotrexate (MTX), and cytarabine (hyperCVAD) with intrathecal- (IT-) MTX and IT-cytarabine, but responded when BV was substituted for vincristine (hyperCBAD). The second patient was a man with stage IV diffuse large B-cell lymphoma (DLBCL) with leptomeningeal involvement whose disease progressed during first-line rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) and progressed despite salvage therapy with rituximab, dexamethasone, cytarabine, and cisplatin (R-DHAP) in whom addition of BV to topotecan resulted in a significant response. This report describes the first successful salvage treatments of highly aggressive, double refractory CD30+ NHL using two unreported BV-based chemoimmunotherapy regimens. Both regimens appear effective and have manageable toxicities. Further clinical trials assessing novel BV combinations are warranted.
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spelling doaj-art-ca1d3ece5fed4f13b9354f2a4da8566f2025-08-20T02:20:01ZengWileyCase Reports in Oncological Medicine2090-67062090-67142016-01-01201610.1155/2016/25964232596423Novel Brentuximab Vedotin Combination Therapies Show Promising Activity in Highly Refractory CD30+ Non-Hodgkin Lymphoma: A Case Series and Review of the LiteratureWilfred Delacruz0Robert Setlik1Arash Hassantoufighi2Shyam Daya3Susannah Cooper4Dale Selby5Alexander Brown6Hematology/Oncology Service, San Antonio Military Medical Center, Fort Sam Houston, San Antonio, TX 78234, USAHematology/Oncology Service, San Antonio Military Medical Center, Fort Sam Houston, San Antonio, TX 78234, USADepartment of Internal Medicine, San Antonio Military Medical Center, Fort Sam Houston, San Antonio, TX 78234, USADepartment of Internal Medicine, San Antonio Military Medical Center, Fort Sam Houston, San Antonio, TX 78234, USAHematology/Oncology Service, San Antonio Military Medical Center, Fort Sam Houston, San Antonio, TX 78234, USADepartment of Pathology, San Antonio Military Medical Center, Fort Sam Houston, San Antonio, TX 78234, USAHematology/Oncology Service, San Antonio Military Medical Center, Fort Sam Houston, San Antonio, TX 78234, USANon-Hodgkin lymphomas (NHLs) are a heterogeneous group of hematologic malignancies which typically respond to standard first-line chemoimmunotherapy regimens. Unfortunately, patients with refractory NHL face a poor prognosis and represent an unmet need for improved therapeutics. We present two cases of refractory CD30+ NHL who responded to novel brentuximab vedotin- (BV-) based regimens. The first is a patient with stage IV anaplastic large cell lymphoma (ALCL) with cranial nerve involvement who failed front-line treatment with cyclophosphamide, doxorubicin, vincristine, etoposide, and prednisone (CHOEP) and second line cyclophosphamide, vincristine, doxorubicin, dexamethasone alternating with high-dose methotrexate (MTX), and cytarabine (hyperCVAD) with intrathecal- (IT-) MTX and IT-cytarabine, but responded when BV was substituted for vincristine (hyperCBAD). The second patient was a man with stage IV diffuse large B-cell lymphoma (DLBCL) with leptomeningeal involvement whose disease progressed during first-line rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) and progressed despite salvage therapy with rituximab, dexamethasone, cytarabine, and cisplatin (R-DHAP) in whom addition of BV to topotecan resulted in a significant response. This report describes the first successful salvage treatments of highly aggressive, double refractory CD30+ NHL using two unreported BV-based chemoimmunotherapy regimens. Both regimens appear effective and have manageable toxicities. Further clinical trials assessing novel BV combinations are warranted.http://dx.doi.org/10.1155/2016/2596423
spellingShingle Wilfred Delacruz
Robert Setlik
Arash Hassantoufighi
Shyam Daya
Susannah Cooper
Dale Selby
Alexander Brown
Novel Brentuximab Vedotin Combination Therapies Show Promising Activity in Highly Refractory CD30+ Non-Hodgkin Lymphoma: A Case Series and Review of the Literature
Case Reports in Oncological Medicine
title Novel Brentuximab Vedotin Combination Therapies Show Promising Activity in Highly Refractory CD30+ Non-Hodgkin Lymphoma: A Case Series and Review of the Literature
title_full Novel Brentuximab Vedotin Combination Therapies Show Promising Activity in Highly Refractory CD30+ Non-Hodgkin Lymphoma: A Case Series and Review of the Literature
title_fullStr Novel Brentuximab Vedotin Combination Therapies Show Promising Activity in Highly Refractory CD30+ Non-Hodgkin Lymphoma: A Case Series and Review of the Literature
title_full_unstemmed Novel Brentuximab Vedotin Combination Therapies Show Promising Activity in Highly Refractory CD30+ Non-Hodgkin Lymphoma: A Case Series and Review of the Literature
title_short Novel Brentuximab Vedotin Combination Therapies Show Promising Activity in Highly Refractory CD30+ Non-Hodgkin Lymphoma: A Case Series and Review of the Literature
title_sort novel brentuximab vedotin combination therapies show promising activity in highly refractory cd30 non hodgkin lymphoma a case series and review of the literature
url http://dx.doi.org/10.1155/2016/2596423
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