Brentuximab-vedotin in combination with cyclophosphamide, doxorubicin, prednisolone for the treatment of aggressive CD30-positive cutaneous T-cell lymphomas

Abstract

Aggressive CD30-positive cutaneous T-cell lymphomas (CD30⁺CTCL) are associated with unfavorable prognosis. Anthracycline-based polychemotherapy (CHOP) and brentuximab-vedotin (BV) monotherapy are related to poor outcomes in case of extracutaneous involvement or rapidly-progressing disease. Our objective was to assess the effectiveness of BV + CHP in aggressive CD30⁺CTCL. We included 7 patients treated with BV + CHP from April 2015 to January 2022: 4 had mycosis fungoides with large-cell transformation, 2 had primary cutaneous anaplastic large-cell lymphoma, and 1 harbored a primary cutaneous aggressive epidermotropic CD8-positive T-cell lymphoma. After a median [IQR] follow-up of 17.2 [13.2–21.0] months, 6/7 patients achieved an ORR lasting ≥4 months. The median [IQR] duration of response was 9.5 [5.9–11.1] months and the median [IQR] progression free survival was 14.9 [11.6–16.4] months. Four patients displayed progression with a median (range) time to next treatment of 15.8 (6.5–16.3) months. Two grade-3 adverse events were reported: febrile neutropenia and thromboembolic event. BV + CHP displayed substantial antitumor activity and favorable safety profile in 7 patients with aggressive CD30⁺CTCL.

Keywords:

• Aggressive CD30-positive cutaneous T-cell lymphoma
• mycosis fungoides with large-cell transformation
• primary cutaneous anaplastic large-cell lymphoma
• primary cutaneous aggressive epidermotropic CD8-positive T-cell lymphoma
• brentuximab-vedotin and chemotherapy (CHP)
• single-centre retrospective study

Author contribution

• Study concept and design: Emmanuel Ribereau-Gayon, Stéphane Dalle.

• Acquisition of data: all authors.

• Analysis and interpretation of data: Emmanuel Ribereau-Gayon, Marie Donzel, Stéphane Dalle, Nicolas Romain-Scelle, Hervé Ghesquières.

• Drafting of the manuscript: Emmanuel Ribereau-Gayon, Stéphane Dalle.

• Critical revision of the manuscript and important intellectual input: All authors.

• Statistical analysis: Nicolas Romain-Scelle.

• All authors declare that they have sufficiently participated in the submitted work to deserve authorship; all have had access to clinical material and have revised the manuscript before submission. The corresponding author (Stephane Dalle) endorses the scientific responsibility of the work reported herein.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

Data available on request due to privacy/ethical restrictions.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.