Estimating long-term outcomes in classic Hodgkin lymphoma: a United States population-based oncology simulation model based on overall survival from the ECHELON-1 trial

Abstract

The six-year ECHELON-1 update showed a survival advantage for frontline (1 L) A + AVD (brentuximab vedotin, doxorubicin, vinblastine, dacarbazine) vs ABVD (doxorubicin, bleomycin, vinblastine, dacarbazine) for stage III/IV classic Hodgkin lymphoma (cHL). As clinical trials have limited ability to track patients for extended periods, we developed an oncology simulation model using ECHELON-1 data to estimate population-based cHL outcomes in the US over 10 years (through 2031). The model included a scenario without (64.5% ABVD, 35.5% PET-adapted ABVD utilization) and scenarios with 1 L A + AVD (27%–80%k utilization). At 27%–80% A + AVD utilization, the model estimated 13.6%–31.7% fewer deaths, 2.4%–6.3% more patients ≥5 years progression free, 9.4%–24.4% fewer stem cell transplants (SCTs), and 7.8%–22.5% fewer second cancers over 10 years. These results suggest that the improved outcomes observed in the ECHELON-1 update with A + AVD vs ABVD may translate to more patients alive and fewer with primary relapsed/refractory cHL, SCTs, and second cancers.

Keywords:

• Epidemiology
• brentuximab vedotin
• classic Hodgkin lymphoma
• simulation model
• frontline
• secondary cancer

Acknowledgments

Medical writing support was provided by Kristin Mickle, MPH, and Beth Lesher, PharmD, BCPS, from OPEN Health, and was funded by the study sponsor.

Disclosure statement

Tycel Phillips is a consultant to AbbVie, ADC, AstraZeneca, Bayer, BeiGene, Bristol Myers Squibb, Epizyme, Gilead, Lilly, Pharmacyclics, Regeneron, Seagen, and Xencor, and he is on the boards of Epizyme, Genentech, and Merck. Kristina S. Yu, Nicholas Liu, and Michelle A. Fanale are employees of Seagen and own stock in Seagen. Kristen Migliaccio-Walle and Brian Bloudek are employees of Curta, and are paid consultants to Seagen in connection with this study. John M. Burke has been a member of the speakers bureaus at Seagen and BeiGene, and he is a consultant to AbbVie, Adaptive Biotechnologies, AstraZeneca, Bayer, BeiGene, Bristol Myers Squibb, Epizyme, Foresight Diagnostics, Genentech/Roche, Kura, Kymera, Lilly, MorphoSys, Novartis, Nurix, Seagen, TG Therapeutics, Verastem, and X4 Pharmaceuticals.