Brentuximab Vedotin, Expanding Role in Therapy for Lymphomas

Review Article

Ann Hematol Oncol. 2015; 2(9): 1065.

Brentuximab Vedotin, Expanding Role in Therapy for Lymphomas

Sanchez A and Provencio M*

Medical Oncology Service, Hospital Universitario Puerta de Hierro-Majadahonda, Spain

*Corresponding author: Mariano Provencio, Medical Oncology Service, Hospital Universitario Puerta de Hierro-Majadahonda, Spain

Received: September 05, 2015; Accepted: November 28, 2015; Published: November 30, 2015


The CD30 antigen has an important role as therapeutic target in patients with CD30-positive Hodgkin lymphoma and anaplastic large-cell lymphoma. Brentuximab vedotin (SGN-35) is an antibody that consists of the anti-CD30 monoclonal antibody conjugated with an antimitotic microtubule inhibitor (monomethyl auristatin E). The high response rates and prolonged survival times seen with brentuximab vedotin have changed the treatment paradigm for patients with relapsed or refractory disease which led to its approval for patients with relapsed Hodgkin lymphoma after autologous transplant or after more than two treatment regimens and who are not candidates for chemotherapy intensification and subsequent autologous transplant. It has also been approved for treating patients with anaplastic large-cell lymphoma who relapse after a line of chemotherapy treatment.

It has undergone important clinical development in recent years, and now its utility is being evaluated at different stages of these diseases: as front-line therapy in treatment-naive patients, prior to autologous stem cell transplant, as an adjunct to stem cell transplant and to facilitate a consolidative allogenic transplant. Further investigation is ongoing to assess the potential benefit in other disease settings and other lymphoid malignancies. It has an acceptable toxicity profile, with its main toxicity being accumulative peripheral neurotoxicity. Mature data on overall survival and quality of life are pending.

Keywords: Brentuximab Vedotin; CD30; Hodgkin Lymphoma; Anaplastic Large-Cell Lymphoma; Target Therapy


Allo-SCT: Allogeneic Stem Cell Transplantation; ALCL: Anaplastic Large-Cell Lymphoma; ASCT: Autologous Stem-Cell Transplant; CR: Complete Response; DLBCL: Diffuse Large B-Cell Lymphoma; DFS: Disease-Free Survival; FDG-PET: 18-Fluoro- Deoxyglucose Positron Emission Tomography; FDA: Food and Drug Administration; HL: Hodgkin Lymphoma; mAb: Monoclonal Antibodies; MMAE: Monomethyl Auristatin E; OR: Objective Response; ORR: Overall Response Rate; OS: Overall Survival; PFS: Progression-Free Survival; PR: Partial Responses; PTCL-NOS: Peripheral T-Cell Lymphoma Not Otherwise Specified


The CD30 antigen has emerged as an ideal therapeutic target in patients with CD30-positive Hodgkin Lymphoma (HL) and Anaplastic Large-Cell Lymphoma (ALCL). CD30 is highly expressed by Reed-Sternberg cells in HL and by ALCL cells, and can also be also be present in many other lymphoma cells. However, it is not expressed in most human tissue under physiologic conditions.

HL derives from the pre-apoptotic germinal center B cells and is characterized by the presence of a scant number of large bi- or multinucleated cells with prominent nucleoli (Reed-Sternberg cells) in a non-neoplastic inflammatory microenvironment. Reed-Sternberg cells stain positive for CD30 and CD15 [1] (Figure 1). For most patients with refractory or relapsed HL, high-dose therapy followed by Autologous Stem-Cell Transplant (ASCT) is the treatment of choice. ASCT can induce durable responses in approximately 50% of these patients [2,3]. Prognoses are especially poor in those patients with refractory disease or those that relapse during the year after high-dose therapy followed by ASCT [4]. At this stage of the disease there is no standard of care, and novel therapies, such as brentuximab vedotin, bendamustine, everolimus, panobinostat, lenalidomida, ipilimumab and nivolumab, are currently under investigation. Brentuximab vedotin has shown significant clinical activity with a manageable safety profile in patients with relapsed or refractory HL.