Transcript
Dr. Evens: We'll transition now to some ASH abstracts and keep it in newly diagnosed, and also really looking at an ECHELON backbone.
There was an oral presentation that was given 2 days ago on Saturday entitled, "Safety and Efficacy of Brentuximab Vedotin in Combination with AVD in STAGE II-IV HIV-Associated Classical Hodgkin lymphoma." This was a phase 2 study from the AIDS Malignancy Consortium.
Dr. Vose, any quick thoughts from this? Obviously, it was a phase 2 study. It wasn't randomized. Any quick thoughts about this data?
Dr. Vose: I think the data was really exciting. That patient population sometimes, they're a little bit more difficult to treat. I thought that the combination actually looked very promising and very tolerable in that population. They did seem to have a little bit more neuropathy than the non-HIV patients.
There was a couple patients that had to be dropped out of study because there's some drug interactions or issues with the antiviral medications. You do have to be careful about that. I thought overall the abstract looked very promising and definitely something that you would want to use in your HIV-associated Hodgkin's patients, carefully, with those caveats.
Dr. Evens: CYP3A4 inhibitors like ritonavir was actually an exclusion for the study. They had a few sneak in with some severe toxicities. It's definitely an issue. They had a provocative data that CD4 count went up. I don't know if you guys had seen that. Obviously, it's hard to draw a conclusion why would that go up.
Dr. Ansell, do you guys...HIV-related? Is this something you would think about in a careful fashion like Dr. Vose mentioned?
Dr. Ansell: I do think that data was very promising. I think it was very encouraging to see, like we're seeing in large cell lymphoma and other diseases, that if patients are relatively well-controlled as it relates to their HIV, they can tolerate very similar therapies to other patients. I think that was good.
As Julie pointed out, there was a little bit more in the way of toxicity. I think again that's not entirely unexpected. To your point about the CD4 counts, I think CD4 is affected not only by the infection, but also by the disease.
I think when you keep the infection well-controlled and then the disease is well-controlled, you may well see the immune system just in general improving. I think that was reflected in that data.
Dr. Evens: Great. More to come on that. Of course, careful, with any patient with a vinca drug to really actively ask them about neuropathy, sometimes patients don't want to volunteer that, and maybe those reductions are needed.
