DR SEHN: The AETHERA trial is a very important trial — they randomized patients that they deemed to be high risk of relapse after autologous stem cell transplant for relapsed Hodgkin lymphoma into either a placebo group — or, essentially, observation group — versus patients getting consolidation with brentuximab. In this case, it was given at the standard dose of 1.8 mg/kg every 3 weeks for a year.

They did try to identify a higher-risk group to enter into this trial, so patients who were going to be at higher risk of recurrence. And they defined their high-risk patients as patients who were either refractory to up-front therapy for Hodgkin lymphoma, patients who had an early relapse within 12 months of completing therapy, or patients who had a high risk based on extranodal involvement at the time of their relapse.

And what the trial showed was that the patients receiving the brentuximab consolidation actually had a very significant improvement in their progression-free survival compared to the patients in the placebo arm. At the time of evaluation, there wasn’t an overall survival advantage, but it was still a very early evaluation. And I think the real question is, with longer follow-up, are we going to actually see the consolidation of brentuximab leading to a higher cure rate post stem cell transplant in these high-risk patients?

In my own clinic, I’d have to say that, although the trial targeted a higher-risk patient in terms of who was enrolled in the study, we know that all patients who relapse with their Hodgkin lymphoma are essentially high risk. Even in the best-case scenario, patients that have good risk factors going into the transplant, they still only have about a 60% to 70% chance of cure, at best, with the stem cell transplant.

So I think it really begs the question, should all patients get brentuximab consolidation post stem cell transplant? Because we know that that really is their last line of potentially curative therapy that we have available right now. In my own clinic, we actually don’t distinguish patients on risk. I mean, if you’ve actually relapsed and need a stem cell transplant, we see all those patients as high risk. So although it’s only indicated in the higher-risk patients, we actually are treating all of our patients post stem cell transplant with consolidation brentuximab.

Non-Hodgkin lymphoma (NHL), Hodgkin lymphoma and chronic lymphocytic leukemia (CLL)

Acute and chronic leukemias and myeloproliferative neoplasms

Multiple myeloma (MM)