The Children's Oncology Group (COG) conducted a large multicenter clinical trial led by pediatric oncologists from Roswell Park Comprehensive Cancer Center, Children's Healthcare of Atlanta, and Winship Cancer Institute of Emory University to see whether a targeted therapy will improve children with high-risk Hodgkin's lymphoma (HL) risk for a relapse.
Per Medical Xpress' report, researchers found that combining targeted antibody-drug conjugate (ADC) brentuximab vedotin (BV) with chemotherapy reduced relapse rates in children by 10%. Dr. Kara Kelly noted that it is quite a big gain and expects that this treatment regimen will soon become the standard of care for pediatric patients with high-risk Hodgkin's lymphoma.
Dr. Christian Hinrichs (R), an investigator at the National Cancer Institute in immunotherapy for HPV+ cancers, shows patient Fred Janick, a survivor of metastatic cancer, the difference between his CT scan showing cancerous tumors (R) and a clean scan after treatment (L), after a day of medical exams showing no recurrence of cancer, at the National Institutes of Health (NIH) in Bethesda, Maryland, February 8, 2018.
Hodgkin's lymphoma in Children
Hodgkin's lymphoma is the most common cancer in younger people ages 12 to 29. Around 97% of those under 19 have a five-year survival rate after the diagnosis, but one-third are classified as high risk with a 15% to 20% chance of relapse.
According to the National Cancer Institute, HL is a type of cancer that develops in the lymphatic system. The two main types of childhood HL are classic and nodular lymphocyte-dominant. People with a family history of HL and Epstein-Barr virus infection have a significantly higher risk of childhood HL.
Signs and symptoms of HL include swollen lymph nodes, fever, drenching night sweats, and weight loss. Doctors test the lymphatic system and other parts of the body to diagnose and identify the stage of childhood HL. Certain factors could affect its prognosis or chance of recovery and treatment options.
There are six standard treatment options for HL, including chemotherapy, radiation therapy, targeted therapy, immunotherapy, surgery, and high-dose chemotherapy with stem cell transplant. But there is still another treatment being tested in clinical trials. The treatment the COG recently tested is new and proven to be effective in high-risk childhood HL.
Combined Targeted Therapy and Chemotherapy Reduced Relapse Risk by 10%
The COG study is the largest and only randomized phase III trial with the CD-30 targeted ADC ever conducted with 587 participants ages 2 to 21 with previously untreated disease, Inside Precision Medicine reports.
They were divided into two groups in which both received the treatment for five 21-day cycles. The control group only received chemotherapy, while the second group received a combined targeted therapy of brentuximab vedotin and standard pediatric chemotherapy.
Moreover, both groups received site radiation therapy based on their reaction after two cycles of treatment. Researchers follow-up the patients every three and a half years after the treatment and found that 92.1% in the experimental group did not relapse compared to 82.5% of the control group.
Researchers noted that a lower risk of relapse could eliminate the need for re-treatment with additional toxic therapies, which may lead to a higher risk of other types of cancer, stroke, myocardial infarction, infertility, restrictive pulmonary disease, and shortened lifespan.
Kelly added that Brentuximab vedotin is not anticipated to have long-term toxicity because it could be given more consistently to improve its efficacy with no increase in neuropathy or serious infection.
Dr. Frank Keller, a professor of pediatrics at Emory University School of Medicine and a co-author of the study remarks that the demonstration of the effectiveness of combined targeted therapy and standard chemotherapy for high-risk childhood HL is a significant step toward improving cure rates.
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