The Evolving Paradigm in Treatment for Hodgkin Lymphoma
Clay Siegall, Ph.D.
Annually, Hodgkin lymphoma affects less than 9,000 patients in the United States annually, and for the past 40 years, these patients have been treated with a 4-drug regimen. Because of this, Seattle Genetics has spent the last 5-and-a-half years attempting to redefine front-line therapy for patients with advanced stages of this rare cancer.
At the 59th American Society of Hematology (ASH) Annual Meeting and Exposition, Rare Disease Report sat down with the company's President and CEO, Clay Siegall, Ph.D., to discuss why the plenary data of Adcetris (brentuximab vedotin) that was presented over the weekend is so important to the rare cancer community.
Siegall: Our most important (presentation) was yesterday, and that was a primary presentation on frontline data on Hodgkin lymphoma of a study that was a 5-and-a-half year study to try to redefine frontline therapy for patients with advanced Hodgkin Lymphoma. So, Hodgkin Lymphoma affects a little more than 8,000 patients in the United States every year and they are treated with a 4-drug regiment known as ABVD since 1977. For 40 years, the same regiment. It is an effective regiment, but it’s also a very toxic regiment. What we did is we pulled out one of the units, the B, bleomycin, which causes a lot of lung toxicity, pulmonary toxicity that’s what it’s referred to, and we replaced it with Adcetris, our drug.
Adcetris was approved 6 years ago for relapse Hodgkin Lymphoma and that is how it’s been used largely, as well as for relapsed t-cell lymphoma, which is another rare disease. What we get is we substitute it in, Adcetris, instead of bleomycine. What we were able to show in a large long study is that we get a higher long-term disease-free survival rate, which in Hodgkin lymphoma often leads to cures. At the same time, it’s getting rid of the bleomycine related pulmonary toxicity that doctors have been trying to get rid of for decades. So, we were very pleased with our results. We have breakthrough therapy designation from FDA based on our data and yesterday our data was published in the New England Journal of Medicine. It was very challenging, the enrollment took years and we had to do it across geographies: US, Europe, Asia and we needed 1,334 patients total in both arms of the randomized trial and it took over 230 sites around the world to get enough patients and it took years to approve the patients. So yes, in a disease that is relatively rare it is a challenging undertaking to do such a frontline experiment.