AVELUMAB MONOTHERAPY FOLLOWED BY A PET ADAPTED CHEMOTHERAPY APPROACH IN THE FIRST LINE TREATMENT OF CLASSICAL HODGKIN LYMPHOMA: INITIAL RESULTS FROM THE AVENUE WINDOW STUDY
Notice bibliographique
Résumé
Introduction: Inhibitors of programmed cell death receptor 1 (PD1) used with chemotherapy result in high response rates and durable remissions in the first line (1L) treatment of classical Hodgkin Lymphoma (cHL). Avelumab is an inhibitor of the immune checkpoint PDL1, which is highly expressed by Reed-Sternberg cells, and has demonstrated activity in relapsed/refractory cHL. The AVENuE window study assessed the efficacy and safety of avelumab prior to response adapted chemotherapy as 1L treatment in cHL. It is the first study to report on PDL1 inhibition in this setting. Financial support was provided as an investigator sponsored research grant from Pfizer Ltd. Methods: Adult patients (pts) with advanced cHL were enrolled in this phase 2 study. Pts received 2 cycles (4 doses) of avelumab then underwent a PET/CT followed by 2 cycles of ABVD and PET/CT (iPET). iPET neg (Deauville score 1–3) pts received further 4 × AVD and PET pos (DS 4–5), escalated BEACOPP. RATHL study results were used as a historical comparison. The primary endpoint was overall response rate (complete & partial metabolic response: CMR/PMR) after 2 cycles of avelumab with >40% deemed worthy of further study and <20% considered unacceptable (5% 1-sided alpha, 90% power required 47 pts). Response was assessed as per modified Lugano criteria. Results: 47 pts were eligible. Median age 30 y (range: 17–58); 64% male; 23%, 26% and 51% had high risk stage II, stage III and IV disease respectively; 60% had B symptoms; 40% had IPSS of >2. 44 pts completed 2 cycles of avelumab (2 stopped due to toxicity, 1 due to site concerns over progressive disease (PD); indeterminate response (IR) by modified Lugano). 89% of subsequent ABVD/AVD cycles were delivered without delay (compared with 89% in RATHL). Overall response to 2 cycles of avelumab was 44.7% (90% CI: 32.2–57.7); CMR 11%; PMR 34%. The remainder were IR. iPET after 2 cycles of ABVD was positive in 5 pts (10.6%) (95% CI 3.5–23.1) versus 16.3% in the RATHL study. Pts with IR to avelumab did not show a worse response to ABVD compared with responders (87.5% vs. 88.0%). 5 pts had eBEACOPP of whom 4 converted to PET neg subsequently. With a median follow up of 14 months (range 4–32) there is a 1y PFS of 100% but 2 PDs have been reported at 14 and 23 months. Grade 3+ adverse events at least possibly related to avelumab occurred in 9 pts (20%) including one each of colitis, pneumonitis, autoimmune hepatitis, renal tubular acidosis and 2 reports of tumour flare. The research was funded by: Pfizer Keywords: Hodgkin lymphoma, immunotherapy Conflicts of interests pertinent to the abstract E. A. Hawkes Research funding: Merck KgA
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».