S820 FRONTLINE BRENTUXIMAB VEDOTIN WITH CHEMOTHERAPY FOR STAGE 3/4 CLASSICAL HODGKIN LYMPHOMA: 3‐YEAR UPDATE OF THE ECHELON‐1 STUDY
Bibliographic record
Abstract
Background: The phase 3 ECHELON‐1 study (NCT01712490) demonstrated that brentuximab vedotin with doxorubicin, vinblastine, and dacarbazine (A+AVD) was superior to doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD), in terms of modified progression‐free survival (PFS) per independent review and per investigator, for the frontline treatment of stage 3/4 classical Hodgkin lymphoma (cHL) (Connors JM, et al. N Engl J Med 2018;378: 331–344). The RATHL, and SWOG S0816 studies utilized positron‐emission tomography (PET) scan‐adapted strategies performed after cycle 2 (PET2), demonstrating short‐ and long‐term toxicities in PET2‐positive (PET2+) patients switched to bleomycin, etoposide, adriamycin, cyclophosphamide, vincristine, procarbazine, and prednisone (BEACOPP), or escalated BEACOPP, and frequent relapses in PET2‐negative (PET2‐) patients. Long‐term follow‐up of patients with stage 3/4 disease who were aged ≤60 years in the RATHL and SWOG S0816 studies demonstrated 3‐year PFS of 79.8% (PET2‐, 82.1%), and 5‐year PFS of 74% (PET2‐, 76%), respectively. Aims: Here we present a 3‐year update of the ECHELON‐1 study to compare the effects of frontline A+AVD vs ABVD in patients with stage 3/4 cHL, including PFS per investigator and outcomes by PET status for the intention‐to‐treat (ITT) population. Methods: Patients with stage 3/4 cHL were randomized 1:1 to receive up to six cycles of A+AVD (n = 664) or ABVD (n = 670). Interim PET2 was conducted, patients with Deauville score of 5 at PET2 were allowed to switch to an alternative therapy. All analyses of PFS are exploratory and per investigator assessment. Results: At a median follow‐up of 37 months, analysis of PFS in the ITT population favored the A+AVD treatment arm (Table), with a 3‐year PFS of 83.1% for A+AVD vs 76.0% for ABVD; the 3‐year PFS values for PET2‐ patients aged <60 years were 87.2% vs 81.0%, respectively. A trend toward benefit for PET2+ patients aged <60 years treated with A+AVD was also observed, with a 3‐year PFS of 69.2% vs 54.7% with ABVD. Data from subgroups, together with safety follow‐up, including for peripheral neuropathy, will be presented. Summary/Conclusion: Follow‐up at 3 years demonstrates that frontline treatment of stage 3/4 cHL with A+AVD provides a durable treatment benefit compared with ABVD that is independent of PET2 status. While direct comparisons cannot be made, efficacy with A+AVD appears favorable in the context of findings with PET‐adapted strategies, without requiring interim PET assessment, escalation of therapy, or bleomycin. image
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.006 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".