Brentuximab vedotin in CD30+ primary cutaneous T-cell lymphomas: a review and analysis of existing data

Abstract

Background: The utility of brentuximab vedotin (BV) in CD30⁺ systemic lymphomas is established, however evidence for treating primary cutaneous lymphoma remains limited. This study aimed to evaluate BV in treating CD30⁺ transformed mycosis fungoides (MF) and primary cutaneous anaplastic large cell lymphoma (PC-ALCL).

Methods: A literature review was conducted, and we analyzed data from published trials and case reports obtained via search of Ovid-MEDLINE^® and PubMed databases. The search yielded 372 reports, and 10 publications met inclusion criteria. Sixty-one patients with CD30⁺ transformed MF and seven with PC-ALCL were included.

Results: Mean age at BV initiation was 60.8 years (67 - PC-ALCL; 60.1 - MF), and 4.1 therapies were attempted prior to BV (3.1 - PC-ALCL; 4.2 - MF). The overall response rate was 67.7% (100% - PC-ALCL; 63.9% - MF), with 16.2% of patients experiencing complete response (100% - PC-ALCL; 6.6% - MF). Mean time to clinical response was 5.3 and 9.3 weeks for PC-ALCL and MF, respectively. Mean response duration for patients with PC-ALCL was 7.6 and 7.8 months for MF. Peripheral neuropathy (57.2%) and fatigue (35.6%) were the most commonly reported adverse effects.

Conclusions: This analysis summates the current evidence regarding the use of BV in treating CD30⁺ MF and PC-ALCL. Preliminary results indicate that BV is effective for CD30⁺ CTCL, however additional studies with larger sample sizes are necessary. The study provides clinicians with the clinical context in which BV may be appropriate as well as information regarding therapeutic expectations and outcomes.