Systemic ALCL Treated in Routine Clinical Practice: Outcomes Following First-Line Chemotherapy from a Multicentre Cohort

Nicolas Martinez-Calle; Amy A Kirkwood; Maxine Lamb; Alexandra Gwen Smith; Jahanzaib Khwaja; Kate Manos; Caroline Shrubsole; Nicola Gray; Katharine Lewis; Ann Tivey; Mark J Bishton; Eliza Hawkes; Matthew J Ahearne; Wendy Osborne; Graham P Collins; Timothy Illidge; Kim M Linton; Kate Cwynarski; Cathy Burton; Christopher P Fox

doi:10.1007/s12325-021-01764-0

Systemic ALCL Treated in Routine Clinical Practice: Outcomes Following First-Line Chemotherapy from a Multicentre Cohort

Nicolas Martinez-Calle, Amy A Kirkwood, Maxine Lamb, Alexandra Gwen Smith, Jahanzaib Khwaja, Kate Manos, Caroline Shrubsole, Nicola Gray, Katharine Lewis, Ann Tivey, Mark J Bishton, Eliza Hawkes, Matthew J Ahearne, Wendy Osborne, Graham P Collins, Timothy Illidge, Kim M Linton, Kate Cwynarski, Cathy Burton, Christopher P Fox

Health Sciences

Research output: Contribution to journal › Article › peer-review

Abstract

INTRODUCTION: Brentuximab vedotin (BV)-CHP is the new standard regimen for first-line treatment of systemic anaplastic large cell lymphoma (sALCL). We undertook a retrospective analysis of consecutive patients diagnosed with sALCL, treated in routine practice, to serve as a benchmark analysis for comparison BV-CHP efficacy in routine practice.

METHODS: Patients aged 16 years or older with sALCL treated in seven UK and Australian centres and from 14 additional centres from the UK Haematological Malignancy Research Network database (n = 214). Treatment allocation was clinician choice and included best supportive care (BSC). Main outcomes were time to treatment failure (TTF) and overall survival (OS). Multivariable analysis for predictors of both TTF and OS was also undertaken.

RESULTS: The median age 52 years (range 16-93), 18% ECOG ≥ 3 and 40% of cases were ALK positive. CHOP (cyclophosphamide, adriamycin, vincristine, prednisolone) was employed in 152 (71%) of patients and CHOEP (CHOP + etoposide) in 4% of patients. For CHOP-treated patients overall response rate (ORR) was 65% and complete response (CR) 47%. Only 9% of patients underwent autologous stem cell transplant (ASCT). With 57 months median follow-up, 4-year TTF and OS were 41.2% (95% CI 33.1-49.1) and 58.9% (95% CI 50.3-66.5) respectively. Multivariable analysis showed ALK+ status was independently associated with superior TTF (HR 0.36, 95% CI 0.21-0.63) but not OS (0.44, 95% CI 0.18-1.07).

DISCUSSION: We present a retrospective analysis with mature follow-up of one of the largest multicentre populations of sALCL available, comparable to similar large retrospective studies. ALK status remains a strong predictor of outcomes.

CONCLUSION: These data serve as a robust benchmark for BV-CHP as the new standard of care for sALCL. Similar real-world evidence with BV-CHP will be desirable to confirm the findings of ECHELON-2.

Original language	English
Pages (from-to)	3789–3802
Number of pages	14
Journal	Advances in therapy
Volume	38
Early online date	26 May 2021
DOIs	https://doi.org/10.1007/s12325-021-01764-0
Publication status	Published - 1 Jul 2021

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Systemic ALCL Treated in Routine Clinical Practice: Outcomes Following First-Line Chemotherapy from a Multicentre Cohort
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Martinez-Calle, N., Kirkwood, A. A., Lamb, M., Smith, A. G., Khwaja, J., Manos, K., Shrubsole, C., Gray, N., Lewis, K., Tivey, A., Bishton, M. J., Hawkes, E., Ahearne, M. J., Osborne, W., Collins, G. P., Illidge, T., Linton, K. M., Cwynarski, K., Burton, C., & Fox, C. P. (2021). Systemic ALCL Treated in Routine Clinical Practice: Outcomes Following First-Line Chemotherapy from a Multicentre Cohort. Advances in therapy, 38, 3789–3802. https://doi.org/10.1007/s12325-021-01764-0

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abstract = "INTRODUCTION: Brentuximab vedotin (BV)-CHP is the new standard regimen for first-line treatment of systemic anaplastic large cell lymphoma (sALCL). We undertook a retrospective analysis of consecutive patients diagnosed with sALCL, treated in routine practice, to serve as a benchmark analysis for comparison BV-CHP efficacy in routine practice.METHODS: Patients aged 16 years or older with sALCL treated in seven UK and Australian centres and from 14 additional centres from the UK Haematological Malignancy Research Network database (n = 214). Treatment allocation was clinician choice and included best supportive care (BSC). Main outcomes were time to treatment failure (TTF) and overall survival (OS). Multivariable analysis for predictors of both TTF and OS was also undertaken.RESULTS: The median age 52 years (range 16-93), 18% ECOG ≥ 3 and 40% of cases were ALK positive. CHOP (cyclophosphamide, adriamycin, vincristine, prednisolone) was employed in 152 (71%) of patients and CHOEP (CHOP + etoposide) in 4% of patients. For CHOP-treated patients overall response rate (ORR) was 65% and complete response (CR) 47%. Only 9% of patients underwent autologous stem cell transplant (ASCT). With 57 months median follow-up, 4-year TTF and OS were 41.2% (95% CI 33.1-49.1) and 58.9% (95% CI 50.3-66.5) respectively. Multivariable analysis showed ALK+ status was independently associated with superior TTF (HR 0.36, 95% CI 0.21-0.63) but not OS (0.44, 95% CI 0.18-1.07).DISCUSSION: We present a retrospective analysis with mature follow-up of one of the largest multicentre populations of sALCL available, comparable to similar large retrospective studies. ALK status remains a strong predictor of outcomes.CONCLUSION: These data serve as a robust benchmark for BV-CHP as the new standard of care for sALCL. Similar real-world evidence with BV-CHP will be desirable to confirm the findings of ECHELON-2.",

author = "Nicolas Martinez-Calle and Kirkwood, {Amy A} and Maxine Lamb and Smith, {Alexandra Gwen} and Jahanzaib Khwaja and Kate Manos and Caroline Shrubsole and Nicola Gray and Katharine Lewis and Ann Tivey and Bishton, {Mark J} and Eliza Hawkes and Ahearne, {Matthew J} and Wendy Osborne and Collins, {Graham P} and Timothy Illidge and Linton, {Kim M} and Kate Cwynarski and Cathy Burton and Fox, {Christopher P}",

note = "{\textcopyright} The Author(s) 2021",

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doi = "10.1007/s12325-021-01764-0",

language = "English",

volume = "38",

pages = "3789–3802",

journal = "Advances in therapy",

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Martinez-Calle, N, Kirkwood, AA, Lamb, M , Smith, AG, Khwaja, J, Manos, K, Shrubsole, C, Gray, N, Lewis, K, Tivey, A, Bishton, MJ, Hawkes, E, Ahearne, MJ, Osborne, W, Collins, GP, Illidge, T, Linton, KM, Cwynarski, K, Burton, C & Fox, CP 2021, 'Systemic ALCL Treated in Routine Clinical Practice: Outcomes Following First-Line Chemotherapy from a Multicentre Cohort', Advances in therapy, vol. 38, pp. 3789–3802. https://doi.org/10.1007/s12325-021-01764-0

TY - JOUR

T1 - Systemic ALCL Treated in Routine Clinical Practice

T2 - Outcomes Following First-Line Chemotherapy from a Multicentre Cohort

AU - Martinez-Calle, Nicolas

AU - Kirkwood, Amy A

AU - Lamb, Maxine

AU - Smith, Alexandra Gwen

AU - Khwaja, Jahanzaib

AU - Manos, Kate

AU - Shrubsole, Caroline

AU - Gray, Nicola

AU - Lewis, Katharine

AU - Tivey, Ann

AU - Bishton, Mark J

AU - Hawkes, Eliza

AU - Ahearne, Matthew J

AU - Osborne, Wendy

AU - Collins, Graham P

AU - Illidge, Timothy

AU - Linton, Kim M

AU - Cwynarski, Kate

AU - Burton, Cathy

AU - Fox, Christopher P

PY - 2021/7/1

Y1 - 2021/7/1

N2 - INTRODUCTION: Brentuximab vedotin (BV)-CHP is the new standard regimen for first-line treatment of systemic anaplastic large cell lymphoma (sALCL). We undertook a retrospective analysis of consecutive patients diagnosed with sALCL, treated in routine practice, to serve as a benchmark analysis for comparison BV-CHP efficacy in routine practice.METHODS: Patients aged 16 years or older with sALCL treated in seven UK and Australian centres and from 14 additional centres from the UK Haematological Malignancy Research Network database (n = 214). Treatment allocation was clinician choice and included best supportive care (BSC). Main outcomes were time to treatment failure (TTF) and overall survival (OS). Multivariable analysis for predictors of both TTF and OS was also undertaken.RESULTS: The median age 52 years (range 16-93), 18% ECOG ≥ 3 and 40% of cases were ALK positive. CHOP (cyclophosphamide, adriamycin, vincristine, prednisolone) was employed in 152 (71%) of patients and CHOEP (CHOP + etoposide) in 4% of patients. For CHOP-treated patients overall response rate (ORR) was 65% and complete response (CR) 47%. Only 9% of patients underwent autologous stem cell transplant (ASCT). With 57 months median follow-up, 4-year TTF and OS were 41.2% (95% CI 33.1-49.1) and 58.9% (95% CI 50.3-66.5) respectively. Multivariable analysis showed ALK+ status was independently associated with superior TTF (HR 0.36, 95% CI 0.21-0.63) but not OS (0.44, 95% CI 0.18-1.07).DISCUSSION: We present a retrospective analysis with mature follow-up of one of the largest multicentre populations of sALCL available, comparable to similar large retrospective studies. ALK status remains a strong predictor of outcomes.CONCLUSION: These data serve as a robust benchmark for BV-CHP as the new standard of care for sALCL. Similar real-world evidence with BV-CHP will be desirable to confirm the findings of ECHELON-2.

AB - INTRODUCTION: Brentuximab vedotin (BV)-CHP is the new standard regimen for first-line treatment of systemic anaplastic large cell lymphoma (sALCL). We undertook a retrospective analysis of consecutive patients diagnosed with sALCL, treated in routine practice, to serve as a benchmark analysis for comparison BV-CHP efficacy in routine practice.METHODS: Patients aged 16 years or older with sALCL treated in seven UK and Australian centres and from 14 additional centres from the UK Haematological Malignancy Research Network database (n = 214). Treatment allocation was clinician choice and included best supportive care (BSC). Main outcomes were time to treatment failure (TTF) and overall survival (OS). Multivariable analysis for predictors of both TTF and OS was also undertaken.RESULTS: The median age 52 years (range 16-93), 18% ECOG ≥ 3 and 40% of cases were ALK positive. CHOP (cyclophosphamide, adriamycin, vincristine, prednisolone) was employed in 152 (71%) of patients and CHOEP (CHOP + etoposide) in 4% of patients. For CHOP-treated patients overall response rate (ORR) was 65% and complete response (CR) 47%. Only 9% of patients underwent autologous stem cell transplant (ASCT). With 57 months median follow-up, 4-year TTF and OS were 41.2% (95% CI 33.1-49.1) and 58.9% (95% CI 50.3-66.5) respectively. Multivariable analysis showed ALK+ status was independently associated with superior TTF (HR 0.36, 95% CI 0.21-0.63) but not OS (0.44, 95% CI 0.18-1.07).DISCUSSION: We present a retrospective analysis with mature follow-up of one of the largest multicentre populations of sALCL available, comparable to similar large retrospective studies. ALK status remains a strong predictor of outcomes.CONCLUSION: These data serve as a robust benchmark for BV-CHP as the new standard of care for sALCL. Similar real-world evidence with BV-CHP will be desirable to confirm the findings of ECHELON-2.

U2 - 10.1007/s12325-021-01764-0

DO - 10.1007/s12325-021-01764-0

M3 - Article

C2 - 34037958

SN - 0741-238X

VL - 38

SP - 3789

EP - 3802

JO - Advances in therapy

JF - Advances in therapy

ER -