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NICE recommends brentuximab vedotin in combination with chemotherapy as frontline treatment for systemic anaplastic large cell lymphoma

Jul 13, 2020

The National Institute for Health and Care Excellence ( NICE) has recommended the combination of brentuximab vedotin (BV) with cyclophosphamide, doxorubicin, and prednisone (CHP) as a treatment option in treatment-naïve patients with systemic anaplastic large cell lymphoma (sALCL).

The recommendation, which reflects the European Commission marketing authorizationextension, is based on data from the phase III ECHELON-2trial ( NCT01777152 ). This randomized controlled trial, evaluated BV plus CHP  vs cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) as first-line treatment in patients with CD30+ peripheral T-cell lymphoma.

Data from the sALCL subgroup demonstrated:

  • Better objective response rate, 88% vs71%, for patients in the BV plus CHP arm (95% confidence interval [CI], 81.6─92.3) vspatients in the CHOP arm (95% CI, 62.9─77.8; p = 0.0001), respectively
  • Reduced risk of a progression event in the BV plus CHP arm vsCHOP arm (stratified hazard ratio 0.59, 95% CI, 0.42─0.84; p = 0.0031)
  • Improved overall survival in the BV plus CHP arm vsCHOP arm (hazard ratio 0.54, 95% CI, 0.337─0.867; p = 0.0096)

The appraisal committee concluded that BV in combination with CHP would replace CHOP for patients with untreated sALCL in the National Health Service (NHS).

  1. NICE. Final appraisal document: Brentuximab vedotin in combination for untreated systemic anaplastic large cell lymphoma. https://www.nice.org.uk/guidance/gid-ta10514/documents/final-appraisal-determination-document. Published Jul 09, 2020. Accessed Jul 10, 2020.