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

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 authorization extension, is based on data from the phase III ECHELON-2 trial (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% vs 71%, for patients in the BV plus CHP arm (95% confidence interval [CI], 81.6─92.3) vs patients 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 vs CHOP arm (stratified hazard ratio 0.59, 95% CI, 0.42─0.84; p = 0.0031)
• Improved overall survival in the BV plus CHP arm vs CHOP 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).