Management of peripheral neuropathy associated with brentuximab vedotin in the frontline treatment of classical Hodgkin lymphoma

Crit Rev Oncol Hematol. 2024 Dec:204:104499. doi: 10.1016/j.critrevonc.2024.104499. Epub 2024 Sep 6.

Abstract

The ECHELON-1 trial demonstrated the effectiveness of brentuximab vedotin (BV) in combination with doxorubicin, vinblastine, and dacarbazine as a frontline treatment regimen in classical Hodgkin lymphoma. However, peripheral neuropathy (PN) is common with this regimen, occurring in up to two-thirds of patients. While standard prescribing information recommends BV dose modification at the onset of grade 2 PN, management strategies for PN are not well-defined. Most commonly, clinicians dose reduce or discontinue BV, vinblastine, or both. We review evidence-based and practical approaches for managing peripheral neuropathy, emphasizing early detection and dose modification.

Keywords: Brentuximab vedotin; Classical Hodgkin lymphoma; Dose modification; Peripheral neuropathy; Vinblastine.

Publication types

  • Review

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Brentuximab Vedotin* / adverse effects
  • Brentuximab Vedotin* / therapeutic use
  • Disease Management
  • Doxorubicin / administration & dosage
  • Doxorubicin / adverse effects
  • Doxorubicin / therapeutic use
  • Hodgkin Disease* / drug therapy
  • Humans
  • Immunoconjugates / administration & dosage
  • Immunoconjugates / adverse effects
  • Immunoconjugates / therapeutic use
  • Peripheral Nervous System Diseases* / chemically induced
  • Peripheral Nervous System Diseases* / drug therapy

Substances

  • Brentuximab Vedotin
  • Immunoconjugates
  • Doxorubicin