Brentuximab vedotin in CD30+ cutaneous lymphoma: How do we treat - How shall we treat? A review of the literature.
Brentuximab vedotin is an antibody-drug conjugate that brings the antimicrotubule agent monomethyl auristatin E into CD30-expressing cells. Some prior studies could demonstrate good efficacy in cutaneous lymphomas. The standard therapeutic scheme is 1.8 mg/kg every 3 weeks. Background of this work is the fact that cutaneous lymphoma has a different pathophysiology, and a dynamic other than systemic lymphoma. The objectives of this review were to get an overview of the currently used therapeutic regimen, and to check whether dose reduction or modified time intervals could benefit in a similar activity with less toxicity. Therefore, we conducted a systemic review of literature indexed in PubMed and Cochrane Central Register of Controlled Trials (Central) on April 2016. The procedure was based on the PRISMA criteria. The review showed that the currently used therapeutic regimen is 1.8 mg/kg every three weeks. No publications of dose finding studies in CD30+ cutaneous T-cell lymphoma were found. Two cases of patients, treated with a lower dosage than 1.8 mg/kg, have been published. Brentuximab vedotin seems to be a powerful treatment option in refractory CD30+ CTCL, and there is a trend that dose reductions, as well as prolonged treatment intervals, work without any loss of response and with fewer side effects.