A PHASE III clinical trial, ECHELON-3, has demonstrated survival benefits for patients with relapsed or refractory (R/R) diffuse large B-cell lymphoma (DLBCL) using a combination therapy of brentuximab vedotin (BV), lenalidomide (Len), and rituximab (R). The trial, involving 230 patients, compared this combination against a placebo plus Len and R, yielding encouraging results for heavily pretreated patients.
The study’s primary endpoint was overall survival (OS), with secondary endpoints including progression-free survival (PFS) and objective response rate (ORR). After a median follow-up of 16.4 months, the results were compelling. Patients receiving BV + Len + R experienced a median OS of 13.8 months, significantly longer than the 8.5 months observed in the placebo group (hazard ratio: 0.63, p = .009). The PFS was similarly improved, with a median of 4.2 months versus 2.6 months for the placebo group (hazard ratio: 0.53, p < .001). The combination therapy also led to a higher ORR of 64%, compared to 42% in the placebo group. Notably, complete response rates were 40% for BV + Len + R, doubling the 19% observed with the placebo regimen. While treatment-emergent adverse events (AEs) were common across both groups (97%), the safety profile of BV + Len + R was deemed manageable. The most frequently reported AEs included neutropenia, thrombocytopenia, diarrhea, and anemia. These findings highlight BV + Len + R as a promising option for patients with relapsed DLBCL, offering statistically significant survival improvements while maintaining an acceptable safety profile. As a result, this combination could represent a vital addition to the therapeutic landscape for this challenging patient population. Reference: Bartlett NL et al. Brentuximab Vedotin Combination for Relapsed Diffuse Large B-Cell Lymphoma. J Clin Oncol. 2025. doi:10.1200/JCO-24-02242. Anaya Malik | AMJ
