A Systematic Review Of The Efficacy And Safety Of Brentuximab Vedotin Combined With Bendamustine In The Treatment Of Relapsed Or Refractory Hodgkin’s Lymphoma

Objective:This study aims to systematically evaluate the efficacy and safety of brentuximab vedotin combined with bendamustine in the treatment of relapsed and refractory Hodgkin’s lymphoma.Methods:A literature retrieval was conducted in CNKI,Weipu database,Wanfang Data,the Cochrane Library,Wed of Science,Pub Med,EMBase,and other databases and evaluated the quality of the literature and extracted the data.Finally,Stata15.0 was used for statistical analysis to calculate the effective rate,incidence of adverse reactions and drug withdrawal.Results:A total of 14 English literature were included for systematic review.The effectiveness results showed:the total response rate of brentuximab vedotin and bendamustine for relapsed and refractory Hodgkin’s lymphoma was 82%(95%CI:76%-88%),and complete response rate of 62%(95%CI: 52%-73%).The 2-year OS was 92%(95%CI: 87%-96%),and the 2 year PFS was 72%(95%CI: 61%-84%).The results of the subgroup analysis of literature showed that the overall response rate of the clinical trial and the real world were 81%(95%CI: 72%-89%),84%(95%CI: 75%-93%),respectively;the complete response rate were both 62%(95%CI: 52%-73%).In terms of safety,the incidence of neutropenia,anemia and thrombocytopenia in hematological adverse events ≥ grade 3 were 22%(95%CI: 13%-31%),10%(95%CI:-6%-25%)and 13(95%CI:-6%-32%),respectively.The incidence of infection,peripheral sensory neuropathy,infusion-related reactions and rash in non-hematological adverse events ≥grade 3 were 13%(95%CI: 1%-25%),12%(95%CI:-1%-25%),12%(95%CI:-4%-28%)and 14%(95%CI: 1%-28%),respectively;The rate of drug withdrawal due to adverse events was 17%(95%CI: 8%-25%).The results of the subgroup analysis were as follows:The incidence of ≥ grade 3 neutropenia and anemia in clinical trials and real world were26%(95%CI: 14%-38%),17%(95%CI: 3%-31%)and 16%(95%CI:-7%-38%),4%(95%CI:-18%-26%),respectively.The incidence of ≥ grade 3 infection and peripheral sensory neuropathy in clinical trials and real world were 21%(95%CI: 4%-39%),5%(95%CI:-12%-22%)and 20%(95%CI: 0%-39%),6%(95%CI:-10%-23%),respectively.The rate of drug withdrawal due to adverse events was 21%(95%CI: 10%-31%)and9%(95%CI:-6%-24%).Conclusion:Brentuximab vedotin combined with bendamustine in the treatment of relapsed and refractory Hodgkin lymphoma has a significant effect,the incidence of serious adverse events is low,and the overall tolerability is acceptable;And the efficacy of Brentuximab vedotin and bendamustinewas superior to the brentuximab vedotin monotherapy for relapsed and refractory Hodgkin lymphoma Patients.There is no significant difference between the results of clinical and real-world retrospective studies for the treatment of R/R HL patients,but the incidence of severe adverse events was lower in real-world studies than that in clinical studies.