What does a CD30 (Cluster of Differentiation 30) positive result indicate?

From the Guidelines

Brentuximab vedotin in combination with CHP is the recommended first-line therapy for patients with previously untreated CD30-positive PTCL, due to its significantly improved PFS and OS compared to CHOP, as demonstrated in the ECHELON-2 trial 1.

Key Considerations

• The ECHELON-2 trial showed that brentuximab vedotin in combination with CHP resulted in a median PFS of 63 months, compared to 24 months for CHOP, with estimated 5-year PFS rates of 51% and 43%, respectively 1.
• The median OS was not reached for either arm, and the estimated 5-year OS rates were 69% and 60% for brentuximab vedotin plus CHP and CHOP, respectively 1.
• The most common grade ≥3 adverse events with brentuximab vedotin plus CHP were neutropenia, anemia, diarrhea, peripheral neuropathy, and nausea 1.

Treatment Implications

• Brentuximab vedotin is typically administered at a dose of 1.8 mg/kg intravenously every 3 weeks, with treatment duration varying based on response and disease type 1.
• Regular monitoring is necessary to manage potential side effects, such as peripheral neuropathy, fatigue, nausea, and neutropenia 1.
• CD30 positivity is a valuable prognostic indicator in some lymphomas, with treatment decisions often guided by the percentage of cells expressing this marker and the intensity of expression 1.

From the FDA Drug Label

CD30 is a member of the tumor necrosis factor receptor family and is expressed on the surface of sALCL cells and on Hodgkin Reed-Sternberg (HRS) cells in cHL. CD30 is variably expressed in other T-cell lymphomas. Brentuximab vedotin is an antibody-drug conjugate (ADC). The antibody is a chimeric IgG1 directed against CD30.

The drug brentuximab vedotin is directed against CD30-positive cells.

• Key points:
  • CD30 is expressed on the surface of certain lymphoma cells.
  • Brentuximab vedotin is an antibody-drug conjugate that targets CD30-positive cells. 2 2

From the Research

CD30 Positive Lymphomas

• CD30 is overexpressed in several lymphoma types, including classic Hodgkin lymphoma (cHL), some peripheral T-cell lymphomas (PTCL), and some cutaneous T-cell lymphomas 3.
• The antibody-drug conjugate brentuximab vedotin targets CD30-positive cells and has been evaluated for the treatment of various lymphoma entities 3, 4.
• CD30 testing is essential in the diagnosis of classical HL and ALCL, and expression can also be seen in other lymphoma subtypes 4.
• Brentuximab vedotin has been shown to be effective in CD30-expressing lymphomas, including HL, ALCL, and PTCL 3, 4, 5, 6, 7.

Treatment Options

• Brentuximab vedotin is approved for the treatment of relapsed HL and ALCL, as well as post-transplant maintenance for HL 4, 6.
• Combination therapies, such as brentuximab vedotin with doxorubicin, vinblastine, and dacarbazine (AVD), have been evaluated for the treatment of CD30-positive lymphomas 5.
• Novel therapies targeting CD30, including chimeric antigen receptor therapies and bispecific antibody T-cell engagers, are being developed and may improve outcomes for patients with CD30-positive lymphomas 3, 4.

Diagnostic Testing

• CD30 expression can be detected by immunohistochemical staining of biopsy samples or flow cytometry analysis of fresh tissue and cell aspiration specimens 6, 7.
• Accurate CD30 evaluation is limited by inconsistencies in detection methodology and expression cutoffs defining CD30-expressing disease 7.
• Greater understanding of CD30 testing and reporting will enable more patients with CD30-expressing PTCL and CTCL to be identified and treated appropriately 7.