The antibody drug conjugate (ADC) brentuximab vedotin (BV), targeting CD30, is currently
registered for the treatment of previously untreated stage III-IV Hodgkin lymphoma (HL),
relapsed Hodgkin lymphoma, relapsed systemic anaplastic large T-cell lymphoma (sALCL) and
relapsed CD30 expressing cutaneous T-cell lymphoma, type mycosis fungoides (CTCL, MF) with
overall response rates (ORR) up to 70%. BV has shown promising results in other CD30
expressing non-hodgkin lymphoma (NHL), including relapsed angio-immunoblastic T-cell lymphoma
(AITL), peripheral T-cell lymphoma not otherwise specified (PTCL-NOS), post-transplant
lymphoproliferative diseases (PTLD) and diffuse large B-cell lymphoma (DLBCL) with ORR rates
of 50%, 40% and 45%, respectively. Despite expression of CD30 on tumor cells, no objective
responses were observed in relapsed primary mediastinal B-cell lymphoma (PMBCL). Strikingly,
thus far correlative studies have not found predictive markers in tissue or blood that are
predictive for response to treatment. Since CD30 expression in tumor tissue is unrelated to
treatment outcome, this suggests involvement of phenomena like tumor heterogeneity, drug
uptake in the tumor micro-environment or very low CD30 expression below the
immunohistochemistry (IHC) threshold. In this imaging study the biodistribution of
brentuximab will be investigated by using Zirconium-89 (89Zr)-labeled brentuximab.
89Zr-brentuximab imaging will help to assess tumor uptake and pharmacokinetic (PK) and
-dynamic properties of brentuximab in patients who are intended to be treated with BV, either
in one of the registered indications (HL, CTCL and sALCL) or as part of the HOVON 136 trial
for patients with DLBCL. The hypothesize is that the results of this imaging study might be
used to facilitate the identification of patients that would benefit most from BV treatment