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<p>Frontline therapy for classic Hodgkin Lymphoma (cHL) incorporating brentuximab vedotin (BV) improves outcomes compared with traditional chemotherapy, but up to 20% of patients relapse and need salvage treatment. Prior retrospective studies examining salvage therapies are mostly limited to patients who received chemotherapy-based treatment in frontline without novel agents. We evaluated outcomes in 116 patients with relapsed/refractory (R/R) cHL who received brentuximab and anthracycline-containing frontline treatment. High risk factors at relapse or progression were common, including primary refractory disease (62%), advanced stage (63%), and extranodal disease (46%). At first salvage, 73% of patients received PD-1 blockade (58% in conjunction with chemotherapy), and 81% received PD-1 blockade at any salvage line. Overall, 78% of patients proceeded to ASCT. With a median follow-up of 19 months, the 2-year PFS and OS from the start of salvage in all patients were 61% and 97% respectively. Among patients with ASCT, the 2-year post-transplant PFS (PFS<sub>HCT</sub>) was 76% for patients who had PD-1 blockade as salvage before ASCT, compared with 59% for those who did not. In univariate analysis, PD-1 blockade use in first salvage was significantly associated with improved PFS<sub>HCT</sub>, and this association remained statistically significant after adjusting for stage, extranodal involvement, and primary refractory disease (HR 0.31, <i>p</i> = 0.04). Primary refractory disease after BV-AVD emerged as an ongoing unmet need with a significantly inferior 2-year PFS<sub>HCT</sub> compared with relapsed patients (58% vs 86%, <i>p</i> = 0.017). Among primary refractory patients who received ASCT, first salvage incorporating a PD-1 blockade showed a trend toward improved PFS<sub>HCT</sub> compared with non-PD-1 blockade salvage. These results support PD-1 blockade incorporation as preferred first salvage in R/R cHL after BV-containing frontline therapy.</p>

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Outcomes of patients with relapsed or refractory classic Hodgkin lymphoma after frontline brentuximab vedotin

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年6月25日

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  • Shin Yeu Ong,
  • Lu Chen,
  • Jomel Meeko Manzano,
  • Reid Merryman,
  • Harsh Shah,
  • Robert Stuver,
  • Sanjal H. Desai,
  • Ann LaCasce,
  • Ayo Falade,
  • Kelsey Baron,
  • Nivetha Ganesan,
  • Tiffany Chang,
  • Urshila Durani,
  • Tamer Othman,
  • Philippe Armand,
  • Matthew Mei,
  • Alison J. Moskowitz,
  • Alex F. Herrera

摘要

Frontline therapy for classic Hodgkin Lymphoma (cHL) incorporating brentuximab vedotin (BV) improves outcomes compared with traditional chemotherapy, but up to 20% of patients relapse and need salvage treatment. Prior retrospective studies examining salvage therapies are mostly limited to patients who received chemotherapy-based treatment in frontline without novel agents. We evaluated outcomes in 116 patients with relapsed/refractory (R/R) cHL who received brentuximab and anthracycline-containing frontline treatment. High risk factors at relapse or progression were common, including primary refractory disease (62%), advanced stage (63%), and extranodal disease (46%). At first salvage, 73% of patients received PD-1 blockade (58% in conjunction with chemotherapy), and 81% received PD-1 blockade at any salvage line. Overall, 78% of patients proceeded to ASCT. With a median follow-up of 19 months, the 2-year PFS and OS from the start of salvage in all patients were 61% and 97% respectively. Among patients with ASCT, the 2-year post-transplant PFS (PFSHCT) was 76% for patients who had PD-1 blockade as salvage before ASCT, compared with 59% for those who did not. In univariate analysis, PD-1 blockade use in first salvage was significantly associated with improved PFSHCT, and this association remained statistically significant after adjusting for stage, extranodal involvement, and primary refractory disease (HR 0.31, p = 0.04). Primary refractory disease after BV-AVD emerged as an ongoing unmet need with a significantly inferior 2-year PFSHCT compared with relapsed patients (58% vs 86%, p = 0.017). Among primary refractory patients who received ASCT, first salvage incorporating a PD-1 blockade showed a trend toward improved PFSHCT compared with non-PD-1 blockade salvage. These results support PD-1 blockade incorporation as preferred first salvage in R/R cHL after BV-containing frontline therapy.