Efficacy of escalating therapy with brentuximab vedotin‐AVD in advanced stage Hodgkin lymphoma patients with positive interim positron emission tomography after ABVD

• Published in: Hematological oncology Vol. 42; no. 5; pp. e3299 - n/a
• Main Authors: Martínez, Carmen, Carcelero, Esther, Gutiérrez, Antonio, Sancho, Esther, Martí‐Tutusaus, Josep Maria, Magnano, Laura, Mozas, Pablo, Fernández‐Avilés, Francesc, Antelo, María Gabriela, Setoain, Xavier, Rodríguez, Sonia, Esteve, Jordi
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01-09-2024
• Subjects: ABVD; Adult; Aged; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Bleomycin - administration & dosage; Bleomycin - therapeutic use; brentuximab vedotin; Brentuximab Vedotin - therapeutic use; Clinical trials; Comorbidity; Dacarbazine - administration & dosage; Dacarbazine - therapeutic use; Doxorubicin - administration & dosage; Doxorubicin - therapeutic use; Female; first‐line chemotherapy; Follow-Up Studies; Hodgkin Disease - diagnostic imaging; Hodgkin Disease - drug therapy; Hodgkin Disease - mortality; Hodgkin Disease - pathology; Hodgkin Disease - therapy; Hodgkin lymphoma; Hodgkin's lymphoma; Humans; Lymphoma; Male; Middle Aged; Neoplasm Staging; positive PET interim; Positron emission; Positron emission tomography; Remission; Stem cell transplantation; Stem cells; Treatment Outcome; Vinblastine - administration & dosage; Vinblastine - therapeutic use; Young Adult; ABVD; positive PET interim; first‐line chemotherapy; Hodgkin lymphoma; brentuximab vedotin
• ISSN: 0278-0232; 1099-1069; 1099-1069
• DOI: 10.1002/hon.3299

Patients with advanced‐stage Hodgkin lymphoma treated with ABVD who have a positive interim FDG‐PET (iPET) have a poor prognosis. Escalation to BEACOPP has been shown to improve progression‐free survival (PFS). However, randomized trials are lacking to determine the best strategy for intensification. We report on A‐AVD escalation treatment outcomes for 15 iPET‐positive patients post‐ABVD. Overall response and complete response rates were 80% and 60%, respectively. Four patients underwent salvage therapy followed by autologous stem cell transplantation. At a median 17‐month follow‐up, all patients are alive, 87% in complete remission, and 1‐year PFS was 57.8%. For patients ineligible for BEACOPP due to age, comorbidities, or preference, A‐AVD escalation may be a viable alternative.