Outcomes in patients with classic Hodgkin lymphoma refractory or intolerant to brentuximab vedotin and anti-PD-1 therapy: A real world analysis from 15 U.S. academic centers Journal Article
| Authors: | Voorhees, T. J.; McLaughlin, E. M.; Torka, P.; Florindez, J.; Kim, N. H.; Moyo, T. K.; Reves, H.; Sumransub, N.; Deshpande, S.; Rose, A.; Duarte, C.; Faisal, M. S.; Hamid, S.; Subbiah, S.; Ayyappan, S.; Shea, L.; Cortese, M.; Patel, K.; Major, A.; Saeed, H.; Svoboda, J.; Desai, S.; Geethakumari, P. R.; Hamadani, M.; Grover, N.; Epperla, N. |
| Article Title: | Outcomes in patients with classic Hodgkin lymphoma refractory or intolerant to brentuximab vedotin and anti-PD-1 therapy: A real world analysis from 15 U.S. academic centers |
| Abstract: | Anti-PD-1 based therapies and brentuximab vedotin (BV) have significantly improved survival in patients with classic Hodgkin lymphoma (cHL) and have been incorporated into earlier lines of therapy. However, there is insufficient data regarding the clinical outcomes in patients who develop refractory disease or who become intolerant of BV and anti-PD-1 therapies (double refractory/intolerant; DR/INT). Here, we evaluated outcomes in patients with DR/INT cHL from 15 US academic medical centers. A total of 173 patients were identified as DR/INT. The median overall survival from the time of cHL diagnosis (OS-1) was 14.8 years (95% CI: 10.9–20.9 years) and the 10-year OS-1 estimate was 62% (95% CI: 52–70%). After accounting for differences in age, patients who underwent autologous stem cell transplant prior to developing DR/INT had significantly longer OS-1 (HR 0.53, 95% CI: 0.29–0.96, p = 0.04). Median OS from time of DR/INT (OS-2) was 7.4 years (95% CI: 4.3-NR) and the 5-year OS-2 estimate was 57% (95% CI: 48-66%). Both anti-PD-1 and BV based therapy rechallenge were effective with median PFS of 237 days (95% CI: 155-357 days) and 183 days (95% CI: 108–273 days), respectively. Finally, advanced therapy options such as CD30 directed chimeric antigen receptor T-cell therapy and allogeneic stem cell transplant after DR/INT were associated with improved OS-2 (p < 0.001). To our knowledge, this represents the largest cohort of patients with DR/INT cHL. OS-2 will serve as a benchmark for future studies aiming to improve survival in DR/INT cHL. © The Author(s) 2025. |
| Keywords: | adolescent; adult; treatment outcome; treatment response; aged; middle aged; retrospective studies; young adult; human cell; overall survival; clinical trial; drug tolerability; mortality; doxorubicin; drug withdrawal; united states; outcome assessment; dacarbazine; peripheral neuropathy; cohort analysis; autologous stem cell transplantation; retrospective study; vinblastine; hodgkin disease; drug hypersensitivity; multicenter study; bleomycin; drug therapy; university hospital; immunopathology; classical hodgkin lymphoma; programmed death 1 receptor; academic medical centers; clinical outcome; immune checkpoint inhibitor; brentuximab vedotin; refractory disease; nivolumab; humans; human; male; female; article; pembrolizumab; pdcd1 protein, human; programmed cell death 1 receptor; immune checkpoint inhibitors; chimeric antigen receptor t-cell immunotherapy |
| Journal Title: | Blood Cancer Journal |
| Volume: | 15 |
| ISSN: | 2044-5385 |
| Publisher: | Nature Publishing Group |
| Date Published: | 2025-03-26 |
| Start Page: | 45 |
| Language: | English |
| DOI: | 10.1038/s41408-025-01257-1 |
| PUBMED: | 40140364 |
| PROVIDER: | scopus |
| PMCID: | PMC11947194 |
| DOI/URL: | |
| Notes: | Article -- Source: Scopus |
