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

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.

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Publication Details

Journal
Blood Cancer Journal
Published
2025-03-26
DOI
https://doi.org/10.1038/s41408-025-01257-1
Citations
6
Primary Topic
Lymphoma Diagnosis and Treatment
Type
article
Field-Weighted Citation Impact
8.83

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article

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

S. Deshpande, Jakub Svoboda, Mehdi Hamadani, Praveen Ramakrishnan Geethakumari et al.
6 citations
Blood Cancer Journal
Lymphoma Diagnosis and Treatment
8.83
article

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

S. Deshpande, Jakub Svoboda, Mehdi Hamadani, Praveen Ramakrishnan Geethakumari, Sabarish Ayyappan, Sanjal H. Desai, Nuttavut Sumransub, Krish Patel, Lauren Shea, Suki Subbiah, Hayder Saeed, Pallawi Torka, Jorge A. Florindez, Eric McLaughlin, Muhammad Salman Faisal, Tamara Kay Moyo, Miriam M. Cortese‐Krott, Heather Reves, Ajay Major, Natalie Sophia Grover, Ashley Rose, Cassandra Duarte, Narendranath Epperla, Timothy J. Voorhees, Na Hyun Kim, Showkat Hamid
article en
6 citations

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.

Blood Cancer JournalVol. 15(1)
University of North Carolina at Chapel Hill (US), Louisiana State University (US), University of Iowa (US), Roswell Park Comprehensive Cancer Center (US), University of Minnesota (US), Memorial Sloan Kettering Cancer Center (US), Medical College of Wisconsin (US), University of Utah (US), The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (US), Huntsman Cancer Institute (US), Stanley Foundation (US), Moffitt Cancer Center (US), University of Alabama at Birmingham (US), Levine Cancer Institute (US), University of Colorado Cancer Center (US), UNC Lineberger Comprehensive Cancer Center, University of Iowa Holden Comprehensive Cancer Center, Medical College of Wisconsin Cancer Center, The Ohio State University (US), University of Pennsylvania (US), The University of Texas Southwestern Medical Center (US), University of Colorado Denver (US)
Lymphoma Research Foundation
Openalex Percentile: Top 2%
Lymphoma Diagnosis and Treatment
8.83
DOIOpen Access PDFOpenAlex
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