Efficacy of post-transplant brentuximab vedotin maintenance by pre-transplant disease status in relapsed/refractory classic Hodgkin lymphoma

Patients with classic Hodgkin lymphoma (cHL) with primary refractory disease, early relapse, or extranodal disease have a higher risk of relapse after salvage therapy and autologous stem cell transplant (ASCT). Post-ASCT brentuximab vedotin (BV) maintenance improved progression-free survival (PFS) in high-risk relapsed/refractory (R/R) cHL in the AETHERA trial, but subgroup analysis suggested that the benefit in patients transplanted in complete metabolic response (CMR) is unclear. In a large international real-world cohort, we assessed the efficacy of BV maintenance stratified by pre-ASCT metabolic response and by the number of clinical risk factors as defined in the AETHERA trial. Adult patients with R/R cHL who met AETHERA risk criteria were included. Utilizing propensity score analyses, PFS and OS were assessed overall and in subgroups of CMR (442 pts) and partial metabolic response (PMR, 249 pts). We observed that post-ASCT BV maintenance was associated with significantly higher PFS in the subgroup with PMR (5-year PFS: 59.6% vs 43.3% HR = 0.52, CI 95 : 0.33–0.82; p = 0.007). In the subgroup of patients with CMR, BV maintenance did not significantly improve PFS (5-year PFS: 75.8% vs 62.3% HR = 0.88, CI 95 : 0.59–1.32; p = 0.29). However, when focusing on patients with CMR treated post-FDA approval of BV, there was a significant PFS benefit observed in those treated with BV maintenance vs. not (5-year PFS: 81.2% vs 55.2% HR = 0.40, CI 95 : 0.22–0.72; p = 0.003). Overall, BV maintenance after ASCT remains an important therapy for high-risk R/R cHL patients, especially for those in PMR or those in CMR.

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Journal
Blood Cancer Journal
Published
2026-06-25
DOI
https://doi.org/10.1038/s41408-026-01523-w
Primary Topic
Lymphoma Diagnosis and Treatment
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article
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article

Efficacy of post-transplant brentuximab vedotin maintenance by pre-transplant disease status in relapsed/refractory classic Hodgkin lymphoma

Haris Hatic, Vít Procházka, Catherine Diefenbach, Jozef Michalka et al.
Blood Cancer Journal
Lymphoma Diagnosis and Treatment
article

Efficacy of post-transplant brentuximab vedotin maintenance by pre-transplant disease status in relapsed/refractory classic Hodgkin lymphoma

Haris Hatic, Vít Procházka, Catherine Diefenbach, Jozef Michalka, Alice Šýkorová, Sanjal H. Desai, Uroosa Ibrahim, Nuttavut Sumransub, Nina Wagner‐Johnston, Elyse I. Harris, Raya Saba, Ivana N. Micallef, Levi Pederson, Gaurav Goyal, Kristie A. Blum, Ranjana H. Advani, Andrew M. Evens, Veronika Bachanová, Brad S. Kahl, Brendon Fusco, Michael A. Spinner, Harsh Shah, Yun Choi, Firas Baidoun, Susan M. Geyer, KC Rappazzo, Vaishalee P. Kenkre, Cheryl Chang, Heidi Mocikova, Deepa Jagadeesh, Kathleen Dorritie, Jacques Azzi, Siddharth Iyengar
article en

Abstract

Patients with classic Hodgkin lymphoma (cHL) with primary refractory disease, early relapse, or extranodal disease have a higher risk of relapse after salvage therapy and autologous stem cell transplant (ASCT). Post-ASCT brentuximab vedotin (BV) maintenance improved progression-free survival (PFS) in high-risk relapsed/refractory (R/R) cHL in the AETHERA trial, but subgroup analysis suggested that the benefit in patients transplanted in complete metabolic response (CMR) is unclear. In a large international real-world cohort, we assessed the efficacy of BV maintenance stratified by pre-ASCT metabolic response and by the number of clinical risk factors as defined in the AETHERA trial. Adult patients with R/R cHL who met AETHERA risk criteria were included. Utilizing propensity score analyses, PFS and OS were assessed overall and in subgroups of CMR (442 pts) and partial metabolic response (PMR, 249 pts). We observed that post-ASCT BV maintenance was associated with significantly higher PFS in the subgroup with PMR (5-year PFS: 59.6% vs 43.3% HR = 0.52, CI 95 : 0.33–0.82; p = 0.007). In the subgroup of patients with CMR, BV maintenance did not significantly improve PFS (5-year PFS: 75.8% vs 62.3% HR = 0.88, CI 95 : 0.59–1.32; p = 0.29). However, when focusing on patients with CMR treated post-FDA approval of BV, there was a significant PFS benefit observed in those treated with BV maintenance vs. not (5-year PFS: 81.2% vs 55.2% HR = 0.40, CI 95 : 0.22–0.72; p = 0.003). Overall, BV maintenance after ASCT remains an important therapy for high-risk R/R cHL patients, especially for those in PMR or those in CMR.

Blood Cancer Journal
Rutgers, The State University of New Jersey (US), University of Minnesota (US), University of Wisconsin System (US), Cleveland Clinic (US), Mayo Clinic (US), University of Wisconsin–Madison (US), Emory University (US), Washington University in St. Louis (US), Masaryk University (CZ), Huntsman Cancer Institute (US), University of Alabama at Birmingham (US), Mount Sinai Medical Center (US), Piedmont Cancer Institute (US), University Hospital Brno (CZ), University Hospital Olomouc (CZ), Mayo Clinic in Arizona (US), University of Minnesota Medical Center (US), Stanford Medicine (US), University Hospital Hradec Králové (CZ), Mayo Clinic in Florida (US), University Hospital Kralovske Vinohrady (CZ), Sidney Kimmel Comprehensive Cancer Center (US), Pittsburg State University (US), New York University (US), Palacký University Olomouc (CZ), Stanford University (US), Icahn School of Medicine at Mount Sinai (US)
Bristol-Myers Squibb, Eli Lilly and Company, Pfizer, AstraZeneca, Gilead Sciences, Celgene, Karyopharm Therapeutics, Regeneron Pharmaceuticals, TG Therapeutics, Atara Biotherapeutics, MEI Pharma, Constellation Pharmaceuticals, BeiGene, Incyte, Seagen, MorphoSys, Ipsen, Genentech, Pharmacyclics, NYU Grossman School of Medicine, Loxo Oncology, Daiichi Sankyo Europe, Cilag
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