Abstract P020

Real-life experience with BV-AVD combination in advanced stage classical Hodgkin Lymphoma: A multicenter study from Greece

Background: Brentuximab Vedotin (BV) in combination with doxorubicin, vinblastine and dacarbazine (BV-AVD ) was approved for the first-line treatment of patients with advanced stage Hodgkin lymphoma (HL), based on the results of the ECHELON-1 study initially for stage IV and subsequently for stages III and IV. We aimed to describe the real-life experience with BV-AVD in a multicenter setting in Greece.

Methods: Retrospective analysis of newly diagnosed patients with advanced HL, who received BV-AVD treatment in 8 centers in Greece. Interim PET (iPET) was evaluated according to Deauville 5-point scale and was considered as positive in cases with scores 4 or 5.

Results: 57 patients were treated with BV-AVD (2 started with a half or one cycle of ABVD, and then continued with BV-AVD). The median age was 41 years (range: 17-84; 24% of patients ≥ 60 years old) 57% were males, 82% had B-symptoms and 15% had bulky disease at diagnosis. By conventional staging, 71, 25 and 4% of the patients had disease stage IV, III and IIB respectively, while 90% of the patients had stage IV disease based on baseline PET/CT. 2 deaths occurred during treatment: one due to febrile neutropenia in a 78-year old patient during the first cycle and one due to myocardial infraction in a 51-year old patient during the 6th cycle. iPET was available in 50/57 patients and was positive in 6 (12%). All iPET+ patients had DS4 (SUVmax: 4.1-7.4) and none switched to a different regimen. Among iPET+ patients, at the end of treatment (EoT): 2 patients remained PET+ with DS4 but had no evidence of disease progression and remained currently disease-free, 3 patients converted to PET- and one died due to myocardial infraction prior to EoT evaluation. Overall, there were 6 relapses, occurring between 7-43 months from treatment initiation, all derived from the iPET- population. With a median follow-up of 17 months, 2- and 3-year FFP was 88% and 82% respectively.

Conclusion: Our real-life study provided comparable results to ECHELON-1 regarding treatment efficacy of BV-AVD, despite the vast predominance of stage IV owing to the approved indication of BV-AVD during the study period. The rate of iPET positivity was slightly higher in our study, but a iPET+ did not compromise patients’ outcome as the majority were either converted to PET- or were falsely PET+ at the EoT. All relapses occurred in iPET- patients implying that detection of prognostic factors in this subgroup of patients remains relevant.