Abstract P006

BrECADD in Three Days: Condensing an Intensive First-Line Regimen in Classic Hodgkin Lymphoma

Intensive multi-agent treatment regimens have substantially improved outcomes in advanced-stage classic Hodgkin lymphoma (cHL). BrECADD is the first-line regimen that demonstrated the highest efficacy in cHL reported to date (Borchmann et al., Lancet 2024). The regimen combines brentuximab vedotin (BV) with etoposide, cyclophosphamide, doxorubicin, dacarbazine and dexamethasone given in 21-day intervals with cytotoxic agents during the first four days. Simplifying multi-day treatment schedules has the potential to reduce treatment burden and logistical demands in routine clinical practice. We thus developed a condensed BrECADD protocol with BV being administered alongside etoposide, cyclophosphamide, doxorubicin and dexamethasone on day 1 of each cycle, reducing i.v. administration days to only three (-25%). From January 2024 to February 2026, 22 patients were treated with the newly developed 3-day BrECADD protocol. Data was retrospectively collected from medical records for patients treated at the University Hospital in Cologne. Primary objective was to describe feasibility and safety. Secondary objectives included evaluation of treatment response, one-year-progression free survival (PFS) and one-year-overall survival (OS). A total of 96 treatment cycles were administered across the 22 patients. CTCAE Grade ≥3 adverse events occurred in 13 patients (59%), with hematological toxicities being most frequent. Five patients (23%) had grade ≥3 infections (3 viral, 2 bacterial), and 4 patients (18%) had febrile neutropenia without pathogen detection. After 2 treatment cycles of BrECADD, a complete remission (CR) was achieved in 18 patients (82%). Irradiation due to PET-positive residual disease was performed in 2 patients (9%). No treatment discontinuations occurred. With a median follow up of 19 months (min-max: 4-26), one-year PFS and OS were both 100%. Based on these encouraging results, the condensed 3-day protocol is considered feasible and beneficial for logistical considerations in clinical practice. We thus recommend the condensed 3-day protocol for future BrECADD use.