Abstract P015

High efficacy and acceptable toxicity of BrECADD regimen in advanced-stage classical Hodgkin lymphoma

Background: The HD21 trial conducted by the German Hodgkin Lymphoma Study Group established BrECADD, a regimen including brentuximab vedotin, etoposide, cyclophosphamide, doxorubicin, dacarbazine, and dexamethasone, as the standard first-line therapy for advanced-stage classical Hodgkin lymphoma (cHL). Our retrospective analysis provides real-world data on the efficacy and toxicity of BrECADD regimen in patients with cHL in the Czech Republic.

Methods: Patient demographics and baseline characteristics were analyzed using descriptive statistics. PET/CT scans were performed before starting treatment, after completing two cycles of chemotherapy, upon the conclusion of treatment, and assessed according to the Lugano criteria. Overall survival (OS) and progression-free survival (PFS) were calculated utilizing the Kaplan-Meier method.

Results: A total of 97 patients, including 58 males, who received at least one cycle of the BrECADD regimen between November 2023 and February 2026, were evaluated. The median age was 32 (range 18-66) years. Among the 97 patients, 76 (78%) were classified as being in clinical stages III or IV, while 21 (21.6%) were in stage IIB with a massive mediastinal tumor and/or extranodal disease. Additionally, 18 patients (18.5%) had an International Prognostic Score 4-7. Overall 7.2% of patients did not complete the planned number of BrECADD cycles. A complete metabolic response was observed in 63.9% of cases after two cycles and increased to 84.5% by the end of the treatment. Only four (4.1%) patients received radiotherapy. During a median follow-up of 8.2 months three patients relapsed. The estimated 1-year PFS rate was 96.5% and the 1-year OS rate was 100%. Although the incidence of grade ≥3 neutropenia was high at 65%, the occurrence of grade ≥3 infections remained relatively low at 15.8%. Toxicity resulted in treatment reductions for 25.4% of patients. Brentuximab vedotin was prematurely discontinued in two (3.1%) patients due to grade ≥3 peripheral neuropathy.

Conclusion: The BrECADD regimen was well-tolerated, and our efficacy findings closely match those reported in the HD21 trial. This work was supported by the grant AZV NU22-03-00182 from the Ministry of Health of the Czech Republic and by the Cooperatio Program, research area “Oncology and Haematology”