Abstract P079

Survival benefit of brentuximab vedotin in classical Hodgkin lymphoma: a multicenter real-world study

Background: Classical Hodgkin lymphoma (cHL) is highly curable, yet a meaningful proportion of patients still relapse after frontline chemotherapy, making deeper and more durable first-line responses a key goal. Adding the CD30-directed antibody–drug conjugate brentuximab vedotin (BV) to AVD(Doxorubicin、Vinblastine、Dacarbazine) has increasingly used in clinical practice due to improved survival outcome. However, pivotal comparative evidence derives largely from selected, advanced-stage trial populations, whereas real-world, multicenter data across the full spectrum of disease stages are needed to confirm the benefit of BV+AVD over ABVD(Doxorubicin、Bleomycin、Vinblastine、Dacarbazine) and to inform first-line regimen selection. Applying rigorous propensity-score matching to balance baseline risk, we directly compared first-line BV+AVD with ABVD in a real-world cohort.

Methods: Patients with cHL receiving first-line BV+AVD or ABVD were retrospectively analyzed. Response rates were compared by Fisher's exact test. PFS and OS were estimated by Kaplan–Meier curve. To reduce confounding, 1:1 propensity-score matching was used to analyze the survival benefit of different treatment regimens.

Results: A total of 356 patients were enrolled, of whom 84 received the BV+AVD regimen and 272 received ABVD regimen. Compared with the ABVD regimen, the BV+AVD regimen achieved higher ORR (96.4% vs 83.8%; P=0.002) and CRR (92.9% vs 66.2%; P<0.001). The 2-year PFS was 86.3% in the whole cohort. The 2-year PFS were 93.6% (95% CI 87.6–100) for BV+AVD versus 78.7% (69.6–89.0) and 74.2% (64.0–86.0) for ABVD (log-rank P=0.015). BV+AVD was associated with significantly improved PFS (HR 0.28, 95% CI 0.09–0.88; P=0.029). After matching, the BV+AVD regimen significantly improved PFS (2-year PFS 93.6% vs 78.7% and 74.2%; log-rank P=0.015; HR 0.28, 95% CI 0.09–0.88).

Conclusion: In this multicenter real-world matched analysis, the BV+AVD regimen provided superior PFS and response rates, supporting it as an effective frontline option in routine practice and extending comparative evidence beyond selected trial populations. Longer follow-up is warranted to assess overall survival.