Abstract P120

From Clinical Trials to Clinical Practice: A Decade of Experience with Nivolumab in Relapsed/Refractory Classical Hodgkin Lymphoma

Background: Nivolumab (nivo) is an established treatment option for patients (p) with relapsed/refractory classical Hodgkin lymphoma (R/R cHL).

Methods: Among 82 p treated with nivo between 2015 and 2025, 69 p receiving nivo monotherapy were analyzed. Clinical characteristics, treatment responses, survival, outcomes, and toxicity were evaluated in this retrospective analysis.

Results: Median age at nivo initiation was 42 years (y) (range, 20–77), with 52% aged ≤ 60y, most p were male (n=45; 65%). Patients received median of 3 (range, 1-12) prior treatment lines, 64% had advanced stage, 51% extranodal involvement, 5.7% bulky disease and 19% B symptoms. Prior autologous SCT was performed in 78% of p, while 67% were previously exposed to brentuximab vedotin (BV). Median time from diagnosis to first nivo dose was 34.7 months (range, 6–299). Median number of nivo administrations was 19 (range, 1–165). Median dose was 240 mg (range, 165–480mg) with administration every 2 weeks in 64p. Best overall response rate (ORR) was 75% (complete remission, CR 42%). Treatment-related toxicity occurred in 22 p (32%); grade 3–4 in 7 (32%) of these p. Reasons for nivo discontinuation were CR (n=12), partial remission (PR; n=2), stable disease (n=1), progression (PD; n=33), toxicity (n=6), and other reasons (n=7). Ten p underwent nivo retreatment (8p were evaluable for BOR). Two p achieved CR and 3 p remain in treatment. Median treatment duration was 5.5 months (range, 2-15). During follow-up, 10 p received allogeneic SCT.

After median follow-up of 49.2 months, median progression-free survival (PFS) and overall survival (OS) were 18.3 and 70.2 months. 3y PFS and OS were 21.4% and 76.7% (Fig.1). Median duration of response was 19.2, 30 and 12.8 months for ORR, CR and PR. Previous treatment with BV did not influence survival. At last follow-up, 24 p were in CR (22 p remained alive). Causes of death (n=25) included PD (n=10), infections (n=7), secondary malignancies (n=3), allogeneic SCT-related complications (n=1), other (n=2) and unknown causes (n=2).

Conclusion: Our findings support nivo monotherapy as an effective and well-tolerated option for heavily pretreated patients, with improved outcomes over the past decade, although its role may evolve as immunotherapy shifts to earlier treatment lines. 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”.