Abstract P126

REAL WORLD EFFICACY AND SAFETY COMPARISON OF SALVAGE REGIMENS COMBINING BRENTUXIMAB VEDOTIN AND CHEMOTHERAPY IN SECOND-LINE HODGKIN LYMPHOMA: A LYSA MULTICENTER RETROSPECTIVE STUDY.

The treatment of R/R HL involves polychemotherapy combined with Bv or anti-PD1 followed by ASCT for eligible patients. Polychemo combinations are based on phase II studies. No direct comparison allows for an evidence-based choice and treatment selection reflects habits.

Aim: To compare the efficacy and toxicity of Bv-chemo regimens in patients with R/R HL who have been treated in a second line setting.

Method: This retrospective multicenter study included patients with R/R Hodgkin lymphoma treated with Bv-chemo with intent to proceed to ASCT across 19 LYSA centers in France between 2014 and 2025.

Result: 288 patients were included: 81 (28%) treated with Bv-benda, 110 (38%) with Bv-ICE and 97 (34%) with Bv-DHAC/X/P (Bv-DHA). The median age was 33 years, and median follow-up was 41 months. ABVD first line treatment was more frequent in patients receiving Bv-benda (p<0.01). Age, stage at relapse and time to relapse were also significantly different (p<0.01, p<0.01 and p=0.01). 97 patients (34%) had a refractory disease and 118 (41%) relapsed more than 1 year after EOT. 215 patients (75%) underwent ASCT after second line, 24 (8%) after third line. CR was observed in 72.4% of patients without difference between treatment groups (78% for Bv-benda, 76% for Bv-ICE and 67% for Bv-DHA; p=0.21). Similarly, 3 years PFS was 62% (712% (IC95% 61-80) for Bv-benda, 59 % (IC95% 50-68) with Bv-ICE, 59% (IC95% 48-68) with Bv-DHA), with no significant difference in PFS (log rank p=0.48). In multivariable Cox analysis adjusted for first-line treatment, age, time to relapse, and stage at relapse, PFS was not significantly (p=0.20): using Bv-DHA as the comparator, the HR for the Bv-benda group was 0.6 (95% CI, 0.3-1.1) and 0.8 (95% CI, 0.5-1.4) for Bv-ICE group. Hematological toxicity was higher with Bv-ICE in terms of both RBC (p<0.001) and platelet transfusions (p<0.001). Hospitalization median duration was significantly shorter in patients treated with Bv-benda (1.7 days/cycle) compared to those treated with Bv-ICE (4.3 days/cycle) or Bv-DHA (3.2 days/cycle). Severe infections rates were similar between the groups (p=0.81). Recrutement is ongoing and updated data will be presented at conference.

Conclusion: Bv-benda, Bv-ICE and Bv-DHA showed similar efficacy as 2nd line salvage treatments for HL, with Bv-ICE being associated with significantly increased toxicity. These results provide real-world comparative data that may guide treatment selection among Bv-based salvage regimens.