Patients with classical Hodgkin lymphoma experiencing disease progression after treatment with brentuximab vedotin have poor outcomes.
Brentuximab vedotin (BV) is a key therapeutic agent for patients with relapsed/refractory classical Hodgkin lymphoma (cHL). The outcomes of patients experiencing disease progression after BV are poorly described.



We reviewed our institutional database to identify patients with cHL treated with BV who were either refractory to treatment or experienced disease relapse. We collected clinicopathologic features, treatment details at progression and outcome.



One hundred patients met inclusion criteria, with a median age of 32 years (range 18-84) at progression after BV. The median number of treatments before BV was 3 (range 0-9); 71 had prior autologous stem cell transplant. The overall response rate (ORR) to BV was 57%, and the median duration of BV therapy was 3 months (range 1-25). After disease progression post-BV, the most common treatment strategies were investigational agents (n = 30), gemcitabine (n = 15) and bendamustine (n = 12). The cumulative ORR to therapy was 33% (complete response 15%). After a median follow-up of 25 months (range 1-74), the median progression-free (PFS) and overall survival (OS) were 3.5 and 25.2 months, respectively. In multivariate analysis, no factors analyzed were predictive of PFS; age at progression >45 years and serum albumin <40 g/l at disease progression were associated with increased risk of death. Among patients who achieved response to therapy, allogeneic stem cell transplantation was associated with a non-significant trend toward superior OS (P = 0.11).



Patients with BV-resistant cHL have poor outcomes. These data serve as a reference for newer agents active in BV-resistant disease.
Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, USA Department of Haematology, Pathwest Laboratory Medicine WA and Sir Charles Gairdner Hospital, Nedlands School of Pathology and Laboratory Medicine, University of Western Australia, Crawley, Australia.
C Y
CY
Cheah
Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, USA.
D
D
Chihara
Department of Pharmacy.
S
S
Horowitz
Department of Pharmacy.
A
A
Sevin
Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, USA.
Y
Y
Oki
Department of Biostatistics.
S
S
Zhou
Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, USA.
N H
NH
Fowler
Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, USA.
J E
JE
Romaguera
Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, USA.
F
F
Turturro
Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, USA.
F B
FB
Hagemeister
Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, USA.
L E
LE
Fayad
Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, USA.
M
M
Wang
Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, USA.
S S
SS
Neelapu
Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, USA.
L J
LJ
Nastoupil
Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, USA.
J R
JR
Westin
Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, USA.
M A
MA
Rodriguez
Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, USA.
F
F
Samaniego
Department of Stem Cell Transplant and Cellular Therapies, The University of Texas MD Anderson Cancer Center, Houston, USA.
P
P
Anderlini
Department of Stem Cell Transplant and Cellular Therapies, The University of Texas MD Anderson Cancer Center, Houston, USA.
Y
Y
Nieto
Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, USA mfanale@mdanderson.org.
M A
MA
Fanale
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000069461:Bendamustine Hydrochloride / Q000008:administration & dosage / Q000009:adverse effects; D000079963:Brentuximab Vedotin; D003841:Deoxycytidine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives; D018450:Disease Progression; D018572:Disease-Free Survival; D019008:Drug Resistance, Neoplasm / Q000187:drug effects*; D005260:Female; D006689:Hodgkin Disease / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D006801:Humans; D018796:Immunoconjugates / Q000008:administration & dosage* / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D000093542:Gemcitabine
D018796:Immunoconjugates; D003841:Deoxycytidine; D000079963:Brentuximab Vedotin; D000069461:Bendamustine Hydrochloride; D000093542:Gemcitabine
Hodgkin lymphoma; antibody drug conjugates; brentuximab vedotin; outcomes research; retrospective studies; treatment