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BRENTUXIMAB VEDOTIN CONSOLIDATION AFTER AUTOLOGOUS STEM CELLS TRANSPLANTATION FOR HODGKIN LYMPHOMA: A REAL‐LIFE EXPERIENCE BY FONDAZIONE ITALIANA LINFOMI (FIL)

2021; Wiley; Volume: 39; Issue: S2 Linguagem: Inglês

10.1002/hon.65_2881

1099-1069

Fulvio Massaro, Vincenzo Pavone, Pietro Maria Stefani, Barbara Botto, Alessandro Pulsoni, Caterina Patti, Maria Cantonetti, Andrea Visentin, Potito Rosario Scalzulli, Andrea Rossi, Sara Galimberti, Michele Cimminiello, Guido Gini, Maurizio Musso, Marco Sorio, Annalisa Arcari, Vittorio Ruggero Zilioli, Alessia Bari, Donato Mannina, Alberto Fabbri, Giuseppe Pietrantuono, Ombretta Annibali, Agostino Tafuri, Eleonora Del Prete, Antonino Mulè, Elisa Barbolini, Luigi Marcheselli, Stefano Luminari, Francesco Merli,

Vascular Tumors and Angiosarcomas

Introduction: Classical Hodgkin lymphoma (cHL) is a highly curable cancer, but up to 30% of patients have a refractory or relapsed (R/R) disease. Salvage therapy followed by consolidation with autologous hematopoietic stem cell transplantation (ASCT) can save only approximately half of R/R patients. In the phase 3 AETHERA trial, cHL patients at high-risk of progression or relapse who received Brentuximab Vedotin (BV) as consolidation therapy after ASCT showed a reduced risk of progression compared to a placebo group, with 5-year progression-free survival (PFS) rates of 59% and 41%, respectively. We report here the results of a real-life study on 105 cHL patients treated with BV as consolidation after ASCT. Methods: This retrospective study included R/R cHL patients from 15 Italian centers treated between April 2011 and August 2020. Patients were eligible if they had received at least 2 cycles of BV after ASCT, independently from prior treatments. The primary aim was PFS and OS assessment and its comparison to data already reported in literature. Results: We included 105 patients, with a median follow-up of 20 months (range 2-108). Patients received a median of 2 lines of treatment before ASCT. The 51% (54 patients) of total population received BV also immediately before ASCT. PET-CT evaluation before and after ASCT reported a Deauville score (DS) 1-3 in 72 (75%) and 68 (78%) patients, respectively. Considering pre ASCT high-risk features (refractory disease, CR < 12 months, extranodal disease at relapse), 30 (29%) patients presented at least 2 factors. The median number of BV consolidation cycles was 10. A complete schedule of sixteen cycles of BV was administered to 57 (54%) subjects in the whole population (60% of patients who received both consolidation and pre ASCT and 43% of subjects treated with BV post-ASCT only). Main causes for treatment interruption were: adverse events (AEs; 15; 33%), disease progression (13; 28%), consolidation with allo-SCT (8; 17%). Among the grade 3-4 AEs leading to treatment interruption, we reported 8 peripheral neuropathies, 4 infections, 2 infusion reactions, 1 liver toxicity. Concerning efficacy data, the 3-year PFS and OS were 62% (95% CI: 49-72) and 86% (95% CI: 73-93), respectively (Figure 1). In univariate analysis the only feature significantly associated with both reduced PFS and OS was a DS 4-5 before ASCT (HR 3.81; 95% CI: 1.80-8.09; p < 0.001). Interestingly the administration of BV pre ASCT was not associated with different risk of progression PFS (HR 0.87, 95% CI 0.44-1.73, p = 0.965) or death (HR 0.71, 95% CI 0.20-2.49, p = 0.594). Conclusions: BV treatment as post ASCT consolidation is confirmed by our real-life study as an effective and safe option for R/R cHL patients in line with the results of the AETHERA trial. The use of BV also before ASCT did not negatively impact on its safety and efficacy, and likely allowed to offer to a higher number of patients the option of ASCT. Kaplan-Meier plots showing OS and PFS Keywords: Hodgkin lymphoma, Immunotherapy Conflicts of interests pertinent to the abstract A. Pulsoni Consultant or advisory role: Takeda M. Cantonetti Consultant or advisory role: Takeda Educational grants: Takeda A. Visentin Educational grants: Takeda A. Rossi Consultant or advisory role: Takeda V. R. Zilioli Consultant or advisory role: Takeda A. Fabbri Consultant or advisory role: Takeda Educational grants: Takeda F. Merli Consultant or advisory role: Takeda