Abstract 903P
Background
The problem of salvage therapy of relapsed and refractory classical Hodgkin lymphoma (r/r cHL) is still unresolved. Despite the new agents such as nivolumab (N) and brentuximab vedotin (BV), a significant group of patients remain refractory to monotherapy. Thus, the search for new approaches to therapy for r/r cHL is highly relevant. One of these approaches is a combination of N with BV.
Methods
This retrospective analysis included 22 patients (15 male/7 female) with r/r cHL who were treated with combination of N with BV (N+BV) in a 28-day cycle. Median age of patients was 31 (12-40). BV (1,8 mg/m2) was infused on day 1 and N (dosage range 0,5-3 mg/kg) on day 1,15. The response was evaluated by PET-CT according to LYRIC criteria. During the survival analysis, the PFS was censored at the time of additional therapy initiation. Safety was evaluated by registration of adverse events (AEs) according to NCI CTCAE 4.03.
Results
The median follow-up was 21 (2-39) months. Prior to N+BV therapy, 95% of patients had disease stage 4, 9% of patients had B-symptoms. Partial remission (PR) was observed in 14% of patients, indeterminate response (IR) to nivolumab therapy in 9%, progressive disease (PD) in 77%. The median number of previous therapy lines was 6 (2-13). Nivolumab as monotherapy was prior treatment in 82% of patients, and with BV in 68%. The median number of N+BV cycles was 4 (2-12). Overall response rate was 73%: complete remission was achieved in 32% of patients, PR in 41%. Stable disease was observed in 14% of patients, IR in 9% and PD in 5% of patients. The median PFS was 11 (9-13) months. The median OS was not reached: 86% of patients were alive at the time of analysis. Allo-HSCT after N+BV was performed in 8 pts. AEs were observed in 68% of patients (3/4 grade in 14%). All cases of immune-related AEs resolved completely after glucocorticosteroid therapy.
Conclusions
The combination of N with BV was shown to be effective and safe for the treatment of r/r cHL. Moreover, this therapy has shown efficacy in a group of patients who were refractory to N or BV monotherapy. Thus, N+BV can be used in the treatment of this population, particularly, as a «bridge» therapy before allo-HSCT.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.