Brentuximab Vedotin/Chemo Regimens Show Similar Efficacy in 2L Lymphoma

Brentuximab vedotin (Adcetris) showed comparable efficacy when combined with 3 chemotherapy-containing regimens, including with bendamustine; with ifosfamide (Ifex), carboplatin, and etoposide (ICE); and with dexamethasone, cytarabine, carboplatin, capecitabine, and cisplatin (DHAC/X/P), as a second-line treatment for patients with relapsed/refractory classic Hodgkin lymphoma (cHL), according to findings from a real-world efficacy and safety analysis presented at the European Hematology Association (EHA) 2026 Congress.

The complete response (CR) rate was 72.4% across the entire study population (n = 288). In the bendamustine arm, the CR rate was 77.5%; in the ICE arm, it was 76.1%; and in the DHAC/X/P, arm it was 67.0% (P = 0.21).

The 24-month progression-free survival (PFS) rate was 63.9% across all patients treated on the study. In the bendamustine arm (n = 81), the 24-month PFS rate was 71.5% (95% CI, 60.9%-80.2%). In the ICE arm (n = 109), it was 60.2% (95% CI, 50.5%-69.1%). For the DHAC/X/P-containing arm (n = 97), it was 60.4% (95% CI, 50.2%-69.8%).

A multivariable Cox analysis adjusting for frontline treatment, age, time to relapse, and Ann Arbor stage at progression showed that PFS did not significantly differ among the treatment arms (P = 0.21). Using brentuximab vedotin plus dexamethasone, cytarabine, and carboplatin (DHA) as a comparator, the HR for PFS was 0.60 (95% CI, 0.33-1.07) in the bendamustine-containing group and 0.84 (95% CI, 0.53-1.35) in the ICE-containing group.

Additionally, the 24-month overall survival (OS) rate was 96.3% overall. The rate in the bendamustine, ICE, and DHAC/X/P-containing arms was 94.9% (95% CI, 87.5%-98.0%), 95.1% (95% CI, 89.0%-97.9%), and 99.0% (95% CI, 94.3%-99.8%), respectively.

Regarding toxicity, the number of red blood cells transfused per cycle for patients in each arm was 0.0 (SD, 0.1), 0.4 (SD, 1.1), and 0.2 (SD, 0.4), respectively (P <.01). Moreover, the number of pooled platelet concentrates transfused per cycle per patient was 0.0 (SD, 0.1), 0.3 (SD, 1.5), and 0.2 (SD, 0.5), respectively (P <.01).

Patients treated with the ICE-containing regimen had a greater median number of hospitalization days per cycle, at a median 4.3 days (IQR, 4.0-5.0) vs 1.7 days (IQR, 1.0-3.8) with bendamustine and 3.2 days (IQR, 2.0-4.0) with DHAC/X/P (P <.01). Furthermore, the number of grade 3 or greater infections per cycle per patient was 0.2 (SD, 0.5) with the ICE-containing regimen compared with 0.1 (SD, 0.4) and 0.1 (SD, 0.4) with bendamustine and DHAC/X/P, respectively (P = 0.81).

“[Brentuximab vedotin with bendamustine, with ICE, and with DHAC/X/P] showed similar efficacy as second-line brentuximab vedotin-based salvage treatments for cHL, with [brentuximab vedotin/ICE] being associated with significantly increased toxicity and number of days spent in the hospital,” Juliette Wencel of the Department of Hematology at the Necker-Enfants Malades University Hospital in Paris, France, wrote in the presentation with study coinvestigators. “These results provide real-world comparative data that may guide treatment selection among [brentuximab vedotin-based] salvage regimens.”

Patients with relapsed/refractory cHL who received second-line chemotherapy-containing regimens with the intention of proceeding to autologous stem cell transplantation (ASCT) were enrolled between 2014 and 2025 in France. Data collection was performed via a standardized electronic case report form.

A majority of patients in the bendamustine, ICE, and DHAC/X/P arms had Ann Arbor stage III to IV disease at diagnosis, encompassing 64.2%, 68.8%, and 63.5% of each arm (P = 0.69). The most common first-line treatment was doxorubicin, bleomycin, vinblastine, and dacarbazine, with 90.0%, 59.1%, and 33.0% of each arm receiving the treatment (P <.01). The mean time to relapse was 19.5 days (SD, 40.6), 17.6 days (SD, 29.1), and 25.0 days (SD, 35.8), respectively (P = .01).

The mean age at relapse was 40.4 years (SD, 14.1), 37.1 years (SD, 14.3), and 32.5 years (SD, 12.1) in each respective arm (P <.01). Most patients had Ann Arbor Stage III or IV disease at relapse in each arm, at 51.3%, 56.3%, and 52.1%, respectively (P = 0.73).

The study assessed CR rate, OS, and PFS using x², log-rank tests, or adjusted Cox models. Toxicity data were gathered prior to ASCT.

Reference

Wencel J, Pages A, Chevillon F, et al. Real world efficacy and safety comparison of salvage regimens combining brentuximab vedotin and chemotherapy in second-line hodgkin lymphoma: a Lysa multicenter retrospective study. Presented at: European Hematology Association 2026 Congress; June 11-14, 2026; Stockholm, Sweden. Abstract PF922.