Anti–programmed cell death protein 1–based salvage therapy for relapsed/refractory Hodgkin lymphoma: a multicenter real-world analysis

Abstract

In relapsed/refractory classic Hodgkin lymphoma (r/r cHL), salvage followed by high-dose chemotherapy and autologous stem cell transplantation (HD-ASCT) yields suboptimal outcomes. PD-1 inhibitor-based salvage regimens have shown superior complete response (CR) rates of up to 95% (for P-GVD) with unprecedented PFS after HD-ASCT. However, immune checkpoint inhibitors are not EMA-approved in 2nd line, and European data remain sparse. This retrospective, multicentric analysis included r/r cHL patients who received salvage with intent to consolidation. Response before and after SCT consolidation, and PFS and OS were assessed. 47 patients were included (median prior lines: 2). Salvage regimens were PD-1 monotherapy (n=10), PD-1 + chemotherapy [P-ICE/ N-ICE /P-GVD] (n=34), or PD-1 + BV (brentuximab vedotin) (n=3). Overall response (OR)/CR were 90.9%/47.7%. OR/CR rates by salvage regimen were: PD-1 monotherapy 80/10%; PD-1 + chemotherapy, 93.6/61.3%; PD-1 + BV, 100/33.3%. With median follow-up of 16 months, 1- year PFS was 83.9% and OS was 95.6%. In the subgroup of patients with one prior line (n=22), 1-year PFS was 100%. In this real-world cohort, previously reported high CR rates were not reached. However, with the restriction of a limited follow-up, outcomes after HDASCT were excellent, supporting the role of PD-1 inhibitor-based salvage followed by consolidative HD-ASCT for r/r cHL.