Brentuximab Vedotin With Adriamycin, Vinblastine, and Dacarbazine for Patients Aged 18–59 Years With Untreated Advanced Stage Classical Hodgkin Lymphoma: The Largest Real‐Life Series From Southern Italy Cancer Centers

ABSTRACT BV + AVD is increasingly used for frontline treatment of stage III/IV cHL. Young adults and adults (Ya&A) were the most common patients treated with BV + AVD in clinical trials but have not been studied in non‐trial settings. We conducted a real‐life study in secondary and tertiary cancer centers to evaluate the PFS in 18–59 years aged patients who were scheduled to receive six BV + AVD for newly diagnosed advanced stage cHL. This is the largest cohort of Ya&A reported to date including 150 patients from four clinical institutions in Southern Italy, all of which employed structured supportive care programs for HL. Fifty patients (30%) had at least one ECHELON‐1 ineligibility criterion, including comorbidities and/or adverse performance status. All 150 patients underwent BV + AVD with a median relative dose intensity of 100% (dose reduction and/or discontinuation ≥ 15%, in 11% of them). At end‐of‐treatment (EoT) FDG‐PET, 93% (140/147) of patients (three did not undergo EoT FDG‐PET due to early grade 5 toxicity) achieved a complete response (95% CI, 88.1–96.8). Altogether, four patients (2.7%) received consolidation radiotherapy of residual nodal masses with a Deauville score of 4. Grade ≥ 2 peripheral neuropathy, cardiotoxicity, and febrile neutropenia were reported by 13%, 7%, and 3% of patients, respectively. With a 24 month median follow‐up, PFS in the entire analyzed population was 91% (95% CI, 0.864–0.958). In Ya&A with high‐risk cHL, our data suggest that a BV‐driven strategy (without bleomycin and consolidation radiotherapy) is an effective up‐front option in oncologic centers specialized in HL care, improving the rate of durable complete remission in routine clinical practice. Trial Registration: ClinicalTrials.gov identifier: NCT06857500