BrECADD in three days: Implementation of a condensed intensive first‐line regimen in Hodgkin lymphoma

Summary Intensive multiagent treatment regimens have substantially improved outcomes in advanced‐stage classic Hodgkin lymphoma (cHL). Brentuximab vedotin (BV), etoposide, cyclophosphamide, doxorubicin, dacarbazine and dexamethasone (BrECADD) demonstrated the highest efficacy in cHL reported to date in a randomised phase III trial. Cytotoxic agents are conventionally administered during the first 4 days of a 21‐day cycle. A total of four cycles are applied to patients with a complete response after two cycles, otherwise six cycles. We developed a condensed BrECADD protocol, reducing intravenous administration days to only three (−25%). Between January 2024 and July 2026, 30 patients received 132 cycles of 3‐day BrECADD at our institution. Primary objective was to describe feasibility and safety; secondary objectives included response, progression‐free survival (PFS) and overall survival (OS). Grade ≥3 adverse events occurred in 23 patients (77%), predominantly haematological. Six patients (20%) had grade ≥3 infections (four viral, two bacterial) and six (20%) had pathogen‐unspecified febrile neutropenia. Twenty‐four patients (80%) required only four BrECADD cycles. There were no treatment discontinuations. After a median follow‐up of 18 months (range 4–29), 1‐year PFS and OS rates were both 100%. Based on these encouraging results, the condensed 3‐day protocol is considered feasible and we recommend it for future BrECADD use.