Pembrolizumab as First Therapy for Hodgkin Lymphoma Is Deliverable in Older or Abvd‐ineligible Patients, Allows Subsequent Therapy, and Gives Adequate Survival.

switched to two cycles of BEACOPPesc and INRT (superiority design).Primary end point was progression-free survival (PFS).In January 2019, a preplanned analysis on 10y follow-up was launched.So far, out of 1925 patients constituting the original study population, 1419 cases have been updated, and are included in the present analysis; 506 cases showing similar baseline characteristics and 5y OS and PFS than updated patients were excluded so far.Results: After a median follow-up of 9.5 yrs, a total of 57 deaths and 136 events for PFS were reported in the analyzed population, leading to an overall 10-year OS and PFS rates of 96% and 90% respectively.In ePET-positive patients, 10y PFS increased from 79% for standard ABVD + INRT to 85% for intensification to BEACOPPesc + INRT (hazard ratio [HR] = 0.67; 95% CI, 0.37 to 1.20), although the difference was not statistically significant.The 10y OS rates were 90% and 92%, respectively (hazard ratio [HR] = 0.92; 95% CI, 0.43-1.97).In the F ePET negative group the 10y PFS rates were 99% versus 85% (HR = 13.2;95% CI, 3.1-55.8)in favor of ABVD + INRT, and the difference was statistically significant.The 10y OS rates were 100% versus 98% for ABVD + INRT and ABVD only arms, respectively (hazard ratio [HR] = 2.80; 95% CI, 0.3-26.9).Finally, in the U ePET negative group 10y PFS rates were 91% and 87% (HR = 1.52; 95% CI, 0.8-2.8)for standard and experimental arm, respectively.The 10y OS rates were 94% versus 95% for ABVD + INRT and ABVD only arms, respectively (hazard ratio [HR] = 0.84; 95% CI, 0.4-2.0). Conclusion:The present long-term analysis confirms that in F ePETnegative patients, the omission of INRT is associated with lower 10y PFS, although no differences in terms of OS emerged.Moreover, in the U ePET negative and in the ePET positive patients, no significant differences between standard and experimental arms emerged in terms of 10y PFS and OS.