Safety and effectiveness of brentuximab vedotin in Chinese patients with CD30-positive lymphomas: A multicenter real-world analysis

Abstract Introduction: Brentuximab vedotin (BV), an anti-CD30 antibody-drug conjugate, is approved for CD30-positive lymphomas. However, the Real-world safety and effectiveness of BV in Chinese patients across diverse subtypes remains limited. Methods: A multicenter retrospective study evaluated CD30-positive lymphomas treated with BV-based regimens (Jan 2020-Dec 2024). Cases included peripheral T-cell lymphoma (PTCL), cutaneous T-cell lymphoma (CTCL), extranodal NK/T-cell lymphoma (ENKT), classical Hodgkin lymphoma (cHL), and B-cell lymphomas (BCL, e.g., diffuse large B-cell lymphoma DLBCL, primary mediastinal large B-cell lymphoma PMBCL). The primary endpoint was objective response rate (ORR), complete remission (CR), relapse rate. Secondary endpoints included adverse events (AEs) and treatment Patterns, like BV cycles, salvage therapies post-BV failure. Results: A total of 141 patients from 15 centers were included: 41.1% (58/141) were diagnosed with PTCL, 40.4% (57/141) with cHL, 9.9% (14/141) with BCL, and 8.5% (12/141) with other subtypes (CTCL/ENKTL). The cohort's median age was 55.0 years (range 14–87), 58.9% were female, and 41.1% (58/141) had an ECOG performance status ≥2. Advanced-stage disease (Ann Arbor III–IV) was present in 61%, and 16.3% exhibited extranodal involvement at ≥2 sites. CD30 expression 10% in 99.3% of evaluable samples and 30% in 41.1%; 54.6% of patients were relapsed/refractory. The ORR across all patients was 81.6 % ,with a CRR of 48.2% and Relapse after remission were 19.9 %. In the treatment-naïve group, ORR and CRR were 90.5% and 57.1% in cHL (n=21) ,85.3 % and 61.8 % in PTCL(n=34), 83.3% and 0.0 % in BCL(n=6). In R/R patients, ORR and CRR were 83.3 % and 52.8 % in cHL (n=36), 79.2 % and 37.5 % in PTCL, 50.0 % and 25.0 % in BCL(n=8). Most patients (90.8 %) completed ≤ 6 BV cycles; of these, 51.1 % received 1–4 cycles and 39.7 % received 5–6 cycles. In treatment-naïve cohorts, BV-AVD was the predominant regimen for cHL (85.7%), whereas BV-CHP was most common for PTCL (82.4%). Conversely, among R/R cohorts, BV plus AVD remained the primary choice in cHL (41.7%, followed by BV with PD-1 inhibitors at 13.9%). For R/R PTCL, BV plus chidamide ranked first (29.2%), BV plus CHP second (12.5%). Post-BV failure, chidamide predominated as salvage therapy in PTCL, while PD-1 inhibitors or azacitidine were preferentially selected in cHL. Any-grade adverse events (AEs) occurred in 115 patients (81.6 %). Grade ≥3 events were documented in 23 patients (16.3 %); the most common were anemia (5.0 %), infections (6.4 %), and peripheral neuropathy (3.5 %). Hematologic toxicities were observed in XX patients (XX %), with anemia (58.9 %), neutropenia (51.1 %), and thrombocytopenia (31.2 %). The leading non-hematologic AEs were febrile neutropenia (29.1 %), infections (27.0 %), and peripheral neuropathy (17.7 %). Conclusions In this Chinese real-world cohort, BV-based regimens produced high ORR and CR rates in both treatment-naïve and R/R CD30-positive lymphomas, with manageable toxicity. These data support BV as an effective backbone across diverse CD30-positive lymphomas in routine Chinese practice.