Interim-PET predicts progression-free survival in stage IV Hodgkin lymphoma treated with upfront brentuximab vedotin-AVD.

Brentuximab vedotin (BV) plus doxorubicin, vinblastine and dacarbazine (AVD) demonstrated to improve survival compared to ABVD as frontline treatment of advanced stage Hodgkin Lymphoma (HL). We retrospectively collected data of 99 stage IV HL patients treated off-protocol with BV-AVD to evaluate the predictive role of interim-PET. Median age was 36 years (range: 18-82); 83.8% patients completed all planned 6 cycles and 80.8% obtained complete response at PET6. Median follow-up was 14.4 months; 1-year progression-free survival (PFS) and overall survival were 84.1% (CI 95%: 77-91.9) and 96.9% (CI 95%: 93.6-100). PET2-negative patients had a superior 1-year PFS compared to PET2-positive patients: 90.0% vs 46.2% (p < .001). At multivariable analysis, PET2 positivity retained unfavorable statistical significance in PFS: HR 4.6 (95% CI: 1.4-15.2, p = .009). BV-AVD was confirmed to be effective in a real-world setting, while PET2-positive patients displayed a remarkably lower 1-year PFS than that previously reported and might benefit from a PET-driven approach.