Effectiveness and safety of brentuximab vedotin-containing regimen versus standard chemotherapy in relapsed or refractory Hodgkin lymphoma: a multicenter cohort study

Introduction: Hodgkin Lymphoma (HL) accounts for 3.4% of all cancers in Saudi Arabia and poses significant challenges with relapse rates reaching 40% in advanced stages. Brentuximab vedotin (BV), a novel agent targeting CD-30, has shown promise in improving outcomes. This study aims to assess the real-world effectiveness and safety of BV-containing regimens compared to non-BV regimens in Relapse/Refractory HL in Saudi Arabia.Methods: A retrospective multicenter cohort study included 93 adult patients with relapsed/refractory HL (rrHL) in Saudi Arabia between 2016 and 2021. Patients were categorized into BV-containing (n=61) and control groups (n=32). Data collection adhered to ethical guidelines, with outcomes including overall response rate (ORR), complete response (CR), event-free survival (EFS), and post-chemotherapy complications.Results: BV-containing regimens demonstrated a higher ORR (82.5% vs. 76.9%) without statistical significance (adjusted odds ratio (aOR) 12.25, 95% CI 0.99,151.79, p=0.05). CR rates were similar between groups (61.5% of patients in the control group compared to 59.6% of patients who received BV (OR 1.37, 95%CI 0.19,9.83, p=0.76)). BV demonstrated a trend toward longer EFS (22.4 months vs 11.1 months), however, it was statistically not significant (Beta coefficient 0.38, 95% CI -0.13-0.89, p=0.14). All post-chemotherapy complications were comparable between the two groups with more cases of hepatotoxicity and acute kidney injury reported in the BV group.Conclusion: The study suggests a potential benefit of BV in terms of response rates and EFS. Long-term studies with larger sample size are warranted to validate these findings and further optimize treatment strategies for rrHL patients.