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.

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2025
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