Tandem Meetings 2023 | The impact of checkpoint inhibitor-based salvage regimens in patients with R/R HL undergoing autoSCT

In relapsed/refractory classic Hodgkin lymphoma, for several years, salvage chemotherapy and autologous stem cell transplant are standard of care. Recently, there have been few trials with very encouraging results with incorporation of novel regimens like brentuximab vedotin or checkpoint inhibitors to salvage chemotherapy, and they have encouraging response rates and survival.

We do not have, as of yet, a head-to-head comparison of conventional chemotherapy regimens to these novel agent-based salvage therapy in a randomized trial in relapsed/refractory classic Hodgkin’s lymphoma, but we do have some retrospective data that’s coming in. We did a multi-center retrospective cohort study of about 14 institutions where, it’s not 1:1 randomized comparison, but we did compare patients who received conventional chemotherapy to novel agent-based regimen and we compared the outcomes.

We did find that patients who have checkpoint inhibitor-based salvage regimens, mainly BV-nivo, so combination of brentuximab vedotin with nivolumab, they had higher EFS, which meant that they had lower likelihood of requiring second salvage before transplant, lower likelihood of progression before and after transplant, and lower likelihood of death. We also observed that in patients who had chemosensitive disease after first salvage, so they underwent transplant without any further salvage therapy, checkpoint inhibitor-based salvage regimen had lower likelihood of post-transplant progression. This remained after adjusting for response.

So, better outcomes are not only because novel checkpoint inhibitor-based regimens lead to better response rates, it is also in patients who were in complete response, checkpoint inhibitor-based regimens have better post-transplant progression-free survival. So lower likelihood of progression after transplant. That’s very encouraging.