Real-world outcomes of BrECADD therapy in advanced-stage classical Hodgkin lymphoma: A multicentre retrospective...

Advanced-stage classical Hodgkin lymphoma (cHL) has been traditionally treated with effective chemotherapy regimens, albeit some associated with substantial toxicity. The recently introduced brentuximab vedotin, etoposide, cyclophosphamide, doxorubicin, dacarbazine, dexamethasone (BrECADD) regimen has proved more effective and less toxic than escalated BEACOPP (escBEACOPP: bleomycin, etoposide, adriamycin, cyclophosphamide, vincristine, procarbazine, prednisone). Our retrospective multicentre study assessed outcomes of this treatment in the real-world setting. It incorporated 100 advanced-stage cHL patients receiving BrECADD at 19 cancer centres between July 2023 and October 2025. The primary end-point was progression-free survival (PFS); secondary end-points included overall response rate (ORR), positron emission tomography (PET)-2 negativity, complete response (CR), overall survival (OS) and toxicity. The median age was 30 (18-65) years; 80% had stage IV disease; 85% had an International Prognostic Score ≥3. ORR and CR were 100% and 95%, respectively; 83% achieved PET-2 negativity, enabling therapy de-escalation from six to four cycles. At a median follow-up of 13.7 months, estimated 1-year PFS and OS were 96% and 100% respectively. Only 4% required radiotherapy. Grade ≥3 neutropenia (83%) and febrile neutropenia (55%) were common; yet, 95% of patients completed all planned cycles. Peripheral neuropathy occurred in 25%, mostly grade 1-2. In this real-world cohort, including high-risk patients, BrECADD demonstrated remarkable efficacy and tolerability, supporting its feasibility and potential to reduce chemotherapy and radiotherapy exposure, while maintaining high treatment efficacy.