Prognostic value of TARC and quantitative PET parameters in relapsed or refractory Hodgkin lymphoma patients treated with brentuximab vedotin and DHAP

• DOI: 10.1038/s41375-022-01717-8
• Publication Date: 2022-10-14T15:02:58Z
• Authors: Julia Driessen; Marie José Kersten; Lydia Visser; Anke van den Berg; Sanne H. Tonino; Josée M. Zijlstra; Pieternella J. Lu...; Franck Morschhauser; Martin Hutchings; Sandy Amorim; Thomas Gastinne; Marcel Nijland; Gerben J. C. Zwez...; Ronald Boellaard; Henrica C. W. de Vet; Anne I. J. Arens; Roelf Valkema; Roberto D. K. Liu; Esther E. E. Drees; Daphne de Jong; Wouter J. Plattel; Arjan Diepstra
• Keywords: Brentuximab Vedotin; Immunoconjugates; [SDV]Life Sciences [q-bio]; Radboudumc 9: Rare cancers RIHS: Radboud Institute for Health Sciences; Prognosis; Hodgkin Disease; 03 medical and health sciences; 0302 clinical medicine; SDG 3 - Good Health and Well-being; Positron-Emission Tomography; Medical Imaging - Radboud University Medical Center; Humans; Prospective Studies; Neoplasm Recurrence, Local; Vitamin D; Stem Cell Transplantation

Risk-stratified treatment strategies have the potential to increase survival and lower toxicity in relapsed/refractory classical Hodgkin lymphoma (R/R cHL) patients. This study investigated the prognostic value of serum (s)TARC, vitamin D and lactate dehydrogenase (LDH), TARC immunohistochemistry and quantitative PET parameters in 65 R/R cHL patients who were treated with brentuximab vedotin (BV) and DHAP followed by autologous stem-cell transplantation (ASCT) within the Transplant BRaVE study (NCT02280993). At a median follow-up of 40 months, the 3-year progression free survival (PFS) was 77% (95% CI: 67-88%) and the overall survival was 95% (90-100%). Significant adverse prognostic markers for progression were weak/negative TARC staining of Hodgkin Reed-Sternberg cells in the baseline biopsy, and a high standard uptake value (SUV)mean or SUVpeak on the baseline PET scan. After one cycle of BV-DHAP, sTARC levels were strongly associated with the risk of progression using a cutoff of 500 pg/ml. On the pre-ASCT PET scan, SUVpeak was highly prognostic for progression post-ASCT. Vitamin D, LDH and metabolic tumor volume had low prognostic value. In conclusion, we established the prognostic impact of sTARC, TARC staining, and quantitative PET parameters for R/R cHL, allowing the use of these parameters in prospective risk-stratified clinical trials. Trial registration: NCT02280993.