ORIGINAL RESEARCH article
Front. Oncol.
Sec. Hematologic Malignancies
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1636923
Frontline brentuximab vedotin-based therapy for newly diagnosed classical Hodgkin lymphoma: a meta-analysis of randomized controlled trials
Provisionally accepted
- 1Sunshine Union Hospital, Weifang, China
- 2Chinese People's Liberation Army Rocket Force Characteristic Medical Center, Beijing, China
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Background: Brentuximab vedotin (BV), an anti-CD30 antibody-drug conjugate, has established efficacy in relapsed/refractory Hodgkin lymphoma (HL), yet its role as frontline therapy for newly diagnosed classical HL requires systematic evaluation.Methods: We conducted a meta-analysis of randomized controlled trials (RCTs) compared BV-based versus conventional non-BV-containing regimens (namely, classical chemotherapeutic regimens) in previously untreated classical HL patients, assessing progression-free survival (PFS), PET metabolic responses (interim PET-2 negativity and end-of-treatment complete response), and safety profiles (grade ≥3 adverse events [AEs], including febrile neutropenia, peripheral neuropathy, and secondary malignancies).Results: Pooled data from four RCTs (N = 3591 patients) demonstrated significant PFS improvement with BV-based regimens (HR: 0.58, 95% CI: 0.44 to 0.77, P < 0.001), with consistent benefits across subgroups stratified by disease stage, gender, age, and International Prognostic Score (IPS). Although interim PET-2 negativity rates showed only a non-significant trend favoring BV (RR: 1.02, 95% CI: 0.99 to 1.04, P = 0.286), end-of-treatment complete metabolic response rates were significantly higher (RR: 1.03, 95% CI: 1.00 to 1.06, P = 0.024). Safety analyses revealed comparable incidences of grade ≥3 AEs between groups (RR: 1.05, 95% CI: 0.80 to 1.37, P = 0.739), with no increased risk of peripheral neuropathy or secondary malignancies.Conclusions: our meta-analysis demonstrates that incorporation of BV into frontline therapy for classical HL provides significant PFS benefits and improved end-oftreatment metabolic responses, with manageable toxicity. These findings support BVbased regimens as a promising frontline therapeutic strategy in classical HL, though extended follow-up is required to evaluate long-term survival outcomes.
Keywords: Hodgkin lymphoma, Brentuximab vedotin, Meta-analysis, Frontline therapy, Progression-free survival, Safety, randomized controlled trial
Received: 28 May 2025; Accepted: 04 Jul 2025.
Copyright: © 2025 Yang, Liu, Wang, Zhang and Xie. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Jing Xie, Chinese People's Liberation Army Rocket Force Characteristic Medical Center, Beijing, China
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