Safety and efficacy of nivolumab combined with brentuximab vedotin in patients with relapsed and refractory classic Hodgkin lymphoma: Systematic review and meta-analysis.

Abstract

e19040 Background: Relapsed or refractory (R/R) classical Hodgkin lymphoma (cHL) remains a therapeutic challenge despite high frontline cure rates due to its resistance to chemotherapy. Checkpoint inhibitors targeting PD-1 as Nivolumab, and antibody–drug conjugate therapy as Brentuximab Vedotin, have each demonstrated substantial activity in R/R cHL. Their combination has been evaluated across multiple clinical trials and real-world studies; however, the pooled efficacy and safety of this regimen have not been systematically quantified. This study aims to evaluate the safety and efficacy of Nivolumab as PD-1 inhibitors combined with Brentuximab Vedotin in treating relapsed or refractory cHL (rrHL). Methods: A systematic search of PubMed, Scopus, Web of Science, and Cochrane Library was conducted in Jan 2026. Eligible studies were 8, including 7 prospective clinical trials and one retrospective cohort study. evaluating Nivolumab plus Brentuximab Vedotin in patients with R/R cHL. Primary outcomes were overall response rate (ORR) and complete response (CR). Secondary outcomes included progression-free survival (PFS), overall survival (OS), and adverse events (AEs). A random-effects model was used to pool effect estimates. Statistical heterogeneity was assessed using the I² statistic. Risk of bias was evaluated using Cochrane risk of bias 2 (ROB 2) and ROBINS-I. Results: A total of 8 studies including 315 patients with relapsed or refractory Hodgkin lymphoma were included in the meta-analysis. The pooled overall response rate (ORR) was 83.4% (95% CI, 78.2–87.6), with moderate heterogeneity (I² = 47%, tau² = 0). The pooled complete response (CR) rate was 62.5% (95% CI, 56.4–68.2). Grade ≥3 adverse events occurred in 37.5% of patients, most commonly [nausea and sensory peripheral neuropathy]. Conclusions: This meta-analysis suggested that the combination of Nivolumab and Brentuximab vedotin improves the outcomes of response and survival rates with tolerable AEs in patients with relapsed or refractory (R/R) classical Hodgkin lymphoma (cHL). These findings support the regimen as an effective chemotherapy-free option.