Brentuximab vedotin in combination with doxorubicin, vinblastine and dacarbazine [BRE15]
For treating adult patients with previously untreated stage III or IV Hodgkin lymphoma where the following criteria have been met:
- This application is being made by and the first cycle of brentuximab in combination with doxorubicin, vinblastine and dacarbazine will be prescribed by a consultant specialist specifically trained and accredited in the use of systemic anti-cancer therapy.
- The patient is an adult.
- The patient has previously untreated CD30 positive Hodgkin lymphoma.
- The patient has stage III or IV Hodgkin lymphoma. Please mark below which stage applies to this patient:
- stage III disease or
- stage IV disease Note: the use of brentuximab plus chemotherapy is not commissioned in stage I or II Hodgkin lymphoma.
- Brentuximab will be given in combination with doxorubicin, vinblastine and dacarbazine (AVD).
- A maximum of 6 x 28 day cycles of brentuximab plus AVD will be administered to this patient. Note: there is no PET-adapted approach to treatment escalation or de-escalation with this brentuximab-AVD combination.
- The prescribing clinician is aware that the scheduled brentuximab dose per day 1 and day 15 administrations is 1.2mg/Kg (ie not the dose used when brentuximab is given as monotherapy).
- The prescribing clinician is aware that the brentuximab SPC recommends that primary prophylaxis with GCSF should begin with the first dose of brentuximab-AVD.
- The patient has an ECOG performance status of 0 or 1 or 2.
- The prescribing clinician is aware that when a treatment break of more than 6 weeks beyond the expected 4-weekly cycle length is needed, I will complete a treatment break approval form.
- Brentuximab will otherwise be used as set out in its Summary of Product Characteristics (SPC).
CDF funded From: 02 April 2025
Additional information
Current Form Version
Note
The data on this page was produced using version 1.357 of the CDF list, downloaded from an archive of NHS England’s website on 02 April 2025 at 14:00.
If NHS England has published a new version of the CDF List but this site has not yet accessed that, this form may be out of date. Additionally, if any update has occurred without NHS England noting it as a change, this page will be out of date.