Patient has NOT previously received brentuximab vedotin (BV) — eligible for BV-containing...

Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.

ID	`RF-PRIOR-BV-NAIVE`
Type	Red flag
Status	reviewed 2026-04-27 \| pending_clinical_signoff
Diseases	None declared
Sources	`SRC-AETHERA-MOSKOWITZ-2015` `SRC-ECHELON-1-CONNORS-2018` `SRC-ECHELON-2-HORWITZ-2019`

Red Flag Origin

Definition	Patient has NOT previously received brentuximab vedotin (BV) — eligible for BV-containing first-line and salvage regimens in CD30-expressing diseases: A+AVD in advanced cHL (ECHELON-1, Connors NEJM 2018), BV-CHP in CD30+ PTCL/ALCL (ECHELON-2, Horwitz Lancet 2019), BV monotherapy or BV-containing salvage in R/R cHL (AETHERA post-ASCT consolidation). This eligibility flag is used as an inclusion gate for BV-using algorithm branches; firing means standard BV-route is open. Co-fires with disease-specific CD30-positivity flags.
Clinical direction	intensify
Category	other

Trigger Logic

{
  "any_of": [
    {
      "finding": "prior_brentuximab_received",
      "value": false
    },
    {
      "finding": "prior_bv_received",
      "value": false
    },
    {
      "finding": "brentuximab_naive",
      "value": true
    },
    {
      "finding": "prior_therapy_classes",
      "value": "no_bv"
    }
  ],
  "type": "composite_score"
}

Notes

Inclusion-gate flag (eligibility), not a routing flag — direction "intensify" reflects "BV-route is the preferred first-line where applicable; absence of prior BV does NOT alone trigger BV-using regimen, but it removes the contraindication that prior BV refractoriness or high cumulative neuropathy would impose". Combine with RF-CHL-ADVANCED-STAGE (cHL stage III-IV → A+AVD over ABVD) or RF-TCELL-CD30-POSITIVE (PTCL/ALCL CD30+ → BV-CHP). Cumulative neuropathy is the dose-limiting toxicity (peripheral neuropathy ~67% all-grade in ECHELON-1; grade 3-4 ~10%); pre-existing neuropathy ≥grade 2 is a contraindication regardless of BV-naive status. Maintenance BV post-ASCT in high-risk cHL (AETHERA) requires the patient to be both BV-naive AND have ≥1 risk factor (primary refractory, relapse <12 mo, or extranodal disease at relapse).

Used By

Algorithms

ALGO-CHL-2L - ALGO-CHL-2L