Brentuximab vedotin and nivolumab for untreated patients with Hodgkin lymphoma: long-term results

Background: Whereas major improvements have been made in advanced Hodgkin lymphoma (HL) outcomes of patients > 60 yrs are suboptimal with greater toxicity compared with younger patients.In the first phase II study of BV-nivo in older patients with HL (ACCRU RU0515051, NCT02758717), initial results at a median of 20.2 mo of follow-up.(Cheson et al, Lancet Haem, 11:e808, 2020).Herein we present 5-year follow-up for this study.Methods: Eligible pts were either >60 yrs or considered unsuitable for standard chemotherapy because of cardiac, pulmonary or renal dysfunction.Pts received BV at 18 mg/kg (dose cap at 180 mg) and nivo at 3 mg/kg both intravenously every 21 days for 8 cycles.The primary endpoint was overall response rate (ORR).Results: Updated follow-up data were available for 39 of the original 46 pts still alive.At a median follow-up of 58.5 months (0.45-65.4 mo), the median duration of response was 17.2 mo (11.6-45.2).Twenty-seven (58.7%) patients had progressed with the median progression-free survival of 18.3 mo (12.8-46.3mo); thus 19 (41.3%) had still not experienced a progression event.Median overall survival was not yet reached with 39 (84.8%) patients still alive.Conclusions: BV-nivo is an effective regimen for patients >60 yrs, curing approximately 40% of pts.For those not cured by initial therapy, outcome with subsequent treatment is excellent, suggesting check point inhibitor sensitization, or other factors.Optimization of dose and schedule, and incorporation of other novel agents will result in a successful chemo-free approach for older patients with HL.