Nivolumab-AVD Versus Brentuximab Vedotin–AVD in Older Patients With Advanced-Stage Classic Hodgkin Lymphoma Enrolled on S1826
Older patients with classic Hodgkin lymphoma (cHL) have inferior survival compared with younger patients. We report a subset analysis of older patients (60 years and older) enrolled in the phase three S1826 trial conducted by SWOG that randomly assigned patients with newly diagnosed advanced-stage (III-IV) cHL to six cycles of nivolumab (N)-AVD or brentuximab vedotin (BV)-AVD. Of 103 enrolled patients 60 years and older, 99 were eligible. At a median follow-up of 2.1 years, the 2-year progression-free survival was 89% after N-AVD (n = 50) and 64% after BV-AVD (n = 49, HR 0.24, 95%CI 0.09-0.63, 1-sided stratified log-rank <i>P</i> = .001). The 2-year OS was 96% with N-AVD versus 85% with BV-AVD (HR 0.16, 95%CI 0.03-0.75 stratified 1-sided log-rank <i>P</i> = .005). Six cycles were delivered without dose reduction in 69% on N-AVD and 26% on BV-AVD; 55% discontinued BV, and 14% discontinued nivolumab. The nonrelapse mortality was 16% with BV-AVD and 6% with N-AVD. Despite more neutropenia with N-AVD, febrile neutropenia, sepsis, and infections were higher with BV-AVD, as was peripheral neuropathy. Patient-reported outcomes of key adverse events confirmed the improved toxicity profile of N-AVD over BV-AVD. N-AVD was better tolerated and more effective than BV-AVD and is therefore a new standard of care for older patients with advanced-stage cHL fit for anthracycline-based combination therapy.
Authors
- Susan K. Parsons (ORCID: https://orcid.org/0000-0003-0282-6490)
- Hongli Li
- Sonali M. Smith (ORCID: https://orcid.org/0000-0002-9893-4949)
- Anamarija M. Perry (ORCID: https://orcid.org/0000-0002-5700-2141)
- Joo Y. Song (ORCID: https://orcid.org/0000-0003-3497-2513)
- Alex Francisco Herrera (ORCID: https://orcid.org/0000-0002-9665-7415)
- Brian T. Hess (ORCID: https://orcid.org/0000-0003-0176-2050)
- Sharon M. Castellino (ORCID: https://orcid.org/0000-0001-8367-2002)
- John P. Leonard (ORCID: https://orcid.org/0000-0002-5083-1115)
- Jonathan W. Friedberg (ORCID: https://orcid.org/0000-0002-1420-5563)
- Sairah Ahmed (ORCID: https://orcid.org/0000-0001-7302-8299)
- Michael LeBlanc (ORCID: https://orcid.org/0000-0001-7192-2860)
- Joseph M. Tuscano (ORCID: https://orcid.org/0000-0002-0522-1406)
- Pallawi Torka (ORCID: https://orcid.org/0000-0002-1681-5883)
- Andrew M. Evens (ORCID: https://orcid.org/0000-0002-6900-1824)
- Pankaj Kumar (ORCID: https://orcid.org/0000-0003-4284-6787)
- Brad S. Kahl (ORCID: https://orcid.org/0000-0003-0459-6609)
- Kelly Davison (ORCID: https://orcid.org/0000-0001-5159-3916)
- Nancy L. Bartlett (ORCID: https://orcid.org/0000-0001-8470-394X)
- Sarah C. Rutherford (ORCID: https://orcid.org/0000-0002-1064-7727)
- Joseph M. Unger (ORCID: https://orcid.org/0000-0002-5191-0317)
- Carla Casulo (ORCID: https://orcid.org/0000-0001-9993-5065)
- Ryan Jacobs
Institutions
- Rutgers, The State University of New Jersey (US)
- Tufts Medical Center (US)
- Memorial Sloan Kettering Cancer Center (US)
- The University of Texas MD Anderson Cancer Center (US)
- Emory University (US)
- Medical University of South Carolina (US)
- Washington University in St. Louis (US)
- Cornell University (US)
- University of Michigan (US)
- Royal Victoria Regional Health Centre (CA)
- McGill University Health Centre (CA)
- University of Chicago (US)
- Royal Victoria Hospital (CA)
- Fred Hutch Cancer Center (US)
- Levine Cancer Institute (US)
- City of Hope (US)
- Center for Cancer and Blood Disorders (US)
- Illinois CancerCare (US)
- University of California Davis Medical Center (US)
- Weill Cornell Medicine (US)
- University of Rochester (US)
Publication Details
- Journal
- Journal of Clinical Oncology
- Published
- 2025-06-16
- DOI
- https://doi.org/10.1200/jco-25-00204
- Citations
- 14
- Primary Topic
- Lymphoma Diagnosis and Treatment
- Type
- article
- Field-Weighted Citation Impact
- 20.60