Nivolumab with doxorubicin, vinblastine, and dacarbazine in older adults with classic Hodgkin lymphoma: do S1826 results hold up in the real world?

Older adults (OA, ≥60 years) with classic Hodgkin lymphoma (cHL) have historically experienced inferior outcomes compared to younger patients. Nivolumab in combination with doxorubicin, vinblastine, and dacarbazine (NAVD) has demonstrated high efficacy in clinical trials, but real-world data in OA are limited. We conducted a multicenter retrospective study across 20 centers in patients with newly diagnosed advanced stage cHL treated with NAVD and analyzed outcomes in OA across the aging spectrum. Among 327 total patients, 81 (25%) were ≥60 years, with most OA presenting with stage IV disease (58%) and B symptoms (57%). Anygrade and ≥grade 3 AEs occurred in 88% and 67% of OA, respectively. Prophylactic growth factors were used in most OA (82%) which led to low rates of febrile neutropenia (12%) and infection (12%) despite 52% ≥grade 3 neutropenia. Immune-related AEs occurred in 29% (12% ≥grade 3) and treatment was discontinued due to toxicity in 10% of OA. Interim overall (ORR) and complete response rates (CRR) were 100% and 81.6%, end-of-treatment rates were 88% and 82.6%, respectively. At a median follow-up of 12.6 months, 1-year progression-free survival (PFS) and overall survival (OS) in OA were 91.5% and 98.6%, respectively. OS was inferior in OA compared with patients.

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Publication Details

Journal
Haematologica
Published
2026-10-08
DOI
https://doi.org/10.3324/haematol.2026.301545
Primary Topic
Lymphoma Diagnosis and Treatment
Type
article
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article

Nivolumab with doxorubicin, vinblastine, and dacarbazine in older adults with classic Hodgkin lymphoma: do S1826 results hold up in the real world?

Reem Karmali, Efrat Luttwak, Dahlia Sano, Jakub Svoboda et al.
Haematologica
Lymphoma Diagnosis and Treatment
article

Nivolumab with doxorubicin, vinblastine, and dacarbazine in older adults with classic Hodgkin lymphoma: do S1826 results hold up in the real world?

Reem Karmali, Efrat Luttwak, Dahlia Sano, Jakub Svoboda, Peirong Hao, Hua-Jay Jeffery Cherng, Alex Niu, Harsh Shah, Praveen Ramakrishnan Geethakumari, Tatyana A. Feldman, Ayo Samuel Falade, John Graham Sharp, Urshila Durani, Ritwick S. Mynam, Grace Baek, Kanithra Sekaran, Gordon Smilnak, Allison Marie Bock, Yasmin H. Karimi, Pallawi Torka, Drew Gerber, Joanna Meehan Rhodes, Madiha Iqbal, Krithika Shanmugasundaram, John L. Vaughn, Mengyang Di, Ajay Major, Natalie Sophia Grover, Daniel K. Reef, Priyanka Avinash Pophali, Narendranath Epperla, Timothy J. Voorhees, Calvin Lee, Marisa Palmeri, Swetha Kambhampati Thiruvengadam, Vrutti Patel, Yizhe Xu, Nicole Araujo, Alex Herrera, Catherine Diefenbach
article en

Abstract

Older adults (OA, ≥60 years) with classic Hodgkin lymphoma (cHL) have historically experienced inferior outcomes compared to younger patients. Nivolumab in combination with doxorubicin, vinblastine, and dacarbazine (NAVD) has demonstrated high efficacy in clinical trials, but real-world data in OA are limited. We conducted a multicenter retrospective study across 20 centers in patients with newly diagnosed advanced stage cHL treated with NAVD and analyzed outcomes in OA across the aging spectrum. Among 327 total patients, 81 (25%) were ≥60 years, with most OA presenting with stage IV disease (58%) and B symptoms (57%). Anygrade and ≥grade 3 AEs occurred in 88% and 67% of OA, respectively. Prophylactic growth factors were used in most OA (82%) which led to low rates of febrile neutropenia (12%) and infection (12%) despite 52% ≥grade 3 neutropenia. Immune-related AEs occurred in 29% (12% ≥grade 3) and treatment was discontinued due to toxicity in 10% of OA. Interim overall (ORR) and complete response rates (CRR) were 100% and 81.6%, end-of-treatment rates were 88% and 82.6%, respectively. At a median follow-up of 12.6 months, 1-year progression-free survival (PFS) and overall survival (OS) in OA were 91.5% and 98.6%, respectively. OS was inferior in OA compared with patients.

Haematologica
Rutgers, The State University of New Jersey (US), Northwestern University (US), University of North Carolina at Chapel Hill (US), Roswell Park Comprehensive Cancer Center (US), City Of Hope National Medical Center (US), Hackensack University Medical Center (US), Mayo Clinic (US), Memorial Sloan Kettering Cancer Center (US), University of Utah (US), University of Michigan (US), Columbia University Irving Medical Center (US), The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (US), Huntsman Cancer Institute (US), Jacksonville College (US), Fred Hutch Cancer Center (US), Southwestern Medical Center (US), University of Wisconsin Carbone Cancer Center (US), City of Hope (US), New York Oncology Hematology (US), University of Colorado Cancer Center (US), University of Virginia (US), The Ohio State University (US), New York University (US), Columbia University (US), University of Pennsylvania (US), The University of Texas Southwestern Medical Center (US), University of Colorado Denver (US)
Openalex Percentile: Top 12%
Lymphoma Diagnosis and Treatment
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