Multicenter phase 3 trial of nivolumab plus AVD for advanced-stage classical Hodgkin lymphoma

Brentuximab vedotin with doxorubicin, vinblastine, and dacarbazine (BV+AVD) is a standard treatment for advanced classical Hodgkin lymphoma (cHL). Given the toxicity and relatively high rate of relapse of the treatment, there is a need for less toxic and more effacacious treatments. The phase 3 S1826 trial, at 256 centers in the USA and Canada, randomized adolescent and adult patients with newly diagnosed stage III or IV cHL to nivolumab (N) plus AVD or BV+AVD. The primary endpoint was progression-free survival. At a median follow-up of 2.1 years, the 2-year progression-free survival rate was 92% with N+AVD versus 83% with BV+AVD (HR 0.45; 95% CI 0.30-0.65). Immune-related adverse events were infrequent with nivolumab, while brentuximab vedotin was associated with more treatment discontinuation. The authors conclude that among adolescents and adults with stage III or IV cHL, N+AVD resulted in longer progression-free survival than BV+AVD and had a better side-effect profile.