Multinational phase 2 trial of transplant-free approach for relapsed Hodgkin lymphoma in children, adolescents, and young adults

Cohort R1 of the multinational phase 2 CheckMate 744 trial evaluated a transplant-free approach for young patients (aged 5-30 years) with low-risk relapsed classical Hodgkin lymphoma (cHL). Patients received a response-adapted therapy with nivolumab plus brentuximab vedotin induction, followed by brentuximab vedotin plus bendamustine intensification for patients with suboptimal response, and involved-site radiotherapy (ISRT) consolidation. In this nonrandomized trial including 28 patients, complete metabolic response rate per blinded independent central review was 82% after induction and 93% after induction or induction plus intensification. The event-free and progression-free survival rates at 3 years were 87% and 95%, respectively. The safety profile was consistent with that of each agent used. The authors conclude that among younger patients with low-risk relapsed cHL, replacing autologous transplant and high-dose chemotherapy with checkpoint inhibitor-based therapy and ISRT could offer a strategy for maintaining high event-free survival while reducing acute and long-term toxic effects.