Three-year follow-up of nivolumab-AVD versus brentuximab vedotin-AVD in adolescents with advanced-stage classic Hodgkin lymphoma

The multicenter phase 3 S1826 trial evaluated nivolumab, doxorubicin, vinblastine, and dacarbazine (N-AVD) versus brentuximab vedotin (BV)-AVD for patients with newly diagnosed advanced-stage (stages III and IV) classic Hodgkin lymphoma (cHL). Subset analysis of the adolescent cohort of the trial has now been published. Among 994 patients enrolled, 240 (24%) were age 12-17 years. The 3-years progression-free survival (PFS) rate was significantly higher in the N-AVD group compared with the BV-AVD group (93% versus 82%; HR 0.37; 95% CI 0.17-0.80). One N-AVD patients and two BV-AVD patients received protocol-specified residual site radiotherapy (RT). Rates of febrile neutropenia and sepsis were low in both groups. Severe immune-related adverse events were infrequent, althoug thyroid dysfunction was seen in 7% with N-AVD. Sensory neuropathy grade ≥ 2 was more frequent with BV-AVD (14% versus 7%). Premature discontinuation of therapy was reported in 12 N-AVD patients and four BV-AVD patients. Patient-reported outcomes indicated less toxicity with N-AVD. The authors conclude that among adolescents with advanced-stage cHL, N-AVD demonstrated high 3-year PFS rates, with minimal RT use.