https://doi.org/10.55788/131fd7c1
The anti-CD30 antibody drug conjugate brentuximab vedotin (Bv) is standard-of-care in frontline treatment of advanced-stage Hodgkin lymphoma both in paediatric and adult patients, although with a different chemotherapy backbone (AVE-PC vs AVD) [1,2]. However, relapses are still common (7–20%), most paediatric patients still receive consolidating radiotherapy, and in particular paediatric patients are vulnerable to late morbidity.
Recently, nivolumab has shown to be highly effective in relapsed or refractory Hodgkin lymphoma and was well tolerated [3]. Therefore, the SWOG S1826 trial (NCT03907488) compared the efficacy and safety of first-line treatment with nivolumab-AVD and Bv-AVD, both in paediatric and adult patients. The primary endpoint was PFS. Prof. Alex Herrera (City of Hope Medical Center, CA, USA) presented the results [4].
A total of 940 participants (n=237; ≤18 years) with newly diagnosed stage III/IV Hodgkin lymphoma were randomised 1:1 to receive 6 cycles of nivolumab-AVD or 6 cycles of Bv-AVD. In the nivolumab-AVD arm G-CSF was optional, and in the Bv-AVD arm G-CSF was required.
Nivolumab-AVD improved PFS compared with Bv-AVD. At 1-year, PFS rate was 94% compared with 86% in the nivolumab-AVD and Bv-AVD arm, respectively (HR=0.48; P=0.0005). The PFS benefit was observed within all prespecified subgroups (see Figure). In addition, nivolumab-AVD favoured event-free survival (EFS): 1-year EFS rate was 91% compared with 84%, respectively (HR 0.56; P=0.0019). Overall survival data are not yet mature. Less than 1% of patients receive consolidating radiotherapy.
Figure: PFS benefit consisted across prespecified subgroups in SWOG S1826 [1]
AVD, doxorubicin, vinblastine, and dacarbazine; BV, brentuximab vedotin; N, nivolumab; CI, confidence interval; HR, hazard ratio; IPS, international prognostic score.
Nivolumab-AVD was well-tolerated. Although 55% of patients developed neutropaenia, no increased infectious toxicity was observed in the nivolumab-AVD arm compared with the Bv-AVD arm.
“Nivolumab-AVD improves PFS compared with Bv-AVD both in paediatric and adult patients. The low rate of consolidating radiotherapy may reduce late toxic effect of the treatment,” Prof. Herrera concluded. “In addition, this is a key step towards harmonising paediatric and adult therapy of Hodgkin lymphoma.”
- Ansell SM, et al. N Engl J Med 2022;387:310–320.
- Castellino SM, et al. N Eng J Med 2022;387:1649–1660.
- Armand P, et al. J Clin Oncol 2018;36(14):1428–1439.
- Herrera AF, et al. SWOG S1826, a randomized study of nivolumab(N)-AVD versus brentuximab vedotin(BV)-AVD in advanced stage (AS) classic Hodgkin lymphoma (HL). Abstract LBA4, ASCO Annual Meeting 2023, 2–6 June, Chicago, USA.
Copyright ©2023 Medicom Medical Publishers
Posted on
Previous Article
« Vorasidenib successfully targets IDH1/2-mutated glioma Next Article
Immune checkpoint inhibition improves PFS in non-BRCA-mutated ovarian cancer »
« Vorasidenib successfully targets IDH1/2-mutated glioma Next Article
Immune checkpoint inhibition improves PFS in non-BRCA-mutated ovarian cancer »
Table of Contents: ASCO 2023
Featured articles
Real-world data support new SOC in patients with SCLC
What can real-world evidence teach us about atezolizumab plus bevacizumab in HCC?
Colorectal Cancer
7-year outcomes of PRODIGE 23 trial
Neoadjuvant chemotherapy may be viable option in locally advanced colon cancer
De-escalation of neoadjuvant treatment of locally advanced rectal cancer is non-inferior
Breast Cancer
SONIA: No survival benefit with first-line versus second-line CDK4/6 inhibition in metastatic breast cancer
Adjuvant ribociclib improves invasive DFS in early breast cancer
Gene expression profiles predict benefit of neoadjuvant immune checkpoint therapy in triple-negative breast cancer
Lung Cancer
Adding pembrolizumab to perioperative chemotherapy improves EFS in early-stage NSCLC
TTFields therapy: a new treatment modality for metastatic NSCLC
Adding chemotherapy to EGFR TKI does not improve OS in advanced EGFR-mutated NSCLC
Upper GI Cancer
No improved OS in pancreatic cancer after neoadjuvant mFOLFIRINOX
AI detects gastric cancer with high accuracy in common blood tests
Melanoma
Response-directed treatment personalisation in stage III melanoma
Prognostic and predictive biomarkers in patients with resected stage IIB/C melanoma
GU Cancers
Combining PARP inhibition and androgen receptor-signalling inhibition improves radiographic progression-free survival in HRR-deficient mCRPC
Erdafitinib outperforms chemotherapy in FGFR-altered advanced urothelial cancer
Probiotic CBM588 seems to improve clinical effect cabozantinib/nivolumab in mRCC
Exploratory analysis of IMvigor130 trial finds no OS benefit from atezolizumab in subgroups
Miscellaneous
Immune checkpoint inhibition improves PFS in non-BRCA-mutated ovarian cancer
First-line nivolumab-AVD improves PFS both in adult and paediatric patients with advanced Hodgkin lymphoma
Vorasidenib successfully targets IDH1/2-mutated glioma
ASCO Interviews
IMbrave050: Adjuvant atezolizumab plus bevacizumab provides landmark recurrence-free survival for HCC
What can real-world evidence teach us about atezolizumab plus bevacizumab in HCC?
Related Articles
December 18, 2023
Postoperative ctDNA predicts survival in colorectal cancer
© 2024 Medicom Medical Publishers. All rights reserved. Terms and Conditions | Privacy Policy