A NEW Phase III clinical trial has revealed that combining nivolumab with doxorubicin, vinblastine, and dacarbazine (N+AVD) improves progression-free survival in patients with Stage III or IV classic Hodgkin’s lymphoma compared to the standard brentuximab vedotin with AVD (BV+AVD). The study, which included nearly 1,000 patients aged 12 and older, was designed to assess the effectiveness of nivolumab in this advanced patient cohort.
The trial demonstrated that N+AVD achieved a 92% 2-year progression-free survival rate, compared to 83% with BV+AVD. At a median follow-up of 2.1 years, nivolumab-based treatment showed reduced risk of relapse, offering new hope for patients with high-risk Hodgkin’s lymphoma.
The side-effect profile was also more favorable for nivolumab, with immune-related adverse events being rare. In contrast, brentuximab vedotin was associated with higher rates of treatment discontinuation due to toxicities. This suggests that N+AVD could provide an important alternative for patients requiring more tolerable therapies.
The results, which crossed the efficacy threshold in a planned interim analysis, are a promising advancement in the treatment of Hodgkin’s lymphoma. The study also showed minimal use of radiation therapy, further supporting the less-invasive approach with N+AVD.
This breakthrough underscores the potential of PD-1 blockade therapy in combination with conventional chemotherapy, paving the way for improved outcomes in patients with Hodgkin’s lymphoma.
Reference: Herrera AF et al. Nivolumab+AVD in advanced-stage classic Hodgkin’s lymphoma. NEJM. 2024;391:1379-1389.
