WEDNESDAY, Oct. 16, 2024 (HealthDay News) — For patients with stage III or IV Hodgkin lymphoma, nivolumab with doxorubicin, vinblastine, and dacarbazine (N+AVD) yields longer progression-free survival (PFS) than brentuximab vedotin with doxorubicin, vinblastine, and dacarbazine (BV+AVD), according to a study published online Oct. 16 in the New England Journal of Medicine.

Alex F. Herrera, M.D., from the City of Hope Comprehensive Cancer Center in Duarte, California, and colleagues conducted a phase 3, multicenter, randomized trial involving patients at least 12 years of age with stage III or IV newly diagnosed Hodgkin lymphoma. A total of 994 patients were randomly assigned to BV+AVD or N+AVD; 970 were included in the intention-to-treat population for an efficacy analysis.

The researchers found that the threshold for efficacy was crossed at the second planned interim analysis, with a median follow-up of 12.1 months, indicating that PFS was significantly improved with N+AVD versus BV+AVD (hazard ratio for progression or death, 0.48). The analysis was repeated with longer follow-up, and the two-year PFS was 92 and 83 percent with N+AVD and BV+AVD, respectively, with a median follow-up of 2.1 years (hazard ratio for disease progression or death, 0.45). Immune-related adverse events occurred rarely with nivolumab; more treatment discontinuation was seen with BV.

“On the basis of the clinically meaningful improvement in progression-free survival and excellent side-effect profile of N+AVD, the opportunity to avoid potentially toxic consolidative radiation therapy, and the decreased drug-acquisition and supportive-care costs, N+AVD should be a strong candidate for primary treatment in adolescent and adult patients with stage III or IV Hodgkin lymphoma,” the authors write.

Bristol Myers Squibb and SeaGen provided drugs used in the trial.

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