Real‐world outcomes of nivolumab‐ AVD and brentuximab vedotin‐ AVD in paediatric and adult advanced‐stage Hodgkin lymphoma
Abstract
Summary Brentuximab vedotin (BV)‐doxorubicin, vinblastine and dacarbazine (AVD) and nivolumab (N)‐AVD have transformed the frontline treatment of advanced‐stage Hodgkin lymphoma (HL), yet real‐world comparative data remain limited. In this multicentre retrospective study across 17 US centres, 646 patients treated between September 2011 and April 2025 were included; 509 (78.8%) received BV‐AVD and 137 (21.2%) received N‐AVD. Dose reductions or omissions were more common with BV‐AVD (35.8% vs. 14.4%, p < 0.0001). N‐AVD was associated with higher rates of neutropenia (any grade 77.2% vs. 43.9%, p < 0.0001; grade ≥3 58.1% vs. 34.0%, p < 0.0001) and infections (31.9% vs. 19.7%, p = 0.004), while grade ≥3 infections and febrile neutropenia were comparable. Neuropathy was significantly more frequent with BV‐AVD (57.2% vs. 20.6%, p < 0.0001). End‐of‐therapy complete response rates were numerically higher with N‐AVD (86.2% vs. 79.3%, p = 0.11). With a median follow‐up of 26.8 months, 2‐year overall survival (OS) was 97% for BV‐AVD and 100% for N‐AVD ( p = 0.08) and 2‐year progression‐free survival (PFS) was 84% vs. 88% ( p = 0.06). Survival outcomes were consistent in a 1:1 propensity score‐matched cohort. These real‐world data demonstrate comparable survival between regimens, with numerically improved PFS supporting N‐AVD as a frontline standard for advanced‐stage HL; however, higher rates of neutropenia and infections warrant careful monitoring and consideration of growth factor prophylaxis.
// Source
Authors: Karan L. Chohan, Lei Feng, Hunter Cochran, Maya Rosenberg, Leidy Isenalumhe, Elif Yılmaz, Seo‐Hyun Kim, Yun Kyoung Tiger, Pallawi Torka, Hayley M. Flanagan, Sharon Castellino, Jonathan D. Bender, Radhamani Kannaiyan, Justin A. Kahla, B. Paige DePriest, Hiba Narvel, Mallorie B. Heneghan, Samanta Catueno, Katherine Tobon, Julia Fadul, Patricia Faulkenberry, Amy Ayers, Sunita Nathan, Suhaym Mubeen, Efrat Luttwak, Jamie E. Flerlage, Robin Elizabeth Norris, Supreet Kaur, Olivia Tran, Chalothorn Wannaphut, Ashleigh Hawk, Miriam B. Garcia, Branko Cuglievan, Peter Riedell, Kris Michael Mahadeo, Mehdi Hamadani, Catherine Diefenbach, Nancy L. Bartlett, Sairah Ahmed
Institutions: University of Chicago, Cincinnati Children's Hospital Medical Center, Children's Healthcare of Atlanta, Duke University, Washington University in St. Louis, The University of Texas MD Anderson Cancer Center, University of Utah, NYU Langone Health, New York University, The University of Texas at San Antonio Health Science Center, University of Rochester Medicine, The University of Texas Southwestern Medical Center, Memorial Sloan Kettering Cancer Center, Moffitt Cancer Center, Medical College of Wisconsin, Rush University Medical Center, NYU Langone’s Laura and Isaac Perlmutter Cancer Center, Rutgers Cancer Institute, Memorial Hermann, Harold C. Simmons Comprehensive Cancer Center