ASH 2024: High Rates of Disease Control Without Radiotherapy Observed Following Incorporation of Nivolumab in Early Stage cHL

As treatment options for classic Hodgkin lymphoma (cHL) have improved, minimizing late effects while maximizing treatment efficacy has become a critical goal in early stages of treatment. Investigators therefore examined whether the incorporation of brentuximab vedotin (BV) and nivolumab in the treatment of early stage cHL could improve progression-free survival without the use of radiotherapy. Results from this phase II study were presented by Ann S. LaCasce, MD at Dana-Farber Cancer Institute, Chair of the Foundation’s SAB.

The study included 153 patients with a median age of 31 years (range, 18-73 years). Nearly two-thirds of patients were classified as having unfavorable disease, and one-third had bulky disease at study entry. All participants received initial ABVD (adriamycin, bleomycin,
vinblastine, and dacarbazine therapy). After 2 cycles, participants underwent PET/CT to determine the next round of treatment.

Among patients with non-bulky PET2-negative disease after initial ABVD, the 18- and 24-month progression-free survival rates were 100%. Patients in this group received either 2 cycles of additional ABVD plus consolidation nivolumab (3 months) or BV plus nivolumab administered every 3 weeks. Among PET2-negative patients with bulky disease, progression-free survival was 97% at 18 months and 86% at 24 months; patients in this group also received 2 additional cycles of ABVD plus consolidation nivolumab. Patients with PET2-positive disease received 4 cycles of BV-AVD plus consolidation nivolumab and had 18- and 24-month progression-free survival rates of 81% and 76%. No patients in any treatment arm received radiotherapy, and no deaths were reported in any treatment group.

The investigators concluded that the incorporation of nivolumab consolidation therapy, with or without BV, provides good disease control in cHL with a manageable safety profile. They noted that the results of this study support the ongoing AHOD2131 study exploring the incorporation of BV plus nivolumab in early stage cHL.

This study also included contributions from Foundation SAB members Lisa Giulino Roth, MD of Weill Cornell Medicine; Kristie Blum, MD of Winship Cancer Institute of Emory University; Sonali M. Smith, MD of University of Chicago; and Alex Herrera, MD of City of Hope; and Former SAB member Jane N Winter, MD of Robert H. Lurie Comprehensive Cancer Center.