Three-Year Follow-Up of Nivolumab-AVD Versus Brentuximab Vedotin–AVD in Adolescents With Advanced-Stage Classic Hodgkin Lymphoma on S1826
Abstract
We present a subset analysis on the adolescent cohort of the S1826 randomized phase three trial, comparing nivolumab, doxorubicin, vinblastine, dacarbazine (N-AVD) to brentuximab vedotin-AVD (BV-AVD) in newly diagnosed advanced-stage (AS, stages III and IV) classic Hodgkin lymphoma (cHL). Among 994 patients enrolled, 24% (n = 240) were age 12-17 years. The 3-year progression-free survival (PFS) was significantly higher in the N-AVD group (93% [95% CI, 87 to 96]) compared with the BV-AVD group (82% [95% CI, 73 to 88]; hazard ratio, 0.37 [95% CI, 0.17 to 0.80]). One N-AVD and two BV-AVD patients received protocol-specified residual site radiotherapy (RT). Rates of febrile neutropenia and sepsis were low in both groups. Severe immune-related adverse events were infrequent, although thyroid dysfunction was seen in 7% with N-AVD. Sensory neuropathy (grade ≥2) was more frequent with BV-AVD (14% v 7%) by clinician report. Although premature discontinuation of therapy was reported in 12 N-AVD patients and four BV-AVD patients, no PFS events were noted in the N-AVD group. Patient-reported outcomes indicated less toxicity with N-AVD. N-AVD demonstrated high 3-year PFS in adolescents with AS cHL, with minimal RT use. S1826 exemplifies the benefits of harmonized clinical trial protocols, resulting in timely access to novel agents for adolescents.
Article Details
Journal Info
Journal of Clinical Oncology
Lippincott Williams & Wilkins
Authors (22)
Sharon M. Castellino
Hongli Li
Key Laboratory of Genetic Evolution and Animal Models of the Chinese Academy of Sciences, Key Laboratory of Animal Models and Human Disease Mechanisms of Yunnan Province, and Kunming Institute of Zoology and Chinese University of Hong Kong Joint Laboratory of Bioresources and Molecular Research in Common Diseases, Kunming Institute of Zoology, Chinese Academy of Sciences
Alex F. Herrera
10Duarte Cancer Center, City of Hope Medical Center, Duarte, CA
Michael LeBlanc
2Fred Hutchison Cancer Center, Statistics, Seattle, United States
Susan K. Parsons
Division of Hematology/Oncology, Tufts Medical Center, Institute for Clinical Research and Health Policy Studies, Boston, MA
Joseph M. Unger
Public Health Sciences Division Fred Hutchinson Cancer Center Seattle Washington USA
Angela Punnett
9University of Toronto, Pediatrics, Toronto, Canada
David Hodgson
Frank G. Keller
Department of Pediatrics, Emory University School of Medicine, Atlanta, GA
Richard A. Drachtman
Rutgers Cancer Institute New Jersey, New Brunswick, NJ
Adam Lamble
18Seattle Children's Hospital, Seattle, United States
Christopher J. Forlenza
19Department of Pediatric Hematology Oncology, Memorial Sloan Kettering Cancer Center, New York, NY
Andrew Doan
17Children's Hospital of Los Angeles, Los Angeles, United States
Sarah C. Rutherford
Division of Hematology and Medical Oncology, Weill Department of Medicine, Meyer Cancer Center, Weill Cornell Medicine and New York Presbyterian Hospital, New York, NY
Andrew M. Evens
Division of Blood Disorders, Rutgers Cancer Institute, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ
Richard F. Little
17National Cancer Institute, Cancer Therapy Evaluation Program, Rockville, MD
Malcolm A. Smith
National Cancer Institute, Cancer Therapy Evaluation Program, Bethesda, MD
Bradford S. Hoppe
Department of Radiation Oncology, Mayo Clinic, Jacksonville, FL
Joo Y. Song
Sonali M. Smith
3Section of Hematology/Oncology, Department of Medicine, The University of Chicago, Chicago, IL
Jonathan W. Friedberg
18Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY
Kara M. Kelly
Department of Pediatric Oncology, Department of Pediatrics, Roswell Park Comprehensive Cancer Center, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY