Nivolumab Appears to Boost Cure Rate in Advanced Hodgkin Lymphoma

Results from a large NCI-funded clinical trial found that the immunotherapy drug nivolumab should be part of the initial treatment of teens and adults with advanced forms of classic Hodgkin lymphoma.

In the nearly 1,000-patient trial, treatment with nivolumab and a three-drug chemotherapy regimen called AVD was better at eliminating cancer and keeping it at bay than the current standard initial treatment for the disease, AVD combined with the targeted therapy brentuximab.

Two years after starting treatment, about 92% of trial participants randomly assigned to the nivolumab–AVD group were alive without their cancer starting to grow again—a measure known as progression-free survival—compared with 83% in the brentuximab–AVD group. People in the nivolumab–AVD group also had fewer side effects overall and fewer serious side effects, according to findings in the New England Journal of Medicine.

Although Brentuximab–AVD has been shown to modestly improve progression-free survival, many people stop taking the regimen because of its substantial side effects.

Hodgkin lymphoma is one of the most common cancers diagnosed in adolescents, but adolescents and adults have not generally been included in the same clinical trials and given the same treatments. For this trial, about 240 participants were ages 12 to 17.

Many people in this age group diagnosed with Hodgkin lymphoma get radiation therapy, often as a safeguard to help prevent the cancer from coming back. But the radiation can cause serious long-term health problems. The trial was designed so that radiation therapy would only be used under very strict conditions. 

Patients aged 60 and older often have poorer treatment outcomes than younger patients. Study participants aged 60+ had a 2-year progression-free survival rate of 88%.