SWOG researchers studied a new first‑line treatment approach for adolescents and adults with advanced (stage 3 or 4) classic Hodgkin lymphoma, a cancer of the lymphatic system. The large phase 3 clinical trial, known as S1826, compared two treatment combinations: standard chemotherapy (AVD) paired with the immunotherapy drug nivolumab, versus the same chemotherapy paired with brentuximab vedotin, which has been a commonly used targeted therapy. The goal was to see which approach better prevented the cancer from worsening or returning.
The results showed that patients who received nivolumab plus chemotherapy (N‑AVD) did significantly better. After about two years of follow‑up, these patients had roughly half the risk of their cancer progressing or causing death compared with those who received brentuximab plus chemotherapy. About 92% of patients in the nivolumab group were still free of disease progression at two years, compared with 83% in the brentuximab group. Importantly, this benefit was seen consistently across different ages, disease severity levels, and risk categories.
The study also found that the nivolumab‑based treatment was easier for patients to tolerate. Fewer individuals had to stop treatment early because of side effects, and fewer deaths occurred during treatment. Side effects overall were generally less severe, especially for patients older than 60, who often have the hardest time tolerating intensive cancer therapy. Notably, very few patients in either group required radiation therapy, suggesting the drug combination alone was highly effective.
Together, these findings confirm that nivolumab combined with standard chemotherapy offers a more effective and safer option for treating advanced Hodgkin lymphoma. The results, published in The New England Journal of Medicine, support N‑AVD as a potential new standard starting treatment, helping more patients achieve long‑lasting remission while reducing treatment‑related harm.
