Nivolumab instead of brentuximab added onto chemotherapy is suggested as the new standard of care, based on results from the largest Hodgkinlymphoma study in National Clinical Trials Network history.
Across patients' age groups, adding the immune checkpoint inhibitor nivolumab to chemotherapy significantly improves progression-free survival in advanced stage Hodgkin lymphoma while also reducing toxicities, making it a new standard of care, compared with the CD30-targeting drug brentuximab vedotin.
The results are especially important considering that Hodgkin lymphoma disproportionately affects younger patients, including those in their teens, 20s, and 30s, Dr. Herrera noted in an interview. "There are genetic changes in the Hodgkin lymphoma tumor cell that lead to expression of PD-1 ligands on the surface of Hodgkin lymphoma cells, and when we use a drug like nivolumab, we see that even patients with the most treatment-resistant rates of lymphoma have as much as a 70% response rate," he explained in a press briefing.
For the primary endpoint, at a median follow-up of 12.1 months, the rate of progression-free survival was significantly higher in the nivolumab arm , with the rate of 1-year survival at 94% in the nivolumab group versus 86% in the brentuximab group, for a 52% reduction in the risk of disease-related death with nivolumab versus brentuximab.
"I can't emphasize how important neuropathy is as a side effect in these young patients who have the rest of their life ahead of them," Dr. Herrera explained."It's fantastic to be cured of cancer, but tough to not be able to feel your fingers and toes."
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