In a phase I/II trial reported in the Journal of Clinical Oncology, Torka et al found that the addition of nivolumab to standard doxorubicin, vinblastine, and dacarbazine (N-AVD) was “highly effective” as front-line treatment for patients aged ≥ 60 with classical Hodgkin lymphoma.
Study Details
In the multicenter trial, 40 patients received six cycles of AVD at standard doses plus nivolumab at 240 mg once every 2 weeks on days 1 and 15 of each cycle. The primary outcome measure was progression-free survival.
Key Findings
Data freeze was at the end August 2024. Among 37 response-evaluable patients, the median follow-up was 49 months (range = 17–75 months). Progression-free survival at 3 years was 79% (95% confidence interval [CI] = 66%–95%). Overall survival at 3 years was 97% (95% CI = 92%–100%). Among 29 patients with stage III/IV disease, 3-year progression-free survival was 80% (95% CI = 65%–98%) and 3-year overall survival was 97% (95% CI = 90%–100%).
Grade 3/4 treatment-related adverse events occurred in 50% of 40 patients in the safety population, most commonly neutropenia (n = 12), anemia (n = 4), and febrile neutropenia (n = 3). Treatment-related adverse events resulted in discontinuation of treatment in four patients (10%). A total of four grade 3 to 4 immune-mediated adverse events were observed (adrenal insufficiency, colitis, interstitial nephritis, hepatitis).
No correlations between baseline geriatric impairments and survival outcomes or toxicities were observed. Positron-emission tomography after two cycles of treatment was not predictive of progression-free survival or overall survival.
The investigators concluded: “N-AVD is a highly effective and well-tolerated front-line regimen in [older adults] with [classical Hodgkin lymphoma] across a wide range of geriatric impairments.”
Alison J. Moskowitz, MD, of Memorial Sloan Kettering Cancer Center, is the corresponding author for the Journal of Clinical Oncology article.
Disclosures: Supported by grants from the National Cancer Society, Bristol Myers Squibb, and others. For full disclosures of all study authors, visit the Journal of Clinical Oncology.
