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FDA Approves Nivolumab Plus AVD as First-Line Therapy for Advanced Hodgkin Lymphoma

The decision follows a head-to-head phase 3 trial that showed a marked progression-free survival advantage over brentuximab vedotin plus AVD.

Overview

  • The approval covers patients aged 12 years and older with previously untreated stage III or IV classical Hodgkin lymphoma.
  • In the SWOG S1826/CA209-8UT trial of 994 patients, nivolumab plus AVD reduced the risk of progression or death versus brentuximab vedotin plus AVD (HR 0.42) at 13.7 months’ median follow-up.
  • Longer follow-up showed numerically fewer deaths with the nivolumab regimen at 36.7 months (1.8% vs 3.4%).
  • The FDA-recommended dosing is 240 mg IV for patients weighing at least 40 kg or 3 mg/kg for those under 40 kg on days 1 and 15 of 28-day cycles for up to six cycles, with primary G-CSF prophylaxis starting in cycle 1.
  • Safety findings included serious adverse reactions in 39% and immune-mediated events in 9% of patients receiving nivolumab plus AVD, with 2.7% grade 3–4 events.