Castellino SM, Li H, Herrera AF, LeBlanc M, Parsons SK, Unger JM, Punnett A, Hodgson D, Keller FG, Drachtman RA, Lamble A, Forlenza CJ, Doan A, Rutherford SC, Evens AM, Little RF, Smith MA, Hoppe BS, Song JY, Smith SM, Friedberg JW, Kelly KM. Three-Year Follow-Up of Nivolumab-AVD Versus Brentuximab Vedotin-AVD in Adolescents With Advanced-Stage Classic Hodgkin Lymphoma on S1826. J Clin Oncol. 2026 Feb 20;44(6):449-454. doi: 10.1200/JCO-25-00203. Epub 2026 Jan 9. PMID: 41512237; PMCID: PMC13192332.
Publication Citation
Abstract
We present a subset analysis on the adolescent cohort of the S1826 randomized phase three trial, comparing nivolumab (N-AVD) to brentuximab vedotin (BV-AVD) in newly diagnosed advanced stage (AS, Stage 3–4) classic Hodgkin lymphoma (cHL). Among 994 patients enrolled, 24% (n=240) were 12–17 years. The 3-year progression-free survival (PFS) was significantly higher in the N-AVD group (93%; 95%CI 87–96) compared to the BV-AVD group (82%; 95% CI 73–88) (HR 0.37, 95% CI 0.17–0.80). One N-AVD and 2 BV-AVD patients received protocol-specified residual site radiotherapy (RT). Rates of febrile neutropenia and sepsis were low in both groups. Immune-related AEs were infrequent, although thyroid dysfunction was seen in 7% with N-AVD. Sensory neuropathy (grade ≥ 2) was more frequent with BV-AVD (14% vs. 7%) by clinician report. While premature discontinuation of therapy was reported in 12 N-AVD patients and 4 BV-AVD patients, no PFS events were noted in the N-AVD group. Patient-reported outcomes indicated less toxicity with N-AVD. N-AVD demonstrated high 3-year PFS in adolescents with AS cHL, with minimal RT use. S1826 exemplifies the benefits of harmonized clinical trial protocols, resulting in timely access to novel agents for adolescents.