Better Remissions, Fewer Side Effects: Nivolumab + AVD in HL | Alex Herrera MD

Hi, my name is Alex Herrera. I'm the head of the lymphoma group at the City of Hope in the Los Angeles area. This year at the ASH annual meeting, we presented updated results from the SWAG S1826 trial. SWAG S1826 was a randomized phase three clinical trial enrolling patients with advanced stage classic Hotchkill lymphoma. It was a randomized trial where we compared the previous standard Brintuximab Vidoetin combined with AVD chemotherapy and we compared that to Nivolumab, an immunotherapy combined with AVD and patients received six cycles of treatment. And the original trial results demonstrated that Nivolumab combined with AVD chemotherapy led to longer progression free survival, which means more patients basically had a long term durable remission with their initial treatment. Now, you know, it was important to show the long term results from this study because the goal of treating patients with Hotchkill lymphoma is to cure them. And so it was necessary to demonstrate that the benefit that we saw with the Nivolumab AVD was sustained over time. So indeed, when we did this three year follow up analysis, Nivolumab AVD led to 91% of patients being alive and in ongoing remission at three years. And that was compared to 82% in patients with Brintuximab Vidoetin. Now, an important feature of this therapy is that not only are we curing more patients, hopefully, but it's also better tolerated therapy. So Nivolumab AVD was better tolerated than Brintuximab Vidoetin AVD. And we showed this year that even though the follow up is relatively short, there were no concerning long term late toxicities compared to Brintuximab Vidoetin combined with AVD. Now, another important feature with this regimen is that we've reduced the use of radiation. Historically, especially children with advanced stage classic Hotchkill lymphoma have been treated, a majority of folks have been treated with radiation. And in this trial, because we were able to improve on the treatment with Nivolumab AVD, less than 1% of patients received radiotherapy. And so, you know, all in all, you know, this three year update, with this three year update, we demonstrated that Nivolumab AVD improved the long term overall progression free survival rate. And also, we demonstrated that across age subgroups, in particular subgroups of interest, so high risk patients, low risk patients, patients with stage three disease, patients with stage four disease, really across all the subgroups of patients that we analyzed, Nivolumab AVD was associated with improved outcomes compared to Brintuximab Vidoetin AVD. Big or small makes a difference, and we're deeply grateful for your support.