Exploring Improved Treatment for Advanced-Stage Hodgkin’s Lymphoma

Hodgkin’s lymphoma is a type of cancer that affects the lymphatic system, which is part of the body’s germ-fighting immune system. For patients with advanced-stage Hodgkin’s Lymphoma, the standard approach for treatment usually includes a four-drug chemotherapy called ABVD, which is an acronym for the medications used. The ABVD treatment includes doxorubicin, bleomycin, vinblastine, and dacarbazine.

First presented in 2017, The ECHELON-1 study assessed the safety and efficacy of front-line A+AVD (brentuximab vedotin, doxorubicin, vinblastine, and dacarbazine) versus ABVD in patients with stage III or IV classical Hodgkin lymphoma. Results showed a modest modified progression-free survival (PFS) benefit for brentuximab vedotin when given with chemotherapy in patients with previously untreated stage III or IV classical Hodgkin’s lymphoma.

In an updated study published in the New England Journal of Medicine (DOI: 10.1056/NEJMoa2206125), investigators, including co-author Andrew M. Evens, DO, MBA, MSc, associate director for clinical services at Rutgers Cancer Institute of New Jersey and system director of medical oncology, RWJBarnabas Health, found that after a 6-year follow up, patients with previously untreated stage III or IV classical Hodgkin’s lymphoma showed improved overall survival with first-line therapy with A+AVD as compared with ABVD.  Treatment with A+AVD resulted in a 41% lower risk of death than that observed with ABVD therapy.

Altogether, this is the first study to date that has proved an overall survival advantage over classic ABVD for advanced-stage disease. These results suggest that A+AVD should be considered a preferred first-line treatment option for patients with previously untreated stage III or IV classical Hodgkin’s lymphoma.