Ayad Hamdan, MD, discusses factors to consider when choosing between brentuximab vedotin (Adcetris), doxorubicin, vinblastine, and dacarbazine versus AVD plus bleomycin in patients with Hodgkin lymphoma.
Ayad Hamdan, MD, hematologist and associate professor of medicine at Moores Cancer Center at the University of California, San Diego, discusses factors to consider when choosing between brentuximab vedotin (Adcetris), doxorubicin, vinblastine, and dacarbazine (A + AVD) versus AVD plus bleomycin (ABVD) in patients with Hodgkin lymphoma.
In the United States, ABVD is commonly used in this patient population, says Hamdan; this regimen has been used for decades. Although treatment with regimen leads to favorable results, it is associated with many toxicities are involved. A+AVD, an alternative regimen, is also available and it has shown to have similar, if not better, benefit to that of ABVD.
Hamdan says that he tends to use A+AVD in patients who have stage IV disease or an elevated International Prognostic Score (IPS), as long as they don’t have any concerning comorbidities that would put them at increased risk for neuropathy or neutropenia.
It is unknown how the National Comprehensive Cancer Network guidelines will incorporate brentuximab vedotin, says Hamdan. To date, ABVD is still considered to be the preferred regimen in this space per the guidelines; however, A+AVD is another option available in the frontline setting, concludes Hamdan.