Dr Herrera on Important Safety Data and Considerations for Nivolumab Plus AVD in Classical Hodgkin Lymphoma

“Nivolumab [plus] AVD improved the tolerability of frontline treatment [for patients with previously untreated stage III or IV classical Hodgkin lymphoma] and brentuximab vedotin [plus] AVD was associated with an increase with peripheral neuropathy [and other AEs].”

Alex Herrera, MD, a professor and chief of the Division of Lymphoma in the Department of Hematology & Hematopoietic Cell Transplantation, as well as associate medical director of the Briskin Center for Clinical Research, at City of Hope, discussed the March 2026 FDA approval of nivolumab (Opdivo) in combination with doxorubicin, vinblastine, and dacarbazine (AVD) for patients with previously untreated stage III or IV classical Hodgkin lymphoma, specifically highlighting safety data from the phase 3 CA209-8UT/SWOG 1826 study (NCT03907488) that supported the approval and how the regimen impacts quality-of-life (QOL) compared with others.

Herrera began by pointing out how nivolumab plus AVD was associated with improved tolerability in the frontline, whereas the regimen it was being compared with, brentuximab vedotin (Adcetris) plus AVD was associated with increased rates of adverse effects (AEs) like peripheral neuropathy and low white blood cell counts. Moreover, AEs associated with brentuximab vedotin plus AVD often warrant the use of growth factors to boost white blood cell counts which in turn often causes poorer patient QOL due to bone pain and infections. Ultimately, Herrera said that nivolumab plus AVD was an improvement regarding how well tolerated the regimen was and the complications that came with receiving the treatment.

Herrera then highlighted that patient QOL was formally evaluated on the trial, data from which will soon be published. Patient-reported QOL outcomes were improved with nivolumab plus AVD, he mentioned, with specific AEs like neuropathy being reported less often with patients who received nivolumab plus AVD vs brentuximab vedotin plus AVD. However, Hererra pointed out how nivolumab plus AVD might lead to immune-related AEs, AEs that he said can have lasting effects for patients and must be monitored closely when utilizing nivolumab plus AVD.