The Lymphoma Channel is supported with funding from AstraZeneca (Diamond), BMS (Gold), Johnson & Johnson (Gold), Takeda (Silver) and Galapagos (Bronze).
VJHemOnc is an independent medical education platform. Supporters, including channel supporters, have no influence over the production of content. The levels of sponsorship listed are reflective of the amount of funding given to support the channel.
EHA 2026 | BrECADD vs Nivo-AVD in advanced Hodgkin lymphoma: selecting the right patients
Graham Collins, MA, MBBS, MRCP, FRCPath, DPhil, Oxford University Hospitals NHS Foundation Trust, Oxford, UK, shares his perspective on the ongoing debate surrounding BrECADD and Nivo-AVD (nivolumab, doxorubicin, vinblastine, dacarbazine) for advanced-stage Hodgkin lymphoma. He discusses why BrECADD (brentuximab vedotin, etoposide, cyclophosphamide, doxorubicin, dacarbazine, dexamethasone) may offer advantages for selected younger patients, particularly due to its shorter treatment duration and impressive long-term progression-free survival (PFS) data. This interview took place at the 31st Congress of the European Hematology Association (EHA) in Stockholm, Sweden.
These works are owned by Magdalen Medical Publishing (MMP) and are protected by copyright laws and treaties around the world. All rights are reserved.
Transcript
So in classical Hodgkin lymphoma, one of the big points of controversy now is if you had everything available, and not every region does, and certainly in England we don’t, but if we had every sort of regimen available, which one would you use in advanced stage patients? And the big two are BRICAD, so that’s an evolution of escalated BEACOPP to involve brentuximab, switching procarbazine to dacarbazine, prednisolone to dexamethasone, fiddling a little bit with the other chemotherapy doses...
So in classical Hodgkin lymphoma, one of the big points of controversy now is if you had everything available, and not every region does, and certainly in England we don’t, but if we had every sort of regimen available, which one would you use in advanced stage patients? And the big two are BRICAD, so that’s an evolution of escalated BEACOPP to involve brentuximab, switching procarbazine to dacarbazine, prednisolone to dexamethasone, fiddling a little bit with the other chemotherapy doses. That’s BRICAD. And that’s quite an intensive approach versus nivolumab AVD. So it takes ABVD and simply replaces the bleomycin with nivolumab. That’s the SWOG S1826 study that showed a benefit over ABVD for that regimen. Both are excellent regimens. You know, there’s no doubt about it. But the debate we were having is in a particularly young patient, would you use BRICAD or Nivo AVD? I was arguing for BRICAD. I do believe quite passionately in BRICAD there, partly because the five-year progression-free survival in the 18 to 60-year-olds from the HD21 study is 94%. I mean, you know, you can’t get much higher than that. You know, 94%, excellent. Nivo AVD, a little bit lower at the three-year mark. That’s 91%. Of course, the trials aren’t identical, but still an excellent result. But the real advantage, I think, of BRICAD is the duration of treatment. So for most patients, they only need four cycles and that’s over in three months. So I was trying to illustrate that, you know, it’s June now. So if we started a young patient, we’d be finished by August and they may be able to go off to university because they’re often young patients by the end of September. Whereas if they were on Nivo AVD, that’s always six months of treatment. And we’d probably be just about ruining their Christmas, you know, because it’s so much longer. So that short duration of treatment enables people to get back to work, back to their studies much more quickly. So I think for the right patient, not for every patient, but that more intensive, shorter approach with excellent outcome data is the right way to go.
This transcript is AI-generated. While we strive for accuracy, please verify this copy with the video.
Read more...
