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ICML 2025 | Impact of EBV status on outcomes with nivo-AVD versus BV-AVD in patients with Hodgkin lymphoma
Sairah Ahmed, MD, The University of Texas MD Anderson Cancer Center, Houston, TX, comments on the results of SWOG S1826 (NCT03907488), a clinical trial comparing nivolumab-AVD (nivo-AVD) versus brentuximab vedotin-AVD (BV-AVD) in patients with advanced-stage Hodgkin lymphoma (HL). Dr Ahmed notes that Epstein–Barr virus (EBV)-positive patients demonstrated better outcomes with nivo-AVD compared to BV-AVD, suggesting that this subset of patients benefits from the incorporation of checkpoint inhibition into their treatment regimen.
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Transcript
Historically, EBV-positive Hodgkin lymphoma has had worse outcomes and part of that is the association with older age. And there really have not been specific treatment modalities that have shown benefit for that subset of patients. SWOG 1826 is a clinical trial that randomized patients to brentuximab vedotin plus AVD versus nivolumab plus AVD for advanced stage patients, and within that analysis of patients we were able to look at patients who had EBV-positive status and assess their response to treatment in either the BV-AVD arm or the nivo-AVD arm...
Historically, EBV-positive Hodgkin lymphoma has had worse outcomes and part of that is the association with older age. And there really have not been specific treatment modalities that have shown benefit for that subset of patients. SWOG 1826 is a clinical trial that randomized patients to brentuximab vedotin plus AVD versus nivolumab plus AVD for advanced stage patients, and within that analysis of patients we were able to look at patients who had EBV-positive status and assess their response to treatment in either the BV-AVD arm or the nivo-AVD arm. And those data demonstrate that patients do better with nivolumab plus chemotherapy in comparison to brentuximab vedotin plus chemotherapy. There are several kind of basic science reasons for that, including the checkpoint inhibition association with EBV-positive disease. But I think what it demonstrates is that a targeting of patients with EBV Hodgkin lymphoma with a checkpoint inhibitor portends for a better response and better progression-free survival for those patients.
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