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Publications

Journal Article Ahead of print

PubMed: 42845039 DOI: 10.3324/haematol.2026.301545

Nivolumab with doxorubicin, vinblastine, and dacarbazine in older adults with classic Hodgkin lymphoma: do S1826 results hold up in the real world?

Haematologica

Authors: Pallawi Torka, Allison M Bock, Peirong Hao, Yizhe Xu, Swetha K Thiruvengadam, Efrat Luttwak, Kanithra Sekaran, Dahlia Sano, John Vaughn, John Sharp, Ajay Major, Vrutti Patel, Gordon Smilnak, Nicole Araujo, Ritwick Mynam, Daniel Reef, Marisa Palmeri, Drew Gerber, Calvin Lee, Grace Baek, Ayo Falade, Madiha Iqbal, Harsh R Shah, Praveen Ramakrishnan Geethakumari, Urshila Durani, Mengyang Di, Alex Niu, Hua-Jay J Cherng, Joanna M Rhodes, Natalie Grover, Priyanka Pophali, Tatyana Feldman, Krithika Shanmugasundaram, Jakub Svoboda, Timothy Voorhees, Catherine Diefenbach, Yasmin Karimi, Reem Karmali, Alex Herrera, Narendranath Epperla

Affiliations

  • Department of Medicine, Division of Hematologic Malignancies, Memorial Sloan Kettering Cancer Center, New York City, New York.
  • Department of Internal Medicine, Division of Hematology and Hematologic Malignancies, Huntsman Cancer Institute at the University of Utah, Salt Lake City, Utah.
  • Department of Internal Medicine, Division of Epidemiology, University of Utah, Salt Lake City, Utah.
  • Department of Hematology and Hematopoietic Cell Transplantation, Division of Lymphoma, City of Hope National Medical Center, Duarte, California.
  • Department of Medicine, Division of Hematology and Oncology, Northwestern University, Evanston, Illinois.
  • Department of Medicine, Division of Hematology and Oncology, University of Michigan, Ann Arbor, Michigan.
  • Department of Medicine, Division of Hematology and Medical Oncology, New York University, New York, New York.
  • Department of Medicine, Division of Hematology, The James Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio.
  • Department of Medicine, Division of Hematology, University of Colorado Cancer Center, Aurora, Colorado.
  • Department of Medicine, Division of Hematology and Oncology, University of Pennsylvania, Philadelphia, Pennsylvania.
  • Department of Medicine, Division of Hematology and Oncology, University of Virginia, Charlottesville, Virginia.
  • Department of Medicine, Division of Lymphoma, Hackensack University Medical Center, Hackensack, New Jersey.
  • Department of Medicine, Division of Hematology, Medical Oncology and Palliative Care, University of Wisconsin Carbone Cancer Center, Madison, Wisconsin.
  • Department of Medicine, Division of Hematology, University of North Carolina, Chapel Hill, North Carolina.
  • Department of Medicine, Division of Hematology, Rutgers Cancer Institute, New Brunswick, New Jersey.
  • Department of Medicine, Division of Hematology/Oncology, Columbia University, New York, New York.
  • Department of Medicine, Division of Hematology and Oncology, Roswell Park, Buffalo, New York.
  • Department of Medicine, Divison of Hematology and Oncology, Fred Hutchinson Cancer Center, Seattle, Washington.
  • Department of Medicine, Division of Hematology, Mayo Clinic, Rochester, Minnesota.
  • Department of Medicine, Division of Hematology, Mayo Clinic, Jacksonville, Florida.
  • Department of Medicine, Division of Hematology and Oncology, Harold C. Simmons Comprehensive Cancer Center, UT Southwestern Medical Center, Dallas, Texas.
  • Department of Internal Medicine, Division of Hematology and Hematologic Malignancies, Huntsman Cancer Institute at the University of Utah, Salt Lake City, Utah.

Abstract

Older adults (OA, ≥60 years) with classic Hodgkin lymphoma (cHL) have historically experienced inferior outcomes compared to younger patients. Nivolumab in combination with doxorubicin, vinblastine, and dacarbazine (NAVD) has demonstrated high efficacy in clinical trials, but real-world data in OA are limited. We conducted a multicenter retrospective study across 20 centers in patients with newly diagnosed advanced stage cHL treated with NAVD and analyzed outcomes in OA across the aging spectrum. Among 327 total patients, 81 (25%) were ≥60 years, with most OA presenting with stage IV disease (58%) and B symptoms (57%). Anygrade and ≥grade 3 AEs occurred in 88% and 67% of OA, respectively. Prophylactic growth factors were used in most OA (82%) which led to low rates of febrile neutropenia (12%) and infection (12%) despite 52% ≥grade 3 neutropenia. Immune-related AEs occurred in 29% (12% ≥grade 3) and treatment was discontinued due to toxicity in 10% of OA. Interim overall (ORR) and complete response rates (CRR) were 100% and 81.6%, end-of-treatment rates were 88% and 82.6%, respectively. At a median follow-up of 12.6 months, 1-year progression-free survival (PFS) and overall survival (OS) in OA were 91.5% and 98.6%, respectively. OS was inferior in OA compared with patients.

MeSH

Hematology, Hodgkin Disease, Lymphoma, Neutropenia, Doxorubicin, Dacarbazine, Nivolumab, Vinblastine, Therapeutics