Real‐world outcomes of nivolumab‐
AVD
and brentuximab vedotin‐
AVD
in paediatric and adult advanced‐stage Hodgkin lymphoma
Karan L. Chohan, Lei Feng, Hunter Cochran, Maya Rosenberg, Leidy Isenalumhe, Elif Yilmaz, Seo‐Hyun Kim, Yun Kyoung Tiger, Pallawi Torka, Hayley Flanagan, Sharon Castellino, Jonathan D. Bender, Radhamani Kannaiyan, Justin Kahla, B. Paige DePriest, Hiba Narvel, Mallorie B. Heneghan, Samanta Catueno, Katherine Tobon, Julia Fadul, Patricia Faulkenberry, Amy Ayers, Sunita Nathan, Salmaan Mubeen, Efrat Luttwak, Jamie Flerlage, Robin E. Norris, Supreet Kaur, Olivia Tran, Chalothorn Wannaphut, Ashleigh Hawk, Miriam B. Garcia, Branko Cuglievan, Peter Riedell, Kris M. Mahadeo, Mehdi Hamadani, Catherine Diefenbach, Nancy Bartlett, Sairah Ahmed Summary
Brentuximab vedotin (BV)‐doxorubicin, vinblastine and dacarbazine (AVD) and nivolumab (N)‐AVD have transformed the frontline treatment of advanced‐stage Hodgkin lymphoma (HL), yet real‐world comparative data remain limited. In this multicentre retrospective study across 17 US centres, 646 patients treated between September 2011 and April 2025 were included; 509 (78.8%) received BV‐AVD and 137 (21.2%) received N‐AVD. Dose reductions or omissions were more common with BV‐AVD (35.8% vs. 14.4%, p < 0.0001). N‐AVD was associated with higher rates of neutropenia (any grade 77.2% vs. 43.9%, p < 0.0001; grade ≥3 58.1% vs. 34.0%, p < 0.0001) and infections (31.9% vs. 19.7%, p = 0.004), while grade ≥3 infections and febrile neutropenia were comparable. Neuropathy was significantly more frequent with BV‐AVD (57.2% vs. 20.6%, p < 0.0001). End‐of‐therapy complete response rates were numerically higher with N‐AVD (86.2% vs. 79.3%, p = 0.11). With a median follow‐up of 26.8 months, 2‐year overall survival (OS) was 97% for BV‐AVD and 100% for N‐AVD ( p = 0.08) and 2‐year progression‐free survival (PFS) was 84% vs. 88% ( p = 0.06). Survival outcomes were consistent in a 1:1 propensity score‐matched cohort. These real‐world data demonstrate comparable survival between regimens, with numerically improved PFS supporting N‐AVD as a frontline standard for advanced‐stage HL; however, higher rates of neutropenia and infections warrant careful monitoring and consideration of growth factor prophylaxis.