Brentuximab vedotin with chemotherapy for stage III or IV Hodgkin's lymphoma

Because up to 30% of advanced Hodgkin's lymphoma patients succumb to refractory disease or relapse after first-line treatment with doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD), researchers tested a new approach. The ECHELON-1 multinational trial randomized 670 treatment-naive participants with stage III or IV Hodgkin's to standard therapy and assigned 664 others to brentuximab vedotin, doxorubicin, vinblastine, and dacarbazine (A+AVD). The main outcome was the rate of modified progression-free survival at 2 years—defined as a composite risk of progression, death, or noncomplete response and the use of a different anticancer therapy. At median followup of 2.9 years, this measurement reached 82.1% in the A+AVD group and 77.2% in the ABVD group. All secondary efficacy endpoints, including development of neutropenia and peripheral neuropathy, also favored A+AVD. The results of this Phase III study demonstrate the superior efficacy of A+AVD compared with ABVD as the first-line treatment for patients with advanced Hodgkin's lymphoma.