{"entity":{"id":"idea-chemo-free-hodgkin","kind":"idea","name":"Chemotherapy-free Hodgkin lymphoma: brentuximab + PD-1 in early stage","aka":[],"tldr":"For a cancer already cured in 90% of young people, the goal is curing without the chemotherapy and radiation that cause heart disease and second cancers decades later.","summary":"Classical Hodgkin lymphoma is already cured in most young people, so the aim of this idea is to cure early-stage disease without the chemotherapy and radiotherapy that cause heart disease and second cancers decades later. Brentuximab vedotin plus nivolumab hits the Reed-Sternberg cell through CD30 and its immune shield through PD-1 and PD-L1, and the doublet has produced high complete response rates in relapsed disease and as frontline induction in older patients in the SGN35-015 cohort. The hypothesis is that PET- or ctDNA-adapted brentuximab-nivolumab with minimal or no chemotherapy achieves high progression-free survival in stage I to II disease with fewer late effects than ABVD-based therapy. AHOD2131, run by the Children's Oncology Group, is testing this at an early clinical stage.","asOf":"2026-09-07","links":[{"label":"ClinicalTrials.gov NCT05675410: AHOD2131 (COG / NCTN)","url":"https://clinicaltrials.gov/study/NCT05675410"}],"tags":[],"related":[],"cancers":["hodgkin-lymphoma"],"sections":[],"technologies":["pet-adapted-therapy","checkpoint-inhibitor","adc","ctdna-lymphoma-monitoring"],"targets":[],"drugs":["brentuximab-vedotin","nivolumab"],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":["ahod2131"],"people":[],"bottlenecks":[],"keyPapers":["paper-brentuximab-vedotin-hodgkin-lymphoma-lancet-oncol-2016","paper-checkmate-205-nivolumab-rr-hodgkin-extended-follow-up-jco-2018","paper-brentuximab-vedotin-hodgkin-lymphoma-blood-2018"],"journals":[],"dependsOn":[],"notes":[],"hypothesis":"In early-stage classical Hodgkin lymphoma, PET/ctDNA-adapted brentuximab-nivolumab with minimal or no chemotherapy achieves 3-year PFS ≥90% with fewer late effects than ABVD-based therapy.","rationale":"Two non-cytotoxic mechanisms hit both the Reed-Sternberg cell (CD30) and its immune shield (PD-1/PD-L1); late toxicity of anthracyclines, alkylators and radiation dominates survivorship.","test":"AHOD2131 primary results; a follow-on trial substituting ctDNA for interim PET; 20-year late-effects registry.","maturity":"early-clinical"},"route":"/ideas/idea-chemo-free-hodgkin/","neighbours":{"cancer":[{"id":"advanced-stage-classical-hodgkin-lymphoma","kind":"cancer","name":"Advanced-stage classical Hodgkin lymphoma (stage III to IV)","route":"/cancers/advanced-stage-classical-hodgkin-lymphoma/"},{"id":"hodgkin-lymphoma","kind":"cancer","name":"Hodgkin lymphoma","route":"/cancers/hodgkin-lymphoma/"}],"technology":[{"id":"adc","kind":"technology","name":"Antibody-drug conjugate (ADC)","route":"/technologies/adc/"},{"id":"ctdna-lymphoma-monitoring","kind":"technology","name":"ctDNA monitoring in lymphoma (PhasED-seq, clonoSEQ)","route":"/technologies/ctdna-lymphoma-monitoring/"},{"id":"checkpoint-inhibitor","kind":"technology","name":"Immune checkpoint inhibitors","route":"/technologies/checkpoint-inhibitor/"},{"id":"pet-adapted-therapy","kind":"technology","name":"PET-adapted (response-adapted) therapy","route":"/technologies/pet-adapted-therapy/"}],"drug":[{"id":"brentuximab-vedotin","kind":"drug","name":"Brentuximab vedotin","route":"/drugs/brentuximab-vedotin/"},{"id":"nivolumab","kind":"drug","name":"Nivolumab","route":"/drugs/nivolumab/"}],"trial":[{"id":"ahod2131","kind":"trial","name":"AHOD2131 (COG / NCTN)","route":"/trials/ahod2131/"}],"paper":[{"id":"paper-checkmate-205-nivolumab-rr-hodgkin-extended-follow-up-jco-2018","kind":"paper","name":"CheckMate 205: nivolumab for relapsed or refractory classical Hodgkin lymphoma after autologous transplant failure, extended follow-up","route":"/key-papers/paper-checkmate-205-nivolumab-rr-hodgkin-extended-follow-up-jco-2018/"},{"id":"paper-brentuximab-vedotin-hodgkin-lymphoma-blood-2018","kind":"paper","name":"Interim results of brentuximab vedotin in combination with nivolumab in patients with relapsed or refractory Hodgkin lymphoma","route":"/key-papers/paper-brentuximab-vedotin-hodgkin-lymphoma-blood-2018/"},{"id":"paper-brentuximab-vedotin-hodgkin-lymphoma-lancet-oncol-2016","kind":"paper","name":"Nivolumab for classical Hodgkin's lymphoma after failure of both autologous stem-cell transplantation and brentuximab vedotin: a multicentre, multicohort, single-arm phase 2 trial","route":"/key-papers/paper-brentuximab-vedotin-hodgkin-lymphoma-lancet-oncol-2016/"}],"roadmap":[{"id":"lymphoma-roadmap","kind":"roadmap","name":"Lymphoma roadmap: from a jaw tumour in Uganda and the first human cancer virus to gene-expression subtypes, PET-adapted chemotherapy, CAR-T cells, bispecific antibodies and the genetics-directed trials now recruiting","route":"/roadmaps/lymphoma-roadmap/"}],"idea":[{"id":"lymphoma-ev-radiotherapy-free-early-hodgkin","kind":"idea","name":"A radiotherapy-free cure for early Hodgkin lymphoma that actually holds","route":"/ideas/lymphoma-ev-radiotherapy-free-early-hodgkin/"}]}}