{"entity":{"id":"swog-s1826","kind":"trial","name":"SWOG S1826","aka":[],"tldr":"Immunotherapy plus chemotherapy beat the previous best regimen with far less nerve damage, in the first Hodgkin trial to enrol children and adults together; approved March 2026.","summary":"1-year PFS 94% vs 86%; 2-year PFS 92% vs 83% (HR 0.45, NEJM 2024). Peripheral neuropathy 28.1% vs 54.2%; fewer treatment discontinuations. Radiotherapy given to <1%. FDA approval 20 March 2026 for ages 12+. Now the frontline standard for advanced-stage disease in North America; HD21's BrECADD is the European alternative.","status":"positive","asOf":"2026-09-07","links":[{"label":"ClinicalTrials.gov NCT03907488","url":"https://clinicaltrials.gov/study/NCT03907488"},{"label":"FDA approval (Mar 2026)","url":"https://www.targetedonc.com/view/fda-approves-nivolumab-plus-avd-for-classical-hodgkin-lymphoma"}],"tags":[],"related":["src-targeted-oncology"],"cancers":["hodgkin-lymphoma","advanced-stage-classical-hodgkin-lymphoma"],"sections":[],"technologies":["checkpoint-inhibitor"],"targets":["pd1"],"drugs":["nivolumab","brentuximab-vedotin","doxorubicin"],"companies":["swog","childrens-oncology-group"],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":["kara-kelly","alex-herrera"],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"nct":"NCT03907488","phase":"3","setting":"Untreated stage III-IV classical Hodgkin lymphoma, age ≥12: nivolumab + AVD vs brentuximab vedotin + AVD","sponsor":"SWOG / NCI (with COG)","result":"2-year PFS 92% vs 83%, HR 0.45.","started":"2019-08-29","startedType":"actual","yearReported":2023,"enrolled":994,"enrolledBasis":"registry","outcomes":[{"endpoint":"Progression-free survival at 2 years","primary":true,"unit":"%","arms":[{"name":"Nivolumab-AVD","n":489,"value":92},{"name":"BV-AVD","n":487,"value":83}],"hr":0.45,"ci":[0.3,0.65],"p":"<0.001","source":"https://www.nejm.org/doi/full/10.1056/NEJMoa2405888"},{"endpoint":"Any-grade peripheral neuropathy","unit":"%","arms":[{"name":"Nivolumab-AVD","value":28.1},{"name":"BV-AVD","value":54.2}],"source":"https://doi.org/10.1056/NEJMoa2405888"}],"replication":"Consistent with phase 2 N-AVD data (CheckMate 205 cohort D) and with pembrolizumab-AVD single-arm studies; no second randomised trial yet."},"route":"/trials/swog-s1826/","neighbours":{"collection":[{"id":"src-targeted-oncology","kind":"collection","name":"Targeted Oncology","route":"/collections/src-targeted-oncology/"}],"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/"},{"id":"non-hodgkin-lymphoma","kind":"cancer","name":"Non-Hodgkin lymphoma (all types)","route":"/cancers/non-hodgkin-lymphoma/"}],"technology":[{"id":"checkpoint-inhibitor","kind":"technology","name":"Immune checkpoint inhibitors","route":"/technologies/checkpoint-inhibitor/"}],"target":[{"id":"pd1","kind":"target","name":"PD-1","route":"/targets/pd1/"}],"drug":[{"id":"brentuximab-vedotin","kind":"drug","name":"Brentuximab vedotin","route":"/drugs/brentuximab-vedotin/"},{"id":"doxorubicin","kind":"drug","name":"Doxorubicin","route":"/drugs/doxorubicin/"},{"id":"nivolumab","kind":"drug","name":"Nivolumab","route":"/drugs/nivolumab/"}],"company":[{"id":"childrens-oncology-group","kind":"company","name":"Children's Oncology Group (COG)","route":"/companies/childrens-oncology-group/"},{"id":"swog","kind":"company","name":"SWOG Cancer Research Network","route":"/companies/swog/"}],"person":[{"id":"alex-herrera","kind":"person","name":"Alex F. Herrera","route":"/people/alex-herrera/"},{"id":"kara-kelly","kind":"person","name":"Kara M. Kelly","route":"/people/kara-kelly/"}],"pairing":[{"id":"pd1-plus-avd-hodgkin","kind":"pairing","name":"PD-1 blockade + AVD chemotherapy","route":"/pairings/pd1-plus-avd-hodgkin/"}],"term":[{"id":"lymphoma-tx-uk-versus-us","kind":"term","name":"British and American lymphoma practice: where they differ, and why","route":"/terms/lymphoma-tx-uk-versus-us/"},{"id":"lymphoma-decision-beacopp-or-abvd","kind":"term","name":"Escalated chemotherapy or ABVD in advanced Hodgkin lymphoma: more cures, more late harm, and what the interim scan changed","route":"/terms/lymphoma-decision-beacopp-or-abvd/"}],"paper":[{"id":"paper-echelon-1-brentuximab-avd-nejm-2018","kind":"paper","name":"ECHELON-1: brentuximab vedotin replacing bleomycin in first-line chemotherapy for advanced Hodgkin lymphoma","route":"/key-papers/paper-echelon-1-brentuximab-avd-nejm-2018/"},{"id":"paper-swog-s1826-nivolumab-avd-nejm-2024","kind":"paper","name":"SWOG S1826: nivolumab plus AVD chemotherapy versus brentuximab-AVD for advanced Hodgkin lymphoma in adolescents and adults","route":"/key-papers/paper-swog-s1826-nivolumab-avd-nejm-2024/"}]}}