PD-1 blockade + AVD chemotherapy

Giving nivolumab alongside AVD chemotherapy, whose anthracycline component is doxorubicin, from the first cycle is a combination pairing for advanced-stage classical Hodgkin lymphoma. Reed-Sternberg cells carry amplification of the PD-L1 locus at 9p24.1 and depend on immune evasion, so chemotherapy debulks the disease while PD-1 blockade engages the abundant reactive T cells already present in the tumour. In the phase 3 SWOG S1826 trial nivolumab-AVD improved progression-free survival compared with brentuximab vedotin-AVD and caused much less peripheral neuropathy, and the regimen was approved in March 2026 for patients aged 12 and over. Supporting phase 2 evidence comes from cohort D of CheckMate 205, and the linked S1826 paper covers adolescents and adults.