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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.
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.
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
994 enrolled.
| Endpoint | Arm | n | Value | HR (95% CI) | p | Source |
|---|---|---|---|---|---|---|
| Progression-free survival at 2 yearsprimary | Nivolumab-AVD | 489 | 92% | 0.45 (0.3 to 0.65) | <0.001 | link |
| BV-AVD | 487 | 83% | ||||
| Any-grade peripheral neuropathy | Nivolumab-AVD | - | 28.1% | - | - | link |
| BV-AVD | - | 54.2% |
S1826 moved checkpoint blockade into first-line Hodgkin lymphoma and made N-AVD a preferred regimen for advanced disease in patients from adolescence to older age, while removing radiotherapy for most. It also showed the value of a single trial spanning paediatric and adult groups. Longer follow-up is needed for overall survival and late immune effects in young patients.
ECHELON-1 made a targeted antibody-drug conjugate part of first-line Hodgkin therapy and eventually showed that this saves lives, not just relapses. It set the reference arm against which nivolumab-AVD (SWOG S1826) and BrECADD (HD21) were later compared. Neuropathy is the main price and needs proactive dose modification.
Shares Kara M. Kelly, SWOG S1826: nivolumab plus AVD chemotherapy versus brentuximab-AVD for advanced Hodgkin lymphoma in adolescents and adults, Brentuximab vedotin, Children's Oncology Group (COG).
Shares Escalated chemotherapy or ABVD in advanced Hodgkin lymphoma: more cures, more late harm, and what the interim scan changed, ECHELON-1: brentuximab vedotin replacing bleomycin in first-line chemotherapy for advanced Hodgkin lymphoma, British and American lymphoma practice: where they differ, and why, SWOG S1826: nivolumab plus AVD chemotherapy versus brentuximab-AVD for advanced Hodgkin lymphoma in adolescents and adults.
Shares Escalated chemotherapy or ABVD in advanced Hodgkin lymphoma: more cures, more late harm, and what the interim scan changed, ECHELON-1: brentuximab vedotin replacing bleomycin in first-line chemotherapy for advanced Hodgkin lymphoma, SWOG S1826: nivolumab plus AVD chemotherapy versus brentuximab-AVD for advanced Hodgkin lymphoma in adolescents and adults, Brentuximab vedotin.
Shares PD-1 blockade + AVD chemotherapy, Hodgkin lymphoma, Nivolumab, Immune checkpoint inhibitors.
Shares Brentuximab vedotin, Advanced-stage classical Hodgkin lymphoma (stage III to IV), Children's Oncology Group (COG), Doxorubicin.
Shares Brentuximab vedotin, Advanced-stage classical Hodgkin lymphoma (stage III to IV), Doxorubicin, Hodgkin lymphoma.
Shares Brentuximab vedotin, Advanced-stage classical Hodgkin lymphoma (stage III to IV), Doxorubicin, Hodgkin lymphoma.
Shares ECHELON-1: brentuximab vedotin replacing bleomycin in first-line chemotherapy for advanced Hodgkin lymphoma, Brentuximab vedotin, Hodgkin lymphoma.