SWOG S1826 TRIAL

At the ICML meeting, the results from the S1826 study were discussed, which focused on patients with advanced-stage Hodgkin Lymphoma (HL). This randomised phase 3 study compared brentuximab vedotin plus AVD (control) with nivolumab plus AVD for six cycles. The study previously showed that nivolumab-AVD improved PFS compared to brentuximab vedotin plus AVD and was better tolerated.

New analyses were presented, focusing on EBV status and histologic subtype (Nodular Sclerosis vs. non-Nodular Sclerosis). Both EBV-negative and EBV-positive patients benefited from nivolumab-AVD, with notably better outcomes observed in EBV-positive patients compared to those treated with brentuximab vedotin-AVD. Nivolumab seemed to neutralise the negative impact of EBV. Similarly, non-NS patients, who typically have worse outcomes, showed significantly improved results with nivolumab-ABD, approaching the outcomes seen in NS patients.

CtDNA analysis at baseline, after two cycles, and at the end of treatment in 400 patients revealed that baseline ctDNA levels correlated with clinical characteristics and had modest prognostic value, a finding observed in each treatment arm.  A significant drop in ctDNA after two cycles correlated with favourable outcomes, even if ctDNA remained detectable. Undetectable ctDNA at the end of treatment was associated with the best outcomes, whereas detectable ctDNA indicated poorer PFS. These findings suggest that ctDNA could serve as an important biomarker for personalised therapy, enabling de-escalation or intensification of treatment based on individual profiles.