# Chemotherapy-free Hodgkin lymphoma: brentuximab + PD-1 in early stage

Source: https://onco.cc/ideas/idea-chemo-free-hodgkin/  
OnCo record `idea-chemo-free-hodgkin` (Idea). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

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.

## Fields

- Kind: Idea
- Last checked: 2026-09-07
- 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.
- Proposed test: AHOD2131 primary results; a follow-on trial substituting ctDNA for interim PET; 20-year late-effects registry.
- Maturity: early-clinical

## Sources

- ClinicalTrials.gov NCT05675410: AHOD2131 (COG / NCTN): https://clinicaltrials.gov/study/NCT05675410

## Connected records

- cancers: [Advanced-stage classical Hodgkin lymphoma (stage III to IV)](https://onco.cc/cancers/advanced-stage-classical-hodgkin-lymphoma/), [Hodgkin lymphoma](https://onco.cc/cancers/hodgkin-lymphoma/)
- technologies: [Antibody-drug conjugate (ADC)](https://onco.cc/technologies/adc/), [ctDNA monitoring in lymphoma (PhasED-seq, clonoSEQ)](https://onco.cc/technologies/ctdna-lymphoma-monitoring/), [Immune checkpoint inhibitors](https://onco.cc/technologies/checkpoint-inhibitor/), [PET-adapted (response-adapted) therapy](https://onco.cc/technologies/pet-adapted-therapy/)
- drugs: [Brentuximab vedotin](https://onco.cc/drugs/brentuximab-vedotin/), [Nivolumab](https://onco.cc/drugs/nivolumab/)
- trials: [AHOD2131 (COG / NCTN)](https://onco.cc/trials/ahod2131/)
- key papers: [CheckMate 205: nivolumab for relapsed or refractory classical Hodgkin lymphoma after autologous transplant failure, extended follow-up](https://onco.cc/key-papers/paper-checkmate-205-nivolumab-rr-hodgkin-extended-follow-up-jco-2018/), [Interim results of brentuximab vedotin in combination with nivolumab in patients with relapsed or refractory Hodgkin lymphoma](https://onco.cc/key-papers/paper-brentuximab-vedotin-hodgkin-lymphoma-blood-2018/), [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](https://onco.cc/key-papers/paper-brentuximab-vedotin-hodgkin-lymphoma-lancet-oncol-2016/)
- roadmaps: [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](https://onco.cc/roadmaps/lymphoma-roadmap/)
- ideas: [A radiotherapy-free cure for early Hodgkin lymphoma that actually holds](https://onco.cc/ideas/lymphoma-ev-radiotherapy-free-early-hodgkin/)

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