# AHOD1331: brentuximab vedotin with chemotherapy in paediatric high-risk Hodgkin lymphoma

Source: https://onco.cc/key-papers/paper-ahod1331-brentuximab-vedotin-paediatric-hodgkin-castellino-nejm-2022/  
OnCo record `paper-ahod1331-brentuximab-vedotin-paediatric-hodgkin-castellino-nejm-2022` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Swapping bleomycin for the antibody-drug conjugate brentuximab vedotin in children's chemotherapy for advanced Hodgkin lymphoma cut the risk of relapse or death by 59 percent with no extra toxicity.

## Summary

Open-label multicentre randomised phase 3 trial: 600 patients aged 2 to 21 with untreated high-risk classical Hodgkin lymphoma were assigned to five cycles of brentuximab vedotin with doxorubicin, vincristine, etoposide, prednisone and cyclophosphamide or to standard ABVE-PC, with PET-directed involved-site radiotherapy to slow-responding lesions.

At a median follow-up of 42.1 months three-year event-free survival was 92.1 percent with brentuximab vedotin against 82.5 percent with standard care (hazard ratio 0.41). Radiotherapy use (53.4 against 56.8 percent) and toxic effects were similar; three-year overall survival was 99.3 and 98.5 percent.

## Fields

- Kind: Key paper
- Last checked: 2026-09-22
- Journal: New England Journal of Medicine
- Year: 2022
- DOI: 10.1056/NEJMoa2206660
- Authors: Castellino SM, Pei Q, Parsons SK, et al.
- Findings: Three-year event-free survival 92.1 percent (95% CI 88.4 to 94.7) versus 82.5 percent (77.4 to 86.5); hazard ratio 0.41 (0.25 to 0.67), p < 0.001.; Three-year overall survival 99.3 versus 98.5 percent.; Involved-site radiotherapy given to 53.4 versus 56.8 percent; toxic effects similar.
- What it means: Brentuximab vedotin with AVEPC is the new standard for high-risk paediatric Hodgkin lymphoma and led to the first paediatric approval of the drug in November 2022.
- Caveats: Open-label; the trial did not reduce radiotherapy use, which later trials are testing.

## Sources

- N Engl J Med 2022: https://doi.org/10.1056/NEJMoa2206660
- PubMed: https://pubmed.ncbi.nlm.nih.gov/36322844/

## 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/)
- drugs: [Brentuximab vedotin](https://onco.cc/drugs/brentuximab-vedotin/)
- trials: [AHOD1331](https://onco.cc/trials/ahod1331/)
- journals: [New England Journal of Medicine](https://onco.cc/journals/nejm/)

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