# PD-1 blockade + AVD chemotherapy

Source: https://onco.cc/pairings/pd1-plus-avd-hodgkin/  
OnCo record `pd1-plus-avd-hodgkin` (Pairing). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Immunotherapy given alongside standard chemotherapy from day one cures more advanced Hodgkin lymphoma with less nerve damage.

## Summary

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.

## Fields

- Kind: Pairing
- Last checked: 2026-09-07
- Pairs: Nivolumab + Doxorubicin
- Type: combination
- Rationale: Reed-Sternberg cells are PD-L1-amplified (9p24.1) and immune-dependent; chemotherapy debulks while PD-1 blockade engages the abundant reactive T cells in the tumour.
- Evidence: Phase 3 (S1826) positive; phase 2 CheckMate 205 cohort D.

## Sources

- ClinicalTrials.gov NCT03907488: SWOG S1826: https://clinicaltrials.gov/study/NCT03907488
- ClinicalTrials.gov NCT02181738: CheckMate 205: https://clinicaltrials.gov/study/NCT02181738

## 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/)
- trials: [CheckMate 205](https://onco.cc/trials/checkmate-205/), [SWOG S1826](https://onco.cc/trials/swog-s1826/)
- drugs: [Doxorubicin](https://onco.cc/drugs/doxorubicin/), [Nivolumab](https://onco.cc/drugs/nivolumab/)
- key papers: [SWOG S1826: nivolumab plus AVD chemotherapy versus brentuximab-AVD for advanced Hodgkin lymphoma in adolescents and adults](https://onco.cc/key-papers/paper-swog-s1826-nivolumab-avd-nejm-2024/)

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