OnCo
ideasIdea

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

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.

Brentuximab-nivolumab doublets produce ~60-80% CR in relapsed disease and high CR rates as frontline induction in older patients (SGN35-015 cohort). AHOD2131 tests BV-nivo response-adapted therapy in stage I-II; ctDNA could replace PET for steering.

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.
What would test it
AHOD2131 primary results; a follow-on trial substituting ctDNA for interim PET; 20-year late-effects registry.
Maturity
early clinical

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cancers

1
Hodgkin lymphoma

technologies

4
Antibody-drug conjugate (ADC)ctDNA monitoring in lymphoma (PhasED-seq, clonoSEQ)Immune checkpoint inhibitorsPET-adapted (response-adapted) therapy

drugs

2
ApprovedADC
Brentuximab vedotin · Adcetris
ApprovedMonoclonal antibody (anti-PD-1)
Nivolumab · Opdivo / Opdivo Qvantig (SC)

trials

1
AHOD2131 (COG / NCTN)