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Brentuximab Vedotin, Ipilimumab, + Nivolumab Combination Hodgkin Lymphoma [ASH 2023]

Catherine Diefenbach, MD, a Hematologist and Medical Oncologist at NYU Langone Health, led a study titled “Results from an Intergroup Randomized Phase II Study of the Combinations of Ipilimumab, Nivolumab, and Brentuximab Vedotin in Patients with Relapsed/Refractory Classic Hodgkin Lymphoma: A Trial of the ECOG-ACRIN Research Group (E4412).”

This Phase II study investigated the efficacy and safety of combining immune checkpoint blockade with the CD30-targeting antibody-drug conjugate brentuximab vedotin in patients with relapsed/refractory Classic Hodgkin lymphoma (cHL).

The study’s importance lies in its approach to addressing the challenges of cHL treatment. By combining immune checkpoint inhibitors (Ipilimumab and Nivolumab) with brentuximab vedotin, the research aimed to enhance therapeutic outcomes. The study design considered the unique challenges associated with relapsed/refractory cHL, providing insights into improving patient outcomes.

The study found a non-statistically significant difference in the complete response rate between the BV/N and BV/N/I arms. Despite this, both regimens demonstrated promising disease control. These findings could impact treatment strategies for patients with relapsed/refractory cHL, especially considering prior brentuximab vedotin exposure. The study suggests both regimens as viable options, allowing physicians to tailor treatments based on individual patient profiles and previous treatment history.

However, the safety analysis identified a higher incidence of grade 3 rash in the BV/N/I arm compared to the BV/N arm. This finding has clinical implications, influencing the real-world management and tolerability of the BV/N/I regimen. Physicians must weigh the potential benefits against the higher incidence of adverse events, particularly rash, to make informed decisions about treatment options for patients with relapsed/refractory cHL. Further research and clinical experience are crucial to refining the use of these combination therapies and optimizing their efficacy and safety profiles in managing this challenging condition.

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