Combination of the drug nivolumab along with chemotherapy halves the rate of cancer progression or death for patients as compared to the former protocol of AVD therapy – the first-line treatment of newly diagnosed Hodgkin's lymphoma or advanced blood cancer, according to a new study.

The new "N-AVD" treatment also has less onerous side effects than the prior regimen, researchers from the University of Rochester reported in the New England Journal of Medicine.

Hodgkin lymphoma - also known as Hodgkin disease, is a type of cancer that develops in the lymph system - which protects your body from infection and disease.

According to the American Cancer Society, around 10,000 new cases of the deadly disease are diagnosed every year - and in 2024 Hodgkin lymphoma is expected to claim about 910 lives. "It disproportionately affects younger patients, the median age of patients diagnosed with Hodgkin lymphoma may be around 30, meaning half the patients are younger than that," noted Dr. Johnathan Friedberg, study corresponding author at the University of Rochester.

Before the new trial, the standard of care for stage 3 or 4 Hodgkin lymphoma was brentuximab vedotin plus AVD (BV-AVD). However, last year, early results from a trial comparing BV-AVD with the newer N-AVD regimen found outcomes in people getting N-AVD were very positive -- so positive that a "preset threshold" for treatment effectiveness had already been achieved.

Now, more than two years of follow-up is confirming those early hopes. “This new analysis with more patient follow-up is critical to understanding the clinically meaningful benefit obtained from N-AVD compared to BV-AVD,” said Michael LeBlanc, lead biostatistician on the study, in a news release.

According to experts, the phase 3 clinical compared outcomes for both drug regimens among nearly 1000 newly diagnosed adolescents and adults – battling stage 3 or 4 classic Hodgkin lymphomas. After a follow-up of two years, the team found that the rate of survival without any sign of the lymphoma progressing was 92 per cent for those getting N-AVD, compared to 83 per cent of those receiving BV-AVD.

Researchers said fewer patients taking the regimen that included nivolumab died during treatment compared to those getting BV-AVD.

All of this adds up to a roughly halving of the rate of cancer progression or death for folks on the newer regimen. As well, fewer people taking N-AVD had to stop therapy early compared to those on the BV-AVD regimen.

Study authors said side effects were generally lower on the nivolumab regimen, which is especially true for older patients - those aged 60 years and above.

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