PET‐Adapted Therapy with Nivolumab plus Adriamycin, Vinblastine, and Dacarbazine for Newly Diagnosed Stage III or IV Hodgkin Lymphoma

Introduction: Interim PET is highly predictive of outcome for patients (pts) with stage III or IV Hodgkin lymphoma (HL) treated 6 cycles Adriamycin, Bleomycin, Vinblastine, Dacarbazine (ABVD). The RATHL study showed that PET-2 negative (neg) pts receiving ABVD can stop bleomycin after 2 without compromising efficacy. Furthermore, positive (pos) appear to have improved outcomes if treatment intensified BEACOPP (Johnson, et al. NEJM 2016). We hypothesized introduction programmed death (PD)-1 blockade may also improve pos and allow them avoid BEACOPP-associated toxicity. Methods: conducted a multicenter, investigator-initiated phase II newly diagnosed HL. Pts initially received ABVD. neg (defined as Deauville score 3 better) 4 additional AVD. AVD plus nivolumab (240 mg every 14 days). could receive 1 off-study enroll was determined be (Deauville 5). primary endpoint 2-year progression-free survival (PFS) pts. designed 26 however due slow accrual, the closed 19 enrolled. Results: 39 enrolled, including 20 pos. on-study. Among them, (77%) were (23%) An 13 enrolled based upon positivity. pts, median age 35 years (19–58), 74% had disease, 46% IPS 3–7 (Table). there events; pt biopsy confirmed refractory HL biopsy-confirmed relapse 23 months completion. remained PET-positive on PET-6 end biopsies gray zone T-cell/histiocyte rich B cell lymphoma, respectively. developed 7–18 2-yr PFS (Figure) 90% (95% CI: 78–100) 65.7% 46.6–92.6), After follow-up 36 months, (in who experienced sudden while in remission completion). research funded by: Bristol Myers Squibb; Adam R. Spector Foundation Keywords: Chemotherapy, Immunotherapy Conflicts interests pertinent abstract. A. Moskowitz Honoraria: Affimed, Imbrium Therapeutics L.P./Purdue, Janpix Ltd., Merck, Seattle Genetics, Takeda Research funding: ADC Therapeutics, Beigene, Miragen, Bristol-Myers Squibb, Incyte, SecuraBio Z. Epstein-Peterson Kymera, Amgen, Viracta Kumar Consultant advisory role: Genentech stra Zeneca, Kite Pharmaceuticals, Janssen, Genentech, Loxo/Lily Pharmaceuticals AbbVie, Adaptive Biotechnologies, Celgene, Pharmacyclics, Genetics Zelenetz Genentech/Roche Gilead, Novartis, Biotechnology, MorphoSys, Abbvie, AstraZeneca, MEI Pharma Genentech/Roche, Beigene Other remuneration: – DMC Chair, BMS/Celgene/Juno Member S. Horwitz Daiichi Sankyo, Kyowa Hakko Kirin, ONO SecuraBio, Shoreline Biosciences, Inc. Takeda, Yingli Limited, Abcuro, Tubulis Auxilius Pharma, Crispr Millennium /Takeda, C4, Verastem/SecuraBio L. Falchi Roche, genentech, abbvie, Genmab, therapeutics, seagen, astrazeneca Genmab Educational grants: W. Johnson Myeloid M. Palomba Synthekine, Cellectar, Kite, BMS G. Salles BMS/Celgene, Epizyme, Kite/Gilead, Loxo, Milteniy, Molecular Partners, Morphosys, Nordic Nanovector, Rapt, ; Debiopharm/Velosbio/Ipsen Stock ownership: Owkin Bayer, Regeneron P. Torka GenMab, Seagen Lilly USA Dogan EUSA Loxo Roche Takeda.