EHA 2019 | Two-year follow-up of CheckMate 205: nivolumab plus doxorubicin, vinblastine, and dacarbazine in newly diagnosed advanced-stage cHL

On Saturday, 15 June 2019, during the 24^th Congress of the European Hematology Association (EHA) in Amsterdam, NL, Eva Domingo-Domènech, from the Institut Catala d’Oncologia, Barcelona, ES, discussed the results of a phase II study (NCT02181738; CheckMate 205) in patients with newly diagnosed, previously untreated classical Hodgkin lymphoma (cHL). During this trial, patient cohort D received multi-agent chemotherapy with nivolumab, doxorubicin, vinblastine, and dacarbazine (N-AVD).¹

Current multi-agent chemotherapy regimens lead to suboptimal results in newly diagnosed patients with advanced-stage cHL. However, the use of nivolumab, an anti–PD-1 checkpoint inhibitor, followed by N-AVD has shown promising activity in this patient population, as indicated by the 9-month follow-up of the CheckMate 205 that was presented last year at EHA.² This year, Dr Domingo-Domènech provided an update on the study results after a 2-year follow-up of the patient cohort.

Study design

• Patients received monotherapy with nivolumab (four doses; 240mg intravenously every two weeks) for approximately eight weeks, followed by N-AVD combination therapy (12 doses) for approximately 22 weeks
• 49 out of 51 patients (96%) completed monotherapy and 45/50 (90%) completed N-AVD combination therapy
• Median follow-up was 25.3 months (n=48)

Key findings

• Progression-free survival (PFS) at 21 months by investigator assessment was 83% (95% CI, 69–91)
• Combination therapy improved response rates, with the majority of patients achieving complete response (CR) or complete metabolic response (CMR) at the end of therapy (see table below)

 Safety

• Two patients died after the last dose of N-AVD
  • One patient (68 years old), treated for 175 days, died 38 days after the last dose due to the study drug toxicity (acute respiratory failure)
  • One patient (85 years old), treated for 209 days, died 451 days after the last dose due to disease progression

Conclusion

Nivolumab followed by N-AVD offered benefit to patients with newly diagnosed, advanced stage cHL, leading to high ORR (86%) and CMR (75%), as well as prolonged PFS (83% at 21 months). The therapy was also well tolerated. Dr Domingo-Domènech concluded that this treatment strategy may be a promising alternative to the current standard of care for newly diagnosed, previously untreated patients with advanced-stage cHL.