Evaluating the combination of brentuximab vedotin with ipilimumab and nivolumab in relapsed/refractory Hodgkin lymphoma.

This study investigated the effectiveness and safety of combination regimens of brentuximab vedotin (BV; Adcetris), ipilimumab (Yervoy), and nivolumab (Opdivo) in patients with relapsed/refractory Hodgkin lymphoma (HL). The data showed that the treatment combinations had promising effectiveness and manageable side effects.

A high number of patients with Hodgkin lymphoma (HL) experience relapse (worsening of the disease) or are refractory (not responsive) to standard treatments.

BV is an immune therapy for patients with relapsed/refractory Hodgkin lymphoma (r/r HL). Ipilimumab and nivolumab are immune checkpoint inhibitors that prevent the immune system from switching off. This allows the immune system to target and kill cancer cells. A combination of BV and nivolumab has shown activity in patients with r/r HL. However, there are few studies investigating the activity and safety of the combination of all 3 drugs in patients with r/r HL.

This study involved 61 patients with r/r HL. They were divided into 3 groups. Group 1 included 21 patients who received BV plus ipilimumab. Group 2 included 18 patients who received BV plus nivolumab. Group 3 included 22 patients who received a combination of all 3 drugs. Patients in group 1 were followed for an average of 2.6 years. Those in group 2 for an average of 2.4 years and those in group 3 for an average of 1.7 years.

The overall response rates (ORR; the partial or complete disappearance of the cancer) was 76% in group 1, 89% in group 2, and 82% in group 3. 57% of group 1, 61% of group 2, and 73% of group 3 patients achieved a complete response. 

After 1 year, 61% of group 1, 70% of group 2, and 80% of group 3 patients were free of cancer progression. 

43% of group 1, 16% of group 2, and 50% of group 3 patients had severe treatment-related side effects. The main side effects were fatigue, fever, rash, and gastritis.

This study showed that the combination of BV with nivolumab or both nivolumab and ipilimumab was effective and had manageable side effects in patients with relapsed Hodgkin lymphoma.

The sample size and follow-up time were very short. The combinations of BV with nivolumab and with both nivolumab and ipilimumab are currently undergoing larger studies.