When would you use AVD + brentuximab instead of ABVD for newly diagnosed stage 3 or 4 Hodgkin lymphoma?

Topics: Hematologic Malignancies • Medical Oncology • Lymphoma • Hematology

Since ECHELON-1 trial showed an improvement in PFS (but not OS), are there any situations where you would replace bleomycin with brentuximab?

Answer from: Medical Oncologist at Academic Institution

By reducing the risk of primary treatment failure from 23% to 18%, the ECHELON-1 study demonstrated that compared to ABVD, AVD + brentuximab vedotin reduces the risk of primary treatment failure by about 25% for patients with advanced stage classic Hodgkin lymphoma. If given with prophylactic G-CSF,...

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Medical Oncologist at Alpha Med Physicians Group
Will insurance cover this?

Answer from: Medical Oncologist at Community Practice

As of this writing, NCCN guidelines prefer starting patients with stage 3/4 disease with 2 cycles of ABVD following by PET/CT. If there is a favorable response, AVD can be resumed removing any possibly of bleomycin toxicity. Until more experience is gained with BV, this guideline will likely not cha...

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