Collaboration between adult and pediatric oncologists is fostering advancements in the treatment of lymphoma in adolescents and young adults (AYA). According to Andrew M. Evens, DO, MBA, MSc, the harmonization of treatment efforts is crucial for this patient population. Two prominent trials, the phase 3 SWOG S1826 trial (NCT03907488) and the phase 3 AHOD2131 trial (NCT05675410), exemplify this collaborative approach.
SWOG S1826 Trial Results
The SWOG S1826 trial compared nivolumab (Opdivo) plus AVD (doxorubicin hydrochloride, vinblastine sulfate, and dacarbazine) to the standard of care, brentuximab vedotin (Adcetris) plus AVD. The results indicated that the nivolumab combination was both more effective and better tolerated.
"You could say it was, generally speaking, a double winner," Evens noted. "[The nivolumab combination] was more effective at 2 years; the progression-free survival [PFS] was greater than 90%, [which was] a remarkable output." This represents a clinically significant improvement in outcomes for patients with advanced-stage Hodgkin lymphoma.
Tolerability Profile
In addition to improved efficacy, the nivolumab-based regimen demonstrated a more favorable tolerability profile. "When I say a double winner, it was also largely better tolerated. There was less neuropathy, [fewer] infections, and less sepsis [vs brentuximab vedotin plus AVD]. Surprisingly, to a certain extent, [there were] not many immune-related adverse events outside of thyroid [events]," Evens explained.
Collaborative Impact and Unmet Needs
Evens emphasized the impact of collaboration between adult and pediatric oncology, particularly highlighting the Lymphoma Research Foundation's efforts in convening AYA lymphoma symposiums and establishing an AYA consortium. Despite these advancements, unmet needs remain, including mitigating late toxicities following treatment and addressing inconsistencies in lymphoma treatment guidelines for the AYA group.
Addressing Disparities and Providing Support
Mitigating disparities and addressing barriers to care are critical, especially given the complexities of treatment for AYA patients. Evens underscored the importance of providing educational, medical, and psychosocial resources to ensure patients feel supported throughout their treatment journey. "At the end of the day, be an advocate. Be an advocate for yourself. Be an advocate for others and know that there are [many] resources and people out there to help. We want to make sure nobody has to go through this alone, and that they have the medical and other psychosocial resources available to them," Evens concluded.
