GHSG HD21
A new brentuximab-based intensive regimen matched Europe's most effective (and most toxic) chemotherapy with far fewer side effects.
BrECADD (brentuximab, etoposide, cyclophosphamide, doxorubicin, dacarbazine, dexamethasone) non-inferior and then superior for PFS: 4-year 94.3% vs 90.9% (Lancet 2024); 5-year 94% vs 91% (ASH 2025). Treatment-related morbidity 42% vs 59%; fertility markers preserved. 4-6 cycles guided by PET2.
- 94.3 vs 90.9 out of 100 alive without the cancer growing at 4 years with BrECADD compared with eBEACOPP; 3.4 more per 100.
- Roughly one extra person helped for every 29 treated. That is a rough figure taken from the two percentages, not a guarantee for any one person.
- Put another way, the treated group had about 34 percent lower chance of the event at any given time (hazard ratio 0.66, likely range 0.45 to 0.97).
- This is a surrogate endpoint: it measures the cancer being controlled or absent on scans and tests, which often, but not always, translates into living longer.
- 42 vs 59 out of 100 reached this endpoint with BrECADD compared with eBEACOPP; 17 fewer per 100.
- On this measure the first group did worse, not better.
- This endpoint is not one of the standard survival or response measures; read it alongside the trial's primary result.
- These results apply to the people the trial enrolled: Untreated advanced-stage classical Hodgkin lymphoma, age 18-60: PET-guided BrECADD vs escalated BEACOPP. People in a different situation may not see the same effect.
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
1,500 participants enrolled.
| Endpoint | Arm | n | Value | HR (95% CI) | p | Source |
|---|---|---|---|---|---|---|
| Progression-free survival at 4 yearsprimary | BrECADD | 742 | 94.3% | 0.66 (0.45–0.97) | — | link |
| eBEACOPP | 740 | 90.9% | ||||
| Treatment-related morbidity | BrECADD | — | 42% | — | — | — |
| eBEACOPP | — | 59% |
S1826 moved checkpoint blockade into first-line Hodgkin lymphoma and made N-AVD a preferred regimen for advanced disease in patients from adolescence to older age, while removing radiotherapy for most. It also showed the value of a single trial spanning paediatric and adult groups. Longer follow-up is needed for overall survival and late immune effects in young patients.
ECHELON-1 made a targeted antibody-drug conjugate part of first-line Hodgkin therapy and eventually showed that this saves lives, not just relapses. It set the reference arm against which nivolumab-AVD (SWOG S1826) and BrECADD (HD21) were later compared. Neuropathy is the main price and needs proactive dose modification.
Pages like this
not linked directly; found by shared links- TrialECHELON-1
Shares ECHELON-1: brentuximab vedotin replacing bleomycin in first-line chemotherapy for advanced Hodgkin lymphoma, SWOG S1826: nivolumab plus AVD chemotherapy versus brentuximab-AVD for advanced Hodgkin lymphoma in adolescents and adults, Brentuximab vedotin, Doxorubicin.
- TrialAHOD2131 (COG / NCTN)
Shares PET-adapted (response-adapted) therapy, SWOG S1826: nivolumab plus AVD chemotherapy versus brentuximab-AVD for advanced Hodgkin lymphoma in adolescents and adults, Brentuximab vedotin, Hodgkin lymphoma.
- TrialSWOG S1826
Shares ECHELON-1: brentuximab vedotin replacing bleomycin in first-line chemotherapy for advanced Hodgkin lymphoma, SWOG S1826: nivolumab plus AVD chemotherapy versus brentuximab-AVD for advanced Hodgkin lymphoma in adolescents and adults, Brentuximab vedotin, Doxorubicin.
- PairingCaution: bleomycin lung toxicity, especially with brentuximab or G-CSF
Shares PET-adapted (response-adapted) therapy, Brentuximab vedotin, Hodgkin lymphoma.
- TargetCD30
Shares ECHELON-1: brentuximab vedotin replacing bleomycin in first-line chemotherapy for advanced Hodgkin lymphoma, SWOG S1826: nivolumab plus AVD chemotherapy versus brentuximab-AVD for advanced Hodgkin lymphoma in adolescents and adults, Brentuximab vedotin, Hodgkin lymphoma.
- IdeaChemotherapy-free Hodgkin lymphoma: brentuximab + PD-1 in early stage
Shares PET-adapted (response-adapted) therapy, Brentuximab vedotin, Hodgkin lymphoma.
- PairingPD-1 blockade + AVD chemotherapy
Shares SWOG S1826: nivolumab plus AVD chemotherapy versus brentuximab-AVD for advanced Hodgkin lymphoma in adolescents and adults, Doxorubicin, Hodgkin lymphoma.
- PersonAlex F. Herrera
Shares SWOG S1826: nivolumab plus AVD chemotherapy versus brentuximab-AVD for advanced Hodgkin lymphoma in adolescents and adults, Brentuximab vedotin, Hodgkin lymphoma.