SWOG S1826
Immunotherapy plus chemotherapy beat the previous best regimen with far less nerve damage, in the first Hodgkin trial to enrol children and adults together; approved March 2026.
1-year PFS 94% vs 86%; 2-year PFS 92% vs 83% (HR 0.45, NEJM 2024). Peripheral neuropathy 28.1% vs 54.2%; fewer treatment discontinuations. Radiotherapy given to <1%. FDA approval 20 March 2026 for ages 12+. Now the frontline standard for advanced-stage disease in North America; HD21's BrECADD is the European alternative.
- 92 vs 83 out of 100 alive without the cancer growing at 2 years with Nivolumab-AVD compared with BV-AVD; 9 more per 100.
- Roughly one extra person helped for every 11 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 55 percent lower chance of the event at any given time (hazard ratio 0.45, likely range 0.3 to 0.65).
- 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.
- 28.1 vs 54.2 out of 100 reached this endpoint with Nivolumab-AVD compared with BV-AVD; 26.1 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 stage III-IV classical Hodgkin lymphoma, age ≥12: nivolumab + AVD vs brentuximab vedotin + AVD. 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.
994 participants enrolled.
| Endpoint | Arm | n | Value | HR (95% CI) | p | Source |
|---|---|---|---|---|---|---|
| Progression-free survival at 2 yearsprimary | Nivolumab-AVD | 489 | 92% | 0.45 (0.3–0.65) | <0.001 | link |
| BV-AVD | 487 | 83% | ||||
| Any-grade peripheral neuropathy | Nivolumab-AVD | — | 28.1% | — | — | — |
| BV-AVD | — | 54.2% |
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.
- TrialGHSG HD21
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 SWOG S1826: nivolumab plus AVD chemotherapy versus brentuximab-AVD for advanced Hodgkin lymphoma in adolescents and adults, Brentuximab vedotin, Children's Oncology Group (COG), Hodgkin lymphoma.
- TrialCheckMate 205
Shares PD-1 blockade + AVD chemotherapy, Hodgkin lymphoma, Nivolumab.
- 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 Brentuximab vedotin, Hodgkin lymphoma, Nivolumab, Immune checkpoint inhibitors.
- TermABVD, BEACOPP and BrECADD (Hodgkin lymphoma regimens)
Shares Brentuximab vedotin, Doxorubicin, Hodgkin lymphoma, Nivolumab.
- TrialKEYNOTE-204
Shares Brentuximab vedotin, Hodgkin lymphoma.