The randomized ECHELON-1 trial comparing standard ABVD with the combination of brentuximab vedotin and AVD (A-AVD) in advanced-stage classical HL was controversially discussed in the plenary session.

The final analysis of this study revealed an improved modified 2-year progression-free survival (PFS) for A-AVD (82.1%) as compared to ABVD (77.2%).

However, conventional PFS was not reported and the improvement in tumor control did not translate into better overall survival. There was more neuropathy and hematological toxicity associated with A-AVD but fewer pulmonary events. Based on these results, final conclusions on the possible role of A-AVD in advanced classical HL could not be drawn and discussions will continue at ISHL11.

In HL patients relapsing after first-line treatment, a phase I/II study evaluating the combination of brentuximab vedotin and the anti- PD1 antibody nivolumab as salvage approach prior to high-dose chemotherapy and autologous stem cell transplantation (ASCT) demonstrated high response rates.

Thus, a relevant proportion of patients might be treated without conventional chemotherapy at first relapse. It remains unclear whether the presented data already allow the use of such a strategy outside clinical studies since the follow-up is still limited.

The optimal use of targeted drugs as salvage treatment prior to high- dose chemotherapy and ASCT will therefore be one of the issues to be addressed in the session on relapsed HL at ISHL11.

We very much look forward to discussing these study results and a variety of other topics during the ISHL11.

ISHL11 will take place in Cologne, Germany, between October 27 and 29, 2018.

¹Please note that ISHL11 is not affiliated with the American Society of Hematology.