What adverse events would make you switch off nivo + AVD therapy and to what second line therapy in patients with Hodgkin Lymphoma?
Answer from: Medical Oncologist at Academic Institution
The question of how to handle severe IRAEs when using the N+AVD regimen is an important one. First, of course, is to hold CPI therapy, empirically treat as indicated to avoid ongoing or worsening organ injury, and concurrently ensure that there is no other cause for the observed event(s). But if you...
Answer from: Medical Oncologist at Academic Institution
Any grade 3 immune-related AE attributable to nivolumab (colitis, pneumonitis, nephritis, etc.) I would tend to discontinue permanently. For a grade 2 irAE, I would hold nivolumab until it resolves to at least a grade 1 before continuing.
Neurologic events; other severe irAEs.Second line - would depend on where the patient is at the time of discontinuation. For patients with Stage IIIB and IVA disease, AHOD1331 (BV-AVEPC arm) provided good data about efficacy. So, using a brentuximab-based regimen would be the preference as second li...