Clinical efficacy and safety of pembrolizumab and nivolumab in frontline treatment for classical Hodgkin lymphoma: systematic review and meta-analysis of clinical trials - Summary - MDSpire
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Clinical efficacy and safety of pembrolizumab and nivolumab in frontline treatment for classical Hodgkin lymphoma: systematic review and meta-analysis of clinical trials
To investigate the clinical efficacy and safety of pembrolizumab and nivolumab for frontline treatment of classical Hodgkin lymphoma (cHL).
Approach:
Literature Search: A comprehensive search was conducted through PubMed, EBSCO Host, and CENTRAL using relevant keywords to select full-text publications in English of clinical trials.
Data Evaluation: Pooled analysis evaluated complete response rate (CRR), overall response rate (ORR), 2-year overall survival (OS), 2-year progression-free survival (PFS), and grade ≥3 adverse events (AEs).
Key Findings:
Pooled data from nine trials showed an overall response rate (ORR) of 86% (95% CI, 59-96%) and a complete response rate (CRR) of 57% (95% CI, 62-97%).
2-year progression-free survival (PFS) was 90% (95% CI, 70-97%) and 2-year overall survival (OS) was 97% (95% CI, 91%-99%).
41% of patients (95% CI, 21-64%) experienced grade ≥3 adverse events, with 17% (95% CI, 6-38%) having grade ≥3 immune-related AEs.
Nivolumab with brentuximab vedotin had worse outcomes compared to AVD with pembrolizumab or nivolumab.
Interpretation:
The adoption of nivolumab or pembrolizumab combinations in frontline treatment for cHL is a valid strategy for advanced disease or patients unfit for intensive chemotherapy.
Limitations:
The analysis included a limited number of trials and patients.
The median age of patients varied significantly across studies, potentially affecting outcomes.
Conclusion:
Nivolumab and pembrolizumab are effective in frontline treatment for cHL, particularly for advanced disease or patients not suitable for intensive chemotherapy.
Harold Burstein, MD, PhD, and Erica Mayer, MD, MPH discuss results from the TRAK-ER trial, which were presented at the 2026 ESMO Breast Cancer Congress.
