Personalized Chemotherapy Reduction Using Blood DNA Testing for Advanced Hodgkin Lymphoma in a Phase 2 Study

What this Trial Is About

Researchers are evaluating a personalized approach to reduce chemotherapy intensity for patients with advanced Hodgkin lymphoma, which may have spread to nearby tissues, lymph nodes, or distant body parts. This phase II trial investigates how measuring circulating tumor DNA ctDNA in the blood can guide the number of chemotherapy cycles patients receive. Chemotherapy drugs such as nivolumab, doxorubicin, vinblastine, and dacarbazine are studied for their ability to stop tumor growth by killing cells or preventing their division and spread. Participants first receive two cycles of combination chemotherapy with nivolumab, doxorubicin, vinblastine, and dacarbazine administered intravenously on days 1 and 15 of each 28-day cycle. After these cycles, patients undergo measurable residual disease MRD testing based on ctDNA results. Those who are MRD negative continue with two more cycles of combination chemotherapy followed by two cycles of nivolumab alone. Those who are MRD positive receive four additional cycles of the full combination chemotherapy. Treatment continues as long as there is no disease progression or unacceptable side effects. Throughout the study, participants undergo echocardiography or multigated acquisition MUGA scans, PETCT scans, complete questionnaires, and provide blood samples. After finishing treatment, patients are monitored every three months for one year, then periodically for up to five years. The primary outcome measured is progression-free survival at one year for patients with undetectable MRD after two treatment cycles, with other outcomes including overall progression-free survival and best response over several years.

Personalized Reduction of Chemotherapy Intensity Through ctDNA Evaluation for the Treatment of Patients With Advanced Hodgkin Lymphoma