Safety and Efficacy in Pediatric Patients with Relapsed/Refractory Classic Hodgkin Lymphoma enrolled on an Intergroup Randomized Phase II Study of the Combinations of Ipilimumab, Nivolumab and Brentuximab Vedotin (E4412)
Bibliographic record
Abstract
Introduction The Phase 1/2 ECOG-ACRIN sponsored intergroup trial E4412 (NCT01896999) investigated brentuximab vedotin (BV) combined with the checkpoint inhibitors nivolumab (N) and ipilimumab (I) in patients with relapsed or refractory classic Hodgkin lymphoma (R/R HL). Here we present the safety and efficacy results for the cohort of pediatric patients aged 12-17 years. Methods Patients were randomly assigned to treatment with the doublet of BV/N or triplet of BV/N/I, with the following dosing: BV 1.8 mg/kg every 21 days for up to 16 cycles; Nivolumab 3 mg/mg every 21 days for up to 34 cycles; Ipilimumab 1 mg/kg every 9 weeks for up to 9 doses. Response evaluation by PET/CT was performed after 4 cycles. Transplant-eligible patients with CR could discontinue protocol therapy to receive a consolidative autologous stem cell transplant (ASCT). Results Sixteen pediatric patients with a median age of 16 (range 12-17) were randomized. 75% of patients had received only 1 prior line of treatment with none having previously received BV and only 1 patient with prior ASCT. All patients were treated (8 in each arm) and included in the pediatric safety analysis cohort receiving at least one cycle of therapy. There were four reported grade (gr) 3 or greater treatment-related toxicities: lymphopenia (gr 3) and neutropenia (gr 3) on the BV/N arm; and neutropenia (gr 4) and rash (gr 3) on the BV/N/I arm. Rash of any grade was more common in patients treated with BV/N/I arm (n=6) compared to BV/N (n=1). Peripheral sensory neuropathy was reported in 2 patients (BV/N, gr 2, n=2) There were no grade 5 toxicities. Fourteen patients (7 in each arm) were evaluable for response. The CR rate on both the BV/N and BV/N/I arms was 100%. The median progression-free survival (PFS) follow up was 31.5 months (15.4 – 48.6). The 24-month PFS was 42.9% for BV/N (95% CI: 9.8-73.4) and 100% for BV/N/I (p=0.02). Six patients (2 BV/N; 4 BV/N/I) discontinued protocol therapy to receive a consolidative ASCT. The 24-month PFS for patients consolidated with an ASCT was 100%. Eight patients (3 BV/N and 5 BV/N/I) treated without an ASCT had a 12-month PFS of 20% (95% CI: 0.8 – 58.2) and 100% for the BV/N and BV/N/I patients, respectively (p=0.05). Conclusion Pediatric patients receiving both BV/N and BV/N/I had 100% CR rate with limited toxicity. Although, this is a small cohort, there have been no progression events observed in patients treated with BV/N/I, including patients treated without a consolidative ASCT. Publication History Article published online: 02 December 2025 © 2025. Thieme. All rights reserved. Georg Thieme Verlag KG Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".