6/28/23, 9:49 PM ECHELON-1 Pathway Feedback Search Clinical Topics Home Studies ECHELON 1 ECHELON 1 Disease Hodgkin's lymphoma Trial question What is the role of front-line chemotherapy with brentuximab vedotin, doxorubicin, vinblastine, and dacarbazine in patients with previously untreated stage III or IV classical Hodgkin's lymphoma? Study design Multi-center Open label RCT Population Characteristics of study participants 42.0% female N = 1334 58.0% male 1334 patients (558 female, 776 male) Inclusion criteria: adult patients with previously untreated stage III or IV classical Hodgkin's lymphoma Key exclusion criteria: nodular lymphocyte predominant Hodgkin's lymphoma; cerebral/meningeal disease; sensory or motor peripheral neuropathy; prior immunosuppressive chemotherapy, therapeutic radiation, or any immunotherapy within 12 weeks of first study drug dose Interventions N=664 brentuximab vedotin, doxorubicin, vinblastine, and dacarbazine (at a dose of 1.2 mg/kg, 25 mg/m , 6 mg/m , and 375 mg/m , respectively, IV on days 1 and 15 of each 28-day cycle for up to 6 cycles) https://web.pathway.md/studies/rec64WDZTmyqJPIEv 1/2 6/28/23, 9:49 PM ECHELON-1 Pathway N=670 doxorubicin, bleomycin, vinblastine, and dacarbazine (at a dose of 25 mg/m , 10 U/m2, 6 mg/m , and 375 mg/m , respectively, IV on days 1 and 15 of each 28-day cycle for up to 6 cycles) Primary outcome Progression-free survival at 5 years 82.2 % 82.2 75.3 61.7 % 41.1 % Significant increase 20.6 % NNT = 14 0.0 % Brentuximab vedotin, doxorubicin, vinblastine, and dacarbazine Doxorubicin, bleomycin, vinblastine, and dacarbazine Significant increase in progression-free survival at 5 years (82.2% vs. 75.3%; HR 1.47, 95% CI 1.15 to 1.89) Secondary outcomes Significant increase in progression-free survival at 5 years, among patients with positron emission tomography scan negativity rate at cycle 2 (84.9% vs. 78.9%; HR 1.51, 95% CI 1.13 to 2) No significant difference in progression-free survival at 5 years, among patients with positron emission tomography scan positivity rate at cycle 2 (60.6% vs. 45.9%; HR 1.42, 95% CI 0.79 to 2.56) Safety outcomes No significant difference in improvement or resolution of peripheral neuropathy. Conclusion In adult patients with previously untreated stage III or IV classical Hodgkin's lymphoma, brentuximab vedotin, doxorubicin, vinblastine, and dacarbazine were superior to doxorubicin, bleomycin, vinblastine, and dacarbazine with respect to a progression-free survival at 5 years. Reference David J Straus, Monika D ugosz-Danecka, Joseph M Connors et al. Brentuximab vedotin with chemotherapy for stage III or IV classical Hodgkin lymphoma (ECHELON-1): 5-year update of an international, open-label, randomised, phase 3 trial. Lancet Haematol. 2021 Jun;8(6):e410-e421. Open reference URL https://web.pathway.md/studies/rec64WDZTmyqJPIEv 2/2