brentuximab vedotin + nivolumab + doxorubicin + dacarbazine

The combination of **brentuximab vedotin + nivolumab + doxorubicin + dacarbazine** is an investigational multi-agent regimen studied primarily for untreated, early-stage and advanced-stage classical Hodgkin lymphoma. This regimen substitutes nivolumab, a PD-1 immune checkpoint inhibitor, for vinblastine in the traditional brentuximab vedotin–containing combination, aiming to improve efficacy and reduce toxicity. Brentuximab vedotin is an antibody-drug conjugate targeting CD30, causing cell death via its MMAE payload. Nivolumab enhances immune-mediated tumor destruction by inhibiting the PD-1 pathway on T-cells. Doxorubicin is a cytotoxic anthracycline antibiotic that intercalates DNA and generates free radicals, leading to cell death. Dacarbazine is an alkylating agent causing DNA methylation and crosslinking. The combination is used in clinical trials (typically called "AN+AD") to spare bleomycin and vinblastine components and has demonstrated high response rates and manageable safety profiles in phase II studies for classical Hodgkin lymphoma[1][2][3][4].