Older patients (aged ≥60 years) with previously untreated advanced-stage classical Hodgkin lymphoma: a detailed analysis from the phase III ECHELON-1 study by Andrew M. Evens, Joseph M. Connors, Anas Younes, Stephen M. Ansell, Won Seog Kim, John Radford, Tatyana Feldman, Joseph Tuscano, Kerry J. Savage, Yasuhiro Oki, Andrew Grigg, Christopher Pocock, Monika Dlugosz-Danecka, Keenan Fenton, Andres Forero-Torres, Rachael Liu, Hina Jolin, Ashish Gautam, and Andrea Gallamini Haematologica 2021 [Epub ahead of print] Citation: Andrew M. Evens, Joseph M. Connors, Anas Younes, Stephen M. Ansell, Won Seog Kim, John Radford, Tatyana Feldman, Joseph Tuscano, Kerry J. Savage, Yasuhiro Oki, Andrew Grigg, Christopher Pocock, Monika Dlugosz-Danecka, Keenan Fenton, Andres Forero-Torres, Rachael Liu, Hina Jolin, Ashish Gautam, and Andrea Gallamini. Older patients (aged ≥60 years) with previously untreated advanced-stage classical Hodgkin lymphoma: a detailed analysis from the phase III ECHELON-1 study. Haematologica. 2021; 106:xxx doi:10.3324/haematol.2021.278438 Publisher's Disclaimer. E-publishing ahead of print is increasingly important for the rapid dissemination of science. Haematologica is, therefore, E-publishing PDF files of an early version of manuscripts that have completed a regular peer review and have been accepted for publication. E-publishing of this PDF file has been approved by the authors. After having E-published Ahead of Print, manuscripts will then undergo technical and English editing, typesetting, proof correction and be presented for the authors' final approval; the final version of the manuscript will then appear in print on a regular issue of the journal. All legal disclaimers that apply to the journal also pertain to this production process. ORIGINAL ARTICLE Older patients (aged ≥60 years) with previously untreated advanced-stage classical Hodgkin lymphoma: a detailed analysis from the phase III ECHELON-1 study Andrew M. Evens,1* Joseph M. Connors,2 Anas Younes,3* Stephen M. Ansell,4 Won Seog Kim,5 John Radford,6 Tatyana Feldman,7 Joseph Tuscano,8 Kerry J. Savage,2 Yasuhiro Oki,9 Andrew Grigg,10 Christopher Pocock,11 Monika Dlugosz-Danecka,12 Keenan Fenton,13 Andres Forero-Torres,13 Rachael Liu,14 Hina Jolin,14 Ashish Gautam14 and Andrea Gallamini15 1Division of Blood Disorders, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA 2BC Cancer Centre for Lymphoid Cancer and Department of Medical Oncology, Vancouver, Canada 3Memorial Sloan Kettering Cancer Center, NY, USA 4Mayo Clinic, Rochester, NY, USA 5Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, South Korea 6University of Manchester and the Christie NHS Foundation Trust Manchester Academic Health Science Centre, Manchester, UK 7John Theurer Cancer Center, NJ, USA 8UC Davis Cancer Center, Sacramento, CA, USA 9Genentech, South San Francisco, CA, USA 10Olivia Newton-John Cancer Wellness and Research Centre, Austin Health and Department of Clinical Haemotology, Austin Hospital, Heidelberg, Australia 11Haematology, East Kent Hospitals, Canterbury, UK 12Maria Sklodowska-Curie National Research Institute of Oncology, Krakow, Poland 13Seagen Inc., Bothell, WA, USA 14Millennium Pharmaceuticals, Inc., Cambridge, MA, USA, a wholly owned subsidiary of Takeda Pharmaceutical Company Limited 15Research and Innovation Department, A Lacassagne Cancer Centre, Nice, France *Author affiliation at the time of data analyses and manuscript preparation. Current affiliation is Haematology (Early and Late Stage) Oncology R&D, AstraZeneca, New York, NY, USA 1 Authors’ contributions Data were collected, and study procedures were overseen, by AME, JMC, AY, SMA, WSK, JR, TF, JT, KJS, YO, AG, CP, MD-D, and AGal. Data were verified by KF, AF-T, RL, HT, and AGal, analyzed by RL, and interpreted by all authors. The manuscript was prepared by all authors with the assistance of a medical writer funded by the sponsor. All authors vouch for completeness and accuracy of the data and had final responsibility for the manuscript content and decision to submit. Disclosures AME reports consultancy with honoraria for MorphoSys, Mylteni, Seagen, and Epizyme; membership on an advisory committee with honoraria for Pharmacyclics and Novartis, Inc.; and research funding from Tesaro. JMC reports research funding from Merck, Amgen, Roche Canada, NanoString Technologies, Seagen, Janssen, F Hoffmann-La Roche, Bayer Healthcare, Cephalon, Bristol Myers-Squibb, Lilly, Genentech, and Millennium Pharmaceuticals Inc., a wholly owned subsidiary of Takeda Pharmaceutical Company Limited; patents & royalties: named inventor on a patent licensed to NanoString Technologies; and honoraria from Seagen. AY reports research funding from J&J, BMS, Curis, Genentech, Pharmacyclics, Janssen, Novartis, Roche, Abbvie, and Astra Zeneca; and honoraria from Celgene, BMS, Sanofi, Abbvie, Merck, Bayer, Incyte, Seagen, Roche, and Takeda. SMA reports research funding from LAM Therapeutics, Regeneron, Pfizer, Bristol- Myers Squibb, Merck & Co, Trillium, Seagen, Celldex, Takeda, and Affimed. JR reports research funding from Celgene, ADC Therapeutics, Pfizer, and Millennium Pharmaceuticals Inc., a wholly owned subsidiary of Takeda Pharmaceutical Company Limited; consultancy for ADC Therapeutics, Novartis, Takeda, Seagen, and BMS; equity ownership for GlaxoSmithKline and AstraZeneca; and speakers bureau for Novartis, Takeda, Seagen, and BMS. TF reports research funding from Seagen and Portola; and speakers bureau for Seagen, Janssen, Pharmacyclics, J&J, Celgene, and KITE. JT reports research funding from Millennium Pharmaceuticals Inc., a wholly owned subsidiary of Takeda Pharmaceutical Company Limited, Genentech, Celgene, and Pharmacyclics; speakers bureau for Amgen, Seagen, and Celgene; and honoraria from Amgen, Seagen, and Celgene. KJS reports honoraria and consulting from Seagen, Merck, BMS, Abbvie, Astra Zeneca, and Verastem; Gilead Consulting Servier; research funding from Seagen, Millennium Pharmaceuticals Inc., a wholly owned subsidiary of Takeda Pharmaceutical Company, Merck, BMS, Beigene, and Roche Canada. YO reports employment with Genentech and research funding from Seagen and Millennium Pharmaceuticals Inc., a wholly owned subsidiary of Takeda Pharmaceutical Company Limited; honoraria for Takeda Millennium; and employment from Jazz Pharmaceuticals. AGri reports membership on an entity's Board of Directors or advisory 2 committees for Roche, Gilead, BMS, and Takeda. CP reports employment with Kent & Canterbury Hospital. MD-D reports consultancy for Servier and Roche. KF reports employment and equity ownership with Seagen, Inc. AF-T reports employment with Seagen, Inc. RL, HJ, and AGau report employment with Millennium Pharmaceuticals, Inc., a wholly owned subsidiary of Takeda Pharmaceutical Company Limited. AGal reports consultancy and speaker bureau for Takeda. W-SK has declared no conflicts of interest. This work was supported by Millennium Pharmaceuticals, Inc., Cambridge, MA, USA, a wholly owned subsidiary of Takeda Pharmaceutical Company Limited (grant number not applicable); and Seagen, Inc., Bothell, WA, USA (grant number not applicable). Data were verified by the sponsor, analyzed by sponsor statisticians, and interpreted by academic authors and sponsor representatives. The manuscript was prepared by the authors with the assistance of a medical writer funded by the sponsor. All authors had full access to the data during development of the manuscript. Running head Analysis of older cHL patients in ECHELON-1 (50-character limit, incl. spaces) Correspondence ANDREW M. EVENS [email protected] Data sharing statement The datasets, including the redacted study protocol, redacted statistical analysis plan, and individual participant’s data supporting the results reported in this article, will be made available within 3 months from initial request, to researchers who provide a methodologically sound proposal. The data will be provided after its de-identification, in compliance with applicable privacy laws, data protection, and requirements for consent and anonymization. Abstract word count 249/250 words Main text word count 3209/4000 words Table/figure count 6/8 tables and figures (5 tables, 1 figure) Supplemental file count 1 (containing 4 supplementary tables, 1 supplementary figure, and CONSORT diagram) 3 Acknowledgments The authors would like to thank the patients who participated in this study and their families. They would also like to acknowledge other investigators and staff at all ECHELON-1 clinical sites and the members of the Independent Data Monitoring Committee and Independent Review Committee. The authors acknowledge the writing assistance of Laura Webb and Hedley Coppock of Ashfield MedComms, an Ashfield Health company, part of UDG Healthcare plc, during the development of this manuscript, which was funded by Millennium Pharmaceuticals, Inc., and complied with the Good Publication Practice 3 ethical guidelines.1 Trial registration number ClinicalTrials.gov identifier: NCT01712490; EudraCT number: 2011-005450-60. 4 ABSTRACT Effective and tolerable treatments are needed for older patients with classical Hodgkin lymphoma (cHL). We report results for older patients with cHL treated in the large phase III ECHELON-1 study of frontline brentuximab vedotin plus doxorubicin, vinblastine, and dacarbazine (A+AVD) versus doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD). Modified progression-free survival (PFS) per independent review facility (IRF) for older versus younger patients