Immunotherapy for the treatment of Hodgkin lymphoma

Abstract

Most patients with Hodgkin lymphoma (HL) enjoy durable remissions following front-line treatment but 30% of patients are refractory or relapse after first line therapy. Salvage chemotherapy followed by autologous stem cell transplantation (ASCT) can cure an additional 50-55% of relapsing patients but new treatments are needed for patients with HL who are refractory or relapse after ASCT. Immunotherapy has emerged as a promising treatment for the management of these patients. The availability of the anti-CD30 antibody brentuximab vedotin and new targeted drugs such as immune checkpoint inhibitors, show promising clinical activity in patients with HL and are important milestones for the management of patients with HL particularly for those who have progressed after standard initial therapy and ASCT. Areas covered: Overview of the results from the most relevant clinical trials including monoclonal antibody-based therapy in HL. Phase 2 and phase 3 trials including brentuximab vedotin and immune checkpoints inhibitors in patients with Hodgkin lymphoma have been reviewed. In addition, the potential impact of these new therapies in the management of patients with newly diagnosed HL has also been addressed. Expert commentary: Anti-CD30 antibody brentuximab vedotin and immune checkpoint inhibitors have shown promising results in patients with relapsed and refractory HL. Administration of these therapies earlier in the course of the disease might reduce the proportion of relapsed or refractory patients and, subsequently, minimize the number of patients undergoing high-dose therapy and autologous stem cell transplantation. We have little doubt that this will have substantial effects on the outcome for future generations of HL patients.

Relapsed Hodgkin’s lymphoma in pregnancy: A case review

“…16 Salvage therapy followed by AHCT cures approximately 50% of relapsed HL; in unsuccessful cases, immunotherapy is emerging as a promising treatment, including monoclonal antibodies and immune checkpoint inhibitors. 17 Although our patient presented with relapsed disease, imaging investigation found no evidence of any critical organ compression. It was therefore decided that the pregnancy could continue with regular monitoring and to delay salvage chemotherapy until after delivery.…”

Brentuximab vedotin in Hodgkin lymphoma and anaplastic large-cell lymphoma: an evidence-based review

“…In fact, BV has been combined with currently used conventional chemotherapy regimens, and we already have data that BV can be safely added to several backbone regimens to increase efficacy and prolong durability of the response in these patients and provide them new therapeutic alternatives. 46 Current trials are evaluating different combinations of BV with a variety of agents. Results of these studies may change the current standards of care for patients with HL.…”

“…2017;10(5):417–423, with permission from Taylor & Francis Ltd., http://www.informaworld.com . 46 b Data available in 47 patients. Abbreviations: BV, brentuximab vedotin; SCT, stem cell transplantation; PFS, progression-free survival; OS, overall survival; CI, confidence interval; NA, not available; CR, complete response; PR, partial response.…”

Nanoparticles—Emerging Potential for Managing Leukemia and Lymphoma

“…Treatment depends on the type of leukemia/lymphoma, disease stage, prior history of treatment, age, overall condition, and genetic profile. Most patients are treated with chemotherapy, and some may also undergo radiotherapy, stem cell transplantation, or targeted therapy (Zimmermann et al, 2016 ; Cuellar et al, 2017 ; Donato et al, 2017 ). CML is a good example of how hematological diseases have greatly benefited from the advance of cytogenetic and molecular methodologies.…”