Targeted Therapy in Relapsed Classical Hodgkin Lymphoma

Abstract

Although frontline treatment of advanced Hodgkin lymphoma (HL) produces high cure rates, disease either will not respond to or will relapse after initial therapy in approximately a quarter of patients. Many patients with disease relapse can be successfully salvaged with second-line chemotherapy followed by autologous stem cell transplantation (ASCT). Patients whose disease relapses after ASCT are rarely cured. A unique pathophysiologic feature of HL is that the malignant Reed-Sternberg (HRS) cell is rare and resides within a microenvironment of inflammatory and immunerelated cells. The recent FDA approval of the anti-CD30 antibodydrug conjugate brentuximab vedotin (BV) for patients with either primary refractory HL or those whose disease relapses after ASCT represents a major advance in therapy. This article focuses on BV and other novel agents that target the HRS cell surface, intracellular signaling pathways, and tumor microenvironment. (JNCCN 2013;11:968-976) NCCN: Continuing Education Accreditation StatementThis activity has been designated to meet the educational needs of physicians and nurses involved in the management of patients with cancer. There is no fee for this article. No commercial support was received for this article. The National Comprehensive Cancer Network (NCCN) is accredited by the ACCME to provide continuing medical education for physicians.NCCN designates this journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.NCCN is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center`s Commission on Accreditation.This activity is accredited for 1.0 contact hour. Accreditation as a provider refers to recognition of educational activities only; accredited status does not imply endorsement by NCCN or ANCC of any commercial products discussed/displayed in conjunction with the educational activity. Kristina M. Gregory, RN, MSN, OCN, is our nurse planner for this educational activity.All clinicians completing this activity will be issued a certificate of participation. To participate in this journal CE activity: 1) review the learning objectives and author disclosures; 2) study the education content; 3) take the posttest with a 66% minimum passing score and complete the evaluation at http://education.nccn.org/ node/26206; and 4) view/print certificate. Learning ObjectivesUpon completion of this activity, participants will be able to:• Describe the rationale for targeted therapy in patients with relapsed classical HL• Discuss novel agents that target the rare malignant ReedSternberg (HRS) cell surface, a unique pathophysiologic feature of HL

Treatment outcome in children and adolescents with relapsed Hodgkin lymphoma - results of the UK HD3 relapse treatment strategy

“…The use of FDG -PET-defined relapse strategies (Kahraman et al, 2013), novel agents such as monoclonal antibodies and small molecule inhibitors and allogeneic SCT are the subjects of on going trials (Copeland & Younes, 2012;Moskowitz, 2012;Dinner & Advani, 2013). While there is much interest in the use of Brentuximab vedotin in CD30-positive HL (Kahraman et al, 2013;Zinzani et al, 2013), at present there is insufficient published evidence of its efficacy in paediatric HL.…”

Research on Biological Materials with Oxazinone Derivatives Induce Apoptosis in HT-29 Cells

“…Serious side effects, such as low white blood cell count, loss of appetite, and general weakness, are often observed during and after the treatment, which may therefore lower the quality of life in tumor patients. Targeted therapy has become the main direction for the current research of tumor treatment [6].…”