Treatment of relapsed and refractory Hodgkin Lymphoma

Tresckow, Bastian von; Moskowitz, Craig H.

doi:10.1053/j.seminhematol.2016.05.010

Cited by 33 publications

(27 citation statements)

References 57 publications

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“…Keeping the sources of potential biases and imprecision in mind, our results compare favorably to those observed with different classic polychemotherapy regimens. 40 However, the results of the present retrospective analysis are less impressive compared to those recently reported from three multicenter phase II trials which have investigated the efficacy of BvB association. O'Connor reported 43% CRR and 78% ORR, with infection and grade 3-4 neutropenia occurring as the most frequent serious adverse events.…”

Section: Discussioncontrasting

confidence: 67%

Brentuximab vedotin in association with bendamustine in refractory or multiple relapsed Hodgkin lymphoma. A retrospective real‐world study

Iannitto

Romano

Scalzulli

et al. 2020

European J of Haematology

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Objective and Methods:In order to assess the efficacy of brentuximab vedotin (Bv) in combination with bendamustine (B) in multiple relapsed or refractory (RR) classic Hodgkin lymphoma (cHL), medical records of 47 patients treated with BvB in second relapse or beyond were reviewed. Results:The median number of previous treatments was 2 (1-4). Bv was given at 1.8 mg/kg on day 1 and bendamustine at 90 mg/m 2 on days 1 and 2 of a 21-day cycle. The median number of BvB cycles was 4 (2-7), and all patients were evaluable for efficacy. The CR and OR rates were 49% and 79%, respectively; 67% of responding patients and 2 in stable disease proceeded to a SCT procedure. After a median follow-up of 19 months (5-47), median PFS was 18 months (95%CI: 23-29), and the 2-year OS was 72%. Significantly longer PFS and OS were observed in patients attaining a major clinical response to treatment and in those who received consolidation with SCT. Fifteen (32%) patients experienced severe (G > 2) toxicity. The main toxicities were neutropenia (23%), gastrointestinal (10%), peripheral sensory neuropathy (11%), and infection (4%). Conclusion:Our real-world results suggest that BvB is an effective third-line rescue and bridge-to-transplant regimen for RR-cHL patients.

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Section: Discussioncontrasting

confidence: 67%

Brentuximab vedotin in association with bendamustine in refractory or multiple relapsed Hodgkin lymphoma. A retrospective real‐world study

Iannitto

Romano

Scalzulli

et al. 2020

European J of Haematology

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“…Anthracycline-based chemotherapy regimens with or without radiation therapy are still the mainstay for patients with cHL and result in remarkably high cure rates, particularly in patients with low-risk or early-stage disease. 5 However, patients with advanced-stage or high-risk disease are only cured in ;70% of cases, and high-dose chemotherapy in combination with autologous stem-cell transplantation (ASCT) is successful in only half of patients with relapsed/refractory cHL, 6 necessitating alternative treatment options and better risk stratification for the subsets of patients for whom firstor second-line therapies fail. It is conceivable that the most promising strategy in future clinical trials will be the testing of novel therapeutic concepts in conjunction with predictive biomarkers that are comprehensively informed by and based on underlying tumor pathobiology.…”

Section: Introductionmentioning

confidence: 99%

Biology of classical Hodgkin lymphoma: implications for prognosis and novel therapies

Mottok

Steidl

2018

Blood

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Hodgkin lymphoma is considered a prime example of treatment success, with cure rates exceeding 80% using modern combined modality therapies. However, especially in adolescents and young adults, treatment-related toxicity and long-term morbidity still represent persistent challenges. Moreover, outcomes in patients with relapsed or refractory disease remain unfavorable in the era of high-dose chemotherapy and stem-cell transplantation. Hence, there is a high demand for novel and innovative alternative treatment approaches. In recent years, many new therapeutic agents have emerged from preclinical and clinical studies that target molecular hallmarks of Hodgkin lymphoma, including the aberrant phenotype of the tumor cells, deregulated oncogenic pathways, and immune escape. The antibody-drug conjugate brentuximab vedotin and immune checkpoint inhibitors have already shown great success in patients with relapsed/refractory disease, leading to US Food and Drug Administration approval and new trials testing these agents in various clinical settings. The expanding knowledge and understanding of Hodgkin lymphoma biology and disease progression, as well as the development of robust tools for biomarker-driven risk stratification and therapeutic decision making, continue to be fundamentally important for the success of these and other novel agents. We anticipate that the availability and clinical implementation of novel molecular assays will be instrumental in an era of rapid shifts in the treatment landscape of this disease. Here, we review the current knowledge of Hodgkin lymphoma pathobiology, highlighting the related development of novel treatment strategies and prognostic models that hold the promise to continually challenge and change the current standard of care in classical Hodgkin lymphoma.

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“…Pre-transplantation PET negativity is one of the strongest predictor of HDT/ASCT outcome [49]. Choice of optimal ST is unclear and is chosen on the bases of individual patient [50•]. Salvage ICE has shown overall response rate (ORR) of 80% and CR of 50% [51].…”

Section: Introductionmentioning

confidence: 99%

A Review of Autologous Stem Cell Transplantation in Lymphoma

Zahid

Akbar

Amaraneni

et al. 2017

Curr Hematol Malig Rep

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Purpose of review Chemotherapy remains the first line therapy for aggressive lymphomas. However, 20–30% of patients with non-Hodgkin lymphoma (NHL) and 15% with Hodgkin Lymphoma (HL) recur after initial therapy. We want to explore the role of high dose chemotherapy (HDT) and autologous stem cell transplant (ASCT) for these patients. Recent findings There is some utility of upfront consolidation for high risk/high grade B cell lymphoma, mantle cell lymphoma and T cell lymphoma but there is no role of similar intervention for HL. New conditioning regimens are being investigated which have demonstrated an improved safety profile without compromising the myeloablative efficiency for relapsed or refractory HL. Summary Salvage chemotherapy followed by HDT and rescue autologous stem cell transplant remains the standard of care for relapsed/refractory lymphoma. The role of novel agents to improve disease-related parameters remains to be elucidated in frontline induction, disease salvage, and high dose consolidation or in the maintenance setting.

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Treatment of relapsed and refractory Hodgkin Lymphoma

Cited by 33 publications

References 57 publications

Brentuximab vedotin in association with bendamustine in refractory or multiple relapsed Hodgkin lymphoma. A retrospective real‐world study

Brentuximab vedotin in association with bendamustine in refractory or multiple relapsed Hodgkin lymphoma. A retrospective real‐world study

Biology of classical Hodgkin lymphoma: implications for prognosis and novel therapies

A Review of Autologous Stem Cell Transplantation in Lymphoma

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