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The evolving role of checkpoint inhibitors in the treatment of Hodgkin lymphoma.
Front Oncol
October 2024
Washington University School of Medicine, Siteman Cancer Center, St. Louis, MO, United States.
Since their initial approval as single agent therapy for multiply relapsed/refractory Hodgkin lymphoma (HL), the PD-1 inhibitors nivolumab and pembrolizumab have been incorporated into second-line salvage regimens, and they are being investigated in upfront therapy of newly diagnosed patients. As second-line therapy in combination with brentuximab vedotin or multi-agent chemotherapy, nivolumab and pembrolizumab provide high complete remission rates and durable progression-free survival after consolidative autologous stem cell transplant. Incorporation of these agents into frontline chemotherapy regimens is feasible, and early results from a Phase III trial of nivolumab-AVD compare favorably with the existing standard for advanced stage HL, brentuximab vedotin plus AVD.
View Article and Find Full Text PDFNivolumab+AVD in Advanced-Stage Classic Hodgkin's Lymphoma.
N Engl J Med
October 2024
From City of Hope Comprehensive Cancer Center, Duarte (A.F.H., M.G.M., J.Y.S.), University of California Davis Comprehensive Cancer Center, Sacramento (J.M.T.), and Children's Hospital Los Angeles, Los Angeles (C.F., A.D., A.K.) - all in California; SWOG Statistics and Data Management Center, Fred Hutchinson Cancer Center, (M.L., H.L.) and Seattle Children's Hospital (A.L.) - both in Seattle; Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta (S.M.C.), and Winship Cancer Institute and Emory University Hospital (K.A.B.), Atlanta; Weill Cornell Medicine (S.C.R., J.P.L.), Memorial Sloan Kettering Cancer Center (P.T.), and New York University Langone (L.K.S.), New York, Wilmot Cancer Institute, University of Rochester, Rochester (C.C., L.S.C., J.W.F.), and Roswell Park Comprehensive Cancer Center, University at Buffalo, Buffalo (K.M.K.) - all in New York; Rutgers Cancer Institute of New Jersey, New Brunswick (A.M.E.); McGill University Health Centre, Montreal (K.D.), and SickKids Hospital (Angela Punnett) and Princess Margaret Cancer Centre (D.H., Anca Prica, M.C.), Toronto - all in Canada; Reid R. Sacco AYA Cancer Program, Tufts Medical Center (S.K.P.), and Dana-Farber Cancer Institute (M.A.S.) - both in Boston; M.D. Anderson Cancer Center, Houston (S.A.), and University of Texas Health Science Center at San Antonio, San Antonio (S.K.) - both in Texas; Siteman Cancer Center, Washington University, St. Louis (N.L.B., B.K.); Medical University of South Carolina, Charleston (B.T.H.), and Prisma Health Cancer Institute - Eastside, Greenville (S.C.) - both in South Carolina; Carolinas Medical Center, Levine Cancer Institute, Charlotte, NC (R.J.); Moffitt Cancer Center, Tampa (H.S.), and Sylvester Comprehensive Cancer Center, University of Miami, Miami (C.M.) - both in Florida; Huntsman Cancer Institute, University of Utah, Salt Lake City (B.H.); University of Alabama at Birmingham, Birmingham (G.G.); Illinois CancerCare, Peoria (P.K.), and University of Chicago, Chicago (S.M.S.); Cancer and Hematology Centers of Western Michigan, Grand Rapids (B.B.), and University of Michigan, Ann Arbor (A.M.P.); the Department of Hematology and Oncology, Geisinger Community Medical Center, Scranton, PA (N.S.); Fairview Ridges Hospital, Minnesota Oncology, Burnsville (A.S.); SWOG Cancer Research Network, Teaneck, NJ (H.D.); and the National Cancer Institute, Cancer Therapy Evaluation Program, Bethesda, MD (R.F.L.).
Article Synopsis
- Brentuximab vedotin has been shown to improve outcomes in treating advanced classic Hodgkin's lymphoma, but it also causes more toxic side effects in adults, while many pediatric patients still need radiation therapy and face challenges with relapse.
- A phase 3 trial involving patients aged 12 and older tested two treatment combinations: brentuximab vedotin with standard chemotherapy (BV+AVD) versus nivolumab with standard chemotherapy (N+AVD), aiming to assess progression-free survival.
- Results indicated that N+AVD significantly enhances progression-free survival compared to BV+AVD, with a 2-year survival rate of 92% for N+AVD versus 83% for BV
Treatment approaches for older Hodgkin lymphoma patients.
Curr Opin Oncol
September 2024
University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD).
Purpose Of Review: Hodgkin lymphoma (HL) occurs at two age peaks around 25 and 60 years of age. Due to varying fitness and co-morbidities older patients are a heterogeneous group that has relatively poor treatment outcomes. The evolving therapeutic landscape for older HL is summarized herein.
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