Therapeutic Updates for Relapsed and Refractory Classical Hodgkin Lymphoma.
Timothy J VoorheesAnne W BeavenPublished in: Cancers (2020)
Hodgkin lymphoma (HL) is a B-cell malignancy representing approximately one in ten lymphomas diagnosed in the United States annually. The majority of patients with HL can be cured with chemotherapy; however, 5-10% will have refractory disease to front-line therapy and 10-30% will relapse. For those with relapsed or refractory (r/r) HL, salvage chemotherapy followed by autologous stem cell transplant (ASCT) is standard of care, but half of patients will subsequently have disease progression. Relapse following ASCT has been associated with exceedingly poor prognosis with a median survival of only 26 months. However, in recent years, novel agents including brentuximab vedotin (BV) and programmed cell death protein 1 monoclonal antibodies (anti-PD-1, nivolumab and pembrolizumab) have been shown to extend overall survival in r/r HL. With the success of novel agents in relapsed disease after ASCT, these therapies are beginning to show clinically meaningful response rates prior to ASCT. Finally, a new investigation in r/r HL continues to produce promising treatment options even after ASCT including CD30 directed chimeric antigen receptor T-cell therapy. In this review, we will discuss the recent advances of BV and anti-PD-1 therapy prior to ASCT, novel approaches in r/r HL after ASCT, and review active clinical trials.
Keyphrases
- hodgkin lymphoma
- cell therapy
- poor prognosis
- stem cells
- clinical trial
- free survival
- end stage renal disease
- long non coding rna
- healthcare
- lipopolysaccharide induced
- ejection fraction
- palliative care
- lps induced
- mesenchymal stem cells
- newly diagnosed
- chronic kidney disease
- bone marrow
- prognostic factors
- pain management
- peritoneal dialysis
- acute myeloid leukemia
- chronic pain
- open label
- inflammatory response
- diffuse large b cell lymphoma
- quality improvement
- tyrosine kinase
- protein protein
- amino acid
- smoking cessation