Evaluating PD-1 inhibitors for patients with Hodgkin lymphoma in a real-world setting

This study evaluated the safety and effectiveness of PD-1 inhibitors for patients with classical Hodgkin lymphoma (cHL) outside of clinical trials. This study concluded that PD-1 inhibitors are safe and effective for these patients.

Standard first-line chemotherapy is highly effective in treating 70 – 80% of patients with cHL. Stem cell transplantation (SCT) is the next step for patients whose cancer returns or stops responding to treatment. Another 10% of patients respond to SCT. However, patients whose disease does not respond to SCT have limited treatment options.

PD-1 inhibitors are a new treatment option for these patients. Nivolumab (Opdivo) and pembrolizumab (Keytruda) are new PD-1 inhibitors. This type of treatment binds to cancer cells, marking them as targets for the body’s immune system. This leads to cancer cell death. The effectiveness of PD-1 inhibitors for patients with cHL in the real world (outside of clinical trials) remains under investigation.

This study included 53 patients with cHL that has come back or did not respond to treatment. Patients had an average of 4 prior lines of treatment. 98% of patients were treated with nivolumab for an average of 21 months. 1 patient was treated with pembrolizumab. Patients were followed-up for an average of 20 months.

Overall, 68% of patients responded to treatment. 45% of patients had a complete disappearance of all signs of cancer. 23% of patients had tumor shrinkage. At 1 year after treatment, 89% of all patients were still alive. 75% of patients were still alive without tumor growth or spread. 70% of patients who received further treatment after PD-1 inhibitors had a treatment response.

53% of all patients had side effects. The most common included skin rash, colitis (inflammation of the colon lining), and low levels of thyroid hormone in the blood (11.6% each). 22% of patients stopped treatment due to side effects. 

This study concluded that PD-1 inhibitors are safe and effective for patients with relapsed or unresponsive cHL.

This study was retrospective, meaning it looked back in time to analyze data. This study had a small number of patients. More studies are needed to confirm these results.