Evaluating quality of life after pembrolizumab treatment for classical Hodgkin lymphoma

This phase 2 study evaluated the impact of pembrolizumab (Keytruda) on the quality of life of patients with classical Hodgkin’s lymphoma (cHL) that has come back or stopped responding to treatment. This study concluded that the overall quality of life and health status was improved for these patients.

Most patients with HL respond to first-line chemotherapy regimens. However, the cancer comes back (relapse) or progresses (grows or spreads) in up to 20% of patients after initial treatment. Patients whose disease stops responding to treatment tend to have a poor prognosis. New treatment options are needed for these patients.

Pembrolizumab is a monoclonal antibody. This treatment is a type of targeted immunotherapy. Monoclonal antibodies bind to cancer cells and help the body’s immune system attack the cancer. This leads to cancer cell death. How this treatment impacts the long-term quality of life for patients with relapsed or unresponsive cHL remains under investigation.

This study had 206 patients with cHL that has come back or stopped responding to treatment. All patients experienced tumor growth or spread after initial treatment. 86.7% of patients received at least 3 lines of prior therapy. In this study, patients were treated with pembrolizumab. Quality of life questionnaires were given to all patients before treatment and every subsequent 3 weeks to measure their quality of life. Patients were followed-up for 36 weeks.

Overall, 90% of patients completed the questionnaire before starting pembrolizumab treatment. At 12 weeks, this rate was 95%. This rate was 78% at 24 weeks, and 49% at 36 weeks.

Overall, few patients (10 – 25%) rated their quality of life or overall health as worse.

More patients who had a complete disappearance of all signs of cancer or tumor shrinkage after treatment rated their overall quality of life as improved compared to patients who had disease progression (46.9% vs. 38.7%). In another questionnaire, more of these patients also rated their health as improved compared to patients who had stable disease (neither tumor growth nor shrinkage; 60.2% vs. 50%).

This study concluded that the overall quality of life and health status improved for most patients after pembrolizumab treatment. The authors suggest that patients who responded to treatment had the most improvement.

This study used data from questionnaires, which were patient-reported. This may limit the conclusions that may be drawn from these results. More studies are needed to confirm these results.