Nivolumab: a new treatment option for Hodgkin lymphoma that has relapsed or not responded to treatment

This study examined the use of nivolumab (Opdivo) in patients with heavily pretreated Hodgkin lymphoma. The authors concluded that nivolumab was effective and safe in these patients.

PD-1 is a protein that slows the immune response. Many cancer cells use the PD-1 pathway to block the immune system from attacking cancer cells. Treatments such as nivolumab block, or inhibit, PD-1. This allows the immune system to fight the cancer cells.

Nivolumab has been shown to be effective in solid cancers such as melanoma or lung cancer. It is thought that Reed-Sternberg cells (cells present in Hodgkin lymphoma) are also sensitive to PD-1 inhibitors. It is not clear if nivolumab is safe or effective in patients with heavily pretreated Hodgkin lymphoma.

The current study examined the use of nivolumab in patients with previously heavily treated Hodgkin lymphoma. 23 patients whose disease had relapsed or had not responded to treatment were included in the study. 87% of patients had been treated with three or more previous therapies. 78% had undergone a stem cell transplant. Nivolumab was infused (delivered directly to a vein) every two weeks. Patients were followed for an average of 40 weeks.

The response to treatment rate was 87%. 17% of patients saw a complete response (absence of cancer), and 70% saw a partial response. The progression-free survival rate (time from treatment until disease progression) at 24 weeks was 86%.

78% of patients experienced a drug-related negative side effect. Common side effects included rash in 22% and decreased platelets (a type of blood cell involved in clotting) in 17%. More severe side effects were noted in 22%. These included inflammation of the pancreas, stomach, lung, or intestines, and decreased levels of white blood cells. 52% of patients stopped treatment due to side effects (9%), disease progression (17%) or stem cell transplant (26%).

This study concluded that nivolumab was effective and safe as a treatment for pretreated Hodgkin lymphoma patients.

This study included a small number of participants. Further studies should be done with larger populations. This study was funded by Bristol-Myers Squibb, the manufacturer of nivolumab.