Reviewing treatment options for patients with Hodgkin lymphoma

This article reviewed new developments in treatments for patients with Hodgkin lymphoma (HL).

For most patients with HL, conventional treatments such as chemotherapy are effective. However, about 50 – 60% of patients have cancer come back (relapse) or become resistant to treatment (refractory). High-dose chemotherapy followed by autologous stem cell transplantation is the typical next step for these patients. However, long-term complications due to side effects make treatment challenging.

Targeted therapy can help improve patient outcomes while minimizing side effects. This type of treatment specifically targets certain proteins or genes on cancer cells. This interferes with their growth or function. This leads to cancer cell death. It is important to review different therapies for patients with HL.

For patients with stage 1 – 2 classical HL, ABVD (adriamycin, bleomycin, vinblastine, dacarbazine) chemotherapy remains the standard treatment. Radiation therapy can also be added.

For patients with stage 3 – 4 classical HL, ABVD chemotherapy is also the standard treatment. After 2 cycles of treatment, studies have shown that omitting bleomycin (AVD chemotherapy, or ABVD without bleomycin) can help reduce side effects. Previous studies have shown that bleomycin (Blenoxane) is associated with serious lung side effects.

One new treatment option for patients with advanced classical HL is brentuximab vedotin (Adcetris) plus AVD chemotherapy. Brentuximab vedotin is a monoclonal antibody. This type of targeted therapy helps the body’s immune system attack the cancer cells. In one study, 664 patients received BV+AVD and 670 patients received ABVD. Significantly more patients treated with BV+AVD were still alive 2 years later without tumor growth or spread (82.1% vs. 77.2%).

For patients with relapsed or refractory HL, high-dose chemotherapy followed by a stem cell transplant (SCT) remains the standard of care. For patients who relapse after SCT, targeted therapies are the typical next step. They can be given as single drug or in combination. Brentuximab vedotin plus nivolumab (Opdivo) is one promising combination. In one study of 62 patients, 83% of patients responded to treatment. 68% of patients had survived without signs and symptoms from the disease. 

This article reviewed new developments in treatments for patients with HL. The authors suggest that combining chemotherapy with targeted therapies may help improve outcomes for these patients.