Targeted immunotherapies for classical Hodgkin’s lymphoma

This article reviewed the results of new targeted immunotherapy treatments in patients with classical Hodgkin’s lymphoma that is relapsed or refractory (does not respond to treatment).

Thanks to treatment advances, classical Hodgkin’s lymphoma (cHL) has become one of the most curable cancers. Frontline ABVD (doxorubicin, bleomycin, vinblastine, dacarbazine) chemotherapy has improved overall survival (OS; time from treatment until death from any cause) rates to 70 – 80%. However, better outcomes with less intense treatments are needed, especially for patients with relapsed or refractory cHL (RRcHL).

New treatments are being explored that take advantage of cancer cell survival mechanisms. Nivolumab (Opvido) and pembrolizumab (Keytruda) are a type of targeted immunotherapy. This type of treatment binds to immune system cells. This prevents cancer cells from evading immune attack. The use of these drugs as a frontline treatment for cHL either alone or in combination with other drugs remains under investigation.

This article reviewed the results of targeted immunotherapy studies in patients with RRcHL.

In a 2015 study, patients with RRcHL received nivolumab. The overall response (ORR; cancer shrinks or disappears after treatment) rate was 73%. This was compared to an ORR of 75% with brentuximab vedotin (Adcetris) in another study. The OS rate at 1 year was 95%, compared to an OS or 78% with brentuximab vedotin.

In a 2016 study, patients who relapsed after stem cell therapy and brentuximab vedotin treatment received pembrolizumab. These patients showed an ORR of 66.7%. Pembrolizumab is also being compared to brentuximab vedotin in an ongoing clinical trial (NCT02684292). Results are not yet available.

In a combination study, patients with RRcHL received combined nivolumab and brentuximab vedotin. This study showed an ORR of 100% and a complete response rate (CR; complete disappearance of all signs of cancer) of 62.5%.

For newly diagnosed cHL patients, frontline nivolumab combined with chemotherapy or radiotherapy remain under investigation.

In the 2015 nivolumab study, the most common side effects were fatigue (11%) and diarrhea (11%). In the 2016 pembrolizumab study, fever (11%) and low thyroid hormone levels (hypothyroidism; 10.5%) were most common. Severe or life-threatening side effects were also minimally reported, including low white blood cell count (1.4%), low platelet count (cells needed for blood clotting, 1.0%), and diarrhea (1.0%).

This article reviewed the results of new immunotherapy treatments in cHL patients with relapsed or refractory (does not respond to treatment) disease.