Management of Classical Hodgkin Lymphoma: a Look at Up to Date Evidence and Current Treatment Approaches

Overview

Journal Exp Hematol Oncol

Publisher Biomed Central

Specialty Hematology

Date 2022 Dec 27

PMID 36575540

Authors

Walter Hanel

Alex F Herrera

Narendranath Epperla

Affiliations

Soon will be listed here.

Abstract

The treatment landscape of classical Hodgkin lymphoma (cHL) has undergone significant changes over the past 20 years. Gradual improvements have been made in the management of cHL patients, particularly in prolonging the survival rate for those in the relapsed setting. Most of these improvements came with the addition of brentuximab vedotin and PD1 blockade (nivolumab and pembrolizumab) into the current cHL treatment algorithms. On the other hand, the treatment approach to cHL has become more complex than ever before, with multiple ways to add and sequence therapies to achieve long-term remission. In this review, we will discuss the most up-to-date evidence on the management of cHL patients with the inclusion of ongoing clinical trials in cHL. We will provide a general overview of the current therapeutic landscape of cHL in light of these most recent data. We conclude with our perspective on how the approach to cHL treatment may evolve in the future.

Citing Articles

Evaluation of prognostic factors in patients with high-risk classical Hodgkin lymphoma undergoing autologous transplantation.

Epperla N, Huang Y, Cashen A, Vaughn J, Hanel W, Badar T Blood Adv. 2024; 8(21):5458-5466.

PMID: 39213424 PMC: 11532746. DOI: 10.1182/bloodadvances.2024013743.

Successful Pregnancy and Fetal Outcomes Following Brentuximab Vedotin for Early Relapsed Classic Hodgkin Lymphoma After Autologous Stem Cell Transplant.

Goto A, Fujita C, Horiguchi H, Iyama S, Kobune M Cureus. 2024; 16(3):e57291.

PMID: 38690456 PMC: 11058904. DOI: 10.7759/cureus.57291.

Tislelizumab monotherapy in patients with previously untreated early-stage classical Hodgkin lymphoma: a real-world study.

Sun P, Yang H, Wang Y, Zhao B, Nie M, Huang K Ann Hematol. 2023; 103(3):793-801.

PMID: 37953379 DOI: 10.1007/s00277-023-05541-7.

Classical Hodgkin Lymphoma: From Past to Future-A Comprehensive Review of Pathophysiology and Therapeutic Advances.

Munir F, Hardit V, Sheikh I, Alqahtani S, He J, Cuglievan B Int J Mol Sci. 2023; 24(12).

PMID: 37373245 PMC: 10298672. DOI: 10.3390/ijms241210095.

References

Johnston P, Pinter-Brown L, Warsi G, White K, Ramchandren R . Phase 2 study of everolimus for relapsed or refractory classical Hodgkin lymphoma. Exp Hematol Oncol. 2018; 7:12. PMC: 5948762. DOI: 10.1186/s40164-018-0103-z. View

Armand P, Engert A, Younes A, Fanale M, Santoro A, Zinzani P . Nivolumab for Relapsed/Refractory Classic Hodgkin Lymphoma After Failure of Autologous Hematopoietic Cell Transplantation: Extended Follow-Up of the Multicohort Single-Arm Phase II CheckMate 205 Trial. J Clin Oncol. 2018; 36(14):1428-1439. PMC: 6075855. DOI: 10.1200/JCO.2017.76.0793. View

Moskowitz A, Shah G, Schoder H, Ganesan N, Drill E, Hancock H . Phase II Trial of Pembrolizumab Plus Gemcitabine, Vinorelbine, and Liposomal Doxorubicin as Second-Line Therapy for Relapsed or Refractory Classical Hodgkin Lymphoma. J Clin Oncol. 2021; 39(28):3109-3117. PMC: 9851707. DOI: 10.1200/JCO.21.01056. View

Marofi F, Rahman H, Achmad M, Sergeevna K, Suksatan W, Abdelbasset W . A Deep Insight Into CAR-T Cell Therapy in Non-Hodgkin Lymphoma: Application, Opportunities, and Future Directions. Front Immunol. 2021; 12:681984. PMC: 8261235. DOI: 10.3389/fimmu.2021.681984. View

Gutierrez A, Rodriguez J, Martinez-Serra J, Gines J, Paredes P, Garcia F . Gemcitabine and oxaliplatinum: an effective regimen in patients with refractory and relapsing Hodgkin lymphoma. Onco Targets Ther. 2014; 7:2093-100. PMC: 4235490. DOI: 10.2147/OTT.S70264. View

Cheson B, Bartlett N, Laplant B, Lee H, Advani R, Christian B . Brentuximab vedotin plus nivolumab as first-line therapy in older or chemotherapy-ineligible patients with Hodgkin lymphoma (ACCRU): a multicentre, single-arm, phase 2 trial. Lancet Haematol. 2020; 7(11):e808-e815. DOI: 10.1016/S2352-3026(20)30275-1. View

Josting A, Rudolph C, Reiser M, Mapara M, Sieber M, Kirchner H . Time-intensified dexamethasone/cisplatin/cytarabine: an effective salvage therapy with low toxicity in patients with relapsed and refractory Hodgkin's disease. Ann Oncol. 2002; 13(10):1628-35. DOI: 10.1093/annonc/mdf221. View

Garcia-Sanz R, Sureda A, de la Cruz F, Canales M, Gonzalez A, Pinana J . Brentuximab vedotin and ESHAP is highly effective as second-line therapy for Hodgkin lymphoma patients (long-term results of a trial by the Spanish GELTAMO Group). Ann Oncol. 2019; 30(4):612-620. DOI: 10.1093/annonc/mdz009. View

Straus D, Jung S, Pitcher B, Kostakoglu L, Grecula J, Hsi E . CALGB 50604: risk-adapted treatment of nonbulky early-stage Hodgkin lymphoma based on interim PET. Blood. 2018; 132(10):1013-1021. PMC: 6128083. DOI: 10.1182/blood-2018-01-827246. View

10.

Moskowitz A, Hamlin Jr P, Perales M, Gerecitano J, Horwitz S, Matasar M . Phase II study of bendamustine in relapsed and refractory Hodgkin lymphoma. J Clin Oncol. 2012; 31(4):456-60. PMC: 3862960. DOI: 10.1200/JCO.2012.45.3308. View

11.

Andre M, Girinsky T, Federico M, Reman O, Fortpied C, Gotti M . Early Positron Emission Tomography Response-Adapted Treatment in Stage I and II Hodgkin Lymphoma: Final Results of the Randomized EORTC/LYSA/FIL H10 Trial. J Clin Oncol. 2017; 35(16):1786-1794. DOI: 10.1200/JCO.2016.68.6394. View

12.

Casadei B, Broccoli A, Stefoni V, Pellegrini C, Marangon M, Morigi A . PD-1 blockade as bridge to allogeneic stem cell transplantation in relapsed/refractory Hodgkin lymphoma patients: a retrospective single center case series. Haematologica. 2019; 104(11):e521-e522. PMC: 6821632. DOI: 10.3324/haematol.2019.215962. View

13.

Advani R, Moskowitz A, Bartlett N, Vose J, Ramchandren R, Feldman T . Brentuximab vedotin in combination with nivolumab in relapsed or refractory Hodgkin lymphoma: 3-year study results. Blood. 2021; 138(6):427-438. DOI: 10.1182/blood.2020009178. View

14.

Fornecker L, Lazarovici J, Aurer I, Casasnovas R, Gac A, Bonnet C . Brentuximab Vedotin Plus AVD for First-Line Treatment of Early-Stage Unfavorable Hodgkin Lymphoma (BREACH): A Multicenter, Open-Label, Randomized, Phase II Trial. J Clin Oncol. 2022; 41(2):327-335. DOI: 10.1200/JCO.21.01281. View

15.

Kuppers R, Hansmann M . The Hodgkin and Reed/Sternberg cell. Int J Biochem Cell Biol. 2004; 37(3):511-7. DOI: 10.1016/j.biocel.2003.10.025. View

16.

Peggs K . Should all patients with Hodgkin lymphoma who relapse after autologous SCT be considered for allogeneic SCT?. Blood Adv. 2018; 2(7):817-820. PMC: 5894255. DOI: 10.1182/bloodadvances.2017011122. View

17.

Dores G, Curtis R, Dalal N, Linet M, Morton L . Cause-Specific Mortality Following Initial Chemotherapy in a Population-Based Cohort of Patients With Classical Hodgkin Lymphoma, 2000-2016. J Clin Oncol. 2020; 38(35):4149-4162. PMC: 7723686. DOI: 10.1200/JCO.20.00264. View

18.

Diefenbach C, Hong F, Ambinder R, Cohen J, Robertson M, David K . Ipilimumab, nivolumab, and brentuximab vedotin combination therapies in patients with relapsed or refractory Hodgkin lymphoma: phase 1 results of an open-label, multicentre, phase 1/2 trial. Lancet Haematol. 2020; 7(9):e660-e670. PMC: 7737486. DOI: 10.1016/S2352-3026(20)30221-0. View

19.

Herbaux C, Gauthier J, Brice P, Drumez E, Ysebaert L, Doyen H . Efficacy and tolerability of nivolumab after allogeneic transplantation for relapsed Hodgkin lymphoma. Blood. 2017; 129(18):2471-2478. DOI: 10.1182/blood-2016-11-749556. View

20.

Eichenauer D, Plutschow A, Kreissl S, Sokler M, Hellmuth J, Meissner J . Incorporation of brentuximab vedotin into first-line treatment of advanced classical Hodgkin's lymphoma: final analysis of a phase 2 randomised trial by the German Hodgkin Study Group. Lancet Oncol. 2017; 18(12):1680-1687. DOI: 10.1016/S1470-2045(17)30696-4. View