title: Recent treatment advances in Hodgkin lymphoma: a concise review.
abstract: The majority of patients with Hodgkin lymphoma enjoy durable remissions following front-line treatment. This typically involves combination chemotherapy with or without radiotherapy. A significant minority of patients experience relapsed/refractory disease, of whom only approximately half can be 'salvaged' with conventional second-line treatments. Until recently, for those patients either failing or who are not fit for salvage, there have been few curative alternatives. Furthermore, there is a significant risk of delayed treatment complications to conventional therapies, including secondary malignancies and cardiac disease. However, novel targeted therapies are producing excellent results in clinical trials. They provide additional treatment options for those with relapsing/refractory disease; they may have potential in front-line therapy. The anti-CD30 antibody brentuximab vedotin (BV) has been tested as monotherapy and in combination in a variety of clinical settings, including in relapsed/refractory patients and as consolidative therapy following standard second-line therapy. Nivolumab and pembrolizumab, currently used in other malignancies that are known to utilise the programmed death pathway for survival, have shown outstanding results when used as single agents in heavily pre-treated (including BV refractory) patients. Individualising and adapting a patient's treatment course, whether augmenting or rationalising therapy, based on an interim positron emission tomography/computed tomography response is an important strategy currently under exploration to minimise toxicity while maximising response. Further work is needed to explore clinical and biological factors associated with improved outcomes. Knowledge of these factors combined with the movement of novel therapies into the front-line setting will enable individualised therapy to enhance clinical responses and minimise toxicities.
authors.affiliation: Department of Haematology, Princess Alexandra Hospital, Brisbane, Queensland, Australia.
authors.forename: S
authors.initials: S
authors.lastname: Arulogun
authors.affiliation: Department of Haematology, Prince of Wales Hospital, Sydney, New South Wales, Australia.
authors.forename: M
authors.initials: M
authors.lastname: Hertzberg
authors.affiliation: Department of Haematology, Princess Alexandra Hospital, Brisbane, Queensland, Australia.|Blood Cancer Research Laboratory, University of Queensland Diamantina Institute, Brisbane, Queensland, Australia.
authors.forename: M K
authors.initials: MK
authors.lastname: Gandhi
mesh_terms: D000911:Antibodies, Monoclonal; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols; D000079963:Brentuximab Vedotin; D006689:Hodgkin Disease / Q000276:immunology / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D018796:Immunoconjugates / Q000008:administration & dosage* / Q000627:therapeutic use; D007167:Immunotherapy / Q000379:methods*; D017730:Ki-1 Antigen; D058990:Molecular Targeted Therapy / Q000379:methods* / Q000639:trends; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control*; D049268:Positron-Emission Tomography; D018714:Radiotherapy, Adjuvant; D012074:Remission Induction; D016879:Salvage Therapy / Q000379:methods* / Q000639:trends
chemical_list: D000911:Antibodies, Monoclonal; D000970:Antineoplastic Agents; D018796:Immunoconjugates; D017730:Ki-1 Antigen; D000079963:Brentuximab Vedotin
keywords: Hodgkin lymphoma; PD-1; PET scan; brentuximab vedotin; nivolumab; pembrolizumab