Immunotherapy for classic Hodgkin’s lymphoma
L.V. Filatova (1, 2)
1) N.N. Petrov National Medical Research Center of Oncology, St. Petersburg, Russia;
2) North-Western State Medical University n.a. I.I. Mechnikov, St. Petersburg, Russia
High-dose chemotherapy with autologous hematopoietic stem cell transplantation (HDC with auto-HSCT) is the current standard for the treatment of primary refractory forms and the first recurrences of Hodgkin’s lymphoma (HL). HDC with auto-HSCT is effective for 50–60% of patients with the first late chemotherapy-sensitive recurrence of HL.
Modern therapies for treating HL with high efficacy and low toxicity are particularly relevant for patients with HL who are not candidates for HDC with auto-HSCT, as well as for the occurrence of recurrent HL after HDC with auto-HSCT. Allogeneic hematopoietic stem cell transplantation (alloHSCT) can be performed in patients with recurrent HL after HDC with auto-HSCT with preserved chemosensitivity, preferably in young patients in a framework of prospective clinical studies. Brentuximab vedotin is registered for the treatment of patients with classical HL after failure (progression or early recurrence) of HDC with auto-HSCT or patients not candidates for HDC with auto-HSCT, if two or more chemotherapy lines fail, for consolidation after the HDC with auto-HSCT in patients with HL with a high risk of recurrence or progression, in first-line therapy with advanced stages of HL, most preferably for young patients, patients with a high risk of recurrence. In patients with HL recurrence, high activity of PD-1/PD-L1 checkpoint inhibitors that activate antitumor immunity (nivolumab, pembrolizumab) was noted. The therapeutic efficacy of PD-1/PD-L1 checkpoint inhibitors does not depend on the response to previous therapy regimens (primary refractoriness or refractoriness to brentuximab vedotin). Promising areas of HL therapy are associated with the further study of new tumor cell targets and their signaling pathways.
Keywords: Hodgkin’s lymphoma, second-line therapy (“rescue therapy”), high-dose chemotherapy with autologous hematopoietic stem cell transplantation, allogeneic hematopoietic stem cell transplantation, brentuximab vedotin, nivolumab, pembrolizumab
About the Autors
Corresponding author: Larisa V. Filatova, MD, Leading researcher at the Scientific Department of Innovative Methods of Therapeutic Oncology and Rehabilitation, N.N. Petrov NMRCO; Associate Professor at the Department of Oncology, SNWSMU n.a. I.I. Mechnikov, St. Petersburg, Russia; e-mail: Larisa_Filatova@list.ru, ORCID: https://orcid.org/0000-0002-0728-4582
Address: 68, Leningradskaya Street, Pesochny settlement, St. Petersburg 197758, Russian Federation