Programmed Cell Death-One Inhibition Therapy in Classical Hodgkin Lymphoma |
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| Authors: | Samer A Al-Hadidi Hubert H Chuang Roberto N Miranda Hun Ju Lee |
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| Institution: | 1. Department of Hematology and Oncology, Baylor College of Medicine, Houston, TX;2. Department of Nuclear Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX;3. Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX;4. Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX;1. Division of Hematology, Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada;2. Division of Hematology, Department of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia;1. Hans Messner Allogeneic Transplant Program, Princess Margaret Cancer Centre, Toronto, Ontario, Canada;2. Department of Biostatistics, Princess Margaret Cancer Centre, Toronto, Ontario, Canada;1. Department of Pediatrics, Peking University People’s Hospital, Peking University, Beijing, China;2. Department of Hematology, Peking University People’s Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China; Peking-Tsinghua Center for Life Sciences and Research Unit of Key Technique for Diagnosis and Treatments of Hematologic Malignancies, Chinese Academy of Medical Sciences, Beijing, China;1. Department of Bone Marrow Transplant, Institute of Hematology and Blood Transfusion, Prague, Czech Republic;2. Institute of Clinical and Experimental Hematology, First Faculty of Medicine, Charles University, Prague, Czech Republic;1. Department of Medical Oncology, Olivia Newton-John Cancer Research and Wellness Center, Austin Hospital, Heidelberg, Australia;2. Eastern Health, Melbourne, Australia;3. University of Melbourne, Melbourne, Australia;4. Olivia Newton-John Cancer Research Institute, School of Cancer Medicine, La Trobe University, Melbourne, Australia;5. Department of Medical Oncology, Peter MacCallum Cancer Center, Melbourne, Australia;1. Department of Pathology, University of Michigan, Ann Arbor, MI;2. Department of Radiology, University of Michigan, Ann Arbor, MI;3. Department of Internal Medicine, University of Michigan, Ann Arbor, MI;4. Department of Internal Medicine, Ohio State University, Columbus, OH |
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| Abstract: | The majority of patients with classical Hodgkin lymphoma (cHL) may be cured, but for patients with relapsed or refractory (R/R) cHL, the prognosis is unfavorable. Immune dysfunction is a significant contributor of relapse and a hallmark of cHL; in particular, the immune system is unable to eradicate lymphoma cells that overexpress immune checkpoint proteins. The blocking of this mechanism used by lymphoma cells to evade the immune system has resulted in clinical benefits. Use of checkpoint inhibitors (CPIs) in R/R cHL is associated with high response rates and an acceptable adverse effects profile. There is growing interest in combining chemotherapy with CPIs in frontline therapy of cHL treatment to improve relapse rates without significant additive toxicity. In this review, we discuss the current evidence supporting CPI use in R/R cHL and maintenance therapy. We present emerging CPI data in frontline adult cHL and assess its role in the elderly. In addition, we discuss critical immune-related toxicities and their management, and elaborate on the challenges of monitoring response and minimal residual disease as tools for maximizing efficacy by limiting toxicity. |
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| Keywords: | Checkpoint inhibitors Classic Hodgkin lymphoma Nivolumab PD-1 inhibition Pembrolizumab |
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