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Management of relapsed/refractory classical Hodgkin lymphoma in transplant-ineligible patients

Neha Mehta-Shah and Nancy L. Bartlett

Abstract

Addition of brentuximab vedotin, a CD30 targeted antibody-drug conjugate, and the PD-1 inhibitors, nivolumab and pembrolizumab, to the armamentarium for transplant-ineligible relapsed/refractory classical Hodgkin lymphoma has resulted in improved outcomes, including the potential for cure in a small minority of patients. For patients who have failed prior transplant or are unsuitable for dose-intense approaches based on age or comorbidities, an individualized approach with sequential use of single agents such as brentuximab vedotin, PD-1 inhibitors, everolimus, lenalidomide, or conventional agents such as gemcitabine or vinorelbine, may result in prolonged survivals with minimal or modest effect on quality of life. Participation in clinical trials evaluating new approaches such as combination immune checkpoint inhibition, novel antibody-drug conjugates, or cellular therapies such as EBV-directed cytotoxic T-lymphocytes and chimeric antigen receptor T-cells offer additional options for eligible patients.

  • Submitted September 22, 2017.
  • Accepted November 7, 2017.