Incorporating Immunotherapy Into Hodgkin Lymphoma Treatment Strategies

Stephen M. Ansell, MD, PhD, chair of the Division of Hematology at Mayo Clinic in Rochester, Minnesota, discusses how immunotherapy is being integrated into treatment for patients with advanced stage Hodgkin lymphoma.

Additionally, he explains how the treatment for these patients is becoming more personalized.

Transcription:

0:09 | One of the regimens, the nivolumab [Opdivo]/AVD [doxorubicin, vinblastine, and dacarbazine]/chemotherapy, has an immune checkpoint blocking antibody, the nivolumab right in the combination, but I think more broadly, PD-1 blockade and agents such as pembrolizumab or nivolumab have really been broadly used in patients with Hodgkin lymphoma, many in the post transplant relapse setting and then subsequently in the salvage treatment combinations before going to a transplant. And now, as I mentioned in the frontline therapy. And the advantages are that you can see benefits for patients in each of these scenarios. In fact, interesting data suggests that using a PD-1 blocking antibody before intensive treatment like a stem cell transplant actually results in significantly greater benefit, suggesting that we are doing something immunological when we do that, that kind of treatment

1:03 | I think in many respects, the personalization is really focused on the patient's frailty vs, shall we say, robustness to tolerate treatment. One of the things that has been very interesting is that nivolumab, AVD, and chemotherapy is very well-tolerated in elderly patients. One of the problems with Hodgkin lymphoma is that elderly patients have really been very difficult to treat, purely because of the challenges they have tolerating these treatments. But the use of nivolumab and AVD has actually shown that regimen can be well-tolerated.

1:35 | Similarly, using brentuximab [vedotin; Adcetris]/AVD, by doing the brentuximab alone first and then the rest of the regimen, has also shown that you can give that to elderly patients. So the personalization is not personalized to the point of understanding the tumor biology. It is more personalized to the understanding of the patient and their needs.