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How to choose first salvage therapy in Hodgkin lymphoma: traditional chemotherapy vs novel agents
- Source :
- Hematology Am Soc Hematol Educ Program, Driessen, J, Tonino, S H, Moskowitz, A J & Kersten, M J 2021, ' How to choose first salvage therapy in Hodgkin lymphoma : traditional chemotherapy vs novel agents ', Hematology. American Society of Hematology. Education Program, vol. 2021, no. 1, pp. 240-246 . https://doi.org/10.1182/hematology.2021000311, Hematology. American Society of Hematology. Education Program, 2021(1), 240-246. American Society of Hematology, Hematology (United States), 2021(1), 240-246. American Society of Hematology
- Publication Year :
- 2021
-
Abstract
- Approximately 10% to 30% of patients with classical Hodgkin lymphoma (cHL) develop relapsed or refractory (R/R) disease. Of those patients, 50% to 60% show long-term progression-free survival after standard salvage chemotherapy followed by high-dose chemotherapy (HDCT) and autologous stem cell transplant (ASCT). In the past decade, novel therapies have been developed, such as the CD30-directed antibody–drug conjugate brentuximab vedotin and immune checkpoint inhibitors, which have greatly extended the treatment possibilities for patients with R/R cHL. Several phase 1/2 clinical trials have shown promising results of these new drugs as monotherapy or in combination with chemotherapy, but unfortunately, very few randomized phase 3 trials have been performed in this setting, making it difficult to give evidence-based recommendations for optimal treatment sequencing. Two important goals for the improvement in the treatment of R/R cHL can be identified: (1) increasing long-term progression-free and overall survival by optimizing risk-adapted treatment and (2) decreasing toxicity in patients with a low risk of relapse of disease by evaluating the need for HDCT/ASCT in these patients. In this review, we discuss treatment options for patients with R/R cHL in different settings: patients with a first relapse, primary refractory disease, and in patients who are ineligible or unfit for ASCT. Results of clinical trials investigating novel therapies or strategies published over the past 5 years are summarized.
Details
- ISSN :
- 15204383 and 15204391
- Volume :
- 2021
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- Hematology. American Society of Hematology. Education Program
- Accession number :
- edsair.doi.dedup.....ddd54ebeab01d82f82f04d322a57fca0