BSH 2024 | Tackling PD1i resistance in Hodgkin lymphoma

So, one of the hot topics now in relapsed Hodgkin lymphoma is patients treated with a PD1 inhibitor, it doesn’t really cure people, particularly as monotherapy. So the question is when they relapse and they’re PD1 resistant, how do we perhaps regain that sensitivity to PD1 inhibition. And a number of different things have been tried. So there was a paper in Blood, which I commented on not that long ago, which was combining a PD1 inhibitor with an HDAC inhibitor. And the idea there is that you use this epigenetic modifying drug to re-express some of the immune receptors, and that may make the PD1 inhibitor work better. And certainly this trial which looks at this combination, there was some data suggesting that you could reawaken sensitivity to PD1 inhibition. However, there are a number of other strategies being pursued. So, perhaps targeting multiple checkpoints, and there’s a clinical trial now combining pembrolizumab with favezelimab, which is a LAG-3 inhibitor, and comparing that with chemotherapy in the multiple relapsed setting, so that’ll be an interesting strategy. And there are other novel agents that are, again, targeting this PD1-resistant population.