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SOHO 2021 | Optimal therapy sequencing for Hodgkin lymphoma

Stephen Ansell, MD, PhD, of the Mayo Clinic, Rochester, MN, discusses how clinical trials have been increasingly finding ways to achieve effective treatment of Hodgkin lymphoma at lower and less frequent doses, driven by the emergence of immunological and targeted therapies. Prof. Ansell sheds light on the use of the antibody-drug conjugate brentuximab vedotin as well as PD-1 blockade in combination with chemotherapy for advanced stage patients, and describes how trials have reported high response rates for such combination approaches. Prof. Ansell further talks about novel agents becoming the standard of care in refractory patients. This interview took place during the ninth annual meeting of the Society of Hematologic Oncology (SOHO 2021) congress.

Transcript (edited for clarity)

How we best treat Hodgkin lymphoma has really changed over years. And I think there are two facets to how it’s changed. One is that we realize that we can utilize effects of therapy, but at less and lower doses. And two, we’ve realized that there are immunological and targeted therapies that we can incorporate into our treatment that has really improved the outcome of patients. So just to highlight what I mean, I think we’ve learned that, as particularly in early stage disease, we can utilize fewer rounds of treatment...

How we best treat Hodgkin lymphoma has really changed over years. And I think there are two facets to how it’s changed. One is that we realize that we can utilize effects of therapy, but at less and lower doses. And two, we’ve realized that there are immunological and targeted therapies that we can incorporate into our treatment that has really improved the outcome of patients. So just to highlight what I mean, I think we’ve learned that, as particularly in early stage disease, we can utilize fewer rounds of treatment. We can utilize lower doses of radiation therapy and still maintain very effective and very pleasing and successful outcomes as far as treatment is concerned.

And even in advanced stage patients, bringing in agents such as brentuximab vedotin, the antibody drug conduit, in combination with chemotherapy and now more recently, PD-1 blockade in combination with chemotherapy. That has resulted in very high response rates and are now being tested in randomized trials to see whether those strategies are actually better than some of the treatment approaches we’ve used in the past. In the relapse setting, again, many of these novel agents and targeted therapies have become standard of care. We’ve now seen them utilized before going to stem cell transplant and being used after stem cell transplant. So all told, whereas a decade or two back our approaches were really various types of chemotherapy, now our approaches are still utilizing chemotherapy but often in combination with antibody-drug conjugates or immune checkpoint blockade with as good and sometimes even better responses.

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Disclosures

Stephen Ansell, MD, PhD, has received institutional research funding for clinical trials from Bristol Myers Squibb, Takeda, SeaGen, Regeneron, Trillium and ADC Therapeutics.

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