Targeted therapy in relapsed classical hodgkin lymphoma

J Natl Compr Canc Netw. 2013 Aug;11(8):968-76. doi: 10.6004/jnccn.2013.0117.

Abstract

Although frontline treatment of advanced Hodgkin lymphoma (HL) produces high cure rates, disease either will not respond to or will relapse after initial therapy in approximately a quarter of patients. Many patients with disease relapse can be successfully salvaged with second-line chemotherapy followed by autologous stem cell transplantation (ASCT). Patients whose disease relapses after ASCT are rarely cured. A unique pathophysiologic feature of HL is that the malignant Reed-Sternberg (HRS) cell is rare and resides within a microenvironment of inflammatory and immune-related cells. The recent FDA approval of the anti-CD30 antibody-drug conjugate brentuximab vedotin (BV) for patients with either primary refractory HL or those whose disease relapses after ASCT represents a major advance in therapy. This article focuses on BV and other novel agents that target the HRS cell surface, intracellular signaling pathways, and tumor microenvironment.

MeSH terms

  • Brentuximab Vedotin
  • Disease-Free Survival
  • Hodgkin Disease / drug therapy*
  • Humans
  • Immunoconjugates / therapeutic use*
  • Ki-1 Antigen / antagonists & inhibitors
  • Ki-1 Antigen / drug effects
  • Ki-1 Antigen / immunology*
  • Neoplasm Recurrence, Local / drug therapy*
  • Reed-Sternberg Cells / drug effects
  • Signal Transduction / drug effects
  • Stem Cell Transplantation
  • Transplantation, Autologous
  • Tumor Microenvironment / drug effects

Substances

  • Immunoconjugates
  • Ki-1 Antigen
  • Brentuximab Vedotin