Novel Therapy of Relapsed and Refractory Classical Hodgkin’s Lymphoma

Abstract

Classical Hodgkin’s lymphoma (HL) is generally considered a highly curable disease, with approximately 80 % of patients cured with standard first-line chemotherapy. The standard treatment approach for relapsed/refractory patients is second-line salvage chemotherapy followed by autologous stem cell transplantation (ASCT). About half of all patients undergoing ASCT are rescued and definitely cured by such an approach, but the outcome in patients relapsing or refractory to second-line chemotherapy and ASCT is dismal, with a median survival of less than three years. Therapeutic options for this subset of patients comprise tandem ASCT, reduced-intensity allogeneic stem cell transplantation (allo-SCT) and novel agents. Median overall and progression-free survival rates following allo-SCT have ranged from 27 to 56 % and from 18 to 39 %, respectively, with a treatment-related mortality ranging from 15 to 25 %. Several new compounds have been identified as promising agents for the treatment of patients with relapsed classical HL. These drugs have shown promising activity in a subset of heavily pre-treated relapsed/refractory patients, with response rates and disease control rates exceeding 40 and 70 %. If approved, these compounds will probably change the standard of care, making it possible to develop combination regimens with chemotherapy or other new agents, thus improving efficacy with a decreased toxicity profile.