Khan Niloufer, Moskowitz Alison J
Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA.
Curr Hematol Malig Rep. 2017 Jun;12(3):227-233. doi: 10.1007/s11899-017-0384-z.
The standard approach for relapsed or refractory (rel/ref) Hodgkin lymphoma (HL) following frontline treatment failure is salvage therapy followed by consolidation with high-dose therapy and autologous stem cell transplant (HDT/ASCT). While this overall treatment paradigm has been in place for several decades, recent studies have aimed to improve the efficacy and tolerability of salvage therapies by incorporating newer drugs, such as brentuximab vedotin (BV) and checkpoint inhibitors. Following HDT/ASCT, survival is improved due to the availability of BV and the checkpoint inhibitors, nivolumab and pembrolizumab; however, for patients responding to checkpoint inhibition, the appropriate length of treatment and the role of allogeneic stem cell transplant are unclear. In this review, we discuss our management of rel/ref HL, with particular focus on how BV, nivolumab, and pembrolizumab are currently incorporated into the treatment paradigms for rel/ref HL.
对于一线治疗失败后的复发或难治性(rel/ref)霍奇金淋巴瘤(HL),标准方法是挽救性治疗,随后进行大剂量治疗和自体干细胞移植(HDT/ASCT)巩固治疗。虽然这种总体治疗模式已经存在了几十年,但最近的研究旨在通过纳入新药,如本妥昔单抗(BV)和检查点抑制剂,来提高挽救性治疗的疗效和耐受性。在HDT/ASCT之后,由于有BV以及检查点抑制剂纳武单抗和帕博利珠单抗,生存率有所提高;然而,对于对检查点抑制有反应的患者,合适的治疗时长以及异基因干细胞移植的作用尚不清楚。在这篇综述中,我们讨论了我们对rel/ref HL的管理,特别关注BV、纳武单抗和帕博利珠单抗目前如何纳入rel/ref HL的治疗模式。