Smith Christine Moore, Friedman Debra L
Division of Pediatric Hematology/Oncology, Vanderbilt University Medical Center, Nashville, TN, United States.
Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, United States.
Front Oncol. 2022 Feb 25;12:855725. doi: 10.3389/fonc.2022.855725. eCollection 2022.
Since the initial treatment with radiation therapy in the 1950s, the treatment of Hodgkin lymphoma has continued to evolve, balancing cure and toxicity. This approach has resulted in low rates of relapse and death and fewer short and late toxicities from the treatments used in pursuit of cure. To achieve this balance, the field has continued to progress into an exciting era where the advent of more targeted therapies such as brentuximab vedotin, immunotherapies such as PD-1 inhibitors, and chimeric antigen receptor T-cells (CAR-T) targeted at CD30 are changing the landscape. As in the past, cooperative group and international collaborations are key to continuing to drive the science forward. Increased focus on patient-reported outcomes can further contribute to the goal of improved outcomes by examining the impact on the individual patient in the acute phase of therapy and on long-term implications for survivors. The goals of this review are to summarize recent and current clinical trials including reduction or elimination of radiation, immunotherapies and biologically-targeted agents, and discuss the use of patient-reported outcomes to help discern directions for new therapeutic regimens and more individualized evaluation of the balance of cure and toxicity.
自20世纪50年代首次采用放射治疗以来,霍奇金淋巴瘤的治疗一直在不断发展,力求在治愈疾病与控制毒性之间取得平衡。这种治疗方法降低了复发率和死亡率,同时减少了为治愈疾病而采用的治疗手段所带来的短期和长期毒性。为实现这一平衡,该领域不断发展,进入了一个令人兴奋的时代,诸如维布妥昔单抗等更具针对性的疗法、PD-1抑制剂等免疫疗法以及靶向CD30的嵌合抗原受体T细胞(CAR-T)的出现正在改变治疗格局。与过去一样,协作组和国际合作对于推动科学发展至关重要。通过研究治疗急性期对个体患者的影响以及对幸存者的长期影响,更多地关注患者报告的结局能够进一步助力实现改善治疗效果的目标。本综述的目的是总结近期和当前的临床试验,包括减少或消除放疗、免疫疗法和生物靶向药物,并讨论如何利用患者报告的结局来帮助确定新治疗方案的方向,以及更个性化地评估治愈与毒性之间的平衡。