Department of Internal Medicine, Division of Hematology, Koc University School of Medicine, Istanbul, Turkey.
Basaksehir Cam ve Sakura City Hospital, Division of Hematology, Istanbul, Turkey.
Expert Rev Hematol. 2023 Jul-Dec;16(12):991-1015. doi: 10.1080/17474086.2023.2276212. Epub 2023 Dec 18.
Classical Hodgkin lymphoma (cHL) is a curable disease, with durable remission achieved in about 80% of patients following first-line treatment. Three new drugs were introduced to the daily use in cHL: brentuximab vedotin (BV), nivolumab, and pembrolizumab. All three drugs were initially approved for the treatment of relapsed/refractory cHL (RRHL) and with their promising outcomes, they are now incorporated in different stages of the treatment.
We performed a literature search using PubMed on all cHL studies investigating BV and CPIs within the past 10 years. We analyzed literature to presume the sequencing of these novel agents.
Addition of BV or nivolumab to AVD backbone in the frontline setting showed promising activity in advanced stage cHL. BV and CPIs combined with chemotherapy in the second-line treatment of cHL are evaluated in phase 2 studies and comparable results are reported. The results of BrECADD, with good efficacy and toxicity profile, should be followed. Pembrolizumab was shown to be more effective in RRHL compared to BV in patients who have relapsed post-ASCT or ineligible for ASCT. BV is used in post-ASCT maintenance in high-risk cases, although its role will be questioned as it is increasingly used in the frontline treatment.
经典型霍奇金淋巴瘤（cHL）是一种可治愈的疾病，约 80%的患者在一线治疗后可获得持久缓解。三种新药物已被常规用于治疗 cHL： Brentuximab vedotin（BV）、nivolumab 和 pembrolizumab。这三种药物最初均被批准用于治疗复发/难治性 cHL（RRHL），由于疗效显著，现已被纳入不同的治疗阶段。
我们使用 PubMed 对过去 10 年内所有关于 cHL 研究中 BV 和 CPIs 的文献进行了检索。我们分析了这些新药物的应用顺序。
在一线治疗中，在 AVD 方案中加入 BV 或 nivolumab 显示出对晚期 cHL 的活性。BV 和 CPIs 联合化疗在 cHL 的二线治疗中的评估均在 2 期研究中进行，报告了相似的结果。BrECADD 的结果具有良好的疗效和毒性特征，应密切关注。与 BV 相比，pembrolizumab 在接受 ASCT 后复发或不适合 ASCT 的 RRHL 患者中更有效。BV 用于高危病例的 ASCT 后维持治疗，尽管随着其在一线治疗中的应用越来越广泛，其作用将受到质疑。
