Benevolo Savelli Corrado, Bisio Matteo, Legato Luca, Fasano Filippo, Santambrogio Elisa, Nicolosi Maura, Morra Deborah, Boccomini Carola, Freilone Roberto, Botto Barbara, Novo Mattia
Hematology Division, A.O.U. Città della Salute e della Scienza di Torino, C.so Bramante 88, 10126 Turin, Italy.
Cancers (Basel). 2024 May 10;16(10):1830. doi: 10.3390/cancers16101830.
Classical Hodgkin Lymphoma (cHL) is a highly curable disease, but around 20% of patients experience progression or relapse after standard frontline chemotherapy regimens. Salvage regimens followed by autologous stem cell transplants represent the historical treatment approach for these cases. In the last decade, with the increasing understanding of cHL biology and tumor microenvironment role in disease course, novel molecules have been introduced in clinical practice, improving outcomes in the relapsed/refractory setting. The anti-CD30 antibody-drug conjugated brentuximab vedotin and PD-1/PD-L1 checkpoint inhibitors represent nowadays curative options for chemorefractory patients, and randomized trials recently demonstrated their efficacy in frontline immune-chemo-combined modalities. Several drugs able to modulate the patients' T-lymphocytes and NK cell activity are under development, as well as many anti-CD30 chimeric antigen receptor T-cell products. Multiple tumor aberrant epigenetic mechanisms are being investigated as targets for antineoplastic compounds such as histone deacetylase inhibitors and hypomethylating agents. Moreover, JAK2 inhibition combined with anti-PD1 blockade revealed a potential complementary therapeutic pathway in cHL. In this review, we will summarize recent findings on cHL biology and novel treatment options clinically available, as well as promising future perspectives in the field.
经典型霍奇金淋巴瘤(cHL)是一种治愈率很高的疾病,但约20%的患者在接受标准一线化疗方案后会出现病情进展或复发。 salvage方案联合自体干细胞移植是这些病例的传统治疗方法。在过去十年中,随着对cHL生物学及肿瘤微环境在疾病进程中作用的认识不断加深,新分子已被引入临床实践,改善了复发/难治性患者的治疗结果。抗CD30抗体药物偶联物brentuximab vedotin和PD-1/PD-L1检查点抑制剂如今是化疗难治性患者的治愈性选择,近期的随机试验证明了它们在一线免疫化疗联合方案中的疗效。几种能够调节患者T淋巴细胞和NK细胞活性的药物正在研发中,还有许多抗CD30嵌合抗原受体T细胞产品。多种肿瘤异常表观遗传机制正在作为抗肿瘤化合物(如组蛋白去乙酰化酶抑制剂和低甲基化剂)的靶点进行研究。此外,JAK2抑制联合抗PD1阻断在cHL中显示出潜在的互补治疗途径。在本综述中,我们将总结cHL生物学的最新发现、临床上可用的新治疗选择以及该领域有前景的未来展望。