Immune Checkpoint Blockade for the Treatment of Hodgkin Lymphoma

Abstract

Classical Hodgkin lymphoma is biologically different than other lymphomas. The cancer cells only occupy a small amount of the lymph node and evade the immune system by amplification of PD-L1 and PD-L2. Therefore, checkpoint inhibitors are a logical treatment option for Hodgkin lymphoma patients to unlock the immune system. Checkpoint inhibitors have shown high response rates in clinical trials in advanced-stage Hodgkin lymphoma. The two most commonly used checkpoint inhibitors are pembrolizumab and nivolumab, both FDA approved as third-line therapy. There is increasing interest in the use of checkpoint inhibitors with combination chemotherapy or with other targeted agents in the second-line or even frontline setting. In this review, we will highlight the clinical trials that led to approvals of checkpoint inhibitors for Hodgkin lymphoma.

A systematic review and meta-analysis of immune checkpoint therapy in relapsed or refractory non-Hodgkin lymphoma; a friend or foe?

“…Following great successes in solid tumors such as non-small cell lung cancer, melanoma, renal cell carcinoma [66] , and squamous cell carcinoma of the head and neck [67] , interest has risen to explore these inhibitors in hematologic malignancies. Notably, patients with relapsed or refractory HL showed promising outcomes to PD-1 inhibitors probably due to the PD-L1 and PD-L2 up-regulation in >95% of cases during the immune escape [68] . While ICIs are a logical treatment option for HL patients, there are controversial results about their efficacies in NHL ones.…”

Demyelinating polyneuropathy combined with brachial plexopathy after nivolumab therapy for hodgkin lymphoma: a case report

“…It is the first FDA-approved ICI in relapsed HL as a third-line drug. Growing evidence supports its administration as a second or first-line drug in newly diagnosed HL [ 15 ]. In a recent retrospective study, nivolumab showed comparable safety and efficacy in treating patients with refractory HL [ 16 ].…”

Classical Hodgkin Lymphoma: From Past to Future—A Comprehensive Review of Pathophysiology and Therapeutic Advances

“…In addition, the distinct biology of cHL is inspiring the development of newer molecular therapies [ 152 ]. RS cells exhibit genetic amplification of the 9p24.1 locus; further analysis revealed their overexpression of programmed death ligand 1 (PD-L1) and programmed death ligand 2 [ 152 , 153 ]. This discovery led to the rational development of PD-1 checkpoint inhibitors.…”