T057: Circulating tumor DNA in classical Hodgkin lymphoma patients treated with pembrolizumab and chemotherapy: dynamic response assessment and correlation with baseline total metabolic tumor volume

Lynch, Ryan C.; Alig, Stefan; Ujjani, Chaitra S.; Poh, Christina; Warren, Edus H.; Smith, Stephen; Shadman, Mazyar; Shustov, Andrei R.; Till, Brian G.; Raghunathan, Vikram; Tseng, Yolanda D.; Coye, Hilary; Shelby, Megan L.; Ottemiller, Susan; Keo, Sarith; Verni, Kaitlin; Du, Hongwu; Vandermeer, Jackie; Gaston, Ashley; Rasmussen, Heather; Gulhane, Avanti; Chen, Delphine L.; Martin, Paul; Marzbani, Edmond; Voutsinas, Jenna; Alizadeh, Ash A.; Gopal, Ajay K.

doi:10.1097/01.hs9.0000890796.34979.cc

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“…With the increasing use of immunotherapy, it will be important to identify biomarkers that can predict response, such as 9p24.1 amplification, higher levels of PD-L1 expression, and MHC class II expression, all of which correlate with better responses to PD-1 blockade [ 150 ]. Finally, dynamic biomarkers such as circulating tumor DNA or metabolic tumor volume assessed longitudinally may further inform management decisions and enable a more personalized approach in the future [ 151 , 152 , 153 , 154 ].…”

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confidence: 99%

Optimizing Treatment for Relapsed/Refractory Classic Hodgkin Lymphoma in the Era of Immunotherapy

Randall,

Spinner

2023

Cancers

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Most patients with classic Hodgkin lymphoma (cHL) are cured with combination chemotherapy, but approximately 10–20% will relapse, and another 5–10% will have primary refractory disease. The treatment landscape of relapsed/refractory (R/R) cHL has evolved significantly over the past decade following the approval of brentuximab vedotin (BV), an anti-CD30 antibody-drug conjugate, and the PD-1 inhibitors nivolumab and pembrolizumab. These agents have significantly expanded options for salvage therapy prior to autologous hematopoietic cell transplantation (AHCT), post-transplant maintenance, and treatment of relapse after AHCT, which have led to improved survival in the modern era. In this review, we highlight our approach to the management of R/R cHL in 2023 with a focus on choosing first salvage therapy, post-transplant maintenance, and treatment of relapse after AHCT. We also discuss the management of older adults and transplant-ineligible patients, who require a separate approach. Finally, we review novel immunotherapy approaches in clinical trials, including combinations of PD-1 inhibitors with other immune-activating agents as well as novel antibody-drug conjugates, bispecific antibodies, and cellular immunotherapies. Ongoing studies assessing biomarkers of response to immunotherapy and dynamic biomarkers such as circulating tumor DNA may further inform treatment decisions and enable a more personalized approach in the future.

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