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Symposium | Panel discussion | How to sequence targeted therapies in classic Hodgkin lymphoma
Gilles Salles
Ann Lacasce
Paul Bröckelmann
Test your knowledge! Take our quick quiz before and after you read this article to find out if you improved your knowledge. Results help us to improve content and continually provide open-access education.
Question 1 of 2
According to the 2018 ESMO guidelines, which of the following factors is not a consideration when selecting brentuximab vedotin as a consolidation therapy in patients presenting at relapse?
A
B
C
D
Video series
During the European School of Haematalogy (ESH) 4th How to Diagnose and Treat Lymphoma Conference, the Lymphoma Hub held a symposium on November 02, 2024 titled Treating classic Hodgkin lymphoma (cHL): Spotlight on targeted therapies. Gilles Salles, Memorial Sloan Kettering Cancer Center, New York, US, chaired a panel discussion on sequencing targeted therapies in cHL.
Salles provides an overview of the treatment recommendations for cHL by the National Comprehensive Cancer Network (NCCN) 2024 and European Society for Medical Oncology (ESMO) 2018 guidelines:1,2
- In limited and intermediate-stage disease, treatment usually consists of doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) and/or escalated-dose bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisolone (eBEACOPP).
- In relapsed disease, treatment usually consists of high-dose chemotherapy (HDCT) and autologous stem cell transplant (auto SCT).
- In high-risk patients with relapse, brentuximab vedotin after HDCT/auto SCT can improve tumor control when patients have primary disease progression, early disease recurrence <12 months after the end of first-line treatment, or extranodal disease at the time of relapse.
- Salvage regimens include dexamethasone + high-dose cytarabine + cisplatin (DHAP), ifosfamide + gemcitabine + vinorelbine (IGEV), ifosfamide + carboplatin + etoposide (ICE), or brentuximab vedotin.
Salles discusses case studies (Figures 1-5) with expert insights on treatment approaches from Ann LaCasce from Harvard Medical School, Boston, US, and Paul Bröckelmann from University Hospital of Cologne, Cologne, DE.
Figure 1. Case 1*
CT, computed tomography; FDG, fluorodeoxyglucose; HL, Hodgkin lymphoma; PET, positron emission tomography; SUV, standardized uptake value.
*Case provided by Salles G.
Figure 2. Case 2*
cHL, classic Hodgkin lymphoma.
*Case provided by Salles G.
Figure 3. Case 3*
CT, computed tomography; EBV, Epstein Barr virus; HL, Hodgkin lymphoma; PET, positron emission tomography; SUV, standardized uptake value.
*Case provided by Salles G.
†B symptoms include fever, drenching night sweats, and loss of >10% of bodyweight over 6 months.
Figure 4. Case 4*
CAD, coronary artery disease; EF, ejection fraction; HL, Hodgkin lymphoma; HLP, hyperlipoproteinemia; HTN, hypertension.
*Case provided by Salles G.
Figure 5. Case 5*
ABVD, doxorubicin, bleomycin, vinblastine, and dacarbazine; ASCT, autologous stem cell transplantation; BEAM, carmustine, etoposide, aracytin, and melphalan; CR, complete response; DHAP, dexamethasone, high-dose cytarabine, and cisplatin; Hgb, hemoglobin; PET, positron emission tomography.
*Case provided by Salles G.
Your opinion matters
As a result of my participation in this symposium, I commit to staying aware of the latest clinical trial updates and guidelines for treatment sequencing in patients with cHL and to consider using targeted therapies when appropriate.
This independent educational activity was supported by Takeda. All content was developed independently by the faculty in collaboration with SES. The funder was allowed no influence on the content of the symposium.
References
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