Alison J. Moskowitz, MD, medical oncologist, clinical director, Lymphoma, Memorial Sloan Kettering Cancer Center, discusses the challenges of intensifying treatment in Hodgkin lymphoma. 

In Hodgkin lymphoma, research efforts are ongoing to determine whether intensifying frontline treatment with doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) is feasible for patients, Moskowitz says. 

The most important goal of front-line therapy is to balance efficacy with toxicity, Moskowitz explains. Moreover, it is inefficient to utilize highly aggressive regimens if the patient could encounter substantial toxicities, Moskowitz adds.

This is especially important to consider in Hodgkin Lymphoma because the primary patient population comprises younger individuals. As such, these patients likely have many decades to live, so reducing long-term toxicity is a key consideration in treatment selection, Moskowitz concludes.

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Alison J. Moskowitz, MD, discusses the challenges of intensifying treatment in Hodgkin lymphoma.  

Dr. Moskowitz on the Challenges of Intensifying Treatment in Hodgkin Lymphoma 

Alison J. Moskowitz, MD, clinical director, Lymphoma Inpatient Unit, Memorial Sloan Kettering Cancer Center, discusses important updates in Hodgkin lymphoma.

Interim PET scan results have shown prognostic value in patients who have received 2 cycles of chemotherapy, says Moskowitz. As such, multiple studies are investigating the utility of modifying treatment for patients with Hodgkin lymphoma based on interim PET scan results.

Additionally, novel therapies like brentuximab vedotin (Adcetris), as well as nivolumab (Opdivo) and pembrolizumab (Keytruda) have revolutionized the treatment paradigm in the relapsed/refractory setting. Now, these agents are beginning to be evaluated earlier on in treatment to determine their optimal utility, concludes Moskowitz.

Alison J. Moskowitz, MD, discusses important updates in Hodgkin lymphoma.

Dr. Moskowitz on Important Updates in Hodgkin Lymphoma

Alison J. Moskowitz, MD, clinical director, Lymphoma Inpatient Unit, Memorial Sloan Kettering Cancer Center, discusses the data that led to the approval of brentuximab vedotin (Adcetris) in patients with cutaneous T-cell lymphoma (CTCL).

The data that led to the approval for brentuximab vedotin in CTCL came from the phase III ALCANZA study, which enrolled patients with primary cutaneous anaplastic large cell lymphoma, those who had received prior systemic therapy, and those who showed at least 10% CD30-expressing mycosis fungoides (MF). Patients were randomized to receive either brentuximab vedotin or investigator’s choice of therapy with either methotrexate or bexarotene.

The primary endpoint of the study was an overall response rate that lasted at least 4 months (ORR4). It’s an important response rate in a more chronic disease like CTCL for which physicians aim for durable disease control, Moskowitz says. The ORR4 for the patients with MF who received brentuximab was 50% compared with 10% with investigator’s choice, a clearly statistically significant improvement. Patients are showing a clear improvement in clinical benefit from the treatment, notes Moskowitz.

Alison J. Moskowitz, MD

Articles

Dr. Moskowitz on the Challenges of Intensifying Treatment in Hodgkin Lymphoma

Dr. Moskowitz on Important Updates in Hodgkin Lymphoma

Dr. Moskowitz on the ALCANZA Trial in CTCL