Comparing the UK & US Approaches to First-Line Treatment in Hodgkin Lymphoma

Wendy Osborne, MD, and Sarah Rutherford, MD, comparing the UK and US approaches to first-line treatment in Hodgkin lymphoma.

Videos

, hosted by Matthew Lunning, DO, FACP, is a podcast that seeks to translate the latest hematologic oncology research findings into practical clinical implications for the treatment of patients with hematologic malignancies. Dr Lunning is an associate professor in the Division of Oncology & Hematology, associate vice chair of research in the Department of Internal Medicine, and assistant vice chancellor of clinical research at the University of Nebraska Medical Center in Omaha.

In this episode, Dr Lunning sat down with Sarah Rutherford, MD, to discuss the phase 3 SWOG S1826/ECHELON-1 trial (NCT03907488) of brentuximab vedotin (Adcetris; BV) plus doxorubicin, vinblastine, and dacarbazine (AVD) in older patients with Hodgkin lymphoma. Dr Rutherford is an assistant professor of medicine in the Division of Hematology/Oncology at Weill Cornell Medicine in New York, New York. 

Drs Lunning and Rutherford highlighted key findings from the ECHELON-1 trial in the cohort of patients over 60 years of age, differentiating factors of Hodgkin lymphoma in younger vs older patients, the importance of determining an optimal and tolerable balance of checkpoint inhibitors plus chemotherapy, and more.

Podcasts

Drs Lunning and Rutherford discuss findings from the ECHELON-1 trial of BV-AVD in the cohort of patients with Hodgkin lymphoma over 60 years of age.
 

Lunning and Rutherford Detail Considerations for BV-AVD Use in Older Patients With Hodgkin Lymphoma

Sarah Rutherford, MD, John P. Leonard, M.D./Gwirtzman Family Research Scholar in Lymphoma, assistant professor of medicine, Joan and Sanford I. Weill Department of Medicine, Weill Cornell Medicine/NewYork-Presbyterian Hospital, discusses the importance of including patients with double-hit lymphoma (DHL) in clinical trials.

DHL is a relatively rare, high-risk subtype of B-cell lymphoma that is typically less responsive to standard treatments, says Rutherford.

In oncology, clinical trials may not always be representative of the standard patient population, explains Rutherford.

In a phase 1 study, investigators evaluated the combination of dose-adjusted rituximab (Rituxan), etoposide, prednisone, vincristine, cyclophosphamide, and doxorubicin (DA-EPOCH-R) plus venetoclax (Venclexta) as frontline therapy in aggressive B-cell lymphomas. 

Initial findings presented at the 2020 ASCO Virtual Scientific Program showed that the combination led to an overall response rate of 93% and a complete response rate of 87% in  15 patients with DHL.

Sarah Rutherford, MD, discusses the importance of including patients with double-hit lymphoma in clinical trials.



Dr. Rutherford on the Importance of Including Patients With Double-Hit Lymphoma in Clinical Trials

Sarah Rutherford, MD, John P. Leonard, M.D./Gwirtzman Family Research Scholar in Lymphoma, assistant professor of medicine, Joan and Sanford I. Weill Department of Medicine, Weill Cornell Medicine/NewYork-Presbyterian Hospital, discusses the classification and prevalence of double-hit and double-expressor lymphomas.

Diffuse large B-cell lymphoma is the most common form of non-Hodgkin lymphoma and of all lymphomas, Rutherford explains. Though it is an aggressive disease, two-thirds of patients are able to be cured with R-CHOP chemotherapy. For the one-third of patients who are not cured, researchers have been exploring the differences of their histologies and possible therapeutic approaches.

One example is that there are chromosome changes that can occur in some of these patients, causing them to have more aggressive disease that is not as responsive to chemotherapy. The chromosome changes are called MYC and BCL-2, and when 2 of these are rearranged it is called double-hit lymphomas, she adds. Double-expressor lymphomas are not rearranged, but there is an increased expression of these chromosomes.

Sarah Rutherford, MD, John P. Leonard, M.D./Gwirtzman Family Research Scholar in Lymphoma , assistant professor of medicine, Joan and Sanford I. Weill Department of Medicine , Weill Cornell Medicine/NewYork-Presbyterian Hospital, discusses the classification and prevalence of double-hit and double-expressor lymphomas.

Sarah Rutherford, MD

Articles

Comparing the UK & US Approaches to First-Line Treatment in Hodgkin Lymphoma

Lunning and Rutherford Detail Considerations for BV-AVD Use in Older Patients With Hodgkin Lymphoma

Dr. Rutherford on the Importance of Including Patients With Double-Hit Lymphoma in Clinical Trials

Dr. Rutherford on Double-Hit and Double-Expressor Lymphomas