Promising Therapies on Horizon for Hodgkin Lymphoma

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There are many promising new therapies in development for Hodgkin lymphoma, including the PD-1 inhibitors nivolumab and pembrolizumab. Two studies presented at the 2014 ASH annual meeting showed impressive overall response rates with PD-1 inhibition in pretreated patients with Hodgkin lymphoma, notes John Sweetenham, MD.

With pembrolizumab, the objective response rate (ORR) was 66% in patients with heavily pretreated classical Hodgkin lymphoma (cHL). Six patients (21%) experienced complete remission while 13 patients (45%) achieved a partial remission. With nivolumab, the ORR was 87% in slightly less heavily pretreated group of patients with cHL. Among 18 patients who had previously failed brentuximab vedotin, the ORR was 89% (16/18), with 6% (1/18) achieving complete response and 83% (15/18) partial response.

Histone deacetylase (HDAC) inhibitors, which interfere with chromosome expression, have also demonstrated promise as potential treatments for patients with Hodgkin lymphoma, says Robert W. Chen, MD. These treatments have no shown overwhelming positive activity as single-agents in Hodgkin lymphoma, where response rates are approximately 20% to 30%, notes Chen. However, HDAC inhibitors have low toxicity; thus, studies are looking at combining them with other agents and chemotherapy.

Another class of agent in development are the mTOR inhibitors, which have demonstrated a response rate of 40% in patients with Hodgkin lymphoma. However, anecdotally, Chen notes that he has not seen too much activity with these agents.