@article{3077653,
    title = "Immunotherapy in hodgkin lymphoma: Present status and future strategies",
    author = "Vassilakopoulos, T.P. and Chatzidimitriou, C. and Asimakopoulos, J.V. and Arapaki, M. and Tzoras, E. and Angelopoulou, M.K. and Konstantopoulos, K.",
    journal = "Blood cancer journal",
    year = "2019",
    volume = "11",
    number = "8",
    publisher = "MDPI AG",
    doi = "10.3390/cancers11081071",
    keywords = "antineoplastic agent;  avelumab;  bendamustine;  bleomycin;  brentuximab vedotin;  camrelizumab;  CD20 antigen;  cyclophosphamide;  cyclophosphamide plus doxorubicin plus prednisolone plus rituximab plus vincristine;  dacarbazine;  decitabine;  dexamethasone;  doxorubicin;  gemcitabine;  ibrutinib;  ipilimumab;  iratumumab;  nivolumab;  ofatumumab;  pembrolizumab;  placebo;  platinum complex;  prednisone;  rituximab;  sgn 30;  shr 1210;  sintilimab;  tislelizumab;  tumor necrosis factor receptor superfamily member 8;  unindexed drug;  vinblastine, acute graft versus host disease;  allogeneic stem cell transplantation;  anaplastic large cell lymphoma;  antineoplastic activity;  autologous stem cell transplantation;  body weight gain;  cancer combination chemotherapy;  cancer immunotherapy;  cancer prognosis;  cancer radiotherapy;  chimeric antigen receptor T-cell immunotherapy;  chronic graft versus host disease;  classical Hodgkin lymphoma;  consolidation chemotherapy;  coughing;  diarrhea;  drug efficacy;  drug fatality;  drug indication;  drug mechanism;  drug targeting;  drug withdrawal;  fatigue;  febrile neutropenia;  fever;  hemangioma;  hepatitis;  high risk patient;  Hodgkin disease;  human;  hyperthyroidism;  hypothyroidism;  leukopenia;  liver venoocclusive disease;  lung infection;  lung toxicity;  monotherapy;  motor neuropathy;  multiple cycle treatment;  nausea;  neutropenia;  nodular lymphocyte predominant Hodgkin lymphoma;  pneumonia;  pruritus;  rash;  Review;  salvage therapy;  sensory neuropathy;  side effect;  thyroiditis;  upper respiratory tract infection",
    abstract = "Although classical Hodgkin lymphoma (cHL) is usually curable, 20–30% of the patients experience treatment failure and most of them are typically treated with salvage chemotherapy and autologous stem cell transplantation (autoSCT). However, 45–55% of that subset further relapse or progress despite intensive treatment. At the advanced stage of the disease course, recently developed immunotherapeutic approaches have provided very promising results with prolonged remissions or disease stabilization in many patients. Brentuximab vedotin (BV) has been approved for patients with relapsed/refractory cHL (rr-cHL) who have failed autoSCT, as a consolidation after autoSCT in high-risk patients, as well as for patients who are ineligible for autoSCT or multiagent chemotherapy who have failed ≥ two treatment lines. However, except of the consolidation setting, 90–95% of the patients will progress and require further treatment. In this clinical setting, immune checkpoint inhibitors (CPIs) have produced impressive results. Both nivolumab and pembrolizumab have been approved for rr-cHL after autoSCT and BV failure, while pembrolizumab has also been licensed for transplant ineligible patients after BV failure. Other CPIs, sintilimab and tislelizumab, have been successfully tested in China, albeit in less heavily pretreated populations. Recent data suggest that the efficacy of CPIs may be augmented by hypomethylating agents, such as decitabine. As a result of their success in heavily pretreated disease, BV and CPIs are moving to earlier lines of treatment. BV was recently licensed by the FDA for the first-line treatment of stage III/IV Hodgkin lymphoma (HL) in combination with AVD (only stage IV according to the European Medicines Agency (EMA)). CPIs are currently being evaluated in combination with AVD in phase II trials of first-line treatment. The impact of BV and CPIs was also investigated in the setting of second-line salvage therapy. Finally, combinations of targeted therapies are under evaluation. Based on these exciting results, it appears reasonable to predict that an improvement in survival and a potential increase in the cure rates of cHL will soon become evident. © 2019 by the authors. Licensee MDPI, Basel, Switzerland."
}