Taking part in a clinical trial may be the best treatment choice for some Hodgkin lymphoma (HL) patients. Clinical trials are under way to develop treatments that increase the remission rate or cure the disease. Today's standard treatments for cancer are based on earlier clinical trials. The Leukemia & Lymphoma Society continues to invest funds in HL research.
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Current Hodgkin Lymphoma Research and Clinical Trials
There are clinical trials for both newly diagnosed patients and patients with relapsed or refractory disease. A number of approaches are under study in clinical trials for the treatment of patients with HL.
Genetic Studies. HL is a rare disease. However, there are cases of the disease occurring in more than one person in the same family; this is called “familial clustering.” This supports the theory that there is a genetic basis of HL susceptibility. Studies of familial HL are under way to obtain a better understanding of the genetic causes of the disease and to determine which genetic variations are responsible for the disease in these cases. This information may help doctors predict a person’s risk of developing HL, and also help scientists discover biological pathways that can be targeted with novel treatments.
Interim Positron Emission Tomography-Computed Tomography (PET-CT) as a Decision Tool for Risk-Adapted Therapy. Recent studies have focused on assessing the role of interim PET-CT scans in patients with HL. Accurate mid-treatment scans are expected to further enable tailoring of treatments, allowing healthcare professionals to improve remission rates while minimizing treatment toxicity. Interim PET-CT scans may be useful in identifying a subgroup of patients with early-stage disease that can be treated with chemotherapy alone.
Monoclonal Antibodies. Monoclonal antibodies are immunotherapy drugs that are specially designed to target specific proteins (antigens) in cancer cells. Brentuximab vedotin (Adcetris®), which is approved for untreated and relapsed/refractory cHL, targets CD30 and releases a chemotherapy drug into the cancer cell, causing its death. Various clinical trials are studying the use of this agent in combination with standard chemotherapy drugs and checkpoint inhibitors.
Programmed Death (PD-1) Checkpoint Inhibitors. Two checkpoint inhibitor drugs—nivolumab (Opdivo®) and pembrolizumab (Keytruda®), both of which are approved for refractory and relapsed cHL—are still being studied for other potential uses and indications. While the results of checkpoint inhibitors have been encouraging, most of the responses are partial and not all patients derive benefits. Researchers are now studying approaches that may use combinations of therapies consisting of checkpoint inhibitors, chemotherapy drugs and brentuximab vedotin, along with other immune-activating agents.
CAR T-Cell Therapy. This type of immunotherapy consists of engineering a patient’s own immune cells to recognize and then attack cancerous cells. This approach has shown very promising results in patients with blood cancers. A patient’s T cells are genetically engineered to produce receptors, called “chimeric antigen receptors” (CARs), on their surfaces. These receptors recognize and bind to a specific target found on the cancerous cells. CAR T-cells targeting CD30 have shown promising results in relapsed/refractory cases of HL. Hodgkin and Reed-Sternberg cells overexpress the CD30 molecule, so T lymphocytes that are redirected to eliminate these cells have the potential to generate a sustained antitumor effect. Although there is limited data, CAR T-cell therapy appears to be a promising approach for treating HL. Click here to learn more about CAR T-Cell Therapy.