Combination Immunotherapy Shown to Be Effective Initial Treatment for Relapsed or Refractory Hodgkin Lymphoma

December 11, 2017 | by Katie Neith

Alex Herrera Alex Herrera, M.D.
For many people with classical Hodgkin lymphoma, the disease is one of the most curable forms of cancer with standard chemotherapy or chemo plus radiotherapy. But for the 10 to 30 percent of patients whose cancer relapses, or doesn’t respond to initial therapy, secondary treatment often involves harsher chemotherapies followed by an autologous stem cell transplant, which uses a patient’s own stem cells.
Now, researchers led by Alex Herrera, M.D., assistant professor in City of Hope’s Department of Hematology & Hematopoietic Cell Transplantation and a hematologist/oncologist, have found that a combination of two immunotherapy drugs — free of traditional chemotherapy — may be a more tolerable way for patients to fight the disease before a transplant.
In our clinical trial, we studied a combination of two exciting new drugs — brentuximab vedotin and nivolumab — for treatment of relapsed or refractory Hodgkin lymphoma after the failure of frontline therapy and found that the combination was a safe, well-tolerated and highly effective bridge to transplantation,” said Herrera, who conducted the study with researchers from across the United States.
Their findings were presented by Herrera at the annual meeting of the American Society of Hematology (ASH) in Atlanta on Dec. 11. The study was also published in the journal Blood following Herrera’s talk.
The ASH meeting hosts more than 25,000 hematology professionals focused on research and treatment for blood cancers and other diseases, and encourages clinicians and scientists working both ends of the bench-to-bedside translational research spectrum to discuss the latest studies.
Herrera’s latest work builds upon phase 1 study results that he presented at the 2016 ASH meeting, measuring the safety of brentuximab vedotin — an antibody-based treatment that targets delivery of chemotherapy only to Hodgkin lymphoma cells — combined with nivolumab, which works by blocking something called the PD-1 immune checkpoint pathway that tumors often hijack to evade the immune system.
Now we have shown that the combination is an effective second-line treatment for Hodgkin lymphoma and future trials could explore the role of this regimen in comparison to traditional second-line chemotherapy,” said Herrera.
In addition, he says this treatment regimen is being studied in many settings, including as an initial treatment for elderly patients who are not eligible for chemotherapy, as well as for patients who have relapsed after an autologous stem cell transplantation. Herrera has developed and is leading a clinical trial at City of Hope that will open at five other centers to also test brentuximab vedotin plus nivolumab as consolidation treatment after autologous stem cell transplantation to minimize the likelihood of Hodgkin lymphoma recurrence following the transplant.
Funding for this research was provided by Seattle Genetics Inc. through the joint financial support of Seattle Genetics Inc. and Bristol-Myers Squibb.

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