Treatment Developments and Ongoing Hodgkin Lymphoma Research | Transcript | Hodgkin Lymphoma | Patient Power


Treatment Developments and Ongoing Hodgkin Lymphoma Research

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Beth Probert:

So some of the patients got radiation and the others didn't.  And they found that those patients who did not get radiation therapy had similar routes to relapse, and so the conclusion of the investigators was that adding the radiation therapy remains essential, that you can't drop the radiation, although there was a sort of vibrant discussion after the presentation where some in the room took a different view, and they said, well, actually, maybe it's okay if there's a little bit of a higher relapse risk because you save a lot of patients the toxicities of radiation therapy by not delivering it to so many people who don't need it and that maybe if patients do have a local relapse you can just give the radiation therapy later or give new therapies later and still achieve the same overall outcome, which is survival.  So it was a debated conclusion, and that's the way it goes a lot in Hodgkin lymphoma when it comes to radiation therapy.   

But that was probably for me the most interesting of the studies presented.  There were a number of others, nothing that would dramatically change my practice tomorrow but some interesting stuff came out as well.  

And so it's a commonly debated thing where do you accept a little bit of higher risk of relapse understanding that you're going to spare yourself some toxicities if you skip the radiation therapy, and if you're in that unfortunate few that does relapse then you're going to have to do more, and that might be radiation therapy, it might be more chemo, it might be a stem cell transplant and novel therapies.  So that's kind of the tradeoff that I—discussions that I have with my early?stage Hodgkin lymphoma patients on what their personal treatment course so going to be.  

So you mentioned that there wasn't too much, but from that conference and/or in just the Hodgkin lymphoma community what can these patients look forward to as far as treatment in the coming year?  

Those are the two categories of drugs that over the last several years have been used sort of late as therapies for patients who've relapsed multiple times and really don't have much in the way of other choices and now are being sort of moved sooner into these treatment algorithms.  So rather than save them for people after they've relapsed the big news earlier this year was that the addition of brentuximab vedotin to chemotherapy regimens improves so-called progression-free survival or keeps the lymphoma in remission for a long period of time when incorporated into a chemotherapy regimen. So that's one example of a practice-changing finding that's happened in the last year.  

The big question—a lot of big questions are should that regimen be used for patients with early-stage disease. Right now it's only approved for advanced stage, three and four disease.  Should it be used in elderly patients, and if so how can you best give it to elderly patients who have more trouble tolerating that more complex chemo program.  And so that's really an area of active research right now.  

And then should we be using these checkpoint inhibitors in combination with chemotherapy early, and that's going to be a subject of a large trial that'll take several years. So moving these highly effective treatments earlier in the course of disease is a big area of research that we're going to be hearing about in the next few years.  

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

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Page last updated on September 4, 2019