Updates in Hodgkin Lymphoma From Dr. Burke

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Topics include: Treatments and Understanding

Hodgkin lymphoma Dr. John Burke of Rocky Mountain Cancer Centers speaks with Lee Swanson about new and improving therapies for Hodgkin lymphoma from the American Society of Hematology Annual Meeting (ASH) 2018. Watch now to learn the lastest in Hodgkin lymphoma research.

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Transcript

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.

Lee Swanson:

Welcome to Patient Power. I’m Lee Swanson at the American Society of Hematology Conference in San Diego, and I’m joined right now by Dr. John Burke from the Rocky Mountain Cancer Centers in Colorado. Thanks for taking the time this afternoon.

Dr. Burke:                   

Sure, thanks for having me.

Lee Swanson:             

So, Hodgkin lymphoma. Not all that common. There’ve been changes announced here and coming up in the standard of care or the possible treatments.

Dr. Burke:                   
Yes.

Lee Swanson:             
So, what are we hearing?

Dr. Burke:                   
I think the biggest news within the last year in Hodgkin lymphoma has been the FDA approval of brentuximab vedotin (Adcetris) to be given in combination with chemotherapy being effective for patients with advanced stage Hodgkin lymphoma. So, I think that’s the biggest news within the past year that we’ve heard, suggesting that maybe in those patients, AAVD, the new combination improves what we call progression-free survival compared with the old standard ABVD chemotherapy regimen.

Lee Swanson:             

So, what sort of patient then is eligible, or is that…

Dr. Burke:                   

…yeah, it’s not for every patient with Hodgkin lymphoma. So, the study looked only at patients with advanced stage III or IV disease, meaning not stage I or II disease, 1 or II being where the cancer is limited to one area or two areas of the body, and three or four meaning more widespread disease. So, this new treatment program is applicable only to patients with stage III or IV disease right now.

Lee Swanson:             

So, what’s the conversation a parent or a young adult should have with their community doctor or community oncologist about these treatments and what’s right for them?

Dr. Burke:                   

Yeah, I think what a patient with the disease needs to understand, in terms of choosing therapy, there are a lot of issues. One is, what’s the stage? And that can help choose the best treatment program. I think two is what other comorbidities a person has, what other illnesses do they have? Do they have problems with their lung? Do they have problems with their nerves of their hands? And then another issue that always comes in is to add or not to add radiation therapy for patients with early stage disease after chemotherapy’s finished. And that’s still a challenging issue that doctors and patients face when trying to choose the best treatment.

Lee Swanson:             

And are people dealing with side effects that have to be considered?

Dr. Burke:                   

Yeah. And so, there are sort of differences between the old ABVD regiment and the new AAVD regimen in that toxicity profile. So, bleomycin (Blenoxane), the B in ABVD, can cause lung problems, and occasionally, those lung problems are very serious and even fatal. And so, that’s one issue with the old regimen. There’s a tradeoff. When you use the new AAVD regimen, there is less in the way of lung toxicity, but more in the way of nerve damage, called peripheral neuropathy, where patients report numbness or burning pain in the fingers and toes; and probably an increase in lowering of the blood count. So, there’s probably a higher risk for immune suppression from the new treatment. And when you give the new treatment, you have to go it with growth factor support to kind of try to raise the white cells up. So, there’s definitely a difference in side effect profile that needs to be considered when choosing the best treatment for one individual patient. 

Lee Swanson:             

A lot to think about. A lot to know.

Dr. Burke:                   

It is, yeah.

Lee Swanson:             

Well, thank you for your time this afternoon. Really appreciate it.

Dr. Burke:                   

All right. Well, thanks for having me.

Lee Swanson:             

All right. And at the American Society of Hematology, I’m Lee Swanson.

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 January 24, 2019