Materiały źródłowe

• #1 https://www.lls.org/lymphoma/hodgkin-lymphoma/treatment

  https://www.lls.org/lymphoma/hodgkin-lymphoma/treatment

  Treatment for Hodgkin lymphoma is changing due to new drugs and research findings from clinical trials. Therefore, before treatment begins, it is important to consider getting a second opinion at a center with a Hodgkin lymphoma expert. […] It’s important that your doctor is experienced in treating patients with Hodgkin lymphoma or works in consultation with a Hodgkin lymphoma specialist. This type of specialist is called a hematologist-oncologist. […] For many people with Hodgkin lymphoma, starting treatment helps them focus on moving ahead and looking forward to recovery. Hodgkin lymphoma is considered one of the most curable forms of cancer. […] The goal of Hodgkin lymphoma treatment is to cure the disease. More than 80 percent of all patients diagnosed with Hodgkin lymphoma can be cured by current treatment approaches. The cure rate is higher, approaching 90 percent, in younger patients and those with early-stage favorable disease. Even if disease recurs, many patients can be cured with further treatment.

• #2 The Cure of Hodgkin Lymphoma – Hematology.org

  https://www.hematology.org/about/history/50-years/cure-of-hodgkin-lymphoma

  The cure of Hodgkin lymphoma in the 20th century is another one of cancer’s biggest success stories. Breakthroughs in radiation therapy and chemotherapy paired with careful clinical research transformed an invariably fatal disorder into one that is routinely cured. […] Today, as more than 80 percent of patients are cured after primary treatment, a major emphasis is now placed on survivorship. […] The introduction of the linear accelerator (a radiation machine used to treat cancer) in the treatment of Hodgkin lymphoma at Stanford University resulted in cures of early-stage lymphoma. […] Meanwhile, a team at the National Cancer Institute safely combined four chemotherapy drugs (mustard, vincristine, procarbazine, and prednisone) known as the „MOPP” regimen and reported the first cures of advanced Hodgkin lymphoma in 1964.

• #3 Hodgkin Lymphoma Treatment | Treatment for Hodgkin Disease | American Cancer Society

  https://www.cancer.org/cancer/types/hodgkin-lymphoma/treating.html

  If you (or your child) has been diagnosed with Hodgkin lymphoma (HL), the cancer care team will discuss treatment options with you. It’s important to think carefully about your choices. You will want to weigh the benefits of each treatment option against the possible risks and side effects. […] Chemotherapy and radiation therapy are the main treatments for HL. Depending on the case, one or both of these treatments might be used. […] Certain patients might be treated with immunotherapy or with a stem cell transplant, especially if other treatments haven’t worked. Except for biopsy and staging, surgery is rarely used to treat HL. […] Treatment for HL is based largely on the stage (extent) of the disease. But other factors, including a person’s age and general health, and the type and location of the lymphoma, might also affect treatment options. For almost all people with HL, cure is the main goal. But treatment can have side effects, some that don’t show up for many years. Because of this, doctors try to choose a treatment plan with the lowest risk of possible side effects.

• #4 Hodgkin Lymphoma Treatment & Management: Approach Considerations, Goals of Therapy and Response Assessment, Radiation Therapy

  https://emedicine.medscape.com/article/201886-treatment

  Advanced-stage disease is generally treated with chemotherapy alone, with radiation therapy reserved for selected patients. […] Short-term toxicity varies based on the regimen and modalities used (chemotherapy, radiation, combination of both, and stem cell transplantation) and include: Hematologic toxicity: Anemia (need for transfusion), thrombocytopenia, increased risk of infection (febrile neutropenia). […] Long-term toxicities vary based on patient age and treatment regimen. […] Given the curable nature of this disease and patients long-term survival, goals for treatment are the following: Maximize cure for all stages; Minimize both short-term and long-term complications, assuming this does not have an impact on cure. […] The overarching theme is assessing patients individually for their extent of disease, disease-related prognosis, associated conditions, risk of relapse, and long-term survival.

• #5 Hodgkin lymphoma (Hodgkin disease) – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hodgkins-lymphoma/diagnosis-treatment/drc-20352650

  Hodgkin lymphoma (Hodgkin disease) diagnosis often begins with an exam that checks for swollen lymph nodes in the neck, underarm and groin. […] Many types of treatments exist for Hodgkin lymphoma. Treatment often starts with chemotherapy. Your healthcare team might check to see how the lymphoma is responding and decide whether you need more treatment. Your options might include radiation therapy, chemotherapy, immunotherapy, targeted therapy and bone marrow transplant, also called stem cell transplant. Sometimes, a combination of treatments is used. […] Classical Hodgkin lymphoma treatment usually involves a combination of chemotherapy and radiation therapy. Sometimes chemotherapy may be the only treatment needed. More-advanced disease may be treated with a combination of chemotherapy and medicines that attack specific chemicals in cancer cells, known as targeted therapy.

• #6 Hodgkin Lymphoma Treatment – NCI

  https://www.cancer.gov/types/lymphoma/patient/adult-hodgkin-treatment-pdq

  Treatment for Hodgkin lymphoma may cause side effects. […] The following types of treatment are used: Chemotherapy, Radiation therapy, Targeted therapy, Immunotherapy, Chemotherapy with stem cell transplant. […] For patients with nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL), treatment options also include: Watchful waiting, Active surveillance. […] For pregnant patients with Hodgkin lymphoma, treatment options also include: Watchful waiting, Steroid therapy. […] Treatment of early favorable classic Hodgkin lymphoma in adults may include: Combination chemotherapy with or without radiation therapy to the areas of the body with cancer, Radiation therapy alone in patients who cannot be treated with combination chemotherapy. […] Treatment of early unfavorable classic Hodgkin lymphoma in adults may include: Combination chemotherapy with or without radiation therapy to the areas of the body with cancer, Targeted therapy with a monoclonal antibody (brentuximab vedotin) and combination chemotherapy with or without radiation therapy.

• #7

  https://www.nhs.uk/conditions/hodgkin-lymphoma/treatment/

  Hodgkin lymphoma can usually be treated successfully with chemotherapy alone, or chemotherapy followed by radiotherapy. […] The main treatments for Hodgkin lymphoma are chemotherapy alone, or chemotherapy followed by radiotherapy. Occasionally, chemotherapy may be combined with steroid medicine. Some people also have biological medicines. […] Overall, treatment for Hodgkin lymphoma is highly effective and most people with the condition are eventually cured. […] Chemotherapy is usually given over a period of a few months on an outpatient basis, which means you should not have to stay in hospital overnight. […] If regular chemotherapy is unsuccessful or Hodgkin lymphoma returns after treatment, you may have a course of chemotherapy at a higher dose. […] Radiotherapy is most often used to treat early-stage Hodgkin lymphoma, where the cancer is only in 1 part of the body.

• #8 Patient education: Hodgkin lymphoma in adults (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/hodgkin-lymphoma-in-adults-beyond-the-basics

  HODGKIN LYMPHOMA TREATMENT […] The main treatments for Hodgkin lymphoma are chemotherapy and radiation. […] Chemotherapy — Chemotherapy is a treatment given to stop the growth of cancer cells. Most treatments involve a combination of several chemotherapy drugs (called regimens). Most of the drugs are given into the vein (intravenous, IV). […] Chemotherapy is not typically given every day but instead is given in cycles. A cycle of chemotherapy (which is typically 21 or 28 days) refers to the time it takes to give the treatment and then allow the body to recover from the side effects of the medicines. […] For example, two doses of ABVD chemotherapy (see below) are given 14 days apart to make up one cycle of treatment. If this regimen were repeated for a total of four cycles, it would take up to four months to complete.

• #9 Patient education: Hodgkin lymphoma in adults (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/hodgkin-lymphoma-in-adults-beyond-the-basics

  Chemotherapy regimens for Hodgkin lymphoma include: […] • ABVD – ABVD includes Adriamycin (doxorubicin), bleomycin, vinblastine, and dacarbazine. ABVD is the most commonly used chemotherapy regimen. […] • BV+AVD – This regimen is similar to ABVD, but it substitutes a drug called brentuximab vedotin (BV) for bleomycin. […] • BEACOPP – BEACOPP includes bleomycin, etoposide, Adriamycin, cyclophosphamide, Oncovin (vincristine), procarbazine, and prednisone. This regimen is more commonly used in Europe. Some experts feel that BEACOPP is more effective than other regimens, especially in people with more advanced disease. However, it has more toxic side effects, which some people cannot tolerate. […] Side effects — The type and severity of chemotherapy side effects depend on the combination and dose of chemotherapy medicines given. The most common treatment-related side effects include temporary hair loss, nausea, vomiting, constipation, fatigue, loss of appetite, increased risk of infections, and neuropathy. Many of these side effects can be prevented or treated.

• #10 Hodgkin Lymphoma Treatment & Management: Approach Considerations, Goals of Therapy and Response Assessment, Radiation Therapy

  https://emedicine.medscape.com/article/201886-treatment

  The ABVD regimen is the standard of care for the treatment of classic Hodgkin lymphoma, particularly in the United States. […] Treatment with nivolumab plus AVD (N+AVD) resulted in longer PFS than A+AVD in a phase III trial in 970 adolescents and adults with stage III or IV advanced-stage classic Hodgkin lymphoma; in addition, N+AVD had a better adverse effect profile. […] When induction chemotherapy fails, or patients experience relapse, salvage chemotherapy is generally given. […] High-dose chemotherapy (HDC) at doses that ablate the bone marrow is feasible with reinfusion of the patient’s previously collected hematopoietic stem cells (autologous transplantation) or infusion of stem cells from a donor source (allogeneic transplantation). […] Patients with clinical stages IA or IIA classic Hodgkin lymphoma who do not have unfavorable factors are categorized as having early-stage, low-risk disease.

• #11 The Cure of Hodgkin Lymphoma – Hematology.org

  https://www.hematology.org/about/history/50-years/cure-of-hodgkin-lymphoma

  This time period also featured another major advance in an alternative four-drug chemotherapy regimen (doxorubicin, bleomycin, vinblastine, and dacarbazine), known as „ABVD,” that proved to be more effective than MOPP in treating advanced disease and had fewer side effects. […] The German Hodgkin Study Group introduced an intensive seven-drug chemotherapy program, „BEACOPP,” to address the fact that approximately 30 percent of advanced Hodgkin lymphoma was not cured with ABVD. […] Although associated with more severe early toxicity and sterility, a higher cure rate and improved survival were achieved with BEACOPP in a randomized clinical trial. […] The most recent advance in Hodgkin lymphoma management has come in the form of diagnostic imaging. […] Application of FDG-PET in clinical studies allows physicians to limit more toxic treatments to the subset of patients who are likely to benefit while sparing the majority from adverse effects.

• #12 Treatments for classical Hodgkin lymphoma | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/hodgkin-lymphoma/treatment/classical

  Classical Hodgkin lymphoma (HL) is commonly known as HL. It is treated based on the stage. […] Treatment of stage 1 and 2 (early) HL is also based on whether the HL is favourable or unfavourable. Favourable means that its easier to treat because you dont have any unfavourable (adverse) prognostic factors. Unfavourable means that it needs more or longer treatment because you have one or more unfavourable factors. […] The main treatment for stage 1 and stage 2 favourable HL is chemotherapy, with or without radiation therapy. […] Chemotherapy uses anticancer drugs to destroy cancer cells. Combination chemotherapy is treatment with more than one anticancer drug. The most common combination chemotherapy used to treat classical HL is ABVD. ABVD includes doxorubicin, bleomycin, vinblastine and dacarbazine. ABVD is usually given for 2 to 4 cycles.

• #13 Treatments for classical Hodgkin lymphoma | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/hodgkin-lymphoma/treatment/classical

  Another combination chemotherapy sometimes used for HL is BEACOPP, which is bleomycin, etoposide, doxorubicin, cyclophosphamide (Procytox), vincristine, procarbazine (Matulane) and prednisone. BEACOPP is stronger than ABVD so it is only used for younger people who have a large amount of HL. […] The main treatment for stage 1 and stage 2 unfavourable HL is chemotherapy, with or without radiation therapy. […] The most common chemotherapy combinations used to treat early unfavourable HL are: ABVD doxorubicin, bleomycin, vinblastine and dacarbazine, BEACOPP bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine and prednisone, AVD doxorubicin, vinblastine and dacarbazine. […] The main treatment for stage 3 and stage 4( advanced) HL is chemotherapy. […] The most common chemotherapy combinations used to treat advanced HL are: ABVD doxorubicin, bleomycin, vinblastine and dacarbazine, BEACOPP bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine and prednisone, A + AVD brentuximab vedotin (Adcetris), doxorubicin, vinblastine and dacarbazine. […] Targeted therapy drugs, such as brentuximab vedotin, may be used along with chemotherapy to treat advanced HL. Targeted therapy uses drugs to target specific molecules (such as proteins) on cancer cells or inside them to stop the growth and spread of cancer and limit harm to normal cells.

• #14 The Cure of Hodgkin Lymphoma – Hematology.org

  https://www.hematology.org/about/history/50-years/cure-of-hodgkin-lymphoma

  This time period also featured another major advance in an alternative four-drug chemotherapy regimen (doxorubicin, bleomycin, vinblastine, and dacarbazine), known as „ABVD,” that proved to be more effective than MOPP in treating advanced disease and had fewer side effects. […] The German Hodgkin Study Group introduced an intensive seven-drug chemotherapy program, „BEACOPP,” to address the fact that approximately 30 percent of advanced Hodgkin lymphoma was not cured with ABVD. […] Although associated with more severe early toxicity and sterility, a higher cure rate and improved survival were achieved with BEACOPP in a randomized clinical trial. […] The most recent advance in Hodgkin lymphoma management has come in the form of diagnostic imaging. […] Application of FDG-PET in clinical studies allows physicians to limit more toxic treatments to the subset of patients who are likely to benefit while sparing the majority from adverse effects.

• #15 Patient education: Hodgkin lymphoma in adults (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/hodgkin-lymphoma-in-adults-beyond-the-basics

  Chemotherapy regimens for Hodgkin lymphoma include: […] • ABVD – ABVD includes Adriamycin (doxorubicin), bleomycin, vinblastine, and dacarbazine. ABVD is the most commonly used chemotherapy regimen. […] • BV+AVD – This regimen is similar to ABVD, but it substitutes a drug called brentuximab vedotin (BV) for bleomycin. […] • BEACOPP – BEACOPP includes bleomycin, etoposide, Adriamycin, cyclophosphamide, Oncovin (vincristine), procarbazine, and prednisone. This regimen is more commonly used in Europe. Some experts feel that BEACOPP is more effective than other regimens, especially in people with more advanced disease. However, it has more toxic side effects, which some people cannot tolerate. […] Side effects — The type and severity of chemotherapy side effects depend on the combination and dose of chemotherapy medicines given. The most common treatment-related side effects include temporary hair loss, nausea, vomiting, constipation, fatigue, loss of appetite, increased risk of infections, and neuropathy. Many of these side effects can be prevented or treated.

• #16 Patient education: Hodgkin lymphoma in adults (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/hodgkin-lymphoma-in-adults-beyond-the-basics

  Chemotherapy regimens for Hodgkin lymphoma include: […] • ABVD – ABVD includes Adriamycin (doxorubicin), bleomycin, vinblastine, and dacarbazine. ABVD is the most commonly used chemotherapy regimen. […] • BV+AVD – This regimen is similar to ABVD, but it substitutes a drug called brentuximab vedotin (BV) for bleomycin. […] • BEACOPP – BEACOPP includes bleomycin, etoposide, Adriamycin, cyclophosphamide, Oncovin (vincristine), procarbazine, and prednisone. This regimen is more commonly used in Europe. Some experts feel that BEACOPP is more effective than other regimens, especially in people with more advanced disease. However, it has more toxic side effects, which some people cannot tolerate. […] Side effects — The type and severity of chemotherapy side effects depend on the combination and dose of chemotherapy medicines given. The most common treatment-related side effects include temporary hair loss, nausea, vomiting, constipation, fatigue, loss of appetite, increased risk of infections, and neuropathy. Many of these side effects can be prevented or treated.

• #17 Hodgkin’s Lymphoma Therapy: Past, Present, and Future

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2978071/

  Cure rates greater than 90% for early HL and more than 70% for those with advanced HL are expected. Identifying high-risk patients who will relapse after initial therapy is of paramount importance in the development of intensified and/or improved therapeutic approaches for this unfavorable-risk group of patients. […] The major emphasis of ongoing randomized trials in HL is development and validation of response-adapted strategies utilizing functional imaging with Positron Emission Tomography (PET). […] The stage for an individual HL patient is the most important determinant of prognosis and appropriate therapy. […] The treatment of early stage unfavorable disease is reliant on systemic chemotherapy regimens as in advanced disease with subsequent involved field radiotherapy. Advanced disease is treated primarily with multi-agent chemotherapy regimens with a role for consolidative radiotherapy in cases of partial responses or bulky disease.

• #18 Patient education: Hodgkin lymphoma in adults (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/hodgkin-lymphoma-in-adults-beyond-the-basics

  Chemotherapy regimens for Hodgkin lymphoma include: […] • ABVD – ABVD includes Adriamycin (doxorubicin), bleomycin, vinblastine, and dacarbazine. ABVD is the most commonly used chemotherapy regimen. […] • BV+AVD – This regimen is similar to ABVD, but it substitutes a drug called brentuximab vedotin (BV) for bleomycin. […] • BEACOPP – BEACOPP includes bleomycin, etoposide, Adriamycin, cyclophosphamide, Oncovin (vincristine), procarbazine, and prednisone. This regimen is more commonly used in Europe. Some experts feel that BEACOPP is more effective than other regimens, especially in people with more advanced disease. However, it has more toxic side effects, which some people cannot tolerate. […] Side effects — The type and severity of chemotherapy side effects depend on the combination and dose of chemotherapy medicines given. The most common treatment-related side effects include temporary hair loss, nausea, vomiting, constipation, fatigue, loss of appetite, increased risk of infections, and neuropathy. Many of these side effects can be prevented or treated.

• #19 Latest advances in the management of classical Hodgkin lymphoma: the era of novel therapies | Blood Cancer Journal

  https://www.nature.com/articles/s41408-021-00518-z

  The standard of care for early stage cHL is doxorubicin (or adriamycin), bleomycin, vinblastine, and dacarbazine (ABVD) and form the backbone of frontline management in North America regardless of the stage. […] In advanced-stage cHL, the HD18 trial demonstrated the non-inferiority of reducing therapy to a total of four cycles of eBEACOPP instead of six or eight cycles in the case of PET2 negativity after two cycles of eBEACOPP (5-year PFS 92.2% vs 90.8%, respectively, 95% CI2754). […] The risk-adapted and response-adapted approaches discussed above rely mainly on intensification or de-escalation chemotherapy. More recent approaches combine novel immunotherapies such as brentuximab vedotin (BV) and anti-PD-1 monoclonal antibodies (mAb) to reduce the risk of relapse and chemotherapy-associated toxicity.

• #20 Hodgkin Lymphoma Treatment Protocol by Stage | American Cancer Society

  https://www.cancer.org/cancer/types/hodgkin-lymphoma/treating/by-stage.html

  This section sums up the treatment options for classic Hodgkin lymphoma (cHL) in adults, based on the stage of cancer. Treatment options for cHL depend on many factors, including: […] Most experts agree that treatment in a clinical trial should be considered for HL that is resistant to treatment or comes back (relapses) after treatment. […] Treatment for many patients is chemotherapy (usually 2 to 4 cycles of the ABVD regimen), followed by radiation to the initial site of the disease (involved site radiation therapy, or ISRT). […] If a person cant have chemotherapy because of other health issues, radiation therapy alone may be an option. […] For those who dont respond to treatment, chemo using different drugs or high-dose chemo (and possibly radiation) followed by a stem cell transplant may be recommended. Treatment with an immunotherapy drug such as brentuximab vedotin (Adcetris), nivolumab (Opdivo), or pembrolizumab (Keytruda) might be another option.

• #21 Treatment options for Hodgkin lymphoma | Cancer Research UK

  https://www.cancerresearchuk.org/about-cancer/hodgkin-lymphoma/treatment/treatment-decisions

  When you are diagnosed with Hodgkin lymphoma, a team of healthcare professionals decide if you need treatment straight away. They also look at what treatment options you have and will discuss those with you. This depends on factors such as the type and stage of Hodgkin lymphoma, as well as your general health. You might have more than one treatment. […] The most common treatments for Hodgkin lymphoma are chemotherapy and radiotherapy. […] The treatment of Hodgkin lymphoma is usually very successful in many cases and most people are cured. But sometimes Hodgkin lymphoma can come back (relapse). Some relapsed Hodgkin lymphomas can be difficult to treat. […] The most common treatments for Hodgkin lymphoma are: chemotherapy, radiotherapy, targeted cancer drugs, immunotherapy, a stem cell transplant.

• #22 Hodgkin Lymphoma Treatment Protocol by Stage | American Cancer Society

  https://www.cancer.org/cancer/types/hodgkin-lymphoma/treating/by-stage.html

  This section sums up the treatment options for classic Hodgkin lymphoma (cHL) in adults, based on the stage of cancer. Treatment options for cHL depend on many factors, including: […] Most experts agree that treatment in a clinical trial should be considered for HL that is resistant to treatment or comes back (relapses) after treatment. […] Treatment for many patients is chemotherapy (usually 2 to 4 cycles of the ABVD regimen), followed by radiation to the initial site of the disease (involved site radiation therapy, or ISRT). […] If a person cant have chemotherapy because of other health issues, radiation therapy alone may be an option. […] For those who dont respond to treatment, chemo using different drugs or high-dose chemo (and possibly radiation) followed by a stem cell transplant may be recommended. Treatment with an immunotherapy drug such as brentuximab vedotin (Adcetris), nivolumab (Opdivo), or pembrolizumab (Keytruda) might be another option.

• #23 How We Treat Hodgkin Lymphoma | Dana-Farber Cancer Institute

  https://www.dana-farber.org/cancer-care/types/hodgkin-lymphoma/treatment

  Treatment of early favorable Hodgkin lymphoma may include: Combination chemotherapy, Combination chemotherapy with radiation therapy to parts of the body with cancer, Radiation therapy alone to areas of the body with cancer. […] Treatment of recurrent Hodgkin lymphoma may include: Combination chemotherapy, Some types of immunotherapy, Combination chemotherapy followed by high-dose chemotherapy and stem cell transplant with or without radiation therapy, Radiation therapy with or without chemotherapy, Chemotherapy as palliative therapy to relieve symptoms and improve quality of life.

• #24 Hodgkin Lymphoma Treatment Protocol by Stage | American Cancer Society

  https://www.cancer.org/cancer/types/hodgkin-lymphoma/treating/by-stage.html

  Treatment is generally more intense than that for favorable disease. It typically starts with chemotherapy (usually with the ABVD regimen for 4 to 6 cycles or other regimens such as 3 cycles of Stanford V). […] For those who dont respond to treatment, chemo using different drugs or high-dose chemo (and possibly radiation) followed by a stem cell transplant may be recommended. Treatment with an immunotherapy drug such as brentuximab vedotin (Adcetris), nivolumab (Opdivo), or pembrolizumab (Keytruda) might be another option. […] Doctors generally treat these stages with chemotherapy using more intense regimens than that used for earlier stages. […] For those whose HL doesnt respond to treatment, chemo using different drugs or high-dose chemo (and possibly radiation) followed by a stem cell transplant may be recommended. Treatment with an immunotherapy drug such as brentuximab vedotin, nivolumab, or pembrolizumab (Keytruda) might be another option.

• #25 Patient education: Hodgkin lymphoma in adults (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/hodgkin-lymphoma-in-adults-beyond-the-basics

  Stage III and IV — The most common treatment for people with stage III and IV Hodgkin lymphoma is chemotherapy. Radiation therapy may be added if the tumor was large at the time of diagnosis or if there are areas of tumor that have not completely responded to chemotherapy. […] Most people with stage III and IV disease will get BV-AVD or ABVD. Approximately 80 percent of people will have a complete response after treatment with ABVD. Depending on your situation, medical history, and preferences, your doctor might suggest one of the other regimens (A+AVD, BEACOPP, or Stanford V with radiation) instead. […] Stem cell transplantation — Stem cell transplantation (also known as bone marrow transplantation or hematopoietic stem cell transplantation) might be offered to people who have: […] • Recurrent Hodgkin lymphoma

• #26 Hodgkin Lymphoma Treatment Protocol by Stage | American Cancer Society

  https://www.cancer.org/cancer/types/hodgkin-lymphoma/treating/by-stage.html

  Treatment is generally more intense than that for favorable disease. It typically starts with chemotherapy (usually with the ABVD regimen for 4 to 6 cycles or other regimens such as 3 cycles of Stanford V). […] For those who dont respond to treatment, chemo using different drugs or high-dose chemo (and possibly radiation) followed by a stem cell transplant may be recommended. Treatment with an immunotherapy drug such as brentuximab vedotin (Adcetris), nivolumab (Opdivo), or pembrolizumab (Keytruda) might be another option. […] Doctors generally treat these stages with chemotherapy using more intense regimens than that used for earlier stages. […] For those whose HL doesnt respond to treatment, chemo using different drugs or high-dose chemo (and possibly radiation) followed by a stem cell transplant may be recommended. Treatment with an immunotherapy drug such as brentuximab vedotin, nivolumab, or pembrolizumab (Keytruda) might be another option.

• #27 Treatment of Advanced Stage IIB, III, IV Hodgkin Lymphoma | Nebraska Hematology Oncology – Cancer Care Treatment Blood Disorders Clinical Trials Lincoln Nebraska (NE)

  https://www.yourcancercare.com/types-of-cancer/hodgkin-lymphoma/treatment-of-advanced-stage-iib-iii-iv-hodgkin-lymphoma

  Patients classified as having stage III or IV disease with A or B symptoms, stage II disease and B symptoms, or bulky disease (site of disease greater than 10 centimeters) are all considered to have advanced stage Hodgkins lymphoma (HL). […] Chemotherapy treatment with ABVD (doxorubicin, bleomycin, Velban, and dacarbazine) for 6 cycles consistently cures a majority of patients with stage IB to IV HL and has been the standard of care for many years. […] In 2019 the U.S. Food and Drug Administration (FDA) approved Adcetris (brentuximab vedotin) in combination with chemotherapy in adult patients with previously untreated stage III or IV classical HL based on the successful outcome of the ECHELON-1 clinical trial that compared Adcetris plus AVD (Adriamycin, vinblastine and dacarbazine) to standard ABVD (Adriamycin, bleomycin, vinblastine and dacarbazine) chemotherapy.

• #28 Patient education: Hodgkin lymphoma in adults (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/hodgkin-lymphoma-in-adults-beyond-the-basics

  Stage III and IV — The most common treatment for people with stage III and IV Hodgkin lymphoma is chemotherapy. Radiation therapy may be added if the tumor was large at the time of diagnosis or if there are areas of tumor that have not completely responded to chemotherapy. […] Most people with stage III and IV disease will get BV-AVD or ABVD. Approximately 80 percent of people will have a complete response after treatment with ABVD. Depending on your situation, medical history, and preferences, your doctor might suggest one of the other regimens (A+AVD, BEACOPP, or Stanford V with radiation) instead. […] Stem cell transplantation — Stem cell transplantation (also known as bone marrow transplantation or hematopoietic stem cell transplantation) might be offered to people who have: […] • Recurrent Hodgkin lymphoma

• #29 Hodgkin lymphoma – Wikipedia

  https://en.wikipedia.org/wiki/Hodgkin_lymphoma

  For Hodgkin lymphomas, radiation oncologists typically use external beam radiation therapy (sometimes shortened to EBRT or XRT). […] Radiation therapy directed above the diaphragm to the neck, chest or underarms is called mantle field radiation. […] Radiation to below the diaphragm to the abdomen, spleen or pelvis is called inverted-Y field radiation. […] Total nodal irradiation is when the therapist gives radiation to all the lymph nodes in the body to destroy cells that may have spread. […] The high cure rates and long survival of many people with Hodgkin lymphoma has led to a high concern with late adverse effects of treatment, including cardiovascular disease and second malignancies such as acute leukemias, lymphomas, and solid tumors within the radiation therapy field. […] Most people with early-stage disease are now treated with abbreviated chemotherapy and involved site radiation therapy rather than with radiation therapy alone. […] Clinical research strategies are exploring reduction of the duration of chemotherapy and dose and volume of radiation therapy in an attempt to reduce late morbidity and mortality of treatment while maintaining high cure rates.

• #30 Radiation Therapy for Hodgkin Lymphoma | Nebraska Hematology Oncology – Cancer Care Treatment Blood Disorders Clinical Trials Lincoln Nebraska (NE)

  https://www.yourcancercare.com/types-of-cancer/hodgkin-lymphoma/radiation-therapy-for-hodgkin-lymphoma

  Radiation therapy is an important treatment modality for patients with Hodgkins disease. However, radiation therapy is usually not the sole treatment for Hodgkins disease except in selected circumstances. Chemotherapy alone or combined modality treatment with chemotherapy and radiation therapy is typically utilized even for early stage disease. Therefore, it is essential for patients with Hodgkins disease to be treated at medical centers where medical oncologists, radiation oncologists and surgeons work together. […] The objective of radiation therapy is to kill cancer cells for a maximum probability of cure with a minimum of side effects. Radiation is usually given in the form of high-energy beams that deposit the radiation dose into the body where cancer cells are located. Radiation therapy, unlike chemotherapy, is considered a local treatment. Cancer cells can only be killed where the actual radiation is delivered to the body. If cancer exists outside the radiation field, the cancer cells are not destroyed by the radiation. It is also important to realize that the treatment of Hodgkins disease with radiation therapy and chemotherapy is still evolving, with a trend towards the use of less radiation therapy and more chemotherapy in order to decrease the long-term side effects of radiation.

• #31 Hodgkin lymphoma – Wikipedia

  https://en.wikipedia.org/wiki/Hodgkin_lymphoma

  For Hodgkin lymphomas, radiation oncologists typically use external beam radiation therapy (sometimes shortened to EBRT or XRT). […] Radiation therapy directed above the diaphragm to the neck, chest or underarms is called mantle field radiation. […] Radiation to below the diaphragm to the abdomen, spleen or pelvis is called inverted-Y field radiation. […] Total nodal irradiation is when the therapist gives radiation to all the lymph nodes in the body to destroy cells that may have spread. […] The high cure rates and long survival of many people with Hodgkin lymphoma has led to a high concern with late adverse effects of treatment, including cardiovascular disease and second malignancies such as acute leukemias, lymphomas, and solid tumors within the radiation therapy field. […] Most people with early-stage disease are now treated with abbreviated chemotherapy and involved site radiation therapy rather than with radiation therapy alone. […] Clinical research strategies are exploring reduction of the duration of chemotherapy and dose and volume of radiation therapy in an attempt to reduce late morbidity and mortality of treatment while maintaining high cure rates.

• #32 Treatment options for Hodgkin lymphoma | Cancer Research UK

  https://www.cancerresearchuk.org/about-cancer/hodgkin-lymphoma/treatment/treatment-decisions

  Some people only need one type of treatment. Others need a combination of treatments. […] Chemotherapy uses anti cancer drugs called cytotoxic drugs to destroy cancer cells. The chemotherapy drugs circulate throughout the body in the bloodstream. Your treatment usually includes a combination of different chemotherapy drugs and a steroid. This is called a chemotherapy regimen. […] Radiotherapy is a type of cancer treatment that uses high energy waves similar to x-rays to kill cancer cells. You might have radiotherapy to the lymph nodes where the lymphoma is and the areas around it. This is called involved site radiotherapy (ISRT). You usually have radiotherapy after chemotherapy. […] Targeted cancer drugs work by targeting those differences that a cancer cell has. There are different types of targeted cancer drugs. For Hodgkin lymphoma you might have brentuximab or rituximab.

• #33 Hodgkin lymphoma – Wikipedia

  https://en.wikipedia.org/wiki/Hodgkin_lymphoma

  For Hodgkin lymphomas, radiation oncologists typically use external beam radiation therapy (sometimes shortened to EBRT or XRT). […] Radiation therapy directed above the diaphragm to the neck, chest or underarms is called mantle field radiation. […] Radiation to below the diaphragm to the abdomen, spleen or pelvis is called inverted-Y field radiation. […] Total nodal irradiation is when the therapist gives radiation to all the lymph nodes in the body to destroy cells that may have spread. […] The high cure rates and long survival of many people with Hodgkin lymphoma has led to a high concern with late adverse effects of treatment, including cardiovascular disease and second malignancies such as acute leukemias, lymphomas, and solid tumors within the radiation therapy field. […] Most people with early-stage disease are now treated with abbreviated chemotherapy and involved site radiation therapy rather than with radiation therapy alone. […] Clinical research strategies are exploring reduction of the duration of chemotherapy and dose and volume of radiation therapy in an attempt to reduce late morbidity and mortality of treatment while maintaining high cure rates.

• #34 Patient education: Hodgkin lymphoma in adults (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/hodgkin-lymphoma-in-adults-beyond-the-basics

  Radiation therapy is sometimes recommended in stage I to II and occasionally recommended in stage III to IV to treat Hodgkin lymphoma, usually after finishing chemotherapy. In the past, radiation was directed to the area of affected lymph nodes with a carefully focused beam of radiation; this is called involved field radiation. Radiation oncologists now use involved site or involved nodal irradiation, which involve smaller treatment volumes than involved field radiation. Radiation therapy must be given in small daily doses over a period of weeks to minimize the side effects. […] Side effects — During radiation treatment, some people develop skin changes in the area that was treated, similar to a sunburn. These changes fade over time. Other side effects can include a sore throat or soreness on swallowing, temporary loss of taste and thickness of saliva, fatigue, and sometimes nausea.

• #35 How We Treat Hodgkin Lymphoma | Dana-Farber Cancer Institute

  https://www.dana-farber.org/cancer-care/types/hodgkin-lymphoma/treatment

  The use of therapies that spur the immune system to attack cancerous lymphocytes is showing considerable promise. Newer immunotherapy agents used for some Hodgkin lymphoma include nivolumab, pembrolizumab, and brentuximab. […] Radiation therapy (radiotherapy) is sometimes incorporated as part of early-stage Hodgkin lymphoma therapy. Radiation therapy may also be used in more advanced stages on parts of the body where there are „bulky” sites of the disease. […] Stem cell transplantation is sometimes used for recurrent Hodgkin lymphoma (when the cancer returns after conventional therapy) that has not responded to initial treatment. […] A large and expanding number of other effective treatment options is available, and you will have the opportunity to speak with your physician about which regimen is most appropriate for you.

• #36 Hodgkin Lymphoma Treatment Protocol by Stage | American Cancer Society

  https://www.cancer.org/cancer/types/hodgkin-lymphoma/treating/by-stage.html

  Treatment for HL should remove all traces of the lymphoma. […] If HL is still there after these treatments, most doctors would recommend high-dose chemo (and possibly radiation) followed by an autologous stem cell transplant, if it can be done. […] Another option, either instead of or after a stem cell transplant, may be treatment with an immunotherapy drug, such as brentuximab vedotin (Adcetris), nivolumab (Opdivo), or pembrolizumab (Keytruda). […] If the initial treatment was radiation therapy alone, chemotherapy is usually given for recurrent disease. […] If chemotherapy without radiation therapy was used first, and the cancer comes back only in the lymph nodes, radiation to the lymph nodes can be done, with or without more chemo. […] If the HL still remains after an autologous transplant, an allogeneic stem cell transplant may be an option. Another option, either instead of or after a stem cell transplant, may be treatment with an immunotherapy drug, such as brentuximab vedotin (Adcetris), nivolumab (Opdivo), or pembrolizumab (Keytruda).

• #37 Radiation Therapy for Hodgkin Lymphoma | Nebraska Hematology Oncology – Cancer Care Treatment Blood Disorders Clinical Trials Lincoln Nebraska (NE)

  https://www.yourcancercare.com/types-of-cancer/hodgkin-lymphoma/radiation-therapy-for-hodgkin-lymphoma

  A typical course of radiation for Hodgkin lymphoma would involve daily radiation treatments, Monday through Friday, for 3 to 5 weeks. The actual treatment with radiation generally last no more than a few minutes, during which time the patient is unlikely to feel any discomfort. Anesthesia is not needed for radiation treatments, and patients generally have few restrictions on activities during radiation therapy. Many patients continue to work during the weeks of treatment. Patients are encouraged, however, to carefully gauge how they feel and not overexert themselves. […] The majority of patients diagnosed with Hodgkin disease can expect to be cured of their cancer when modern treatment strategies are appropriately utilized. Many different treatment strategies can cure patients with stage I or IIA Hodgkin lymphoma. The current goal of treatment is to cure patients while producing as few treatment-related side effects as possible.

• #38 Patient education: Hodgkin lymphoma in adults (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/hodgkin-lymphoma-in-adults-beyond-the-basics

  Radiation therapy is sometimes recommended in stage I to II and occasionally recommended in stage III to IV to treat Hodgkin lymphoma, usually after finishing chemotherapy. In the past, radiation was directed to the area of affected lymph nodes with a carefully focused beam of radiation; this is called involved field radiation. Radiation oncologists now use involved site or involved nodal irradiation, which involve smaller treatment volumes than involved field radiation. Radiation therapy must be given in small daily doses over a period of weeks to minimize the side effects. […] Side effects — During radiation treatment, some people develop skin changes in the area that was treated, similar to a sunburn. These changes fade over time. Other side effects can include a sore throat or soreness on swallowing, temporary loss of taste and thickness of saliva, fatigue, and sometimes nausea.

• #39 Hodgkin lymphoma – Wikipedia

  https://en.wikipedia.org/wiki/Hodgkin_lymphoma

  For Hodgkin lymphomas, radiation oncologists typically use external beam radiation therapy (sometimes shortened to EBRT or XRT). […] Radiation therapy directed above the diaphragm to the neck, chest or underarms is called mantle field radiation. […] Radiation to below the diaphragm to the abdomen, spleen or pelvis is called inverted-Y field radiation. […] Total nodal irradiation is when the therapist gives radiation to all the lymph nodes in the body to destroy cells that may have spread. […] The high cure rates and long survival of many people with Hodgkin lymphoma has led to a high concern with late adverse effects of treatment, including cardiovascular disease and second malignancies such as acute leukemias, lymphomas, and solid tumors within the radiation therapy field. […] Most people with early-stage disease are now treated with abbreviated chemotherapy and involved site radiation therapy rather than with radiation therapy alone. […] Clinical research strategies are exploring reduction of the duration of chemotherapy and dose and volume of radiation therapy in an attempt to reduce late morbidity and mortality of treatment while maintaining high cure rates.

• #40 Patient education: Hodgkin lymphoma in adults (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/hodgkin-lymphoma-in-adults-beyond-the-basics

  Radiation therapy is sometimes recommended in stage I to II and occasionally recommended in stage III to IV to treat Hodgkin lymphoma, usually after finishing chemotherapy. In the past, radiation was directed to the area of affected lymph nodes with a carefully focused beam of radiation; this is called involved field radiation. Radiation oncologists now use involved site or involved nodal irradiation, which involve smaller treatment volumes than involved field radiation. Radiation therapy must be given in small daily doses over a period of weeks to minimize the side effects. […] Side effects — During radiation treatment, some people develop skin changes in the area that was treated, similar to a sunburn. These changes fade over time. Other side effects can include a sore throat or soreness on swallowing, temporary loss of taste and thickness of saliva, fatigue, and sometimes nausea.

• #41 Hodgkin Lymphoma – Hematology and Oncology – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/hematology-and-oncology/lymphomas/hodgkin-lymphoma

  Chemotherapy, particularly with drugs such as the alkylating agents (mechlorethamine, cyclophosphamide, procarbazine), doxorubicin, and etoposide, increase the risk of leukemia between years 3 and 10 post-therapy. […] Radiation therapy carries increased risk of malignant solid tumors (eg, breast, gastrointestinal, lung, thyroid, soft tissue). […] Immune checkpoint inhibitors are associated with immune-related toxicities.

• #42 Patient education: Hodgkin lymphoma in adults (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/hodgkin-lymphoma-in-adults-beyond-the-basics

  The pattern is similar in men. BEACOPP chemotherapy causes very low sperm counts and infertility, but ABVD treatment does not. […] • Secondary cancer – There is a risk of developing a second cancer years after the first treatment for Hodgkin lymphoma. The most common secondary cancers include those of the breast, lung, or gastrointestinal system. […] Some forms of radiation therapy increase the risk of developing cancer in areas that were treated (such as to the lungs and breast tissue) years after therapy is finished. Women under 30 are at increased risk of breast cancer, and smokers have an increased risk of lung cancer (beyond the already increased risk of lung cancer from smoking). It is also possible to develop leukemia or other types of lymphoma. […] Radiation therapy — Radiation therapy (RT) involves using high-energy X-rays to stop the growth of cancer cells. Unlike normal cells, cancer cells cannot repair the damage caused by exposure to X-rays over several weeks.

• #43 Hodgkin lymphoma – Wikipedia

  https://en.wikipedia.org/wiki/Hodgkin_lymphoma

  For Hodgkin lymphomas, radiation oncologists typically use external beam radiation therapy (sometimes shortened to EBRT or XRT). […] Radiation therapy directed above the diaphragm to the neck, chest or underarms is called mantle field radiation. […] Radiation to below the diaphragm to the abdomen, spleen or pelvis is called inverted-Y field radiation. […] Total nodal irradiation is when the therapist gives radiation to all the lymph nodes in the body to destroy cells that may have spread. […] The high cure rates and long survival of many people with Hodgkin lymphoma has led to a high concern with late adverse effects of treatment, including cardiovascular disease and second malignancies such as acute leukemias, lymphomas, and solid tumors within the radiation therapy field. […] Most people with early-stage disease are now treated with abbreviated chemotherapy and involved site radiation therapy rather than with radiation therapy alone. […] Clinical research strategies are exploring reduction of the duration of chemotherapy and dose and volume of radiation therapy in an attempt to reduce late morbidity and mortality of treatment while maintaining high cure rates.

• #44 Radiation Therapy for Hodgkin Lymphoma | Nebraska Hematology Oncology – Cancer Care Treatment Blood Disorders Clinical Trials Lincoln Nebraska (NE)

  https://www.yourcancercare.com/types-of-cancer/hodgkin-lymphoma/radiation-therapy-for-hodgkin-lymphoma

  Historically, radiation therapy has been the primary mode of treatment for patients with stage I IIA Hodgkins disease with a high rate of cure. One negative aspect of the use of radiation therapy in the treatment of Hodgkins is pre-treatment staging (determining the extent of spread of the disease), which involves extensive surgery. […] Chemotherapy is also capable of curing early and advanced stage Hodgkin lymphoma. Chemotherapy has an advantage over radiation therapy because it kills cancer cells anywhere in the body. Chemotherapy also has long-term side effects, which may be less severe than those produced by radiation therapy. Recently, patients with stage I or IIA disease have been treated with a combination of chemotherapy and radiation therapy in reduced doses. By utilizing combination therapy, high cure rates can be achieved and the long-term side effects of each treatment may be decreased. […] In summary, the results of this clinical study strongly suggest that patients with early stage Hodgkin disease are likely to experience a higher cure rate if treated with 2 cycles of chemotherapy followed by radiation therapy compared to the historical standard treatment of radiation therapy alone.

• #45 Hodgkin lymphoma (Hodgkin disease) – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hodgkins-lymphoma/diagnosis-treatment/drc-20352650

  Radiation therapy treats cancer with powerful energy beams. The energy can come from X-rays, protons or other sources. During radiation therapy, you lie on a table while a machine moves around you. The machine directs radiation to precise points on your body. […] A bone marrow transplant, also called a bone marrow stem cell transplant, involves putting healthy bone marrow stem cells into the body. These cells replace cells hurt by chemotherapy and other treatments. A bone marrow transplant may be an option if Hodgkin lymphoma returns or doesn’t respond to other treatments. […] Targeted therapy for cancer is a treatment that uses medicines that attack specific chemicals in cancer cells. By blocking these chemicals, targeted therapy can cause cancer cells to die. […] Immunotherapy for cancer is a treatment with medicine that helps the body’s immune system kill cancer cells. For Hodgkin lymphoma, immunotherapy might be considered in certain situations, such as if the disease doesn’t respond to other treatments.

• #46 Hodgkin Lymphoma Treatment – NCI

  https://www.cancer.gov/types/lymphoma/patient/adult-hodgkin-treatment-pdq

  Treatment of advanced classic Hodgkin lymphoma in adults may include: Combination chemotherapy with or without immunotherapy (nivolumab) or targeted therapy (brentuximab vedotin). […] Treatment of recurrent classic Hodgkin lymphoma in adults may include: Immunotherapy with an immune checkpoint inhibitor (pembrolizumab or nivolumab) with or without combination chemotherapy. […] Treatment of NLPHL in adults may include: Watchful waiting or active surveillance, Radiation therapy to the areas of the body with cancer, for patients with early-stage NLPHL, Chemotherapy, for patients with advanced-stage NLPHL, Targeted therapy with a monoclonal antibody (rituximab). […] Treatment of Hodgkin lymphoma during pregnancy may include: Watchful waiting when the cancer is above the diaphragm and is slow-growing, Radiation therapy when the cancer is above the diaphragm, Chemotherapy using one or more drugs.

• #47 Hodgkin Lymphoma Treatment | Memorial Sloan Kettering Cancer Center

  https://www.mskcc.org/cancer-care/types/lymphoma/treatment/hodgkin-lymphoma

  If you have Hodgkin lymphoma that doesnt get better after the first treatment, it is called refractory. There are a number of treatment options we may recommend for refractory lymphoma or lymphoma that has returned (relapsed). These include chemotherapy, radiation, novel drugs, and stem cell transplantation. […] One such treatment is brentuximab vedotin (Adcetris). The FDA approved this drug for Hodgkin lymphoma in 2011. […] Other new treatments are the immunotherapy drugs nivolumab (Opdivo) and pembrolizumab (Keytruda). […] Stem cell transplantation can cure Hodgkin lymphoma that has come back after initial therapy. […] Our researchers are continually running clinical trials to improve treatment options for people with Hodgkin lymphoma.

• #48 Hodgkin Lymphoma Treatment & Management: Approach Considerations, Goals of Therapy and Response Assessment, Radiation Therapy

  https://emedicine.medscape.com/article/201886-treatment

  Early-stage NLPHL can be treated with local excision, involved-field radiation therapy (IFRT), or expectant management. […] In patients with advanced Hodgkin lymphoma and HIV infection, the results with standard chemotherapy can be dramatically improved by simultaneous treatment with effective antiretroviral therapy (ART). […] Patients with Hodgkin lymphoma who have never entered complete remission (CR), or whose disease has relapsed after the attainment of CR, have a very poor prognosis when treated with standard chemotherapy and radiation. […] Brentuximab vedotin was approved by the US Food and Drug Administration (FDA) in 2011 for treatment of patients with Hodgkin lymphoma after failure of autologous HSCT or after failure of at least two prior multi-agent chemotherapy regimens in patients who are not candidates for HSCT.

• #49 Targeted Therapy & Immunotherapy for Hodgkin Lymphoma | Cancer Council NSW

  https://www.cancercouncil.com.au/hodgkin-lymphoma/treatment/targeted-therapy-and-immunotherapy/

  People with Hodgkin lymphoma that has come back (relapsed) or hasn’t fully responded to initial treatment (refractory) may be able to have new drug therapies in certain circumstances. […] Targeted therapy drugs attack specific features of cancer cells to stop the cancer growing or to reduce its size. A drug called brentuximab vedotin combines a targeted therapy drug with a chemotherapy drug. […] Brentuximab vedotin may be used for some people with relapsed or refractory Hodgkin lymphoma. It is usually given through a drip inserted into a vein in the arm (intravenous infusion) every 3 weeks. […] Rituximab may be used to treat people with the less common subtype nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL, also called nodular lymphocyte-predominant B-cell lymphoma). NLPHL cells make a protein called CD20, and rituximab targets this protein. Rituximab is given into a vein through a drip (intravenous infusion).

• #50 Hodgkin Lymphoma Treatment & Pharmacologic Management – Cancer Therapy Advisor

  https://www.cancertherapyadvisor.com/ddi/hodgkin-lymphoma-pharmacologic-treatment/

  Hodgkin lymphoma is classified into 2 types: classic Hodgkin lymphoma (CHL) and nodular lymphocyte predominant Hodgkin lymphoma (NLPHL. Treatment for Hodgkin lymphoma should be individualized for each patient. Guidelines established by the National Comprehensive Cancer Network (NCCN) for the management of Hodgkin lymphoma outline several commonly used therapies to be used alongside radiation therapy and allogeneic stem cell transplant. A broad range of pharmacotherapies are recommended for treating patients with Hodgkin lymphoma. These pharmacological treatments fall into 3 categories: chemotherapy, immunotherapy, and targeted therapy. Chemotherapy agents are cytotoxic drugs that primarily target rapidly dividing cells, often by interfering with DNA synthesis, replication, or cell division. Several chemotherapy agents are used to treat Hodgkin lymphoma, including the following: Bendamustine, Bleomycin, Carboplatin, Cisplatin, Cyclophosphamide, Cytarabine, Dacarbazine, Doxorubicin, Etoposide, Gemcitabine, Ifosfamide, Lenalidomide, Procarbazine, Vinblastine, Vincristine. Immunotherapy is a class of drugs that enhances the immune systems ability to fight cancer. For Hodgkin lymphoma, immune checkpoint inhibitors, such as those targeting the programmed cell death 1 (PD-1) and programmed cell death ligand 1 (PD-L1) axis, restore cytotoxic T cell activity by blocking immune evasion mechanisms of cancer cells, enabling the immune system to recognize and destroy cancerous cells. Pembrolizumab and nivolumab are both PD-1 inhibitors approved by the US Food and Drug Administration (FDA) for treating patients with CHL. Brentuximab vedotin is an antibody-drug conjugate consisting of a monoclonal antibody targeting CD30, a cell surface receptor found on lymphoma cells, covalently linked to the cytotoxic agent monomethyl auristatin E (MMAE). Single-agent everolimus has been used off-label for treating relapsed or refractory Hodgkin lymphoma. Everolimus is a mammalian target of rapamycin (mTOR) inhibitor that causes cell growth arrest, triggering apoptosis. The NCCN has created pharmacotherapy guidelines based on the type and staging of Hodgkin lymphoma. Overall, treatment selection should be based on several factors, including the patients age, sex, comorbid conditions, personal and family history of cancer and cardiac disease, and location of the cancer. The recommended treatment for early-stage favorable disease is 2 cycles of ABVD. Four cycles of CHOP may also be used. Patients with early-stage unfavorable disease or late-stage disease may receive 2 cycles of ABVD followed by 4 cycles of AVD if their PET scan result is negative following 2 cycles of ABVD. Other options for those with early-stage unfavorable disease include CHOP, brentuximab vedotin+dacarbazine; and brentuximab vedotin followed by AVD. Disease outcomes and prognosis tend to be poor in older adults with relapsed or refractory Hodgkin lymphoma. There are no standard treatment recommendations; instead, single-agent therapy for palliative care is often the best approach. Treatment for early-stage NLPHL often involves radiation therapy. Patients with stage IA, IB, IIA bulky or noncontiguous or stage IIB NLPHL are treated with chemotherapy (ABVD, CHOP, or CVbP) plus radiation therapy and rituximab. For those with stage III or IV disease, a combination of chemotherapy and rituximab with or without radiation therapy is recommended. Restaging should be done in all patients after completing initial therapy.

• #51 Hodgkin Lymphoma Treatment & Management: Approach Considerations, Goals of Therapy and Response Assessment, Radiation Therapy

  https://emedicine.medscape.com/article/201886-treatment

  Early-stage NLPHL can be treated with local excision, involved-field radiation therapy (IFRT), or expectant management. […] In patients with advanced Hodgkin lymphoma and HIV infection, the results with standard chemotherapy can be dramatically improved by simultaneous treatment with effective antiretroviral therapy (ART). […] Patients with Hodgkin lymphoma who have never entered complete remission (CR), or whose disease has relapsed after the attainment of CR, have a very poor prognosis when treated with standard chemotherapy and radiation. […] Brentuximab vedotin was approved by the US Food and Drug Administration (FDA) in 2011 for treatment of patients with Hodgkin lymphoma after failure of autologous HSCT or after failure of at least two prior multi-agent chemotherapy regimens in patients who are not candidates for HSCT.

• #52 Treatment of Advanced Stage IIB, III, IV Hodgkin Lymphoma | Nebraska Hematology Oncology – Cancer Care Treatment Blood Disorders Clinical Trials Lincoln Nebraska (NE)

  https://www.yourcancercare.com/types-of-cancer/hodgkin-lymphoma/treatment-of-advanced-stage-iib-iii-iv-hodgkin-lymphoma

  Patients classified as having stage III or IV disease with A or B symptoms, stage II disease and B symptoms, or bulky disease (site of disease greater than 10 centimeters) are all considered to have advanced stage Hodgkins lymphoma (HL). […] Chemotherapy treatment with ABVD (doxorubicin, bleomycin, Velban, and dacarbazine) for 6 cycles consistently cures a majority of patients with stage IB to IV HL and has been the standard of care for many years. […] In 2019 the U.S. Food and Drug Administration (FDA) approved Adcetris (brentuximab vedotin) in combination with chemotherapy in adult patients with previously untreated stage III or IV classical HL based on the successful outcome of the ECHELON-1 clinical trial that compared Adcetris plus AVD (Adriamycin, vinblastine and dacarbazine) to standard ABVD (Adriamycin, bleomycin, vinblastine and dacarbazine) chemotherapy.

• #53 Advances in Hodgkin Lymphoma Treatment: From Molecular Biology to Clinical Practice

  https://www.mdpi.com/2072-6694/16/10/1830

  The ECHELON-1 trial led to the approval of the combination of BV plus doxorubicin, vinblastine, and dacarbazine (BV-AVD) as the first-line treatment of advanced-stage cHL. The 5-year update of this international randomized phase III study showed a PFS benefit of BV-AVD over the ABVD standard arm (5-year PFS of 82.2% vs. 75.3%, HR 0.69, p = 0.0017). […] The role of BV monotherapy in R/R cHL was also analyzed in pre- and post-allogeneic stem cell transplantation (allo-SCT) settings. In a retrospective analysis, 18 patients with R/R cHL treated with BV were subsequently treated with reduced-intensity allo-SCT with successful engraftment and no unexpected toxicities. […] PD-1 inhibitors are not currently approved for frontline treatment, but a number of trials have shown their promising efficacy and limited toxicity when combined with chemotherapy, especially in limited-stage disease.

• #54 Targeted Therapy & Immunotherapy for Hodgkin Lymphoma | Cancer Council NSW

  https://www.cancercouncil.com.au/hodgkin-lymphoma/treatment/targeted-therapy-and-immunotherapy/

  People with Hodgkin lymphoma that has come back (relapsed) or hasn’t fully responded to initial treatment (refractory) may be able to have new drug therapies in certain circumstances. […] Targeted therapy drugs attack specific features of cancer cells to stop the cancer growing or to reduce its size. A drug called brentuximab vedotin combines a targeted therapy drug with a chemotherapy drug. […] Brentuximab vedotin may be used for some people with relapsed or refractory Hodgkin lymphoma. It is usually given through a drip inserted into a vein in the arm (intravenous infusion) every 3 weeks. […] Rituximab may be used to treat people with the less common subtype nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL, also called nodular lymphocyte-predominant B-cell lymphoma). NLPHL cells make a protein called CD20, and rituximab targets this protein. Rituximab is given into a vein through a drip (intravenous infusion).

• #55 Hodgkin Lymphoma Treatment – NCI

  https://www.cancer.gov/types/lymphoma/patient/adult-hodgkin-treatment-pdq

  Treatment of advanced classic Hodgkin lymphoma in adults may include: Combination chemotherapy with or without immunotherapy (nivolumab) or targeted therapy (brentuximab vedotin). […] Treatment of recurrent classic Hodgkin lymphoma in adults may include: Immunotherapy with an immune checkpoint inhibitor (pembrolizumab or nivolumab) with or without combination chemotherapy. […] Treatment of NLPHL in adults may include: Watchful waiting or active surveillance, Radiation therapy to the areas of the body with cancer, for patients with early-stage NLPHL, Chemotherapy, for patients with advanced-stage NLPHL, Targeted therapy with a monoclonal antibody (rituximab). […] Treatment of Hodgkin lymphoma during pregnancy may include: Watchful waiting when the cancer is above the diaphragm and is slow-growing, Radiation therapy when the cancer is above the diaphragm, Chemotherapy using one or more drugs.

• #56 Hodgkin lymphoma (Hodgkin disease) – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hodgkins-lymphoma/diagnosis-treatment/drc-20352650

  Radiation therapy treats cancer with powerful energy beams. The energy can come from X-rays, protons or other sources. During radiation therapy, you lie on a table while a machine moves around you. The machine directs radiation to precise points on your body. […] A bone marrow transplant, also called a bone marrow stem cell transplant, involves putting healthy bone marrow stem cells into the body. These cells replace cells hurt by chemotherapy and other treatments. A bone marrow transplant may be an option if Hodgkin lymphoma returns or doesn’t respond to other treatments. […] Targeted therapy for cancer is a treatment that uses medicines that attack specific chemicals in cancer cells. By blocking these chemicals, targeted therapy can cause cancer cells to die. […] Immunotherapy for cancer is a treatment with medicine that helps the body’s immune system kill cancer cells. For Hodgkin lymphoma, immunotherapy might be considered in certain situations, such as if the disease doesn’t respond to other treatments.

• #57 Hodgkin’s Lymphoma > Fact Sheets > Yale Medicine

  https://www.yalemedicine.org/conditions/hodgkin-lymphoma

  For many patients with Hodgkin’s lymphoma, a treatment called ABVD chemotherapy (the drugs Adriamycin [doxorubicin], bleomycin, vinblastine, and dacarbazine) is given intravenously. […] Newer drugs have been developed for patients with recurrent Hodgkin’s lymphoma, including an immunotherapy called checkpoint inhibitors. […] Hodgkin’s lymphoma is treatable. About 90% of people with early-stage Hodgkin’s lymphoma are cured.

• #58 Hodgkin Lymphoma Treatment | Memorial Sloan Kettering Cancer Center

  https://www.mskcc.org/cancer-care/types/lymphoma/treatment/hodgkin-lymphoma

  If you have Hodgkin lymphoma that doesnt get better after the first treatment, it is called refractory. There are a number of treatment options we may recommend for refractory lymphoma or lymphoma that has returned (relapsed). These include chemotherapy, radiation, novel drugs, and stem cell transplantation. […] One such treatment is brentuximab vedotin (Adcetris). The FDA approved this drug for Hodgkin lymphoma in 2011. […] Other new treatments are the immunotherapy drugs nivolumab (Opdivo) and pembrolizumab (Keytruda). […] Stem cell transplantation can cure Hodgkin lymphoma that has come back after initial therapy. […] Our researchers are continually running clinical trials to improve treatment options for people with Hodgkin lymphoma.

• #59 List of 27 Hodgkin’s Lymphoma Medications Compared

  https://www.drugs.com/condition/hodgkin-s-disease.html

  Hodgkin lymphoma is a one of the cancers of the lymphatic system, which is part of the immune system. […] There are several different subtypes of Hodgkin lymphoma which behave differently and require different types of treatment. […] The medications listed below are related to or used in the treatment of this condition. […] Keytruda to treat Hodgkin’s Lymphoma […] nivolumab to treat Hodgkin’s Lymphoma […] pembrolizumab to treat Hodgkin’s Lymphoma.

• #60 Hodgkin Lymphoma Treatment – NCI

  https://www.cancer.gov/types/lymphoma/patient/adult-hodgkin-treatment-pdq

  Treatment of advanced classic Hodgkin lymphoma in adults may include: Combination chemotherapy with or without immunotherapy (nivolumab) or targeted therapy (brentuximab vedotin). […] Treatment of recurrent classic Hodgkin lymphoma in adults may include: Immunotherapy with an immune checkpoint inhibitor (pembrolizumab or nivolumab) with or without combination chemotherapy. […] Treatment of NLPHL in adults may include: Watchful waiting or active surveillance, Radiation therapy to the areas of the body with cancer, for patients with early-stage NLPHL, Chemotherapy, for patients with advanced-stage NLPHL, Targeted therapy with a monoclonal antibody (rituximab). […] Treatment of Hodgkin lymphoma during pregnancy may include: Watchful waiting when the cancer is above the diaphragm and is slow-growing, Radiation therapy when the cancer is above the diaphragm, Chemotherapy using one or more drugs.

• #61 Hodgkin Lymphoma: Relapsed/Refractory – LRF

  https://www.lymphoma.org/understanding-lymphoma/aboutlymphoma/hl/relapsedhl/

  Hodgkin lymphoma patients who fail to achieve complete remission following frontline therapy or who relapse after achieving complete remission are often treated with second-line chemotherapy regimens, followed by a bone marrow or stem cell transplant. […] There are a variety of single-agent and combination therapy regimens that may be used for relapsed/refractory HL, including: Brentuximab vedotin (Adcetris), Bendamustine (Treanda), Nivolumab (Opdivo), Pembrolizumab (Keytruda), DHAP (dexamethasone, cisplatin, and cytarabine), ESHAP (etoposide, methylprednisolone, cisplatin, and cytarabine), GVD (gemcitabine, vinorelbine, and liposomal doxorubicin), ICE (ifosfamide, carboplatin, and etoposide), IGEV (ifosfamide, gemcitabine, and vinorelbine). […] Although the cure rate in HL is already high, research continues to look for ways to treat the minority of patients who are refractory to treatment and those who relapse. Many promising therapies are currently under investigation in clinical trials for HL including: Anti-CD30-CAR T cells, Atezolizumab (Tecentriq), Bortezomib (Velcade), Carfilzomib (Kyprolis), Everolimus (Afinitor), Ibrutinib (Imbruvica), Lenalidomide (Revlimid), Mocetinostat (MGCD0103), Ruxolitinib (Jakafi), Umbralisib.

• #62 Nivolumab and AVD the New Standard in Hodgkin Lymphoma – NCI

  https://www.cancer.gov/news-events/cancer-currents-blog/2024/hodgkin-lymphoma-nivolumab-avd-first-line

  Nivolumab (Opdivo) should be part of the initial treatment of teens and adults with advanced forms of classic Hodgkin lymphoma, according to updated results from a large NCI-funded clinical trial. […] Treatment with nivolumab and a three-drug chemotherapy regimen called AVD was better at eliminating cancer and keeping it at bay than the current standard initial treatment for the disease, AVD combined with the targeted therapy brentuximab (Adcetris). […] Two years after starting treatment, about 92% of trial participants randomly assigned to the nivolumab-AVD group were alive without their cancer starting to grow again—a measure known as progression-free survival—compared with 83% in the brentuximab-AVD group. […] Based on these new findings, Dr. Friedberg said, we are curing substantially more patients with the nivolumab-AVD regimen.

• #63 Clinical Trial Forges New Standard of Care for Advanced Hodgkin Lymphoma – InventUMPage 1arrow–buttonPage 1arrow–buttonPage 1arrow–buttonPage 1arrow–buttonPage 1arrow–button

  https://news.med.miami.edu/clinical-trial-forges-new-standard-of-care-for-advanced-hodgkin-lymphoma/

  Current treatments for Hodgkin lymphoma are highly effective, but there is still room for improvement. […] Adding the immunotherapy drug nivolumab to a mix of chemotherapy drugs outperformed the current standard therapy for advanced Hodgkin lymphoma in a large clinical trial. […] The new study is rapidly changing how patients are being treated internationally and at Sylvester Comprehensive Cancer Center, part of the University of Miami Miller School of Medicine, said Craig Moskowitz, M.D., Sylvester’s physician-in-chief. […] The trial compared nivolumab with another drug, brentuximab vedotin, in combination with chemotherapy. […] Nivolumab is a “checkpoint inhibitor” that releases the brakes on the immune system, enabling an immune attack on cancer cells. […] A recent phase II trial of Nivolumab plus AVD, for instance, showed low toxicity and high activity against advanced Hodgkin disease, and led to the new clinical trial, said Dr. Moskowitz.

• #64 Nivolumab and AVD the New Standard in Hodgkin Lymphoma – NCI

  https://www.cancer.gov/news-events/cancer-currents-blog/2024/hodgkin-lymphoma-nivolumab-avd-first-line

  Nivolumab (Opdivo) should be part of the initial treatment of teens and adults with advanced forms of classic Hodgkin lymphoma, according to updated results from a large NCI-funded clinical trial. […] Treatment with nivolumab and a three-drug chemotherapy regimen called AVD was better at eliminating cancer and keeping it at bay than the current standard initial treatment for the disease, AVD combined with the targeted therapy brentuximab (Adcetris). […] Two years after starting treatment, about 92% of trial participants randomly assigned to the nivolumab-AVD group were alive without their cancer starting to grow again—a measure known as progression-free survival—compared with 83% in the brentuximab-AVD group. […] Based on these new findings, Dr. Friedberg said, we are curing substantially more patients with the nivolumab-AVD regimen.

• #65 Hodgkin lymphoma (Hodgkin disease) – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hodgkins-lymphoma/diagnosis-treatment/drc-20352650

  Radiation therapy treats cancer with powerful energy beams. The energy can come from X-rays, protons or other sources. During radiation therapy, you lie on a table while a machine moves around you. The machine directs radiation to precise points on your body. […] A bone marrow transplant, also called a bone marrow stem cell transplant, involves putting healthy bone marrow stem cells into the body. These cells replace cells hurt by chemotherapy and other treatments. A bone marrow transplant may be an option if Hodgkin lymphoma returns or doesn’t respond to other treatments. […] Targeted therapy for cancer is a treatment that uses medicines that attack specific chemicals in cancer cells. By blocking these chemicals, targeted therapy can cause cancer cells to die. […] Immunotherapy for cancer is a treatment with medicine that helps the body’s immune system kill cancer cells. For Hodgkin lymphoma, immunotherapy might be considered in certain situations, such as if the disease doesn’t respond to other treatments.

• #66 Patient education: Hodgkin lymphoma in adults (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/hodgkin-lymphoma-in-adults-beyond-the-basics

  Stage III and IV — The most common treatment for people with stage III and IV Hodgkin lymphoma is chemotherapy. Radiation therapy may be added if the tumor was large at the time of diagnosis or if there are areas of tumor that have not completely responded to chemotherapy. […] Most people with stage III and IV disease will get BV-AVD or ABVD. Approximately 80 percent of people will have a complete response after treatment with ABVD. Depending on your situation, medical history, and preferences, your doctor might suggest one of the other regimens (A+AVD, BEACOPP, or Stanford V with radiation) instead. […] Stem cell transplantation — Stem cell transplantation (also known as bone marrow transplantation or hematopoietic stem cell transplantation) might be offered to people who have: […] • Recurrent Hodgkin lymphoma

• #67 Patient education: Hodgkin lymphoma in adults (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/hodgkin-lymphoma-in-adults-beyond-the-basics

  • Hodgkin lymphoma that is resistant to other forms of treatment. This includes people whose disease relapses after the first round of treatment. […] Relapsed disease — For Hodgkin lymphoma that has returned after initial treatment, options include additional chemotherapy with a new regimen, stem cell transplantation, targeted therapy, immunotherapy, and radiation therapy. Targeted therapy involves a medication that works by affecting („targeting”) specific cancer cells. Immunotherapy is the term for drugs that work with your immune system to stop or slow the growth of cancer cells. A combination of treatments may be used. […] The different approaches to treating relapsed Hodgkin lymphoma are being studied to better understand the long-term effects.

• #68 Hodgkin Lymphoma: Treatment Choices | UMass Memorial Health

  https://www.ummhealth.org/health-library/hodgkin-lymphoma-treatment-choices

  Here’s a list of common HL treatments: Radiation therapy uses high-energy X-rays or beams of other particles to kill cancer cells. Many people with HL get radiation as part of their treatment. It may be the only treatment or as part of a treatment plan that includes chemotherapy. […] Chemotherapy (chemo) is the most common treatment for HL. It may be used alone or with radiation. Most people get more than one chemo medicine, called combination therapy. Chemo is most often given right into your blood through a vein (IV). […] If HL comes back after treatment (relapses), very high doses of chemo may be needed. These high doses can permanently damage or destroy the bone marrow. Stem cell transplants allow healthcare providers to give higher doses of chemo. […] A stem cell transplant is used to rebuild healthy bone marrow after high-dose chemo. The stem cells may come from a donor (an allogenic transplant). Or they may come from you (an autologous transplant).

• #69 What Are Treatments for Hodgkin Lymphoma? – HealthTree for Hodgkin Lymphoma

  https://healthtree.org/hodgkin-lymphoma/community/what-are-treatments-for-hodgkin-lymphoma

  Immunotherapy is a type of treatment that uses the body’s immune system to fight cancer. […] In hodgkin lymphoma, the immunotherapy drug used is called Brentuximab vedotin (Adcetris). […] A stem cell transplant is a procedure that replaces damaged or diseased bone marrow with healthy bone marrow stem cells. […] Stem cell transplant is usually considered for hodgkin lymphoma only after other treatments have failed. […] There are two types of stem cell transplants: autologous (using your own stem cells) and allogeneic (using stem cells from a donor).

• #70 Hodgkin Lymphoma Treatment Protocol by Stage | American Cancer Society

  https://www.cancer.org/cancer/types/hodgkin-lymphoma/treating/by-stage.html

  Treatment for HL should remove all traces of the lymphoma. […] If HL is still there after these treatments, most doctors would recommend high-dose chemo (and possibly radiation) followed by an autologous stem cell transplant, if it can be done. […] Another option, either instead of or after a stem cell transplant, may be treatment with an immunotherapy drug, such as brentuximab vedotin (Adcetris), nivolumab (Opdivo), or pembrolizumab (Keytruda). […] If the initial treatment was radiation therapy alone, chemotherapy is usually given for recurrent disease. […] If chemotherapy without radiation therapy was used first, and the cancer comes back only in the lymph nodes, radiation to the lymph nodes can be done, with or without more chemo. […] If the HL still remains after an autologous transplant, an allogeneic stem cell transplant may be an option. Another option, either instead of or after a stem cell transplant, may be treatment with an immunotherapy drug, such as brentuximab vedotin (Adcetris), nivolumab (Opdivo), or pembrolizumab (Keytruda).

• #71 Patient education: Hodgkin lymphoma in adults (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/hodgkin-lymphoma-in-adults-beyond-the-basics

  • Hodgkin lymphoma that is resistant to other forms of treatment. This includes people whose disease relapses after the first round of treatment. […] Relapsed disease — For Hodgkin lymphoma that has returned after initial treatment, options include additional chemotherapy with a new regimen, stem cell transplantation, targeted therapy, immunotherapy, and radiation therapy. Targeted therapy involves a medication that works by affecting („targeting”) specific cancer cells. Immunotherapy is the term for drugs that work with your immune system to stop or slow the growth of cancer cells. A combination of treatments may be used. […] The different approaches to treating relapsed Hodgkin lymphoma are being studied to better understand the long-term effects.

• #72 Hodgkin lymphoma treatment – Leukaemia Foundation

  https://www.leukaemia.org.au/blood-cancer/types-of-blood-cancer/lymphoma/hodgkin-lymphoma/treatment/

  Stem cell transplant […] Occasionally, a stem cell transplant is given, providing some people a better chance of cure or long-term control of their disease. It is generally only suitable in situations where the lymphoma has come back (relapsed) or is at high risk of relapse, and where it doesn’t respond well to standard (conventional) treatment.

• #73 Pediatric Hodgkin Lymphoma Treatment & Management: Approach Considerations, Chemotherapy Regimens, Supportive Medication

  https://emedicine.medscape.com/article/987101-treatment

  High-dose therapy followed by autologous stem cell transplantation, after reinduction or salvage chemotherapy, is the current standard treatment for relapse disease. […] The introduction of a conjugated anti-CD30 antibody conjugated to the antitubulin agent (brentuximab vedotin) has shown excellent results in CD30 positive lymphomas.

• #74 Latest advances in the management of classical Hodgkin lymphoma: the era of novel therapies | Blood Cancer Journal

  https://www.nature.com/articles/s41408-021-00518-z

  The use of sequential pembrolizumab (PEM) and AVD for untreated early unfavourable or advanced-stage cHL was evaluated in a phase II study. […] Overall, the incorporation of immunotherapy in the frontline treatment for older cHL patients is a feasible and promising strategy. Further comparative studies are needed, however, to evaluate the benefit of these novel agents in terms of QoL and OS in this particular population. […] About 10-15% of patients with early stage and 15-30% with advanced-stage cHL fail to respond or relapse after primary conventional treatment. Despite the approval of novel therapies, autologous stem cell transplantation (ASCT) remains the standard of care in these patients. […] An innovative sequential approach using Nivo was evaluated in a phase II trial. Nivo was administered for a maximum of six cycles as first-salvage therapy.

• #75 Hodgkin’s Lymphoma Therapy: Past, Present, and Future

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2978071/

  The IPS predicted the rate of freedom from progression of disease at 5 years of follow-up as: no factor 84%; 1 factor- 77%; 2 factors- 67%; 3 factors- 60%; 4 factors- 51%; and 5 or more factors- 42%. […] The prognostic utility of interim response assessment during therapy of advanced HL was evaluated in a recent meta-analysis. […] The presence of a positive pre-ASCT PET scan correlated with an increased risk of progression and decreased OS. […] The successful integration of two curative therapies- systemic chemotherapy and radiotherapy- results in cure for the large majority of patients with untreated classical HL and for a significant number of relapsing or refractory patients (with ASCT). […] The objective of cure has to be appropriately balanced with that of achieving minimal long-term toxicity.

• #76 Latest advances in the management of classical Hodgkin lymphoma: the era of novel therapies | Blood Cancer Journal

  https://www.nature.com/articles/s41408-021-00518-z

  The combination of BV and bendamustine (BV-Benda) may also be highly active with manageable toxicity as first-salvage therapy especially for fragile patients. […] In a phase I/II study, patients with R/R cHL received up to four cycles of BV-Nivo as first-salvage therapy followed by ASCT. […] The AETHERA trial demonstrated for the first time the benefit of BV maintenance after ASCT for up to 16 cycles. […] Anti-PD1 mAb might also become a new standard for maintenance after ASCT, allowing a schedule twice as short than in the AETHERA trial. […] Although most of the cHL patients can be cured with first- and second-line therapy, some patients may still relapse or progress after intensive chemotherapy and ASCT, and thus, carry a poor prognosis. […] In a large EBMT study, BV was assessed as a bridge to allo-HCT in patients with R/R cHL compared to a group of no BV therapy prior to allo-HCT.

• #77 Hodgkin Lymphoma Treatment & Management: Approach Considerations, Goals of Therapy and Response Assessment, Radiation Therapy

  https://emedicine.medscape.com/article/201886-treatment

  Advanced-stage disease is generally treated with chemotherapy alone, with radiation therapy reserved for selected patients. […] Short-term toxicity varies based on the regimen and modalities used (chemotherapy, radiation, combination of both, and stem cell transplantation) and include: Hematologic toxicity: Anemia (need for transfusion), thrombocytopenia, increased risk of infection (febrile neutropenia). […] Long-term toxicities vary based on patient age and treatment regimen. […] Given the curable nature of this disease and patients long-term survival, goals for treatment are the following: Maximize cure for all stages; Minimize both short-term and long-term complications, assuming this does not have an impact on cure. […] The overarching theme is assessing patients individually for their extent of disease, disease-related prognosis, associated conditions, risk of relapse, and long-term survival.

• #78 Latest advances in the management of classical Hodgkin lymphoma: the era of novel therapies | Blood Cancer Journal

  https://www.nature.com/articles/s41408-021-00518-z

  Pre-transplant exposure to anti-PD-1 mAb may indeed improve PFS in patients who receive Haplo with PT-Cy. […] PD-1 blockade can provide durable disease control and prolonged survival in patients relapsing after allo-HCT, however, at the expense of increased risk of GvHD (30-55%), especially in those with a prior history of GvHD. […] The management of cHL has a huge effect on patients QoL not only due to the treatment but also due to the strain and limitations experienced in most aspects of life.

• #79

  http://www.bccancer.bc.ca/health-info/types-of-cancer/blood-lymphoid/hodgkin-lymphoma

  Hodgkin lymphoma is considered „aggressive”. This means that it will spread and grow, so you need treatment. Treatment works very well for most people. […] Hodgkin lymphoma responds very well to treatment. […] The chance of curing Hodgkin lymphoma is good. […] 10 – 30% (10-30 out of 100) of Hodgkin lymphomas come back (recurrence). Further treatment after recurrence is often successful. […] Systemic therapy (chemotherapy) is given with or without radiation therapy. […] Most people start with systemic therapy and then have more tests. […] Can treat advanced, metastatic or recurrent Hodgkin lymphoma. […] You may need very high dose systemic therapy if you have a bone marrow transplant. […] Radiation therapy uses high energy x-rays to kill or shrink cancer. […] May be given after systemic therapy.

• #80 Hodgkin Lymphoma: Relapsed/Refractory – LRF

  https://www.lymphoma.org/understanding-lymphoma/aboutlymphoma/hl/relapsedhl/

  The term relapsed refers to disease that reappears or grows again after a period of remission. […] The term refractory is used to describe when the lymphoma does not respond to treatment (meaning that the cancer cells continue to grow) or when the response to treatment does not last very long. […] For patients who relapse or become refractory, secondary therapies are often successful in providing another remission and may even cure the disease. […] A number of treatment options are available for patients with relapsed or refractory HL. The type of treatment prescribed for individual patients depends on several factors, including the timing of the relapse, age and overall health of the patient, scope of disease, and previous therapies received. […] The current standard secondary treatment for the majority of patients consists of combination therapy, usually followed by autologous stem cell transplantation (in which a patients own stem cells are used). Involved site radiation therapy (ISRT) may also be used.

• #81 Hodgkin Lymphoma: Relapsed/Refractory – LRF

  https://www.lymphoma.org/understanding-lymphoma/aboutlymphoma/hl/relapsedhl/

  The term relapsed refers to disease that reappears or grows again after a period of remission. […] The term refractory is used to describe when the lymphoma does not respond to treatment (meaning that the cancer cells continue to grow) or when the response to treatment does not last very long. […] For patients who relapse or become refractory, secondary therapies are often successful in providing another remission and may even cure the disease. […] A number of treatment options are available for patients with relapsed or refractory HL. The type of treatment prescribed for individual patients depends on several factors, including the timing of the relapse, age and overall health of the patient, scope of disease, and previous therapies received. […] The current standard secondary treatment for the majority of patients consists of combination therapy, usually followed by autologous stem cell transplantation (in which a patients own stem cells are used). Involved site radiation therapy (ISRT) may also be used.

• #82 Hodgkin Lymphoma Treatment & Management: Approach Considerations, Goals of Therapy and Response Assessment, Radiation Therapy

  https://emedicine.medscape.com/article/201886-treatment

  Early-stage NLPHL can be treated with local excision, involved-field radiation therapy (IFRT), or expectant management. […] In patients with advanced Hodgkin lymphoma and HIV infection, the results with standard chemotherapy can be dramatically improved by simultaneous treatment with effective antiretroviral therapy (ART). […] Patients with Hodgkin lymphoma who have never entered complete remission (CR), or whose disease has relapsed after the attainment of CR, have a very poor prognosis when treated with standard chemotherapy and radiation. […] Brentuximab vedotin was approved by the US Food and Drug Administration (FDA) in 2011 for treatment of patients with Hodgkin lymphoma after failure of autologous HSCT or after failure of at least two prior multi-agent chemotherapy regimens in patients who are not candidates for HSCT.

• #83 Hodgkin Lymphoma Treatment Protocol by Stage | American Cancer Society

  https://www.cancer.org/cancer/types/hodgkin-lymphoma/treating/by-stage.html

  Treatment for HL should remove all traces of the lymphoma. […] If HL is still there after these treatments, most doctors would recommend high-dose chemo (and possibly radiation) followed by an autologous stem cell transplant, if it can be done. […] Another option, either instead of or after a stem cell transplant, may be treatment with an immunotherapy drug, such as brentuximab vedotin (Adcetris), nivolumab (Opdivo), or pembrolizumab (Keytruda). […] If the initial treatment was radiation therapy alone, chemotherapy is usually given for recurrent disease. […] If chemotherapy without radiation therapy was used first, and the cancer comes back only in the lymph nodes, radiation to the lymph nodes can be done, with or without more chemo. […] If the HL still remains after an autologous transplant, an allogeneic stem cell transplant may be an option. Another option, either instead of or after a stem cell transplant, may be treatment with an immunotherapy drug, such as brentuximab vedotin (Adcetris), nivolumab (Opdivo), or pembrolizumab (Keytruda).

• #84 Patient education: Hodgkin lymphoma in adults (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/hodgkin-lymphoma-in-adults-beyond-the-basics

  • Hodgkin lymphoma that is resistant to other forms of treatment. This includes people whose disease relapses after the first round of treatment. […] Relapsed disease — For Hodgkin lymphoma that has returned after initial treatment, options include additional chemotherapy with a new regimen, stem cell transplantation, targeted therapy, immunotherapy, and radiation therapy. Targeted therapy involves a medication that works by affecting („targeting”) specific cancer cells. Immunotherapy is the term for drugs that work with your immune system to stop or slow the growth of cancer cells. A combination of treatments may be used. […] The different approaches to treating relapsed Hodgkin lymphoma are being studied to better understand the long-term effects.

• #85 Hodgkin Lymphoma: Relapsed/Refractory – LRF

  https://www.lymphoma.org/understanding-lymphoma/aboutlymphoma/hl/relapsedhl/

  Hodgkin lymphoma patients who fail to achieve complete remission following frontline therapy or who relapse after achieving complete remission are often treated with second-line chemotherapy regimens, followed by a bone marrow or stem cell transplant. […] There are a variety of single-agent and combination therapy regimens that may be used for relapsed/refractory HL, including: Brentuximab vedotin (Adcetris), Bendamustine (Treanda), Nivolumab (Opdivo), Pembrolizumab (Keytruda), DHAP (dexamethasone, cisplatin, and cytarabine), ESHAP (etoposide, methylprednisolone, cisplatin, and cytarabine), GVD (gemcitabine, vinorelbine, and liposomal doxorubicin), ICE (ifosfamide, carboplatin, and etoposide), IGEV (ifosfamide, gemcitabine, and vinorelbine). […] Although the cure rate in HL is already high, research continues to look for ways to treat the minority of patients who are refractory to treatment and those who relapse. Many promising therapies are currently under investigation in clinical trials for HL including: Anti-CD30-CAR T cells, Atezolizumab (Tecentriq), Bortezomib (Velcade), Carfilzomib (Kyprolis), Everolimus (Afinitor), Ibrutinib (Imbruvica), Lenalidomide (Revlimid), Mocetinostat (MGCD0103), Ruxolitinib (Jakafi), Umbralisib.

• #86 Treatment options for Hodgkin lymphoma | Cancer Research UK

  https://www.cancerresearchuk.org/about-cancer/hodgkin-lymphoma/treatment/treatment-decisions

  Immunotherapy is treatment that stimulates the body’s immune system to fight cancer. You might have immunotherapy if your Hodgkin lymphoma has come back. […] Stem cell transplants are a possible treatment for some types of blood cancers such as lymphoma. You might have a stem cell transplant if you have relapsed Hodgkin lymphoma. […] Treatment for relapsed Hodgkin lymphoma includes: high dose chemotherapy, a stem cell transplant, radiotherapy, targeted therapy, immunotherapy, more chemotherapy. […] For some people, treatment can cure Hodgkin lymphoma that comes back. Even if your lymphoma can’t be cured, you will be able to have treatment to shrink the lymphoma.

• #87 Latest advances in the management of classical Hodgkin lymphoma: the era of novel therapies | Blood Cancer Journal

  https://www.nature.com/articles/s41408-021-00518-z

  The use of sequential pembrolizumab (PEM) and AVD for untreated early unfavourable or advanced-stage cHL was evaluated in a phase II study. […] Overall, the incorporation of immunotherapy in the frontline treatment for older cHL patients is a feasible and promising strategy. Further comparative studies are needed, however, to evaluate the benefit of these novel agents in terms of QoL and OS in this particular population. […] About 10-15% of patients with early stage and 15-30% with advanced-stage cHL fail to respond or relapse after primary conventional treatment. Despite the approval of novel therapies, autologous stem cell transplantation (ASCT) remains the standard of care in these patients. […] An innovative sequential approach using Nivo was evaluated in a phase II trial. Nivo was administered for a maximum of six cycles as first-salvage therapy.

• #88 Latest advances in the management of classical Hodgkin lymphoma: the era of novel therapies | Blood Cancer Journal

  https://www.nature.com/articles/s41408-021-00518-z

  The combination of BV and bendamustine (BV-Benda) may also be highly active with manageable toxicity as first-salvage therapy especially for fragile patients. […] In a phase I/II study, patients with R/R cHL received up to four cycles of BV-Nivo as first-salvage therapy followed by ASCT. […] The AETHERA trial demonstrated for the first time the benefit of BV maintenance after ASCT for up to 16 cycles. […] Anti-PD1 mAb might also become a new standard for maintenance after ASCT, allowing a schedule twice as short than in the AETHERA trial. […] Although most of the cHL patients can be cured with first- and second-line therapy, some patients may still relapse or progress after intensive chemotherapy and ASCT, and thus, carry a poor prognosis. […] In a large EBMT study, BV was assessed as a bridge to allo-HCT in patients with R/R cHL compared to a group of no BV therapy prior to allo-HCT.

• #89 Hodgkin Lymphoma: Relapsed/Refractory – LRF

  https://www.lymphoma.org/understanding-lymphoma/aboutlymphoma/hl/relapsedhl/

  Hodgkin lymphoma patients who fail to achieve complete remission following frontline therapy or who relapse after achieving complete remission are often treated with second-line chemotherapy regimens, followed by a bone marrow or stem cell transplant. […] There are a variety of single-agent and combination therapy regimens that may be used for relapsed/refractory HL, including: Brentuximab vedotin (Adcetris), Bendamustine (Treanda), Nivolumab (Opdivo), Pembrolizumab (Keytruda), DHAP (dexamethasone, cisplatin, and cytarabine), ESHAP (etoposide, methylprednisolone, cisplatin, and cytarabine), GVD (gemcitabine, vinorelbine, and liposomal doxorubicin), ICE (ifosfamide, carboplatin, and etoposide), IGEV (ifosfamide, gemcitabine, and vinorelbine). […] Although the cure rate in HL is already high, research continues to look for ways to treat the minority of patients who are refractory to treatment and those who relapse. Many promising therapies are currently under investigation in clinical trials for HL including: Anti-CD30-CAR T cells, Atezolizumab (Tecentriq), Bortezomib (Velcade), Carfilzomib (Kyprolis), Everolimus (Afinitor), Ibrutinib (Imbruvica), Lenalidomide (Revlimid), Mocetinostat (MGCD0103), Ruxolitinib (Jakafi), Umbralisib.

• #90 Targeted Therapy & Immunotherapy for Hodgkin Lymphoma | Cancer Council NSW

  https://www.cancercouncil.com.au/hodgkin-lymphoma/treatment/targeted-therapy-and-immunotherapy/

  Clinical trials are testing other targeted therapy drugs for Hodgkin lymphoma. Ask your doctor about the latest developments. […] This type of drug therapy uses the body’s own immune system to fight cancer. An immunotherapy drug called pembrolizumab is available for some people with relapsed or refractory Hodgkin lymphoma. It is usually given as an intravenous infusion every 3 weeks. Pembrolizumab can be used alone or combined with chemotherapy. […] Other immunotherapy drugs for Hodgkin lymphoma may be available through clinical trials. Ask your doctor about the latest developments in immunotherapy for Hodgkin lymphoma.

• #91 Hodgkin Lymphoma | Fred Hutchinson Cancer Center

  https://www.fredhutch.org/en/diseases/hodgkin-lymphoma.html

  Many Hodgkin lymphoma patients at Fred Hutchinson Cancer Center receive promising therapies by joining clinical trials. These research studies are done by physician-scientists from Fred Hutch. They test new treatments or new ways to use current treatments. We have clinical trials for all stages of Hodgkin lymphoma. These therapies work well on Hodgkin lymphoma: Chemotherapy regimens, Antibody therapies, Immunotherapies. […] In the past decade, research into antibody therapies and immunotherapies has found new ways to control Hodgkin lymphoma or put it into remission. Fred Hutch is a national leader in advancing these and other options, bringing new hope to patients.

• #92 Hodgkin Lymphoma Treatment | Treatment for Hodgkin Disease | American Cancer Society

  https://www.cancer.org/cancer/types/hodgkin-lymphoma/treating.html

  It’s important to discuss all treatment options, including their goals and possible side effects, with your doctors to help make the decision that best fits your needs. […] Clinical trials are carefully controlled research studies that are done to get a closer look at promising new treatments or procedures. Clinical trials are one way to get state-of-the-art cancer treatment. […] You may hear about alternative or complementary methods to relieve symptoms or treat your cancer that your doctors haven’t mentioned. These methods can include vitamins, herbs, and special diets, or other methods such as acupuncture or massage, to name a few. […] Be sure to talk to your cancer care team about any method you are thinking about using. They can help you learn what is known (or not known) about the method, which can help you make an informed decision.

• #93 https://www.lls.org/lymphoma/hodgkin-lymphoma/treatment

  https://www.lls.org/lymphoma/hodgkin-lymphoma/treatment

  Treatment goals are to: Cure at all stages, Minimize both short-term and long-term side effects and complications, Weigh the risks of toxicity against treatment benefits. […] The treatment your doctor recommends is based on several factors, including: Your disease subtype, Your disease stage and category, Whether your disease is either refractory (the disease does not respond to treatment) or relapsed (the disease has recurred after treatment), Your age, Whether you have coexisting diseases or conditions (for example, heart disease, kidney disease, diabetes). […] If your child is being treated for Hodgkin lymphoma, therapy may differ slightly from that of the average adult. […] As you develop a treatment plan with your doctor, be sure to discuss: The results you can expect from treatment, The potential side effects, including long-term effects and late-term effects, The possibility of participating in a clinical trial, where you may have access to advanced medical treatment that may be more beneficial to you than standard treatment.

• #94 Hodgkin’s Lymphoma Therapy: Past, Present, and Future

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2978071/

  The treatment of Hodgkin lymphoma (HL) with the use of radiotherapy and systemic chemotherapy has been one of the success stories of modern oncology. HL therapy has been the paradigm for the systematic evaluation of different curative modalities resulting in cure for the majority of patients. […] The current focus is on designing initial therapeutic strategies which retain efficacy and minimize long-term toxicity. Appropriate use of pathologic, clinical, biologic and radiologic prognostic factors in identification of aggressive HL is paramount in designing a successful therapeutic strategy. […] The current standard approaches with the use of combined modality therapy and systemic chemotherapy as well as the promising role of future response-adapted strategies is reviewed. […] In HL, appropriate utilization of risk assessment strategies is required to maximize therapeutic outcomes while minimizing toxicity, especially long-term toxicity. Response-adapted therapy utilizing PET has the potential to profoundly improve the therapeutic landscape in HL.

• #95 Hodgkin Lymphoma Treatment & Management: Approach Considerations, Goals of Therapy and Response Assessment, Radiation Therapy

  https://emedicine.medscape.com/article/201886-treatment

  Advanced-stage disease is generally treated with chemotherapy alone, with radiation therapy reserved for selected patients. […] Short-term toxicity varies based on the regimen and modalities used (chemotherapy, radiation, combination of both, and stem cell transplantation) and include: Hematologic toxicity: Anemia (need for transfusion), thrombocytopenia, increased risk of infection (febrile neutropenia). […] Long-term toxicities vary based on patient age and treatment regimen. […] Given the curable nature of this disease and patients long-term survival, goals for treatment are the following: Maximize cure for all stages; Minimize both short-term and long-term complications, assuming this does not have an impact on cure. […] The overarching theme is assessing patients individually for their extent of disease, disease-related prognosis, associated conditions, risk of relapse, and long-term survival.

• #96 Hodgkin’s Lymphoma Therapy: Past, Present, and Future

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2978071/

  The different assignments for sub-classifications result in challenging interpretations and comparisons of trial results involving these sub-groups but it is generally accepted that clinical stages III-IV and early stage patients with bulk disease or systemic symptoms constitute the category of unfavorable-risk patients. […] For this category, prognostic models have been developed incorporating laboratory and clinical parameters in an effort to predict which patients are likely to respond poorly to initial anthracycline-based chemotherapy. […] The urgent need is for prognostic models which can identify patients with extremely poor prognosis whom can be prospectively identified. […] The International Prognostic Score (IPS) was defined as the number of prognostic factors available at diagnosis.

• #97 Hodgkin’s Lymphoma Therapy: Past, Present, and Future

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2978071/

  The IPS predicted the rate of freedom from progression of disease at 5 years of follow-up as: no factor 84%; 1 factor- 77%; 2 factors- 67%; 3 factors- 60%; 4 factors- 51%; and 5 or more factors- 42%. […] The prognostic utility of interim response assessment during therapy of advanced HL was evaluated in a recent meta-analysis. […] The presence of a positive pre-ASCT PET scan correlated with an increased risk of progression and decreased OS. […] The successful integration of two curative therapies- systemic chemotherapy and radiotherapy- results in cure for the large majority of patients with untreated classical HL and for a significant number of relapsing or refractory patients (with ASCT). […] The objective of cure has to be appropriately balanced with that of achieving minimal long-term toxicity.

• #98 Hodgkin’s Lymphoma Therapy: Past, Present, and Future

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2978071/

  The IPS predicted the rate of freedom from progression of disease at 5 years of follow-up as: no factor 84%; 1 factor- 77%; 2 factors- 67%; 3 factors- 60%; 4 factors- 51%; and 5 or more factors- 42%. […] The prognostic utility of interim response assessment during therapy of advanced HL was evaluated in a recent meta-analysis. […] The presence of a positive pre-ASCT PET scan correlated with an increased risk of progression and decreased OS. […] The successful integration of two curative therapies- systemic chemotherapy and radiotherapy- results in cure for the large majority of patients with untreated classical HL and for a significant number of relapsing or refractory patients (with ASCT). […] The objective of cure has to be appropriately balanced with that of achieving minimal long-term toxicity.

• #99 Hodgkin’s Lymphoma Therapy: Past, Present, and Future

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2978071/

  The IPS predicted the rate of freedom from progression of disease at 5 years of follow-up as: no factor 84%; 1 factor- 77%; 2 factors- 67%; 3 factors- 60%; 4 factors- 51%; and 5 or more factors- 42%. […] The prognostic utility of interim response assessment during therapy of advanced HL was evaluated in a recent meta-analysis. […] The presence of a positive pre-ASCT PET scan correlated with an increased risk of progression and decreased OS. […] The successful integration of two curative therapies- systemic chemotherapy and radiotherapy- results in cure for the large majority of patients with untreated classical HL and for a significant number of relapsing or refractory patients (with ASCT). […] The objective of cure has to be appropriately balanced with that of achieving minimal long-term toxicity.

• #100 Hodgkin Lymphoma Treatment & Management: Approach Considerations, Goals of Therapy and Response Assessment, Radiation Therapy

  https://emedicine.medscape.com/article/201886-treatment

  The ABVD regimen is the standard of care for the treatment of classic Hodgkin lymphoma, particularly in the United States. […] Treatment with nivolumab plus AVD (N+AVD) resulted in longer PFS than A+AVD in a phase III trial in 970 adolescents and adults with stage III or IV advanced-stage classic Hodgkin lymphoma; in addition, N+AVD had a better adverse effect profile. […] When induction chemotherapy fails, or patients experience relapse, salvage chemotherapy is generally given. […] High-dose chemotherapy (HDC) at doses that ablate the bone marrow is feasible with reinfusion of the patient’s previously collected hematopoietic stem cells (autologous transplantation) or infusion of stem cells from a donor source (allogeneic transplantation). […] Patients with clinical stages IA or IIA classic Hodgkin lymphoma who do not have unfavorable factors are categorized as having early-stage, low-risk disease.

• #101 Treatments for classical Hodgkin lymphoma | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/hodgkin-lymphoma/treatment/classical

  Classical Hodgkin lymphoma (HL) is commonly known as HL. It is treated based on the stage. […] Treatment of stage 1 and 2 (early) HL is also based on whether the HL is favourable or unfavourable. Favourable means that its easier to treat because you dont have any unfavourable (adverse) prognostic factors. Unfavourable means that it needs more or longer treatment because you have one or more unfavourable factors. […] The main treatment for stage 1 and stage 2 favourable HL is chemotherapy, with or without radiation therapy. […] Chemotherapy uses anticancer drugs to destroy cancer cells. Combination chemotherapy is treatment with more than one anticancer drug. The most common combination chemotherapy used to treat classical HL is ABVD. ABVD includes doxorubicin, bleomycin, vinblastine and dacarbazine. ABVD is usually given for 2 to 4 cycles.

• #102 Hodgkin’s Lymphoma Therapy: Past, Present, and Future

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2978071/

  Cure rates greater than 90% for early HL and more than 70% for those with advanced HL are expected. Identifying high-risk patients who will relapse after initial therapy is of paramount importance in the development of intensified and/or improved therapeutic approaches for this unfavorable-risk group of patients. […] The major emphasis of ongoing randomized trials in HL is development and validation of response-adapted strategies utilizing functional imaging with Positron Emission Tomography (PET). […] The stage for an individual HL patient is the most important determinant of prognosis and appropriate therapy. […] The treatment of early stage unfavorable disease is reliant on systemic chemotherapy regimens as in advanced disease with subsequent involved field radiotherapy. Advanced disease is treated primarily with multi-agent chemotherapy regimens with a role for consolidative radiotherapy in cases of partial responses or bulky disease.

• #103 Hodgkin Lymphoma Treatment & Management: Approach Considerations, Goals of Therapy and Response Assessment, Radiation Therapy

  https://emedicine.medscape.com/article/201886-treatment

  The treatment of these patients requires an individualized approach that provides enough therapy to eradicate the disease and avoid the long-term toxicity of treatment. […] Patients with early-stage disease and unfavorable prognostic factors are classified as having early-stage unfavorable Hodgkin lymphoma. […] The most commonly used regimen is ABVD (Adriamycin [doxorubicin], bleomycin, vinblastine, dacarbazine) for 2-4 cycles followed by involved-site radiation therapy (ISRT) (usually to 30 Gy). […] An alternative regimen, escalated BEACOPP, is recommended by the NCCN for patients with a poor prognosis. […] The role of interim PET-CT scans in the treatment of advanced Hodgkin lymphoma has become more established. […] The majority of data to date suggest that radiation improves progression-free survival but without improving overall survival.

• #104 Chemotherapy for Hodgkin Lymphoma | Cancer Council NSW

  https://www.cancercouncil.com.au/hodgkin-lymphoma/treatment/chemotherapy/

  Chemotherapy uses drugs to kill or slow the growth of cancer cells. There are guidelines (protocols) that set out how much and how often to have particular chemotherapy drugs, depending on the stage of the lymphoma. […] For Hodgkin lymphoma, you will have several chemotherapy drugs, usually given in cycles spread over 3–6 months. Each cycle takes 2–4 weeks and includes rest days. Sometimes after the first 2 cycles, you may have a PET–CT scan to check how the Hodgkin lymphoma has responded. This is known as restaging, and it helps your team work out whether to adjust the chemotherapy you are given. […] You will also have regular blood tests throughout treatment. If your white blood cell count is low (called neutropenia or lymphopenia), you may be given injections of granulocyte-colony stimulating factor (G-CSF). G-CSF is a substance that helps to increase your white cell count and protect you from infection. Sometimes, you may need to delay your chemotherapy until your white cell count improves.

• #105 Latest advances in the management of classical Hodgkin lymphoma: the era of novel therapies | Blood Cancer Journal

  https://www.nature.com/articles/s41408-021-00518-z

  The standard of care for early stage cHL is doxorubicin (or adriamycin), bleomycin, vinblastine, and dacarbazine (ABVD) and form the backbone of frontline management in North America regardless of the stage. […] In advanced-stage cHL, the HD18 trial demonstrated the non-inferiority of reducing therapy to a total of four cycles of eBEACOPP instead of six or eight cycles in the case of PET2 negativity after two cycles of eBEACOPP (5-year PFS 92.2% vs 90.8%, respectively, 95% CI2754). […] The risk-adapted and response-adapted approaches discussed above rely mainly on intensification or de-escalation chemotherapy. More recent approaches combine novel immunotherapies such as brentuximab vedotin (BV) and anti-PD-1 monoclonal antibodies (mAb) to reduce the risk of relapse and chemotherapy-associated toxicity.

• #106 Purpose Beyond a Cure: Advancing Hodgkin Lymphoma Treatment – UF Health

  https://ufhealth.org/stories/2024/purpose-beyond-a-cure-advancing-hodgkin-lymphoma-treatment

  Both drugs have been found to be effective at killing tumors with acceptable side effects in patients with relapsed Hodgkin disease, said UF Health pediatric oncologist William Slayton, MD, the clinical leader of the pediatric disease site group at the UF Health Cancer Center. […] The trial tests whether a chemotherapy backbone is enough by itself to cure the majority of patients, Dr. Slayton said. Through a scheme that classifies patients risk, lower-risk patients get less chemotherapy than higher-risk patients, and a PET scan determines who gets radiation. We want to achieve the cure with fewer side effects.

• #107 Latest advances in the management of classical Hodgkin lymphoma: the era of novel therapies | Blood Cancer Journal

  https://www.nature.com/articles/s41408-021-00518-z

  The standard of care for early stage cHL is doxorubicin (or adriamycin), bleomycin, vinblastine, and dacarbazine (ABVD) and form the backbone of frontline management in North America regardless of the stage. […] In advanced-stage cHL, the HD18 trial demonstrated the non-inferiority of reducing therapy to a total of four cycles of eBEACOPP instead of six or eight cycles in the case of PET2 negativity after two cycles of eBEACOPP (5-year PFS 92.2% vs 90.8%, respectively, 95% CI2754). […] The risk-adapted and response-adapted approaches discussed above rely mainly on intensification or de-escalation chemotherapy. More recent approaches combine novel immunotherapies such as brentuximab vedotin (BV) and anti-PD-1 monoclonal antibodies (mAb) to reduce the risk of relapse and chemotherapy-associated toxicity.

• #108 Hodgkin lymphoma – Wikipedia

  https://en.wikipedia.org/wiki/Hodgkin_lymphoma

  For Hodgkin lymphomas, radiation oncologists typically use external beam radiation therapy (sometimes shortened to EBRT or XRT). […] Radiation therapy directed above the diaphragm to the neck, chest or underarms is called mantle field radiation. […] Radiation to below the diaphragm to the abdomen, spleen or pelvis is called inverted-Y field radiation. […] Total nodal irradiation is when the therapist gives radiation to all the lymph nodes in the body to destroy cells that may have spread. […] The high cure rates and long survival of many people with Hodgkin lymphoma has led to a high concern with late adverse effects of treatment, including cardiovascular disease and second malignancies such as acute leukemias, lymphomas, and solid tumors within the radiation therapy field. […] Most people with early-stage disease are now treated with abbreviated chemotherapy and involved site radiation therapy rather than with radiation therapy alone. […] Clinical research strategies are exploring reduction of the duration of chemotherapy and dose and volume of radiation therapy in an attempt to reduce late morbidity and mortality of treatment while maintaining high cure rates.

• #109 Hodgkin Lymphoma in Children and Teens – Together by St. Jude™

  https://together.stjude.org/en-us/conditions/cancers/hodgkin-lymphoma.html

  Hodgkin lymphoma is a cancer of the lymphatic system, or lymph system. The main treatment for this cancer is chemotherapy. […] The goal is to use the least amount of treatment possible for cure. Using less treatment helps to prevent long-term and late effects of treatment. […] In the U.S., common chemotherapy combinations for childhood Hodgkin disease include: AEPA/CAPDac: Brentuximab, etoposide, prednisone, doxorubicin, cyclophosphamide, and dacarbazine. […] Some patients may also have radiation therapy. […] Risk groups are used to plan treatment. […] Targeted therapy is used in some cases of Hodgkin lymphoma. Brentuximab vedotin and rituximab are examples. […] Patients whose Hodgkin lymphoma does not respond to treatment or returns after treatment may need a stem cell transplant. […] Surgery is not a treatment for Hodgkin lymphoma. […] Hodgkin lymphoma treatment usually takes 26 months. […] The survival rate for Hodgkin lymphoma in the U.S. is more than 95%. […] Hodgkin lymphoma has a 95% survival rate in the U.S.

• #110 https://www.lls.org/lymphoma/hodgkin-lymphoma/treatment

  https://www.lls.org/lymphoma/hodgkin-lymphoma/treatment

  Treatment goals are to: Cure at all stages, Minimize both short-term and long-term side effects and complications, Weigh the risks of toxicity against treatment benefits. […] The treatment your doctor recommends is based on several factors, including: Your disease subtype, Your disease stage and category, Whether your disease is either refractory (the disease does not respond to treatment) or relapsed (the disease has recurred after treatment), Your age, Whether you have coexisting diseases or conditions (for example, heart disease, kidney disease, diabetes). […] If your child is being treated for Hodgkin lymphoma, therapy may differ slightly from that of the average adult. […] As you develop a treatment plan with your doctor, be sure to discuss: The results you can expect from treatment, The potential side effects, including long-term effects and late-term effects, The possibility of participating in a clinical trial, where you may have access to advanced medical treatment that may be more beneficial to you than standard treatment.

• #111 Hodgkin Lymphoma Treatment & Management: Approach Considerations, Goals of Therapy and Response Assessment, Radiation Therapy

  https://emedicine.medscape.com/article/201886-treatment

  Advanced-stage disease is generally treated with chemotherapy alone, with radiation therapy reserved for selected patients. […] Short-term toxicity varies based on the regimen and modalities used (chemotherapy, radiation, combination of both, and stem cell transplantation) and include: Hematologic toxicity: Anemia (need for transfusion), thrombocytopenia, increased risk of infection (febrile neutropenia). […] Long-term toxicities vary based on patient age and treatment regimen. […] Given the curable nature of this disease and patients long-term survival, goals for treatment are the following: Maximize cure for all stages; Minimize both short-term and long-term complications, assuming this does not have an impact on cure. […] The overarching theme is assessing patients individually for their extent of disease, disease-related prognosis, associated conditions, risk of relapse, and long-term survival.

• #112 Pediatric Hodgkin Lymphoma Treatment & Management: Approach Considerations, Chemotherapy Regimens, Supportive Medication

  https://emedicine.medscape.com/article/987101-treatment

  Hodgkin lymphoma is one of the most curable malignancies of childhood and adolescence. The treatment of pediatric Hodgkin lymphoma is based on the experience of adult Hodgkin lymphoma treatment regimens. In general, the treatment of Hodgkin lymphoma is tailored to the subtype, staging, and response to therapy, and, as such, an accurate histopathological diagnosis is required. […] Hodgkin lymphoma can be cured with radiation therapy and/or chemotherapy. Combined-modality therapy, including radiation and chemotherapy, is the preferred approach for most pediatric patients. Because most pediatric patients with Hodgkin lymphoma are successfully treated, an important consideration in the treatment approach of children and adolescents is the selection of a treatment regimen, particularly in reference to the anticipated late toxicities associated with cancer-directed therapy. Late toxicities vary substantially according to the treatment modality used.

• #113 Pediatric Hodgkin Lymphoma Treatment & Management: Approach Considerations, Chemotherapy Regimens, Supportive Medication

  https://emedicine.medscape.com/article/987101-treatment

  Most modern pediatric treatment strategies focus on reducing late effects of therapy while maintaining excellent cure rates with risk-adapted chemotherapy alone or response-adjusted combined-modality regimens. […] The optimum treatment for adolescents and young adults (18-25 years) is not well defined. Pediatric and adult regimens are used depending on center-specific policies and referral patterns. Adult regimens have been shown to be safe and effective; however, the cumulative doses of chemotherapy used on those regimens have a significant impact on the growing child or adolescent. […] The authors believe that children and adolescents (18 y) with Hodgkin lymphoma should be treated at a pediatric oncology center where a multidisciplinary team of pediatric specialists is familiar with the treatment and the acute and long-term complications of pediatric malignancies.

• #114 Pediatric Hodgkin Lymphoma Treatment & Management: Approach Considerations, Chemotherapy Regimens, Supportive Medication

  https://emedicine.medscape.com/article/987101-treatment

  Although pediatric Hodgkin lymphoma is highly sensitive to the treatment regimens devised for adults, long-term toxicity is enhanced in the developing individual. As a result, there have been dual goals in the design of clinical trials for pediatric Hodgkin lymphoma: (1) to reduce long-term organ injury and (2) increase efficacy. […] Radiation therapy was the first curative modality used for Hodgkin lymphoma (HL) in the early 1960s. However, the doses and fields used for the treatment of adult Hodgkin lymphoma caused profound musculoskeletal retardation, cardiac toxicity, and increased incidence of secondary malignancies in the radiation field (eg, breast cancer in female survivors). […] Combined-modality therapy is preferred to avoid the high cumulative doses of alkylating agents, bleomycin, and anthracyclines used in chemotherapy-only protocols.

• #115 Hodgkin Lymphoma in Children and Teens – Together by St. Jude™

  https://together.stjude.org/en-us/conditions/cancers/hodgkin-lymphoma.html

  Hodgkin lymphoma is a cancer of the lymphatic system, or lymph system. The main treatment for this cancer is chemotherapy. […] The goal is to use the least amount of treatment possible for cure. Using less treatment helps to prevent long-term and late effects of treatment. […] In the U.S., common chemotherapy combinations for childhood Hodgkin disease include: AEPA/CAPDac: Brentuximab, etoposide, prednisone, doxorubicin, cyclophosphamide, and dacarbazine. […] Some patients may also have radiation therapy. […] Risk groups are used to plan treatment. […] Targeted therapy is used in some cases of Hodgkin lymphoma. Brentuximab vedotin and rituximab are examples. […] Patients whose Hodgkin lymphoma does not respond to treatment or returns after treatment may need a stem cell transplant. […] Surgery is not a treatment for Hodgkin lymphoma. […] Hodgkin lymphoma treatment usually takes 26 months. […] The survival rate for Hodgkin lymphoma in the U.S. is more than 95%. […] Hodgkin lymphoma has a 95% survival rate in the U.S.

• #116 Pediatric Hodgkin Lymphoma Treatment & Management: Approach Considerations, Chemotherapy Regimens, Supportive Medication

  https://emedicine.medscape.com/article/987101-treatment

  Chemotherapy alone may be effective in low-stage disease with a good response to therapy or in patients with limited-stage nodular lymphocyte-predominant Hodgkin lymphoma. […] For early or favorable disease (stage IA or IIA with 3 nodal sites, and some IIIA without bulky disease) standard treatment includes 2-4 chemotherapy cycles of ABVE, OEPA, or VAMP plus low-dose, involved-field radiation of 15-30 Gy or 6 chemotherapy cycles of COPP alternating with ABVD and no irradiation. […] For intermediate-risk disease (stage IIA bulky disease with extension or 3 nodal sites, stage IIB, stage III, stage IV), standard treatment includes 3-5 cycles (depending on response to induction treatment) with ABVE-PC plus 21 Gy of involved-field radiation. […] In patients with relapsing or unresponsive disease, autologous stem cell transplantation significantly prolongs disease-free survival.

• #117 Hodgkin Lymphoma (Disease) in Children – In Treatment | CureSearch

  https://curesearch.org/Hodgkin-Lymphoma-In-Treatment/

  The goal of treatment for Hodgkin lymphoma, as with most cancers, is curing the disease with minimal short- and long-term side effects. Most Hodgkin lymphoma in children and adolescents cannot be cured with surgery alone to remove the tumor. […] The majority of children with Hodgkin disease are treated with chemotherapy and many receive “combined modality” therapy that includes radiation. Carefully selected children are treated with only chemotherapy. Stem cell transplant may be used for treatment if Hodgkin disease has come back after successful treatment (relapse) or if the cancer does not respond to conventional treatments (refractory). […] Initial therapy depends on the stage and bulk (size) of disease as well as with the subtype of Hodgkin lymphoma. Patients with lower stage (or early stage) disease, such as IA and IIA, receive less chemotherapy than higher stage patients. The amount of therapy can also be affected by whether a patient is designated a rapid early responder (RER), meaning the cancer responds quickly to initial treatment or a slow early responder (SER), meaning the cancer responds more slowly to initial treatment. Currently, RER patients receive less total treatment than patients with the same disease stage designated as SER. While most patients are treated with both chemotherapy and radiation therapy, efforts are underway to identify RER patients who can be treated without radiation therapy while still maintaining equally high survival rates. […] When chemotherapy is administered, it is usually with a combination of four or more drugs. Side effects can include low blood counts, increased infection risk, hair loss, infertility, nausea and vomiting, fatigue, lung damage, heart damage, and increased risk of cancer later in life.

• #118 Purpose Beyond a Cure: Advancing Hodgkin Lymphoma Treatment – UF Health

  https://ufhealth.org/stories/2024/purpose-beyond-a-cure-advancing-hodgkin-lymphoma-treatment

  Emilie Lynch has passed the five-year milestone that doctors consider a yardstick for being cured of Hodgkin lymphoma not once but three times. […] Hodgkin lymphoma, a cancer that affects the lymphatic system and limits the body’s ability to fight infections, has survival rates close to 90% for children and young adults. Treatments are advancing quickly. […] Now, UF Health is at the forefront of clinical trials that aim to reduce the burden of these side effects. The trials, some of which use immunotherapy instead of chemotherapies, seek to fine-tune less-toxic treatments for Hodgkin lymphoma. […] The trial Riley was treated in is testing two new medicines. One, brentuximab vedotin, is a targeted therapy that causes chemotherapy to stick to cancerous cells in Hodgkin disease, called Reed-Sternberg cells.

• #119 Classical Hodgkin lymphoma | Lymphoma Action

  https://lymphoma-action.org.uk/types-lymphoma-hodgkin-lymphoma/classical-hodgkin-lymphoma

  People over 60 are generally more likely to experience serious side effects than younger people. […] Your doctor will consider your fitness and any other health problems you have. […] If the lymphoma is only in one place in your body, you might be given radiotherapy to the affected area. […] If your Hodgkin lymphoma has not responded to treatment, or has come back, you might have more chemotherapy. […] If you respond to salvage chemotherapy and you are fit enough, your doctor might recommend a stem cell transplant. […] Treatment for classical Hodgkin lymphoma is usually successful but doctors continue to research treatments that might provide better outcomes.

• #120 Hodgkin Lymphoma Treatment & Management: Approach Considerations, Goals of Therapy and Response Assessment, Radiation Therapy

  https://emedicine.medscape.com/article/201886-treatment

  Advanced-stage disease is generally treated with chemotherapy alone, with radiation therapy reserved for selected patients. […] Short-term toxicity varies based on the regimen and modalities used (chemotherapy, radiation, combination of both, and stem cell transplantation) and include: Hematologic toxicity: Anemia (need for transfusion), thrombocytopenia, increased risk of infection (febrile neutropenia). […] Long-term toxicities vary based on patient age and treatment regimen. […] Given the curable nature of this disease and patients long-term survival, goals for treatment are the following: Maximize cure for all stages; Minimize both short-term and long-term complications, assuming this does not have an impact on cure. […] The overarching theme is assessing patients individually for their extent of disease, disease-related prognosis, associated conditions, risk of relapse, and long-term survival.

• #121 Latest advances in the management of classical Hodgkin lymphoma: the era of novel therapies | Blood Cancer Journal

  https://www.nature.com/articles/s41408-021-00518-z

  The standard of care for early stage cHL is doxorubicin (or adriamycin), bleomycin, vinblastine, and dacarbazine (ABVD) and form the backbone of frontline management in North America regardless of the stage. […] In advanced-stage cHL, the HD18 trial demonstrated the non-inferiority of reducing therapy to a total of four cycles of eBEACOPP instead of six or eight cycles in the case of PET2 negativity after two cycles of eBEACOPP (5-year PFS 92.2% vs 90.8%, respectively, 95% CI2754). […] The risk-adapted and response-adapted approaches discussed above rely mainly on intensification or de-escalation chemotherapy. More recent approaches combine novel immunotherapies such as brentuximab vedotin (BV) and anti-PD-1 monoclonal antibodies (mAb) to reduce the risk of relapse and chemotherapy-associated toxicity.

• #122 Hodgkin Lymphoma Treatment & Pharmacologic Management – Cancer Therapy Advisor

  https://www.cancertherapyadvisor.com/ddi/hodgkin-lymphoma-pharmacologic-treatment/

  Hodgkin lymphoma is classified into 2 types: classic Hodgkin lymphoma (CHL) and nodular lymphocyte predominant Hodgkin lymphoma (NLPHL. Treatment for Hodgkin lymphoma should be individualized for each patient. Guidelines established by the National Comprehensive Cancer Network (NCCN) for the management of Hodgkin lymphoma outline several commonly used therapies to be used alongside radiation therapy and allogeneic stem cell transplant. A broad range of pharmacotherapies are recommended for treating patients with Hodgkin lymphoma. These pharmacological treatments fall into 3 categories: chemotherapy, immunotherapy, and targeted therapy. Chemotherapy agents are cytotoxic drugs that primarily target rapidly dividing cells, often by interfering with DNA synthesis, replication, or cell division. Several chemotherapy agents are used to treat Hodgkin lymphoma, including the following: Bendamustine, Bleomycin, Carboplatin, Cisplatin, Cyclophosphamide, Cytarabine, Dacarbazine, Doxorubicin, Etoposide, Gemcitabine, Ifosfamide, Lenalidomide, Procarbazine, Vinblastine, Vincristine. Immunotherapy is a class of drugs that enhances the immune systems ability to fight cancer. For Hodgkin lymphoma, immune checkpoint inhibitors, such as those targeting the programmed cell death 1 (PD-1) and programmed cell death ligand 1 (PD-L1) axis, restore cytotoxic T cell activity by blocking immune evasion mechanisms of cancer cells, enabling the immune system to recognize and destroy cancerous cells. Pembrolizumab and nivolumab are both PD-1 inhibitors approved by the US Food and Drug Administration (FDA) for treating patients with CHL. Brentuximab vedotin is an antibody-drug conjugate consisting of a monoclonal antibody targeting CD30, a cell surface receptor found on lymphoma cells, covalently linked to the cytotoxic agent monomethyl auristatin E (MMAE). Single-agent everolimus has been used off-label for treating relapsed or refractory Hodgkin lymphoma. Everolimus is a mammalian target of rapamycin (mTOR) inhibitor that causes cell growth arrest, triggering apoptosis. The NCCN has created pharmacotherapy guidelines based on the type and staging of Hodgkin lymphoma. Overall, treatment selection should be based on several factors, including the patients age, sex, comorbid conditions, personal and family history of cancer and cardiac disease, and location of the cancer. The recommended treatment for early-stage favorable disease is 2 cycles of ABVD. Four cycles of CHOP may also be used. Patients with early-stage unfavorable disease or late-stage disease may receive 2 cycles of ABVD followed by 4 cycles of AVD if their PET scan result is negative following 2 cycles of ABVD. Other options for those with early-stage unfavorable disease include CHOP, brentuximab vedotin+dacarbazine; and brentuximab vedotin followed by AVD. Disease outcomes and prognosis tend to be poor in older adults with relapsed or refractory Hodgkin lymphoma. There are no standard treatment recommendations; instead, single-agent therapy for palliative care is often the best approach. Treatment for early-stage NLPHL often involves radiation therapy. Patients with stage IA, IB, IIA bulky or noncontiguous or stage IIB NLPHL are treated with chemotherapy (ABVD, CHOP, or CVbP) plus radiation therapy and rituximab. For those with stage III or IV disease, a combination of chemotherapy and rituximab with or without radiation therapy is recommended. Restaging should be done in all patients after completing initial therapy.

• #123 Nivolumab and AVD the New Standard in Hodgkin Lymphoma – NCI

  https://www.cancer.gov/news-events/cancer-currents-blog/2024/hodgkin-lymphoma-nivolumab-avd-first-line

  Given the excellent outcomes seen in people treated with nivolumab and AVD, Dr. Friedberg said, oncologists can feel confident following this approach. […] We’ve largely eliminated radiation therapy as part of the initial treatment, he said. We now have a more effective, less toxic regimen that should not only have fewer short-term side effects, but also fewer long-term side effects. […] The nivolumab-AVD regimen and approach to radiation treatment used in the trial will very likely be considered the new standard of care for the adolescent and young adult population at many cancer centers, said Dr. Harker-Murray. […] The 2-year progression-free survival rate of 88% among those in this age group treated with nivolumab-AVD is probably the best ever reported. […] On the basis of these findings, the use of brentuximab-AVD should probably be avoided in older patients.

• #124 Latest advances in the management of classical Hodgkin lymphoma: the era of novel therapies | Blood Cancer Journal

  https://www.nature.com/articles/s41408-021-00518-z

  The use of sequential pembrolizumab (PEM) and AVD for untreated early unfavourable or advanced-stage cHL was evaluated in a phase II study. […] Overall, the incorporation of immunotherapy in the frontline treatment for older cHL patients is a feasible and promising strategy. Further comparative studies are needed, however, to evaluate the benefit of these novel agents in terms of QoL and OS in this particular population. […] About 10-15% of patients with early stage and 15-30% with advanced-stage cHL fail to respond or relapse after primary conventional treatment. Despite the approval of novel therapies, autologous stem cell transplantation (ASCT) remains the standard of care in these patients. […] An innovative sequential approach using Nivo was evaluated in a phase II trial. Nivo was administered for a maximum of six cycles as first-salvage therapy.

• #125 Hodgkin Lymphoma Treatment (PDQ®): Treatment – Patient Information [NCI] | Kaiser Permanente

  https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.hodgkin-lymphoma-treatment-pdq%C2%AE-treatment-patient-information-nci.ncicdr0000257991

  Hodgkin lymphoma is a disease in which malignant (cancer) cells form in the lymph system. […] Treatment is often different from classic Hodgkin lymphoma. […] For Hodgkin lymphoma during pregnancy, treatment options also depend on the wishes of the patient and the age of the fetus. […] Hodgkin lymphoma can usually be cured if found and treated early. […] There are different types of treatment for patients with Hodgkin lymphoma. […] Patients with Hodgkin lymphoma should have their treatment planned by a team of health care providers with expertise in treating lymphomas. […] Treatment for Hodgkin lymphoma may cause side effects. […] Chemotherapy is a cancer treatment that uses one or more drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing.

• #126 Hodgkin Lymphoma Treatment (PDQ®) – PDQ Cancer Information Summaries – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK65804/

  Treatment of NLPHL in adults may include: Watchful waiting or active surveillance, Radiation therapy to the areas of the body with cancer, Chemotherapy, Targeted therapy with a monoclonal antibody (rituximab). […] When Hodgkin lymphoma is diagnosed in the first trimester of pregnancy, it does not necessarily mean that the woman will be advised to end the pregnancy. […] Treatment of Hodgkin lymphoma during the second or third trimester of pregnancy may include: Watchful waiting, Radiation therapy to relieve breathing problems caused by a large tumor in the chest, Combination chemotherapy using one or more drugs, Steroid therapy.

• #127 Hodgkin Lymphoma Treatment – NCI

  https://www.cancer.gov/types/lymphoma/patient/adult-hodgkin-treatment-pdq

  Treatment for Hodgkin lymphoma may cause side effects. […] The following types of treatment are used: Chemotherapy, Radiation therapy, Targeted therapy, Immunotherapy, Chemotherapy with stem cell transplant. […] For patients with nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL), treatment options also include: Watchful waiting, Active surveillance. […] For pregnant patients with Hodgkin lymphoma, treatment options also include: Watchful waiting, Steroid therapy. […] Treatment of early favorable classic Hodgkin lymphoma in adults may include: Combination chemotherapy with or without radiation therapy to the areas of the body with cancer, Radiation therapy alone in patients who cannot be treated with combination chemotherapy. […] Treatment of early unfavorable classic Hodgkin lymphoma in adults may include: Combination chemotherapy with or without radiation therapy to the areas of the body with cancer, Targeted therapy with a monoclonal antibody (brentuximab vedotin) and combination chemotherapy with or without radiation therapy.

• #128 Hodgkin Lymphoma Treatment (PDQ®) – PDQ Cancer Information Summaries – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK65804/

  Treatment of NLPHL in adults may include: Watchful waiting or active surveillance, Radiation therapy to the areas of the body with cancer, Chemotherapy, Targeted therapy with a monoclonal antibody (rituximab). […] When Hodgkin lymphoma is diagnosed in the first trimester of pregnancy, it does not necessarily mean that the woman will be advised to end the pregnancy. […] Treatment of Hodgkin lymphoma during the second or third trimester of pregnancy may include: Watchful waiting, Radiation therapy to relieve breathing problems caused by a large tumor in the chest, Combination chemotherapy using one or more drugs, Steroid therapy.

• #129 Hodgkin Lymphoma Treatment (PDQ®): Treatment – Patient Information [NCI] | Kaiser Permanente

  https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.hodgkin-lymphoma-treatment-pdq%C2%AE-treatment-patient-information-nci.ncicdr0000257991

  Treatment of early unfavorable classic Hodgkin lymphoma in adults may include combination chemotherapy with radiation therapy to the areas of the body with cancer. […] Treatment of advanced classic Hodgkin lymphoma in adults may include combination chemotherapy. […] Treatment of recurrent classic Hodgkin lymphoma in adults may include immunotherapy with an immune checkpoint inhibitor or combination chemotherapy. […] Treatment of NLPHL in adults may include watchful waiting or active surveillance. […] Treatment of Hodgkin lymphoma during the first trimester of pregnancy may include watchful waiting when the cancer is above the diaphragm and is slow-growing. […] Treatment of Hodgkin lymphoma during the second or third trimester of pregnancy may include watchful waiting, radiation therapy, and combination chemotherapy.

• #130 Hodgkin Lymphoma Treatment (PDQ®) – PDQ Cancer Information Summaries – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK65804/

  Treatment of NLPHL in adults may include: Watchful waiting or active surveillance, Radiation therapy to the areas of the body with cancer, Chemotherapy, Targeted therapy with a monoclonal antibody (rituximab). […] When Hodgkin lymphoma is diagnosed in the first trimester of pregnancy, it does not necessarily mean that the woman will be advised to end the pregnancy. […] Treatment of Hodgkin lymphoma during the second or third trimester of pregnancy may include: Watchful waiting, Radiation therapy to relieve breathing problems caused by a large tumor in the chest, Combination chemotherapy using one or more drugs, Steroid therapy.

• #131 Hodgkin Lymphoma Treatment | Treatment for Hodgkin Disease | American Cancer Society

  https://www.cancer.org/cancer/types/hodgkin-lymphoma/treating.html

  If you (or your child) has been diagnosed with Hodgkin lymphoma (HL), the cancer care team will discuss treatment options with you. It’s important to think carefully about your choices. You will want to weigh the benefits of each treatment option against the possible risks and side effects. […] Chemotherapy and radiation therapy are the main treatments for HL. Depending on the case, one or both of these treatments might be used. […] Certain patients might be treated with immunotherapy or with a stem cell transplant, especially if other treatments haven’t worked. Except for biopsy and staging, surgery is rarely used to treat HL. […] Treatment for HL is based largely on the stage (extent) of the disease. But other factors, including a person’s age and general health, and the type and location of the lymphoma, might also affect treatment options. For almost all people with HL, cure is the main goal. But treatment can have side effects, some that don’t show up for many years. Because of this, doctors try to choose a treatment plan with the lowest risk of possible side effects.

• #132 Treatment for Hodgkin Lymphoma | Fred Hutchinson Cancer Center

  https://www.fredhutch.org/en/diseases/hodgkin-lymphoma/treatment.html

  Hodgkin lymphoma is most often treated with chemotherapy. Sometimes this is the only treatment needed, but it may be combined with radiation therapy. […] Targeted therapies are newer cancer treatments that work more selectively than standard chemotherapy. […] Patients with relapsed (the disease gets better but then gets worse) or refractory (does not respond to treatment) Hodgkin lymphoma are often good candidates for targeted therapy. […] Immunotherapies are some of the latest innovations at Fred Hutch. They use the power of your immune system to fight your cancer. […] If initial treatment doesn’t cure your lymphoma or your disease comes back, your physician may recommend a blood or marrow transplant. […] Most transplant recipients with Hodgkin lymphoma have a transplant using their own stem cells (autologous transplant). […] When your disease is in remission and your active treatment ends, it is still important to get follow-up care on a regular basis. […] Your team will also help with any long-term side effects (which go on after treatment ends) or late effects (which may start after treatment is over).

• #133

  http://www.bccancer.bc.ca/health-info/types-of-cancer/blood-lymphoid/hodgkin-lymphoma

  Bone Marrow Transplant (BMT) may be offered to some people, along with very high dose chemotherapy (for advanced or recurrent cancer). […] Follow-up testing and appointments are based on your type of cancer. […] Follow-up after treatment for Hodgkin lymphoma includes guidelines for your doctor, nurse practitioner or specialist. […] After treatment, you may return to the care of your family doctor or specialist for regular follow-up. […] Follow-up appointments and tests include seeing your doctor every 3 months for the first two years after treatment. […] After treatment for Hodgkin lymphoma, a few people develop side effects much later in life. […] Side effects you may have include dental problems such as a dry mouth or cavities. […] People who had a specific type of radiation for their Hodgkin lymphoma, called „mantle’ radiation, are at a high risk for breast cancer.

• #134 Hodgkin Lymphoma | Mays Cancer Center

  https://cancer.uthscsa.edu/cancer-care/types-and-treatments/hodgkin-lymphoma

  We use sophisticated technology to direct high-energy beams at cancer cells, destroying cancer while sparing healthy tissue. […] A stem cell transplant can help doctors treat the most difficult cases of Hodgkin lymphoma. […] Regular follow-up visits and testing help us monitor your health long-term. […] Clinical trials offer eligible patients some of todays promising cancer treatments close to home. […] Your doctor will discuss how clinical trials may benefit you throughout your treatment.

• #135

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=uh3328

  Hodgkin lymphoma is a type of cancer that affects part of the immune system (lymph system). […] Treatment for Hodgkin lymphoma depends on the stage of the lymphoma and what type of lymphoma you have. It is usually treated with medicines called chemotherapy. You may also need radiation treatments or a procedure called a stem cell transplant. Or you may have targeted therapy or immunotherapy. Your doctor will talk to you about what kind of treatment may be best for you. […] Follow-up care is a key part of your treatment and safety.

• #136 Hodgkin lymphoma – Wikipedia

  https://en.wikipedia.org/wiki/Hodgkin_lymphoma

  For Hodgkin lymphomas, radiation oncologists typically use external beam radiation therapy (sometimes shortened to EBRT or XRT). […] Radiation therapy directed above the diaphragm to the neck, chest or underarms is called mantle field radiation. […] Radiation to below the diaphragm to the abdomen, spleen or pelvis is called inverted-Y field radiation. […] Total nodal irradiation is when the therapist gives radiation to all the lymph nodes in the body to destroy cells that may have spread. […] The high cure rates and long survival of many people with Hodgkin lymphoma has led to a high concern with late adverse effects of treatment, including cardiovascular disease and second malignancies such as acute leukemias, lymphomas, and solid tumors within the radiation therapy field. […] Most people with early-stage disease are now treated with abbreviated chemotherapy and involved site radiation therapy rather than with radiation therapy alone. […] Clinical research strategies are exploring reduction of the duration of chemotherapy and dose and volume of radiation therapy in an attempt to reduce late morbidity and mortality of treatment while maintaining high cure rates.

• #137 Patient education: Hodgkin lymphoma in adults (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/hodgkin-lymphoma-in-adults-beyond-the-basics

  Long-term side effects of chemotherapy include: […] • Heart problems – Adriamycin (doxorubicin) can weaken the heart muscle in some people. […] • Lung damage – Bleomycin, which is used in all treatment regimens, can damage the lungs. […] • Infertility – Some types of chemotherapy can damage a woman’s oocytes (eggs). If most or all of the eggs are damaged or destroyed, a woman will go through an early menopause. This means that her periods will stop permanently, and she will have infertility because her eggs are damaged or gone. […] Early menopause, sometimes called „premature ovarian failure” or „primary ovarian insufficiency,” is most common with BEACOPP chemotherapy. About 50 percent of women lose their periods permanently after receiving BEACOPP. In contrast, ABVD chemotherapy does not seem to damage the ovaries.

• #138 Radiation Therapy for Hodgkin Lymphoma | Nebraska Hematology Oncology – Cancer Care Treatment Blood Disorders Clinical Trials Lincoln Nebraska (NE)

  https://www.yourcancercare.com/types-of-cancer/hodgkin-lymphoma/radiation-therapy-for-hodgkin-lymphoma

• #139 Patient education: Hodgkin lymphoma in adults (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/hodgkin-lymphoma-in-adults-beyond-the-basics

  The pattern is similar in men. BEACOPP chemotherapy causes very low sperm counts and infertility, but ABVD treatment does not. […] • Secondary cancer – There is a risk of developing a second cancer years after the first treatment for Hodgkin lymphoma. The most common secondary cancers include those of the breast, lung, or gastrointestinal system. […] Some forms of radiation therapy increase the risk of developing cancer in areas that were treated (such as to the lungs and breast tissue) years after therapy is finished. Women under 30 are at increased risk of breast cancer, and smokers have an increased risk of lung cancer (beyond the already increased risk of lung cancer from smoking). It is also possible to develop leukemia or other types of lymphoma. […] Radiation therapy — Radiation therapy (RT) involves using high-energy X-rays to stop the growth of cancer cells. Unlike normal cells, cancer cells cannot repair the damage caused by exposure to X-rays over several weeks.

• #140 Hodgkin lymphoma – UF Health

  https://ufhealth.org/conditions-and-treatments/hodgkin-lymphoma

  Hodgkin lymphoma is a cancer of lymph tissue. Lymph tissue is found in the lymph nodes, spleen, liver, bone marrow, and other sites. […] Treatment depends on the following: The type of Hodgkin lymphoma, The stage (where the disease has spread), Your age and other medical issues, Other factors, including weight loss, night sweats, and fever. […] You may receive chemotherapy, radiation therapy, or both, or immunotherapy. Your provider can tell you more about your specific treatment. […] High-dose chemotherapy may be given when Hodgkin lymphoma returns after treatment or does not respond to the first treatment. This is followed by a stem cell transplant that uses your own stem cells. […] Hodgkin lymphoma is one of the most curable cancers. Cure is even more likely if it is diagnosed and treated early. Unlike other cancers, Hodgkin lymphoma is also very curable in its late stages. […] Treatments for Hodgkin lymphoma can have complications. Long-term complications of chemotherapy or radiation therapy include: Bone marrow diseases (such as leukemia), Heart disease, Inability to have children (infertility), Lung problems, Other cancers, Thyroid problems.

• #141 Hodgkin lymphoma – Wikipedia

  https://en.wikipedia.org/wiki/Hodgkin_lymphoma

  For Hodgkin lymphomas, radiation oncologists typically use external beam radiation therapy (sometimes shortened to EBRT or XRT). […] Radiation therapy directed above the diaphragm to the neck, chest or underarms is called mantle field radiation. […] Radiation to below the diaphragm to the abdomen, spleen or pelvis is called inverted-Y field radiation. […] Total nodal irradiation is when the therapist gives radiation to all the lymph nodes in the body to destroy cells that may have spread. […] The high cure rates and long survival of many people with Hodgkin lymphoma has led to a high concern with late adverse effects of treatment, including cardiovascular disease and second malignancies such as acute leukemias, lymphomas, and solid tumors within the radiation therapy field. […] Most people with early-stage disease are now treated with abbreviated chemotherapy and involved site radiation therapy rather than with radiation therapy alone. […] Clinical research strategies are exploring reduction of the duration of chemotherapy and dose and volume of radiation therapy in an attempt to reduce late morbidity and mortality of treatment while maintaining high cure rates.

• #142 The Cure of Hodgkin Lymphoma – Hematology.org

  https://www.hematology.org/about/history/50-years/cure-of-hodgkin-lymphoma

  However, high response rates have been reported with the anti-B-cell antibody rituximab in a subtype of Hodgkin lymphoma with B-cell characteristics, and there is active research with new agents that target the microenvironment (non-malignant cells and tissues surrounding sites of lymphoma that modify the activity of the tumor cells) as well as Hodgkin cells. […] Current efforts seek to maintain optimal health for these survivors, to define the least complicated cures for newly diagnosed patients, and, ultimately, to better understand risks for and prevention of this disease.

• #143 Advances in Hodgkin Lymphoma Treatment: From Molecular Biology to Clinical Practice

  https://www.mdpi.com/2072-6694/16/10/1830

  Classical Hodgkin Lymphoma is a blood cancer, accounting for 0.5% of all new cancer diagnoses. Despite high cure chances, approximately 20% of patients are refractory to frontline treatment or relapse thereafter. Treatment strategies for relapsed/refractory patients have progressively lower chances of inducing a persistent complete remission. Therefore, great efforts are being made to further improve rates of response of frontline therapy, as well as to explore the efficacy of new compounds and different drug combinations. […] Classical Hodgkin Lymphoma (cHL) is a highly curable disease, but around 20% of patients experience progression or relapse after standard frontline chemotherapy regimens. Salvage regimens followed by autologous stem cell transplants represent the historical treatment approach for these cases. In the last decade, with the increasing understanding of cHL biology and tumor microenvironment role in disease course, novel molecules have been introduced in clinical practice, improving outcomes in the relapsed/refractory setting. The anti-CD30 antibody-drug conjugated brentuximab vedotin and PD-1/PD-L1 checkpoint inhibitors represent nowadays curative options for chemorefractory patients, and randomized trials recently demonstrated their efficacy in frontline immune-chemo-combined modalities.

• #144 Latest advances in the management of classical Hodgkin lymphoma: the era of novel therapies | Blood Cancer Journal

  https://www.nature.com/articles/s41408-021-00518-z

  Hodgkin lymphoma is a highly curable disease. Although most patients achieve complete response following frontline therapy, key unmet clinical needs remain including relapsed/refractory disease, treatment-related morbidity, impaired quality of life and poor outcome in patients older than 60 years. The incorporation of novel therapies, including check point inhibitors and antibody-drug conjugates, into the frontline setting, sequential approaches, and further individualized treatment intensity may address these needs. We summarize the current treatment options for patients with classical Hodgkin lymphoma from frontline therapy to allogeneic hematopoietic stem cell transplantation and describe novel trials in the field. […] Most patients with cHL will be cured with standard treatment. However, they are at risk of potential long-term complications including the exponential increase in cardiopulmonary toxicities and secondary malignancies as well as QoL impairment. Consequently, the latest advances in the management of cHL have focused on optimizing treatment strategies to improve outcome while reducing toxicity. Identifying patients at low or high risk of recurrence is critical to avoid over- or under-treatment.

• #145 Advances in Hodgkin Lymphoma Treatment: From Molecular Biology to Clinical Practice

  https://www.mdpi.com/2072-6694/16/10/1830

  The ECHELON-1 trial led to the approval of the combination of BV plus doxorubicin, vinblastine, and dacarbazine (BV-AVD) as the first-line treatment of advanced-stage cHL. The 5-year update of this international randomized phase III study showed a PFS benefit of BV-AVD over the ABVD standard arm (5-year PFS of 82.2% vs. 75.3%, HR 0.69, p = 0.0017). […] The role of BV monotherapy in R/R cHL was also analyzed in pre- and post-allogeneic stem cell transplantation (allo-SCT) settings. In a retrospective analysis, 18 patients with R/R cHL treated with BV were subsequently treated with reduced-intensity allo-SCT with successful engraftment and no unexpected toxicities. […] PD-1 inhibitors are not currently approved for frontline treatment, but a number of trials have shown their promising efficacy and limited toxicity when combined with chemotherapy, especially in limited-stage disease.

• #146 Clinical Trial Forges New Standard of Care for Advanced Hodgkin Lymphoma – InventUMPage 1arrow–buttonPage 1arrow–buttonPage 1arrow–buttonPage 1arrow–buttonPage 1arrow–button

  https://news.med.miami.edu/clinical-trial-forges-new-standard-of-care-for-advanced-hodgkin-lymphoma/

  The new publication reveals that nivolumab plus AVD was superior by several measurements. […] At the end of the day, this is a better program with less toxicity for patients with stage 3 and 4 disease, said Dr. Moskowitz. […] This will be the new standard of care for advanced-stage Hodgkin lymphoma, said Dr. Moskowitz. […] Dr. Moskowitz and his team are involved in several other clinical trials for Hodgkin lymphoma. […] We have a number of studies here which give modern therapeutic approaches, where we’re actually trying to cure the patient with less treatment, said Dr. Moskowitz.

• #147 Hodgkin Lymphoma: Relapsed/Refractory – LRF

  https://www.lymphoma.org/understanding-lymphoma/aboutlymphoma/hl/relapsedhl/

  Hodgkin lymphoma patients who fail to achieve complete remission following frontline therapy or who relapse after achieving complete remission are often treated with second-line chemotherapy regimens, followed by a bone marrow or stem cell transplant. […] There are a variety of single-agent and combination therapy regimens that may be used for relapsed/refractory HL, including: Brentuximab vedotin (Adcetris), Bendamustine (Treanda), Nivolumab (Opdivo), Pembrolizumab (Keytruda), DHAP (dexamethasone, cisplatin, and cytarabine), ESHAP (etoposide, methylprednisolone, cisplatin, and cytarabine), GVD (gemcitabine, vinorelbine, and liposomal doxorubicin), ICE (ifosfamide, carboplatin, and etoposide), IGEV (ifosfamide, gemcitabine, and vinorelbine). […] Although the cure rate in HL is already high, research continues to look for ways to treat the minority of patients who are refractory to treatment and those who relapse. Many promising therapies are currently under investigation in clinical trials for HL including: Anti-CD30-CAR T cells, Atezolizumab (Tecentriq), Bortezomib (Velcade), Carfilzomib (Kyprolis), Everolimus (Afinitor), Ibrutinib (Imbruvica), Lenalidomide (Revlimid), Mocetinostat (MGCD0103), Ruxolitinib (Jakafi), Umbralisib.

• #148 Advances in Hodgkin Lymphoma Treatment: From Molecular Biology to Clinical Practice

  https://www.mdpi.com/2072-6694/16/10/1830

  The introduction of BV and PD-1 checkpoint inhibitors represented a treatment paradigm shift for R/R cHL. More recently, the BV-AVD combined modality became the new frontline standard of care for advanced-stage cHL patients, and upcoming final results from the BrECADD scheme and the upfront adoption of nivolumab in the N-AVD regimen will probably further improve the therapeutic landscape for treatment-naïve patients.

• #149 Hodgkin Lymphoma Treatment: Boosting New Options for Young People with Advanced Disease | URMC Newsroom

  https://www.urmc.rochester.edu/news/story/hodgkin-lymphoma-treatment-boosting-new-options-for-young-people-with-advanced-disease

  By eliminating radiation for children enrolled in this trial, we essentially took away the risks of many toxic late effects, Friedberg said. […] Data show that thus far, 11 deaths occurred among patients who received standard therapy, compared to four deaths in the immunotherapy group. […] Hodgkin lymphoma is not a common disease and the NCTN enabled more than 200 pediatric and adult community providers and academic medical centers to work together, he said. Because of that, we were able to get data very quickly and directly impact patient care. This was a critical investment in cancer research and treatment.

• #150 5 Innovative Hodgkin Lymphoma Treatment Options | MD Anderson Cancer Center

  https://www.mdanderson.org/cancer-types/hodgkin-lymphoma/hodgkin-lymphoma-treatment.html

  Because the standard chemotherapy for Hodgkin lymphoma may have long-term effects, especially for young people, we are working to develop effective but more gentle treatments. […] If you are diagnosed with Hodgkin lymphoma, your doctor will discuss the best options to treat it. This depends on several factors, including: […] Your treatment will be customized to your needs. One or more of the following therapies may be recommended to treat the cancer or help relieve symptoms. […] Treatment with drugs is the main therapy for Hodgkin lymphoma. […] Radiation therapy uses focused beams of energy to kill cancer cells. […] Proton therapy delivers high radiation doses directly to the tumor site, with minimal damage to nearby healthy tissue. […] Instead of attacking the disease itself, immunotherapy drugs help the body fight cancer.

• #151 Nivolumab and AVD the New Standard in Hodgkin Lymphoma – NCI

  https://www.cancer.gov/news-events/cancer-currents-blog/2024/hodgkin-lymphoma-nivolumab-avd-first-line

  Given the excellent outcomes seen in people treated with nivolumab and AVD, Dr. Friedberg said, oncologists can feel confident following this approach. […] We’ve largely eliminated radiation therapy as part of the initial treatment, he said. We now have a more effective, less toxic regimen that should not only have fewer short-term side effects, but also fewer long-term side effects. […] The nivolumab-AVD regimen and approach to radiation treatment used in the trial will very likely be considered the new standard of care for the adolescent and young adult population at many cancer centers, said Dr. Harker-Murray. […] The 2-year progression-free survival rate of 88% among those in this age group treated with nivolumab-AVD is probably the best ever reported. […] On the basis of these findings, the use of brentuximab-AVD should probably be avoided in older patients.

• #152 History of Hodgkin’s Lymphoma – Hodgkin’s International

  https://www.hodgkinsinternational.com/resources/history-of-hodgkins-lymphoma/

  Hodgkin lymphoma, also known as Hodgkin’s disease, is a type of cancer that affects the lymphatic system. […] In terms of treatment, radiation therapy and chemotherapy have been the mainstay of treatment for Hodgkin lymphoma for many years. […] More recently, there have been many new developments in the treatment of Hodgkin lymphoma, including the use of immunotherapy drugs such as brentuximab vedotin (Adcetris) and nivolumab (Opdivo). […] Overall, the progress made in understanding the biology of Hodgkin lymphoma and developing new treatment options has greatly improved the outlook for patients with this disease, with many patients now experiencing long-term remission with fewer late-effects.

• #153 Advances in Hodgkin Lymphoma Treatment: From Molecular Biology to Clinical Practice

  https://www.mdpi.com/2072-6694/16/10/1830

  The ECHELON-1 trial led to the approval of the combination of BV plus doxorubicin, vinblastine, and dacarbazine (BV-AVD) as the first-line treatment of advanced-stage cHL. The 5-year update of this international randomized phase III study showed a PFS benefit of BV-AVD over the ABVD standard arm (5-year PFS of 82.2% vs. 75.3%, HR 0.69, p = 0.0017). […] The role of BV monotherapy in R/R cHL was also analyzed in pre- and post-allogeneic stem cell transplantation (allo-SCT) settings. In a retrospective analysis, 18 patients with R/R cHL treated with BV were subsequently treated with reduced-intensity allo-SCT with successful engraftment and no unexpected toxicities. […] PD-1 inhibitors are not currently approved for frontline treatment, but a number of trials have shown their promising efficacy and limited toxicity when combined with chemotherapy, especially in limited-stage disease.

• #154 Nivolumab and AVD the New Standard in Hodgkin Lymphoma – NCI

  https://www.cancer.gov/news-events/cancer-currents-blog/2024/hodgkin-lymphoma-nivolumab-avd-first-line

  Nivolumab (Opdivo) should be part of the initial treatment of teens and adults with advanced forms of classic Hodgkin lymphoma, according to updated results from a large NCI-funded clinical trial. […] Treatment with nivolumab and a three-drug chemotherapy regimen called AVD was better at eliminating cancer and keeping it at bay than the current standard initial treatment for the disease, AVD combined with the targeted therapy brentuximab (Adcetris). […] Two years after starting treatment, about 92% of trial participants randomly assigned to the nivolumab-AVD group were alive without their cancer starting to grow again—a measure known as progression-free survival—compared with 83% in the brentuximab-AVD group. […] Based on these new findings, Dr. Friedberg said, we are curing substantially more patients with the nivolumab-AVD regimen.

• #155 Clinical Trial Forges New Standard of Care for Advanced Hodgkin Lymphoma – InventUMPage 1arrow–buttonPage 1arrow–buttonPage 1arrow–buttonPage 1arrow–buttonPage 1arrow–button

  https://news.med.miami.edu/clinical-trial-forges-new-standard-of-care-for-advanced-hodgkin-lymphoma/

  The new publication reveals that nivolumab plus AVD was superior by several measurements. […] At the end of the day, this is a better program with less toxicity for patients with stage 3 and 4 disease, said Dr. Moskowitz. […] This will be the new standard of care for advanced-stage Hodgkin lymphoma, said Dr. Moskowitz. […] Dr. Moskowitz and his team are involved in several other clinical trials for Hodgkin lymphoma. […] We have a number of studies here which give modern therapeutic approaches, where we’re actually trying to cure the patient with less treatment, said Dr. Moskowitz.

• #156 https://www.lls.org/lymphoma/hodgkin-lymphoma/treatment

  https://www.lls.org/lymphoma/hodgkin-lymphoma/treatment

  Treatment for Hodgkin lymphoma is changing due to new drugs and research findings from clinical trials. Therefore, before treatment begins, it is important to consider getting a second opinion at a center with a Hodgkin lymphoma expert. […] It’s important that your doctor is experienced in treating patients with Hodgkin lymphoma or works in consultation with a Hodgkin lymphoma specialist. This type of specialist is called a hematologist-oncologist. […] For many people with Hodgkin lymphoma, starting treatment helps them focus on moving ahead and looking forward to recovery. Hodgkin lymphoma is considered one of the most curable forms of cancer. […] The goal of Hodgkin lymphoma treatment is to cure the disease. More than 80 percent of all patients diagnosed with Hodgkin lymphoma can be cured by current treatment approaches. The cure rate is higher, approaching 90 percent, in younger patients and those with early-stage favorable disease. Even if disease recurs, many patients can be cured with further treatment.

• #157 Hodgkin’s Lymphoma Therapy: Past, Present, and Future

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2978071/

  The treatment of Hodgkin lymphoma (HL) with the use of radiotherapy and systemic chemotherapy has been one of the success stories of modern oncology. HL therapy has been the paradigm for the systematic evaluation of different curative modalities resulting in cure for the majority of patients. […] The current focus is on designing initial therapeutic strategies which retain efficacy and minimize long-term toxicity. Appropriate use of pathologic, clinical, biologic and radiologic prognostic factors in identification of aggressive HL is paramount in designing a successful therapeutic strategy. […] The current standard approaches with the use of combined modality therapy and systemic chemotherapy as well as the promising role of future response-adapted strategies is reviewed. […] In HL, appropriate utilization of risk assessment strategies is required to maximize therapeutic outcomes while minimizing toxicity, especially long-term toxicity. Response-adapted therapy utilizing PET has the potential to profoundly improve the therapeutic landscape in HL.

• #158 What is Hodgkin Lymphoma? Symptoms, Risk Factors & Treatments | MD Anderson Cancer Center

  https://www.mdanderson.org/cancer-types/hodgkin-lymphoma.html

  Hodgkin lymphoma diagnoses have been trending down over the last decade and the survival rate is relatively high. The average five-year survival rate across all stages is close to 87%, with a survival rate of greater than 91% in cases confined to a single region (stage I). […] Hodgkin lymphoma is divided into two major types according to how the lymph cells look under a microscope and whether Reed-Sternberg cells are present. Knowing the type of lymphoma helps doctors determine your best treatment. […] At MD Anderson, you are cared for by a team of some of the nation’s top authorities on lymphoma. They draw upon the latest and most-advanced treatments for all stages of Hodgkin lymphoma, examining you carefully to determine the best approach and communicating every step of the way. […] As one of the world’s leaders in lymphoma advances, we constantly work to pioneer new treatments that are effective and have the least impact on your body. For instance, MD Anderson has helped advance the development of several new targeted therapies for Hodgkin lymphoma. And we are studying several biomarkers to guide the future development of even more personalized therapies. […] Whether you recently have been diagnosed with Hodgkin lymphoma or have battled the disease for years, we can help.

• #159 Hodgkin lymphoma (Hodgkin disease) – Care at Mayo Clinic – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hodgkins-lymphoma/care-at-mayo-clinic/mac-20352654

  At Mayo Clinic, teams of experts work together to provide individualized care for people with Hodgkin lymphoma. […] Mayo Clinic doctors provide expert, personalized care to those with Hodgkin lymphoma, including rare types of the disease. […] Mayo Clinic doctors are experienced in diagnosing and treating Hodgkin lymphoma. […] Mayo Clinic doctors work with you to review all your treatment options and to choose the one that best suits your needs and goals. Treatments offered to people with Hodgkin lymphoma include chemotherapy, radiation therapy, immunotherapy, targeted therapy and bone marrow transplant. […] Mayo Clinic offers services through cancer survivorship clinics for people who have completed Hodgkin lymphoma treatment. Follow-up medical care is important for every person who has gone through treatment for Hodgkin lymphoma.

• #160 Hodgkin lymphoma (Hodgkin disease) – Care at Mayo Clinic – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hodgkins-lymphoma/care-at-mayo-clinic/mac-20352654

  Mayo Clinic doctors are leaders in conducting clinical trials of Hodgkin lymphoma treatments that are more effective and less toxic. […] Research shows that people with Hodgkin lymphoma who seek care at high-volume medical centers tend to have better survival rates. […] Mayo Clinic is recognized for high-quality lymphoma care and research by national organizations.

• #161 https://www.lls.org/lymphoma/hodgkin-lymphoma/treatment

  https://www.lls.org/lymphoma/hodgkin-lymphoma/treatment

  Treatment for Hodgkin lymphoma is changing due to new drugs and research findings from clinical trials. Therefore, before treatment begins, it is important to consider getting a second opinion at a center with a Hodgkin lymphoma expert. […] It’s important that your doctor is experienced in treating patients with Hodgkin lymphoma or works in consultation with a Hodgkin lymphoma specialist. This type of specialist is called a hematologist-oncologist. […] For many people with Hodgkin lymphoma, starting treatment helps them focus on moving ahead and looking forward to recovery. Hodgkin lymphoma is considered one of the most curable forms of cancer. […] The goal of Hodgkin lymphoma treatment is to cure the disease. More than 80 percent of all patients diagnosed with Hodgkin lymphoma can be cured by current treatment approaches. The cure rate is higher, approaching 90 percent, in younger patients and those with early-stage favorable disease. Even if disease recurs, many patients can be cured with further treatment.

• #162 https://www.lls.org/lymphoma/hodgkin-lymphoma/treatment

  https://www.lls.org/lymphoma/hodgkin-lymphoma/treatment

  Treatment for Hodgkin lymphoma is changing due to new drugs and research findings from clinical trials. Therefore, before treatment begins, it is important to consider getting a second opinion at a center with a Hodgkin lymphoma expert. […] It’s important that your doctor is experienced in treating patients with Hodgkin lymphoma or works in consultation with a Hodgkin lymphoma specialist. This type of specialist is called a hematologist-oncologist. […] For many people with Hodgkin lymphoma, starting treatment helps them focus on moving ahead and looking forward to recovery. Hodgkin lymphoma is considered one of the most curable forms of cancer. […] The goal of Hodgkin lymphoma treatment is to cure the disease. More than 80 percent of all patients diagnosed with Hodgkin lymphoma can be cured by current treatment approaches. The cure rate is higher, approaching 90 percent, in younger patients and those with early-stage favorable disease. Even if disease recurs, many patients can be cured with further treatment.

• #163 The Cure of Hodgkin Lymphoma – Hematology.org

  https://www.hematology.org/about/history/50-years/cure-of-hodgkin-lymphoma

  The cure of Hodgkin lymphoma in the 20th century is another one of cancer’s biggest success stories. Breakthroughs in radiation therapy and chemotherapy paired with careful clinical research transformed an invariably fatal disorder into one that is routinely cured. […] Today, as more than 80 percent of patients are cured after primary treatment, a major emphasis is now placed on survivorship. […] The introduction of the linear accelerator (a radiation machine used to treat cancer) in the treatment of Hodgkin lymphoma at Stanford University resulted in cures of early-stage lymphoma. […] Meanwhile, a team at the National Cancer Institute safely combined four chemotherapy drugs (mustard, vincristine, procarbazine, and prednisone) known as the „MOPP” regimen and reported the first cures of advanced Hodgkin lymphoma in 1964.

• #164

  https://www.nhs.uk/conditions/hodgkin-lymphoma/treatment/

  Hodgkin lymphoma can usually be treated successfully with chemotherapy alone, or chemotherapy followed by radiotherapy. […] The main treatments for Hodgkin lymphoma are chemotherapy alone, or chemotherapy followed by radiotherapy. Occasionally, chemotherapy may be combined with steroid medicine. Some people also have biological medicines. […] Overall, treatment for Hodgkin lymphoma is highly effective and most people with the condition are eventually cured. […] Chemotherapy is usually given over a period of a few months on an outpatient basis, which means you should not have to stay in hospital overnight. […] If regular chemotherapy is unsuccessful or Hodgkin lymphoma returns after treatment, you may have a course of chemotherapy at a higher dose. […] Radiotherapy is most often used to treat early-stage Hodgkin lymphoma, where the cancer is only in 1 part of the body.

• #165 Hodgkin Lymphoma Treatment & Management: Approach Considerations, Goals of Therapy and Response Assessment, Radiation Therapy

  https://emedicine.medscape.com/article/201886-treatment

  Treatment of Hodgkin lymphoma is tailored to disease type, disease stage, and an assessment of the risk of resistant disease. Hodgkin lymphoma is considered to be a curable malignancy, but therapies for this disease can have significant long-term toxicity. General treatment modalities include radiation therapy, induction chemotherapy, salvage chemotherapy, and hematopoietic stem cell transplantation. […] The current treatment of Hodgkin lymphoma seeks to maximize the risk-benefit ratio of treatment. Thus, treatment focuses on tailoring therapy to each patient according to age, risk of short-term and long-term toxicity, and risk of relapse. […] In general, patients with early-stage favorable disease are treated with less intense chemotherapy and radiation regimens than those that are used for early-stage unfavorable disease.

• #166 Hodgkin Lymphoma Treatment Protocol by Stage | American Cancer Society

  https://www.cancer.org/cancer/types/hodgkin-lymphoma/treating/by-stage.html

  Treatment for HL should remove all traces of the lymphoma. […] If HL is still there after these treatments, most doctors would recommend high-dose chemo (and possibly radiation) followed by an autologous stem cell transplant, if it can be done. […] Another option, either instead of or after a stem cell transplant, may be treatment with an immunotherapy drug, such as brentuximab vedotin (Adcetris), nivolumab (Opdivo), or pembrolizumab (Keytruda). […] If the initial treatment was radiation therapy alone, chemotherapy is usually given for recurrent disease. […] If chemotherapy without radiation therapy was used first, and the cancer comes back only in the lymph nodes, radiation to the lymph nodes can be done, with or without more chemo. […] If the HL still remains after an autologous transplant, an allogeneic stem cell transplant may be an option. Another option, either instead of or after a stem cell transplant, may be treatment with an immunotherapy drug, such as brentuximab vedotin (Adcetris), nivolumab (Opdivo), or pembrolizumab (Keytruda).

• #167 Hodgkin Lymphoma: Relapsed/Refractory – LRF

  https://www.lymphoma.org/understanding-lymphoma/aboutlymphoma/hl/relapsedhl/

  Hodgkin lymphoma patients who fail to achieve complete remission following frontline therapy or who relapse after achieving complete remission are often treated with second-line chemotherapy regimens, followed by a bone marrow or stem cell transplant. […] There are a variety of single-agent and combination therapy regimens that may be used for relapsed/refractory HL, including: Brentuximab vedotin (Adcetris), Bendamustine (Treanda), Nivolumab (Opdivo), Pembrolizumab (Keytruda), DHAP (dexamethasone, cisplatin, and cytarabine), ESHAP (etoposide, methylprednisolone, cisplatin, and cytarabine), GVD (gemcitabine, vinorelbine, and liposomal doxorubicin), ICE (ifosfamide, carboplatin, and etoposide), IGEV (ifosfamide, gemcitabine, and vinorelbine). […] Although the cure rate in HL is already high, research continues to look for ways to treat the minority of patients who are refractory to treatment and those who relapse. Many promising therapies are currently under investigation in clinical trials for HL including: Anti-CD30-CAR T cells, Atezolizumab (Tecentriq), Bortezomib (Velcade), Carfilzomib (Kyprolis), Everolimus (Afinitor), Ibrutinib (Imbruvica), Lenalidomide (Revlimid), Mocetinostat (MGCD0103), Ruxolitinib (Jakafi), Umbralisib.

• #168 Hodgkin’s Lymphoma Therapy: Past, Present, and Future

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2978071/

  The treatment of Hodgkin lymphoma (HL) with the use of radiotherapy and systemic chemotherapy has been one of the success stories of modern oncology. HL therapy has been the paradigm for the systematic evaluation of different curative modalities resulting in cure for the majority of patients. […] The current focus is on designing initial therapeutic strategies which retain efficacy and minimize long-term toxicity. Appropriate use of pathologic, clinical, biologic and radiologic prognostic factors in identification of aggressive HL is paramount in designing a successful therapeutic strategy. […] The current standard approaches with the use of combined modality therapy and systemic chemotherapy as well as the promising role of future response-adapted strategies is reviewed. […] In HL, appropriate utilization of risk assessment strategies is required to maximize therapeutic outcomes while minimizing toxicity, especially long-term toxicity. Response-adapted therapy utilizing PET has the potential to profoundly improve the therapeutic landscape in HL.

• #169 Hodgkin lymphoma – Wikipedia

  https://en.wikipedia.org/wiki/Hodgkin_lymphoma

  For Hodgkin lymphomas, radiation oncologists typically use external beam radiation therapy (sometimes shortened to EBRT or XRT). […] Radiation therapy directed above the diaphragm to the neck, chest or underarms is called mantle field radiation. […] Radiation to below the diaphragm to the abdomen, spleen or pelvis is called inverted-Y field radiation. […] Total nodal irradiation is when the therapist gives radiation to all the lymph nodes in the body to destroy cells that may have spread. […] The high cure rates and long survival of many people with Hodgkin lymphoma has led to a high concern with late adverse effects of treatment, including cardiovascular disease and second malignancies such as acute leukemias, lymphomas, and solid tumors within the radiation therapy field. […] Most people with early-stage disease are now treated with abbreviated chemotherapy and involved site radiation therapy rather than with radiation therapy alone. […] Clinical research strategies are exploring reduction of the duration of chemotherapy and dose and volume of radiation therapy in an attempt to reduce late morbidity and mortality of treatment while maintaining high cure rates.

• #170 Nivolumab and AVD the New Standard in Hodgkin Lymphoma – NCI

  https://www.cancer.gov/news-events/cancer-currents-blog/2024/hodgkin-lymphoma-nivolumab-avd-first-line

  Nivolumab (Opdivo) should be part of the initial treatment of teens and adults with advanced forms of classic Hodgkin lymphoma, according to updated results from a large NCI-funded clinical trial. […] Treatment with nivolumab and a three-drug chemotherapy regimen called AVD was better at eliminating cancer and keeping it at bay than the current standard initial treatment for the disease, AVD combined with the targeted therapy brentuximab (Adcetris). […] Two years after starting treatment, about 92% of trial participants randomly assigned to the nivolumab-AVD group were alive without their cancer starting to grow again—a measure known as progression-free survival—compared with 83% in the brentuximab-AVD group. […] Based on these new findings, Dr. Friedberg said, we are curing substantially more patients with the nivolumab-AVD regimen.

• #171 Advances in Hodgkin Lymphoma Treatment: From Molecular Biology to Clinical Practice

  https://www.mdpi.com/2072-6694/16/10/1830

  The introduction of BV and PD-1 checkpoint inhibitors represented a treatment paradigm shift for R/R cHL. More recently, the BV-AVD combined modality became the new frontline standard of care for advanced-stage cHL patients, and upcoming final results from the BrECADD scheme and the upfront adoption of nivolumab in the N-AVD regimen will probably further improve the therapeutic landscape for treatment-naïve patients.

• #172 https://www.lls.org/lymphoma/hodgkin-lymphoma/treatment

  https://www.lls.org/lymphoma/hodgkin-lymphoma/treatment

  Treatment for Hodgkin lymphoma is changing due to new drugs and research findings from clinical trials. Therefore, before treatment begins, it is important to consider getting a second opinion at a center with a Hodgkin lymphoma expert. […] It’s important that your doctor is experienced in treating patients with Hodgkin lymphoma or works in consultation with a Hodgkin lymphoma specialist. This type of specialist is called a hematologist-oncologist. […] For many people with Hodgkin lymphoma, starting treatment helps them focus on moving ahead and looking forward to recovery. Hodgkin lymphoma is considered one of the most curable forms of cancer. […] The goal of Hodgkin lymphoma treatment is to cure the disease. More than 80 percent of all patients diagnosed with Hodgkin lymphoma can be cured by current treatment approaches. The cure rate is higher, approaching 90 percent, in younger patients and those with early-stage favorable disease. Even if disease recurs, many patients can be cured with further treatment.

• #173 Hodgkin lymphoma (Hodgkin disease) – Care at Mayo Clinic – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hodgkins-lymphoma/care-at-mayo-clinic/mac-20352654

  At Mayo Clinic, teams of experts work together to provide individualized care for people with Hodgkin lymphoma. […] Mayo Clinic doctors provide expert, personalized care to those with Hodgkin lymphoma, including rare types of the disease. […] Mayo Clinic doctors are experienced in diagnosing and treating Hodgkin lymphoma. […] Mayo Clinic doctors work with you to review all your treatment options and to choose the one that best suits your needs and goals. Treatments offered to people with Hodgkin lymphoma include chemotherapy, radiation therapy, immunotherapy, targeted therapy and bone marrow transplant. […] Mayo Clinic offers services through cancer survivorship clinics for people who have completed Hodgkin lymphoma treatment. Follow-up medical care is important for every person who has gone through treatment for Hodgkin lymphoma.

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