Pharmacotherapy of Hodgkin lymphoma: standard approaches and future perspectives

Hodgkin lymphoma (HL) is a lymphoid malignancy with an incidence of 2 - 3/100,000/year. Young adults are most often affected. Due to the development of highly active multi-agent chemotherapy protocols and the optimization of radiotherapy (RT) fields and doses, HL has become one of the malignancies with the highest cure rates. As treatment efficacy can hardly be improved, the major goal of clinical HL research consists in decreasing therapy-associated acute and long-term toxicity. To this end, treatment stratification based on interim positron emission tomography and the implementation of targeted drugs such as the antibody-drug conjugate brentuximab vedotin are currently being evaluated in prospective trials.

This article reviews recent randomized Phase III and larger Phase II trials including HL patients.

In early stage HL, excellent results are achieved with a brief chemotherapy followed by involved-field RT. Patients with advanced HL should receive six to eight cycles of chemotherapy optionally followed by localized RT. In relapsed disease, high-dose chemotherapy followed by autologous stem cell transplantation represents the standard of care for most patients. The use of novel drugs and imaging tools that currently undergo evaluation may optimize HL treatment.