Area of Science:

• Oncology
• Immunology
• Hematology

Background:

• Classical Hodgkin lymphoma (HL) is a rare hematologic malignancy primarily affecting young adults.
• While front-line treatments achieve high cure rates (>80%), a significant minority of patients experience primary refractoriness or relapse.
• Existing therapies for relapsed/refractory HL can involve high-dose chemotherapy with substantial toxicity.

Purpose of the Study:

• To review the efficacy and safety of immune checkpoint inhibitors (ICIs) in relapsed and refractory Hodgkin lymphoma.
• To discuss the role of the Programmed cell Death 1 (PD-1)/PD-ligand-1 (PD-L1) pathway in the HL tumor microenvironment.
• To highlight the need for established treatment guidelines for ICIs in HL management.

Main Methods:

• Review of recent studies investigating immune checkpoint inhibitors in Hodgkin lymphoma.
• Analysis of data on the efficacy and safety profiles of PD-1/PD-L1 inhibitors.
• Examination of the immunological context of the Hodgkin lymphoma microenvironment.

Main Results:

• Immune checkpoint inhibitors, such as nivolumab and pembrolizumab, have demonstrated high efficacy in patients with relapsed or refractory HL.
• These agents exhibit a favorable safety profile compared to traditional salvage therapies.
• Long-term outcomes for ICI treatment in HL remain indeterminate, and specific treatment guidelines are yet to be established.

Conclusions:

• Targeting the PD-1/PD-L1 pathway represents a promising therapeutic strategy for relapsed/refractory Hodgkin lymphoma.
• Further research is needed to define optimal treatment protocols and long-term efficacy of ICIs in HL.
• The development of clear clinical guidelines for nivolumab and pembrolizumab in HL management is a critical next step.