Individualized Treatment Approaches for Patients With Hodgkin Lymphoma

At the 2023 Great Debates & Updates in Hematologic Malignancies Meeting, Elizabeth Brem, MD, University of California, Irvine, California, shares brief insights into the treatment approaches discussed at the meeting regarding cases of a patient with stage II Hodgkin lymphoma with bulky disease, a patient with advanced-stage Hodgkin lymphoma, and older patients with Hodgkin lymphoma. 

Transcript: 

I'm Liz Brem. I'm an associate clinical professor at the University of California, Irvine, and I am at the Great Debates & Updates [meeting] in Boston, Massachusetts. I participated this morning in a case discussion with Dr. Andy Evens and Dr. Carla Casulo. We talked about some difficult cases in Hodgkin lymphoma. If I recall, the first was a young woman with unfavorable stage II Hodgkin, who had bulky disease in the mediastinum. 

We talked a lot about the role of radiation and how many times we're trying to avoid it, particularly in our young patients, particularly our female patients, and some of the data and some of the regimens that we can use in that setting.

There was another case of advanced-stage Hodgkin lymphoma that gave us an opportunity to talk a little bit about the study [SWOG S]1826, which was a randomized phase 3 study of brentuximab-[doxorubicin, vinblastine, and dacarbazine] (AVD) versus nivolumab-AVD, which had data presented recently at Lugano and [the American Society of Clinical Oncology annual meeting] (ASCO) by Dr. Alex Herrera, to compare and contrast those kinds of regimens and how that nivo-AVD might fit into our framework going forward.

We talked a little bit about older patients with Hodgkin lymphoma because we have a paucity of data for our patients beyond their 30s, and yet there's this population of patients who get Hodgkin's in their 60s and 70s and they're really underrepresented in clinical trials.

We talked about some of the data that was available, both extrapolating from some of these phase 3 studies, [and] talking about some of the single-arm phase 2 studies. [We also talked] about the role of things like geriatric assessments to help us really figure out what is the best way to approach some of these older patients.

Source: 

Brem, E. Case Discussions. Presented at the Great Debates and Updates in Hematologic Malignancies Meeting; August 17-19, 2023; Boston, Massachusetts.