Abstract
There has been a giant leap forward in the management of Hodgkin's lymphoma (HL) over the past decade. Emergence of long-term data from large, randomized trials in early-stage disease (eHL) and incorporation of brentuximab vedotin (BV) or nivolumab into the frontline setting through three large phase-3 trials in advanced stages (aHL) are driving the paradigm shift in HL. The new landscape promises chances of cure to over 90% of newly diagnosed patients while maintaining caution for long-term toxicity. This review will cover the published evidence regarding primary analyses or updates within the last five years on phase-3 clinical trials conducted in the frontline treatment setting for HL. Concerning areas of clinical significance where no comparative trial data is available, data from phase-2 trials or real-world analyses will be briefly discussed. Consolidative radiotherapy is no longer a strict necessity in eHL cases with complete response to frontline chemotherapy and the decision to irradiate in such cases should be individualized. The state-of-the-art in managing aHL requires the use of either BV or nivolumab as introduced by the GHSG HD21 and SWOG S1826 trials, respectively.
Overview
- The study focuses on the management of Hodgkin's lymphoma (HL) with a paradigm shift driven by long-term data from large, randomized trials.
- The study explores the incorporation of brentuximab vedotin (BV) or nivolumab in the frontline setting through phase-3 trials.
- The study aims to cover the published evidence on phase-3 clinical trials conducted in the frontline treatment setting for HL, with a focus on primary analyses or updates within the last five years.
Comparative Analysis & Findings
- The study highlights the emergence of long-term data from large, randomized trials in early-stage disease (eHL), resulting in a cure rate of over 90% for newly diagnosed patients.
- Consolidative radiotherapy is no longer a strict necessity in eHL cases with complete response to frontline chemotherapy, with individualized decision-making recommended.
- The state-of-the-art in managing advanced stages (aHL) of HL requires the use of either BV or nivolumab, as introduced by the GHSG HD21 and SWOG S1826 trials, respectively.
Implications and Future Directions
- The study's findings have significant implications for the treatment of HL, offering improved cure rates and reduced long-term toxicity.
- Future research should focus on further evaluation of the long-term effects of treatment regimens and individualized decision-making for patients with eHL.
- Studies investigating the use of BV or nivolumab in combination with other agents or for patients with specific risk factors may help improve treatment outcomes for aHL.