Targeting Immune System Alterations in Hodgkin Lymphoma

Curr Hematol Malig Rep. 2017 Aug;12(4):358-369. doi: 10.1007/s11899-017-0398-6.

Abstract

Purpose of review: This review discusses novel immunotherapeutic approaches to treat Hodgkin lymphoma (HL), specifically PD-1 inhibitors and cellular immunotherapy.

Recent findings: PD-1 inhibitors have shown promising results in the treatment of relapsed or refractory HL, leading to FDA approval of nivolumab and pembrolizumab, although complete remissions are rare. Chimeric antigen receptor T cells directed against CD30 have been investigated with preliminary clinical trials showing minimal toxicities and some responses in heavily pre-treated patients with HL. HL is unique as it consists of a small percentage of malignant cells (Hodgkin Reed Sternberg cells) surrounded by an inflammatory microenvironment which promotes tumor growth and suppresses immune responses, making it an ideal target for immunotherapeutic approaches, such as PD-1 inhibitors and cellular immunotherapy. Current research is focused on overcoming barriers to efficacy via rational combinations that overcome resistance to therapy.

Keywords: Cellular immunotherapy; Checkpoint inhibitors; Chimeric antigen receptor T cells; Hodgkin lymphoma; Nivolumab; Pembrolizumab.

Publication types

  • Review

MeSH terms

  • Antibodies, Monoclonal / immunology
  • Antibodies, Monoclonal / therapeutic use*
  • Antibodies, Monoclonal, Humanized / immunology
  • Antibodies, Monoclonal, Humanized / therapeutic use*
  • Antineoplastic Agents / immunology
  • Antineoplastic Agents / therapeutic use
  • Hodgkin Disease / drug therapy*
  • Hodgkin Disease / immunology
  • Hodgkin Disease / metabolism
  • Humans
  • Immune System / drug effects*
  • Immune System / immunology
  • Molecular Targeted Therapy / methods
  • Nivolumab
  • Programmed Cell Death 1 Receptor / antagonists & inhibitors
  • Programmed Cell Death 1 Receptor / immunology
  • Programmed Cell Death 1 Receptor / metabolism
  • Tumor Microenvironment / drug effects
  • Tumor Microenvironment / immunology

Substances

  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Humanized
  • Antineoplastic Agents
  • Programmed Cell Death 1 Receptor
  • Nivolumab
  • pembrolizumab