Minimising the Toxicities of First Line Hodgkin Lymphoma Treatment in the Modern Era

• Published in: Cancers Vol. 14; no. 21; p. 5390
• Main Authors: Follows, Annabel M, Santarsieri, Anna
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 01.11.2022; MDPI
• Subjects: Bleomycin; Cancer; Cancer therapies; Care and treatment; Chemotherapy; Clinical trials; Complications and side effects; Drugs; Hodgkin lymphoma; Hodgkin's disease; Hodgkin's lymphoma; Infertility; Lymphoma; Malignancy; Medical prognosis; Methods; Mortality; Patients; Radiation therapy; Radiotherapy; Review; Side effects; Tomography; Toxicity; United Kingdom; toxicity; radiotherapy; chemotherapy; Hodgkin lymphoma
• ISSN: 2072-6694; 2072-6694
• DOI: 10.3390/cancers14215390

Striking advances in the treatment of Hodgkin lymphoma over the last 30 years have culminated in high rates of disease-free survival in younger patients with early and advanced stage disease. In this review we focus on strategies that have evolved over recent years to reduce short and long-term toxicities of treatment. These strategies include the selection of first-line chemotherapy, the stratification of patients based on initial response and subsequent adaptation of treatment, the addition of novel agents (e.g., brentuximab vedotin), the removal of specific drugs (e.g., bleomycin), the use of drug substitution, and the removal of consolidation radiotherapy based on interim and end of treatment PET assessment. While these strategies have successfully reduced toxicity of Hodgkin lymphoma therapy, the cornerstone of treatment continues to be combination chemotherapy and radiotherapy with significant short- and long-term side effects. To further reduce toxicity while maintaining or improving efficacy, we shall need to incorporate novel agents into our first-line treatment algorithms, and several such potentially practice-changing trials are underway.