In about 10% of children and adolescents with Hodgkin lymphoma, the disease returns (relapse) or responds inadequately to treatment (refractory). They usually receive chemotherapy treatment followed by radiation or a stem cell transplant. While the chemotherapy often works well, it can also have long-term adverse effects. For example, it can cause reduced fertility or the development of other cancers. Therefore, new treatments are needed that have less long-term adverse effects.
Immunotherapy with nivolumab and brentuximab-vedotin represents a promising treatment with limited side effects. In this study, ten children (9-16 years old) with relapsed or refractory Hodgkin lymphoma were treated with nivolumab and brentuximab-vedotin.
Disease completely disappeared
In half of the children, this treatment was sufficient to completely eradicate the disease (complete metabolic remission). In the rest, the disease disappeared after additional treatment with chemotherapy. All children then received consolidation treatment with stem cell transplantation or radiation. The children have been followed for an average of 25 months so far (12-42 months) and in none of them the disease returned.
No serious side effects
Treatment with nivolumab and brentuximab-vedotin was well tolerated and no serious side effects occurred. One of the children experienced decreased thyroid function, a side effect possibly related to the immunotherapy. However, this recovered spontaneously.
The immunotherapy works well and can safely be given to children with relapsed or refractory Hodgkin lymphoma, the researchers conclude. Whether there are any long term adverse effects is not known yet. In order to determine this, the children will continue to be followed longer.
The scientific publication can be found here: Greve P, Beishuizen A, Hagleitner M, Loeffen J, Veening M, Boes M, Peperzak V, Diez C, Meyer-Wentrup F. Nivolumab plus Brentuximab vedotin +/- bendamustine combination therapy: a safe and effective treatment in pediatric recurrent and refractory classical Hodgkin lymphoma. Front Immunol. 2023 Jul 31;14:1229558.