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Each member of the panel of experts provided an interpretation of the evidence and a systematic approach to obtain consensus was used. The working group is made up of a multidisciplinary panel of experts with a significant background in Hodgkin's lymphoma. The Hodgkin's Lymphoma Committee of the Lymphoma Study Association (LYSA) gathered in 2012 to prepare guidelines on the management of transplant-eligible patients with relapsing or refractory Hodgkin's lymphoma. An armamentarium of biologic therapies for HL that are well tolerated and potentially more effective is expected to be available in the near future.Ĭopyright © 2015 by the National Comprehensive Cancer Network. This article reviews 8 major classes of biologic approaches that have been investigated in HL: monoclonal antibodies, immunotoxins, antibody-drug conjugates, radioimmunotherapy, adoptive immunotherapy, immunomodulators, chimeric antigen receptor T cells, and checkpoint inhibitors. Biologic therapies represent a potent treatment option that have produced durable remissions even in patients who have had multiple relapses or with refractory disease. Although the investigation of biologic therapies in HL started decades ago, it has only recently flourished, largely because of the development of new monoclonal antibody drug conjugates and checkpoint inhibitors. Classical Hodgkin lymphoma (HL) is no exception. The advent of biologic approaches for the treatment of solid tumors and hematologic malignancies has been a major accomplishment in oncology and a rapidly growing field of clinical and translational research in cancer therapeutics.
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Conclusions: R-GIFOX retains an attractive therapeutic potential in recurring HL, enabling pre-ABMT cytoreduction and mobilization, and also a safe delivery of a full salvage program to patients unfit for HDT.
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of 12 mo.s for CRs, Disease Free Survival was 79% in patients eligible for ASCT and 41% in those unfit treated with additional R-GIFOX. Five ’bad mobilizers’ had previously undergone radiation therapy (n=3) and radioimmunotherapy (n=2). Eight of 14 eligible patients had effective CD34+ cells harvest and proceeded to subsequent ASCT. Four CRs were achieved among the 6 patients with post-ASCT relapses. The overall response according to FDG-PET/IWC criteria after 3 courses was 86%, with 2 partial and 16 complete responses (CRs) (76% CR=10, CRu=6). Actual dose intensity of the first 3 courses was 82%, 86%, 92 % for G, Ifo and Ox, respectively. Ifosfamide was withdrawn at the 4th course in 2 patients, both aged 64 yrs, due to tachyarrhythmia and encephalopathy. CTCAE v3.0 G4 thrombocytopenia occurred in 18% of courses, G4 infection in 11%. Eighty-three total courses were delivered (median 3, r 3–6). Ten patients (48%) had received ≥ 2 previous CHT lines and 15 (78%) had GHLSG recurring HL prognostic score ≥ 2. Results: Twenty-one patients (median age 33 yrs, r 22–64) with relapsed (n = 16) or primary progressive (n = 5) HL, were prospectively accrued. R-GIFOX consisted of R 375 mg/m ² D1, G 1000 mg/m ² D2, Ox 130 mg/m ² D3 and Ifo 5 g/m ² D3, as a 24-h single infusion, G-CSF 5 mcg/kg/d DD 7–11 (10 mcg/kg/d, 3rd course until SCs mobilization). Methods: Patients were scheduled to receive 3 R-GIFOX courses followed by SCs mobilization and HDT if elegible for autologous transplantation (ASCT) or 3 more courses if not. We assessed activity, toxicity and stem cells (SCs) mobilizing capacity of a bi-weekly salvage combination with these agents in HL recurring after conventional or high dose therapy (HDT). Record, create and share your GIFs with the built-in Dropbox, Google Drive, and Imgur integrations.Background: Gemcitabine (G), ifosfamide (Ifo), oxaliplatin (Ox) and rituximab (R) have been accounted of cross-synergy in preclinical and early clinical studies in Hodgkin lymphoma (HL). This tool also features a set of capturing options accessible via the preferences window, letting you explicitly control the recording and output. Gifox introduces a completely new way of continuous screen capturing with window selection mode. It's your best companion for micro-screencasts & product demos, animated instructions & bug reporting, and selective on-screen video capturing. Gifox is a beautifully-designed and masterfully-crafted app that records your screen into animated GIFs – the great alternative between static images and full-size videos.