The following is a summary of “Role of Response Adapted Therapy in the Era of Novel Agents,” published in the June 2024 issue of Hematology by Schroers-Martin et al.
Classic Hodgkin lymphoma (cHL) management demands a nuanced and personalized treatment strategy guided by initial risk assessment and interim response evaluations using positron emission tomography (PET). The overarching aim is to achieve high cure rates while minimizing the acute toxicity and long-term sequelae associated with treatment. Interim PET-adapted strategies (iPET) originally evolved within the framework of traditional chemotherapy, tailoring treatment intensity based on PET findings showing either a complete response or residual disease.
The recent integration of novel therapeutic agents like brentuximab vedotin and checkpoint inhibitor immunotherapies (CPIs) pembrolizumab and nivolumab into frontline cHL therapy has broadened treatment paradigms, prompting exploration of PET-adapted approaches with these newer agents. This review delves into the evolving landscape of response-adapted strategies that incorporate novel agents, addressing specific challenges such as interpreting PET scans in the context of CPI therapy, which can sometimes present with indeterminate radiographic findings. Additionally, it examines emerging techniques for refining response assessments, including advanced PET imaging metrics that provide deeper insights into treatment efficacy. It explores the potential role of circulating tumor DNA as a complementary tool in this context.
Source: sciencedirect.com/science/article/abs/pii/S0037196324000726