Traditional Treatment Approaches for Hodgkin’s Lymphoma
Lymphomas encompass a diverse group of blood cancers, with various types and treatment approaches depending on factors such as lymphoma subtype, origin, and aggressiveness. One particular lymphoma subtype with unique treatment options is Hodgkin’s lymphoma.
Traditionally, in the United States, Hodgkin’s lymphoma has been treated with a chemotherapy combination known as ABVD:
- A: Doxorubicin (Adriamycin)
- B: Bleomycin
- V: Vinblastine
- D: Dacarbazine (DTIC)
The promising aspect of this treatment, especially for early-stage Hodgkin’s lymphoma, is that many individuals can be cured with just a few cycles of this regimen.
However, for more advanced stages, the cure rates were lower, and the toxicity of the chemotherapies, particularly bleomycin, became a significant concern. If ABVD failed to cure the patient, a stem cell transplant was often necessary.
Need for Minimizing Toxicity and Improving Cure Rates
Bleomycin, derived from the Streptomyces bacteria, posed a risk of toxicity, especially in organs that struggled to metabolize it, such as the lungs. Lung damage caused by bleomycin could be irreversible and, in rare cases, fatal. There was a need to minimize the use of this potentially dangerous drug.
ECHELON-1 Study and the Use of Adcetris-AVD or AAVD Regimen
A comprehensive study known as ECHELON-1 explored the use of Brentuximab vedotin (Adcetris) as a replacement for bleomycin in the ABVD regimen, now referred to as Adcetris-AVD or AAVD. Adcetris is not a traditional chemotherapy; it is classified as an antibody-drug conjugate. Essentially, Adcetris attaches to Hodgkin’s lymphoma cells and delivers the vedotin component within the cancer cell to facilitate its destruction. It’s a targeted approach.
The results of the ECHELON-1 study, in which we participated at Orlando Health, revealed higher cure rates, fewer instances of salvage therapies like stem cell transplants, and a near-elimination of fatal lung complications. For advanced Hodgkin’s lymphoma, this approach has become a standard of care, revolutionizing the treatment of the disease.
Revolutionizing the Treatment Landscape for Advanced Hodgkin’s Lymphoma
Ongoing research is exploring different combinations and immunotherapies. There is hope that, in the future, traditional chemotherapies may no longer be necessary, with combinations of antibody-drug conjugates and immunotherapies working synergistically. As patients reduce their exposure to chemotherapy, concerns about long-term side effects decrease. Progress in this field continues, and Hodgkin’s lymphoma remains one of the most treatable lymphomas we encounter.
About the author
Dr. Daniel Landau is a distinguished board-certified hematologist/oncologist renowned for his exceptional contributions in the field. With an illustrious career spanning across esteemed institutions like the Orlando Health Cancer Institute and the Medical University of South Carolina, Dr. Landau’s expertise shines in both genitourinary oncology and hematology.
Engage with Dr. Landau’s expertise and ignite your curiosity on “Ask MedOnCMD” as he invites you to explore the vast landscape of oncology with a fresh outlook.