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HDAC inhibitors have demonstrated promise; however, there is still more to learn about the utilization of these agents as treatments for patients with hematologic malignancies, notes Andrei R. Shustov, MD. There is wide variation in terms of efficacy and toxicity between each agent, as the result of different targets. Additionally, as epigenetic agents, there is potential to administer these drugs in combination with chemotherapy.
Lenalidomide has been explored as a potential treatment for patients with Hodgkin lymphoma. The response rate for patients with relapsed disease with single-agent lenalidomide is roughly 15%, Anas Younes, MD, suggests. While this treatment is not commonly used, it does represent a potential option if none other exists.
Everolimus is another therapy that has shown promise in the salvage setting for patients with Hodgkin lymphoma, explains Lauren C. Pinter-Brown, MD. In a phase II clinical trial, patients experienced over a 3-year duration of response with everolimus without significant changes in quality of life. This agent warrants further development in Hodgkin lymphoma, Pinter-Brown believes.
The combination of ABVD and rituximab demonstrated promising activity in non-randomized phase II studies, explains Younes. However, other monoclonal antibodies have shown more intriguing results, such as brentuximab vedotin. Additionally, the next area of interest will be the exploration of PD-1 and PD-L1 targeted antibodies in patients with Hodgkin lymphoma, Younes believe.