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Variations exist between treatment selections and outcomes between young and elderly patients with Hodgkin lymphoma, explains Anas Younes, MD. For older patients with multiple comorbidities who are not candidates for chemotherapy, alternative approaches should be considered. In this population, intriguing results have been demonstrated for single-agent brentuximab vedotin, with response rates reaching 80%, Younes says. Outside of this approach, for patients who do not tolerated anthracyclines, alternative curative options exist using other chemotherapy combinations, notes Steven M. Horowitz, MD.
Following relapse on frontline chemotherapy, brentuximab vedotin can be utilized to achieve a negative PET scan prior to transplant, Andrei R. Shustov, MD, states. With this approach, Shustov notes that approximately 67% of patients achieve PET-negativity. However, these findings have not been validated in clinical trials. At this point, several early phase studies are exploring single-agent brentuximab vedotin in the pre-transplant setting, notes Younes.
In the post-transplant setting, if a patient responds well to treatment with brentuximab vedotin, dose reductions can be utilized to remain on treatment while avoiding side effects until progression. For this approach, Younes notes starting at 1.8 mg/kg and reducing to 1.2 mg/kg followed by 0.8 mg/kg.