A new treatment improves the outlook for people with Hodgkin’s disease, a rare form of lymphatic cancer. With the combination of a new immunotherapy and chemotherapy, patients experience fewer side effects and the cancer returns less often, according to a study that today The New England Journal of Medicine appears.
Hodgkin lymphoma develops a new type of cell with two nuclei. These cells attract all kinds of inflammatory cells that together form a tumor. It starts in the lymph node, but can then appear elsewhere in the body. In the Netherlands, 500 young people are diagnosed every year, often in their twenties. The chances of survival have become much greater in recent decades. But the search for new therapies continues, also to reduce side effects and cancer recurrence.
Nearly a thousand patients in dozens of hospitals in the United States and Canada participated in the study. This group size is special because it is difficult to find many patients for rare diseases. All ages were included for this study; the youngest patient was 12, the oldest 83 years old.
Half received the latest standard treatment in the US and Canada: the drug brentuximab vedotin and chemotherapy. The other group received chemotherapy in combination with nivolumab, a new drug. In the Netherlands, patients so far only receive nivolumab if the lymphoma returns.
Kill
Brentuximab vedotin (BV) is an immune drug that recognizes a specific protein on the outside of a cancer cell and releases a chemical that can kill that cell. In combination with chemotherapy, the treatment can cause serious side effects, such as pain in the legs and constipation.
Nivolumab is a so-called checkpoint inhibitor. This latest generation of immune medicines are antibodies that bind to T cells, certain immune cells of the patients. They take off the brakes so that the T cells can recognize and clear the cancer cells. In this way they let the patient’s own defenses do the work.
In the study, nivolumab with chemotherapy showed better outcomes after just one year. And after the patients had been followed for two years, 92 percent of the nivolumab group had not had the disease come back, compared to 83 percent in the standard group. In the elderly, the difference in recurrence after two years was even greater: 88 percent in the nivolumab group compared to 65 percent in the standard group.
In addition, patients in the nivolumab group had fewer side effects. And importantly: both treatments make radiation, which also has adverse late effects, unnecessary for most patients. That is encouraging, especially for young patients, who still have a life ahead of them in which the risk of infertility, breast cancer or heart disease is also reduced, the researchers said.
Heart failure and breast cancer
Auke Beishuizen and Margreet Veening, pediatric oncologists at the Princess Máxima Center, followed the study and are working in Europe on a new protocol for the treatment of Hodgkin lymphoma in children. They praise the research because of the large group with children. They are less pleased with the chemotherapy given in both groups in addition to nivolumab or brentuximab vedotine. Veening: “In Europe we give this chemotherapy in smaller doses to reduce the risk of heart failure and breast cancer.”
Yet they are enthusiastic about the results. “We seemed to have reached a plateau, such large differences between two treatments are really groundbreaking in this day and age,” says Beishuizen. The fact that the researchers also included children is a big plus, he says. This means that new medicines for children will come onto the market sooner.
The American researchers expect that combination treatment with nivolumab will soon become the standard in the US. Veening: “In Europe we also think that the future lies in a checkpoint inhibitor, in combination with chemotherapy.”
It remains to be seen how these patients will fare in ten or twenty years. The patients in the study will be followed for at least five years, said study leader Jonathan Friedberg, director of the Wilmot Cancer Institute in Rochester (NY) at the presentation. “But if you can keep people free of disease for two years, you can be optimistic about the long term.”
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New Horizons for Hodgkin’s Lymphoma Treatment
Well, well, well! It appears that the medical community has finally managed to create a treatment for Hodgkin’s disease that doesn’t involve sacrificing your social life or spending an eternity in a waiting room. It seems there’s a new immunotherapy that’s got patients grinning like a Cheshire cat, if only to keep their spirits high while battling this rare form of lymphatic cancer. And if you were hoping for a riveting page-turner worthy of your average crime thriller, look no further than The New England Journal of Medicine, which is reporting all the juicy details this week!
The Study’s Big Hitters
According to recent findings, patients who received a combo treatment of chemotherapy and the new immunotherapy drug nivolumab are walking away with fewer side effects and, brace yourselves, a lesser chance of the cancer returning. Now that’s something I’d happily clap for! Imagine being able to battle cancer without feeling like you’ve just gone twelve rounds with Mike Tyson—because, let’s face it, who wants to be left with debilitating pain and constipation just because of some rogue cells?
The research boldly claims that 92% of those lovely folks taking nivolumab remained cancer-free after a year compared to just 83% for those stuck with the old-school methods. And for elderly patients, the results were even more staggering! You know what they say: age is just a number, but if you’re a cancer patient, let’s make that number lean in your favor, shall we?
Less Pain, More Gain
Now, let’s talk about the nuances of treatment. In the study, half the patients were given the esteemed brentuximab vedotin—a drug that’s about as complicated as its name sounds—with chemotherapy. This treatment, while effective, often felt like slipping into a pair of jeans two sizes too small. Pain in the legs, constipation—TMI, right?
But the nivolumab patients? They saw fewer side effects and, importantly, radiation therapy—a treatment that can feel like a horror movie’s climax—is rendered unnecessary most of the time. Give these researchers a Nobel Prize or at least a hearty pat on the back!
A Closer Look at the Risks
Auke Beishuizen and Margreet Veening, pediatric oncologists working at the Princess Máxima Center, were quick to catch the details of this groundbreaking trial but expressed a hint of skepticism about the side effects of chemotherapy still attached to both treatments. It’s like that friend who shows up to the party and leaves the door open, letting all the good vibes escape alongside a chill in the air! They’re all for the innovative treatments but want to keep doses in check—not just now but for the long haul, too. Nobody wants to deal with heart troubles or the risk of adding breast cancer onto their plate after getting through cancer treatment!
Looking to the Future
As we glance towards the horizon of cancer treatment, the American researchers are pots of optimism, expecting nivolumab and chemotherapy to soon become standard practices. Meanwhile, our European friends are just a heartbeat behind, mulling over the checkpoint inhibitor route as their beacon—like a lighthouse guiding ships away from jagged rocks.
It’s fantastic news that this study included a range of ages—from the sprightly 12-year-old to the wise 83-year-old. Because let’s face it, if you’re the youngest in the trial, you’re probably thinking, “If this works for me, I could live to be a grumpy old hermit, and I could actually enjoy the view!” And who wouldn’t want to give themselves a shot at that, right?
Of course, we still need to wait and see how these patients fare in ten or twenty years. So for now, it’s like placing bets at a race—let’s keep our fingers crossed, folks! Jonathan Friedberg, the honcho of the Wilmot Cancer Institute in Rochester, advises five years of follow-up, and let’s hope those happy statistics keep coming. If the data holds up and those victory laps continue, it could well be the dawn of a bright new era in Hodgkin’s disease treatment!
In conclusion, it’s a wild ride in the world of cancer therapy, and with treatments like nivolumab stealing the limelight, those cancer cells might start to feel like they’re crashing a party they weren’t invited to. With fewer side effects and better recovery rates, it seems our gallant medics might just be onto something truly remarkable!
