Prof. Wróbel: In Hodgkin’s lymphoma, we fight for every patient. Young people often get sick
Young people often suffer from Hodgkin’s lymphoma. Although the results of treatment are very good, each new therapy is very important as it gives other patients a chance to be cured and at the same time reduces the risk of secondary cancers occurring in the future. Therefore, it would be important for us to be able to use brentuximab vedotin in the first line for all patients with advanced disease – says Prof. Tomasz Wróbel, head of the Department and Clinic of Hematology, Blood Cancer and Bone Marrow Transplantation, Medical University of Wrocław.
Katarzyna Pinkosz, Wprost: Hodgkin’s lymphoma is an aggressive cancer that often affects young people. What is the prognosis for patients with this cancer today?
Prof. Tomasz Wróbel: Hodgkin’s lymphoma is an example of a hematologic malignancy in which treatment outcomes are excellent. Of course, they are not perfect, because the ideal is to cure 100% of patients, but with today’s treatment methods we can cure almost 90% of patients. Of course, a lot depends on how advanced the disease is diagnosed and what comorbidities the patient has, but this cancer is considered to have a good prognosis, provided it is treated, of course. As I mentioned, most patients have a chance of full recovery.
The good news is that in January 2024, there was a big change that patients were waiting for and that experts were talking about: brentuximab vedotin appeared in the first line of treatment for stage 4 patients. What does this mean for patients?
This is a very good change. I said that it is a disease with good prognosis, but of course the prognosis depends on the stage of the disease. Stage three or four are advanced stages where the disease is disseminated. Here, the distant results are slightly weaker and reach 80%. Some patients require subsequent lines of treatment, so any method that increases the effectiveness of the first line in patients with advanced disease is welcome.
Adding brentuximab vedotin, an anti-CD30 antibody, combined with a cytostatic to chemotherapy improved treatment outcomes – not only in terms of progression-free survival, but also in improving overall survival, which is rare. The follow-up in this study was very long, but the researchers proved that it is possible to achieve improved survival in patients with advanced disease – in stages three and four.
During the debate on hemato-oncology in Wprost, you also said that thanks to such treatment there is a lower risk of secondary cancers – even after many years. Does this medicine have such properties?
Indeed, in the ECHELON trial, which compared classic ABVD chemotherapy with combination therapy with brentuximab vedotin, fewer secondary malignancies and less pulmonary toxicity were observed in brentuximab-treated patients, which would indicate that the treatment is less toxic. This is important because patients with Hodgkin’s lymphoma are often young people.
We must remember that anticancer treatment is a burden on health. Secondary cancers, cardiac toxicity, and pulmonary toxicity may become a problem in recovered patients after several years. Therefore, a more effective and less toxic treatment is always welcome.
We mentioned that brentuximab vedotin can already be used from the first line in stage 4 Hodgkin’s lymphoma. However, the drug is also registered for patients in stage 3. How important is it that these patients can also receive this treatment?
Stage three is also an advanced disease, and some patients are at high risk of progression. Sometimes a stage three patient is a higher risk patient. From a practical standpoint, stage three and stage four patients should be treated similarly because they have advanced disease; The use of targeted therapy combined with classic chemotherapy will bring much better results. This is not a large group of patients.
Should people who suffered from Hodgkin’s lymphoma in childhood and were treated with chemotherapy and drugs available at that time now pay attention to whether they have any long-term complications after treatment?
We should all have periodic tests. Patients who have recovered from cancer should especially undergo such tests. It is not about creating fear of disease recurrence, but about health-promoting activities. Mammography, colonoscopy, blood count checks and periodic tests should not be avoided; very important to remember this.
Hodgkin’s lymphoma is an example of a disease where there is great progress in treatment and the prognosis of patients is definitely good?
We would like to have results similar to those achieved in the treatment of Hodgkin’s lymphoma in other hematological malignancies and solid tumors. The results are very good, but that does not mean they are perfect. Every patient is different, and we fight for every patient. Let’s not get lost in percentages, because when we talk about 94%, for example, it’s a lot, but it means that six out of 100 patients lose the disease. We should also fight for them and look for the most optimal treatment.
