LAUSR

Hodgkin lymphoma (HL) affects approximately 1500 new patients annually in the UK (Smith et al, 2011). Most patients are cured with ABVD (doxorubicin, bleomycin, vinblastine, dacarbazine)-based treatment. Of those who relapse, about 60% achieve durable remission with salvage chemotherapy followed by consolidation high dose therapy (HDT) and autologous stem cell transplantation (ASCT). Treatment options at relapse after ASCT are limited and after second relapse, cure is infrequent. Brentuximab vedotin (BV) (Adcetris) is a CD30-directed antibody drug conjugate with an established role in treating relapsed/refractory HL (Gopal et al, 2012; Younes et al, 2012). In the UK, BV has been successfully used as a bridge to allogeneic stem cell transplantation (alloSCT) in approximately 25% of patients (Gibb et al, 2013). Nivolumab and other emerging PD-1 (PD1)/PD-L1 (CD274) checkpoint inhibitors are novel agents with very promising results in early phase clinical trials. In a phase l study of nivolumab involving 23 patients (including 78% post-ACST and 78% post-BV) the overall response rate (ORR) was 87% with 86% progression-free survival (PFS) at 24 weeks (Ansell et al, 2015).