Interesting activity of pegylated liposomal doxorubicin in primary refractory and multirelapsed Hodgkin lymphoma patients: bridge to transplant

Most patients with classical Hodgkin lymphoma (cHL) can be cured with frontline therapy, and those with relapsed or refractory (R/R) disease can often be cured with salvage therapy and autologous stem cell transplantation (ASCT).1-3 However, the prognosis of patients who relapse after or are ineligible to ASCT has historically been extremely poor, with a median overall survival of just over 2 years.1-3 Achieving durable responses in this patient population is a critical treatment goal so far only rarely achieved with conventional chemotherapy.4,5 Brentuximab vedotin (BV) has demonstrated efficacy in patients treated after failure of ASCT, with objective responses seen in 75% of patients in a phase 2 study.6 Recently, because of the unique genetics of cHL, the check point inhibitors nivolumab and pembrolizumab were tested in phase 1 to 2 studies that demonstrated objective responses in 70% to 85% heavily pretreated patients with R/R cHL.7-10 Among the different conventional salvage chemotherapy regimens and conventional single agents, such as bendamustine, BV, nivolumab, and pembrolizumab, there is another drug with interesting results in the setting of R/R cHL, but less known and used: the pegylated liposomal doxorubicin (PLD)