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<p>The introduction of PD1 inhibitors such as pembrolizumab and nivolumab has fundamentally changed the treatment options and management of classic Hodgkin lymphoma (cHL). After initially demonstrating high response rates and, in some cases, durable remissions in patients with refractory cHL, PD1 inhibitors are now being used in a&#xa0;second-line setting and increasingly also in first-line therapy. In the first-line setting, combinations of PD1 inhibitors with doxorubicin, vinblastine, and dacarbazine (AVD)-based chemotherapy regimens have primarily been investigated with the aim of improving efficacy while maintaining good tolerability. With the steadily increasing use of PD1 inhibitors across all lines of therapy, immune-related adverse events (irAEs) are becoming increasingly relevant. Although many irAEs are temporary and generally fully reversible with appropriate management, irreversible long-term consequences such as hypothyroidism requiring hormone replacement, arthralgia, skin changes, or rare adverse events like immune-mediated type&#xa0;1 diabetes mellitus may significantly impair patients. The incidence and long-term impact of these irAEs in the often-young cHL population treated with curative intent remain relatively unclear, making a&#xa0;careful risk–benefit assessment necessary.</p><p>In the current article, we outline the mechanisms of action and adverse effects of PD1 inhibitors in cHL, summarize current therapeutic approaches and future perspectives, and discuss the role of PD1 inhibitor-based treatment strategies in relapsed and refractory cHL as well as emerging treatment perspectives in the first-line setting.</p>

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PD1-Inhibition beim klassischen Hodgkin-Lymphom

  • 期刊论文

  • 发表日期：

    2026年3月30日

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  • Christian Peter Jaworek,
  • Paul Jan Bröckelmann

摘要

The introduction of PD1 inhibitors such as pembrolizumab and nivolumab has fundamentally changed the treatment options and management of classic Hodgkin lymphoma (cHL). After initially demonstrating high response rates and, in some cases, durable remissions in patients with refractory cHL, PD1 inhibitors are now being used in a second-line setting and increasingly also in first-line therapy. In the first-line setting, combinations of PD1 inhibitors with doxorubicin, vinblastine, and dacarbazine (AVD)-based chemotherapy regimens have primarily been investigated with the aim of improving efficacy while maintaining good tolerability. With the steadily increasing use of PD1 inhibitors across all lines of therapy, immune-related adverse events (irAEs) are becoming increasingly relevant. Although many irAEs are temporary and generally fully reversible with appropriate management, irreversible long-term consequences such as hypothyroidism requiring hormone replacement, arthralgia, skin changes, or rare adverse events like immune-mediated type 1 diabetes mellitus may significantly impair patients. The incidence and long-term impact of these irAEs in the often-young cHL population treated with curative intent remain relatively unclear, making a careful risk–benefit assessment necessary.

In the current article, we outline the mechanisms of action and adverse effects of PD1 inhibitors in cHL, summarize current therapeutic approaches and future perspectives, and discuss the role of PD1 inhibitor-based treatment strategies in relapsed and refractory cHL as well as emerging treatment perspectives in the first-line setting.