Immuncheckpointinhibition beim rezidivierten Hodgkin-Lymphom

Treatment options for relapsed classic Hodgkin lymphoma (cHL) have been significantly expanded by the introduction of immune checkpoint inhibitors (ICI) such as nivolumab and pembrolizumab. This has enabled highly effective, chemotherapy-sparing treatment approaches, particularly benefiting patients with chemoresistant disease and older patients. Combined immunochemotherapy regimens such as pembrolizumab with gemcitabine/vinorelbine/liposomal doxorubicin (Pembro-GVD) or nivolumab with ifosfamide/carboplatin/etoposide (Nivo-ICE) play a central role as salvage therapies prior to high-dose chemotherapy (HDCT) and autologous stem cell transplantation (autoSCT). Recently, the combination of nivolumab and brentuximab vedotin (Nivo-BV) has been approved in the second-line setting for patients up to 30 years of age. Monotherapies with ICIs, which are particularly used in patients with relapse after HDCT or those ineligible for HDCT, have emerged as an important strategy for disease control. In this setting, remarkably high and occasionally durable response rates can be achieved. Novel approaches such as treatment beyond progression may help to maintain long-term disease control and symptom relief. In this article, we summarize the current applications of ICIs in relapsed and refractory cHL, discuss their role across different lines of therapy, and provide an outlook on future opportunities and areas of research.