Targeted therapy for Hodgkin lymphoma

Targeted therapy is sometimes used to treat Hodgkin lymphoma (HL). It uses drugs to target specific molecules (such as proteins) on cancer cells or inside them. These molecules help send signals that tell cells to grow or divide. By targeting these molecules, the drugs stop the growth and spread of cancer cells and limit harm to normal cells. Targeted therapy may also be called molecular targeted therapy.

You may have targeted therapy for stage 3 and 4 (advanced) classical HL if it:

• can’t be treated with a stem cell transplant because of age or certain health conditions
• relapses (comes back) after an autologous stem cell transplant
• relapses after treatment with chemotherapy combinations
• continues to grow and spread after chemotherapy, radiation therapy or both (called refractory HL)

Targeted therapy may also be used to treat nodular lymphocyte-predominant HL (NLPHL).

Your healthcare team will consider your personal needs to plan the drugs, doses and schedules of targeted therapy. You may also receive other treatments.

Brentuximab vedotin (Adcetris) is a monoclonal antibody. It may be used along with chemotherapy to treat advanced classical HL. It is also used to treat classical HL that comes back or doesn’t respond to treatment. Brentuximab vedotin is usually given through a needle in a vein (intravenously) every 3 weeks, up to a total of 16 times. Sometimes it is given every 4 weeks instead of every 3 weeks. It may be given alone or with chemotherapy.

Rituximab (Rituxan and biosimilars) is a monoclonal antibody used to treat stage 2, stage 3 and 4 (advanced) NLPHL. It is given intravenously. Rituximab is often given with chemotherapy. Radiation therapy may also be given. When it is used alone, rituximab is usually given once a week for 4 weeks. This schedule may be repeated in a few months. When it is used with chemotherapy, rituximab is usually given on the first day of the chemotherapy cycle.

Side effects can happen with any type of treatment for HL, but everyone’s experience is different. Some people have many side effects. Other people have only a few side effects.

Targeted therapy attacks cancer cells but doesn’t usually damage healthy cells, so there are usually fewer and less severe side effects than with chemotherapy or radiation therapy. Chemotherapy and radiation therapy can damage healthy cells along with cancer cells.

If you develop side effects, they can happen any time during, immediately after or a few days or weeks after targeted therapy. Sometimes late side effects develop months or years after targeted therapy. Most side effects go away on their own or can be treated, but some side effects may last a long time or become permanent.

Side effects of targeted therapy will depend mainly on the type of drug, the dose and your overall health. Some common side effects of targeted therapy for HL are:

• allergic reaction
• flu-like symptoms, such as fever and chills
• fatigue
• skin problems, including rashes, redness, itching and dryness
• headache
• cough
• nausea and vomiting
• diarrhea
• nerve damage (called peripheral neuropathy)

Tell your healthcare team if you have these side effects or others you think might be from targeted therapy. The sooner you tell them of any problems, the sooner they can suggest ways to help you deal with them.

Details on specific drugs change regularly. Find out more about sources of drug information and where to get details on specific drugs.

Find out more about targeted therapy. To make the decisions that are right for you, ask your healthcare team questions about targeted therapy.