Pembrolizumab Approved for Children and Adults with Hard-to-Treat Hodgkin Lymphoma

There is now a new treatment option available for both children and adults with classical Hodgkin lymphoma (cHL): the checkpoint immunotherapy pembrolizumab (Keytruda®, Merck).

Pembrolizumab, which blocks the activity of the PD-1 pathway, is now the third immunotherapy approved for cHL patients, along with brentuximab vedotin (a targeted antibody) and nivolumab, another anti-PD-1 checkpoint inhibitor.

This latest approval―which covers patients with refractory cHL as well as those who have relapsed after three or more prior lines of therapy―was based on results from the phase II KEYNOTE-087 clinical trial, in which 22% of patients experienced a complete response and another 47% experienced a partial response.

Perhaps most importantly, this is the first immunotherapy of any kind approved for children with cHL, and the first checkpoint immunotherapy approved for children with any form of cancer.

“For the patients with classical Hodgkin lymphoma who are not cured with existing treatments, there are limited options, and treating their disease becomes more challenging,” said Dr. Craig Moskowitz, who is the clinical director of the division of hematologic oncology at Memorial Sloan Kettering Cancer Center. “This approval is an important step forward in treating these patients, who are generally young and have a particularly poor prognosis, and gives us the opportunity to help patients in their fight against this devastating disease.”

While this fourth-line pembrolizumab approval offers hope to patients who have run out of other options, in the future it will be crucial to work to make this and other immunotherapies available earlier for patients, especially young children, for whom the effects of chemotherapy and radiation can cause long-term damage.

We here at the Cancer Research Institute are devoted to helping improve survival for lymphoma patients, by supporting scientists who are exploring immune system-based treatments for it, including a vaccine and a strategy that uses our cells’ natural “recycling” machinery. We also partnered with the Lymphoma Research Foundation to develop protocols aimed at improving doctors’ ability to evaluate these patients.

Although the arc of immunotherapy has been long, we are glad to see that, partly due to our efforts, it’s finally starting to bend toward increased benefits for more and more patients.