PETER BORCHMANN :  FRIDAY 31 MARCH 2006, 14:30

Monoclonal Antibody-based Immunotherapy of Hodgkin Lymphoma

Peter Borchmann, Roland Schnell, Andreas Engert
Klinik I für Innere Medizin, Universität Köln, 50924 Köln, Germany

Many new approaches involving antibody-based agents have given promising results in experimental Hodgkin´s lymphoma (HL) models. Early clinical trials using immunotoxins (ITs), radioimmunotherapy (RIT), bispecific molecules (BSMs), and recently monoclonal antibodies (MAbs), have demonstrated some clinical efficacy in patients with advanced refractory HL. Although it seems unlikely to cure chemotherapy resistant patients with larger tumor masses by either of these approaches alone, the combination with conventional chemotherapy might help to overcome resistance of Hodgkin-/Reed-Sternberg (H-RS) cells or to eliminate residual disease. Since the H-RS cells are extremely sensitive to irradiation, RIT might be a promising approach. A murine MAb (Ki-4) based 131 Iodine conjugate showed efficacy in refractory HL patients, but toxicity was a clinical problem and less toxic constructs using alternate MAbs or isotopes should be developed. Currently, a humanized as well as a fully human anti-CD30 MAb are being tested in clinical phase I/II studies. These MAbs could engage the human immune system against the HL and are capable of inducing directly apoptosis of H-RS cells. In addition, these MAbs could be combined with conventional chemotherapy and are thus promising candidates for further improvements in the therapy of HL.

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