Hodgkin lymphoma research
This page tells you about research into the causes, prevention and treatments of Hodgkin lymphoma. You can find information about
- A quick guide to what's on this page
- How treatments are tested
- About clinical trials for treatments
- Research into the causes of Hodgkin lymphoma
- Research into Hodgkin lymphoma treatments
Hodgkin lymphoma research
All treatments must be fully researched before they can be adopted as standard treatment for everyone. This is so that we can be sure they work better than the treatments we already use. And so we know that they are safe.
First of all, treatments are developed and tested in laboratories. Only after we know that they are likely to be safe are they tested in people in clinical trials. Cancer Research UK supports a lot of UK laboratory research into cancer and also supports many UK and international clinical trials.
You can view and print the quick guides for all the pages in the Treating Hodgkin lymphoma section.
All treatments have to be fully researched before they can be adopted as standard treatment for everyone. This is so that
- We can be sure they work
- We can be sure they work better than the treatments that are available at the moment
- They are known to be safe
First, treatments are developed and tested in laboratories. For ethical and safety reasons, experimental treatments must be tested in the laboratory before they can be tried in patients. If a treatment described here is said to be at the laboratory stage of research, it is not ready for patients and is not available either within or outside the NHS. Cancer Research UK supports a lot of UK laboratory research into cancer.
Tests in patients are called clinical trials. Cancer Research UK supports many UK and international clinical trials.
Our trials and research section has information about what trials are including information about the 4 phases of clinical trials. If you are interested in taking part in a clinical trial, visit our searchable clinical trials database. If there is a trial you are interested in, print it off and take it to your own specialist. If the trial is suitable for you, your doctor will need to make the referral to the research team. The database also has information about closed trials and trial results.
Here is a video on experiences of taking part in a clinical trial:
View a transcript of the video (Opens in a new window)
We don’t know exactly what causes Hodgkin lymphoma. There is a study looking at the possible causes in children as well as adults. The researchers are looking at tissue and blood samples taken from people with Hodgkin lymphoma. They use the samples to look at DNA and find out about any viruses the person may have had. They are especially interested in a virus called Epstein Barr, which we know can be linked to Hodgkin lymphoma. The researchers hope that they will also find out why treatment for Hodgkin lymphoma works better for some people than others.
All the new approaches covered here are the subject of ongoing research. Until studies are completed and new effective treatments are found, these treatments cannot be used as standard therapy for Hodgkin lymphoma.
Some trials are using newer chemotherapy drugs and combinations of drugs to treat people whose lymphoma has come back since it was first treated. The ABVD v Stanford V trial has been comparing the standard chemotherapy of ABVD with another combination called Stanford V. The trial found that there was no difference between the two treatments.
The 18 to 30 study looked at whether young adults with Hodgkin lymphoma might do better with a chemotherapy regimen that is usually given to children. The chemotherapy drugs used included some of those mentioned above, as well as cyclophosphamide and procarbazine. The trial team found that the adapted chemotherapy regimen did help young adults. Future trials could now compare this treatment with the standard ABVD treatment for young adults with Hodgkin lymphoma.
Only about 1 in 4 cases of Hodgkin lymphoma are in people over 60. But it is more difficult to treat Hodgkin lymphoma in this age group. This is mainly because it is harder to cope with the side effects of intensive treatment. The SHIELD trial showed that doctors could treat people over 60 with a new combination of chemotherapy called VEPEMB, instead of the more intensive ABVD treatment.
Researchers are looking into whether using a PET scan can help them to make decisions about treatment for Hodgkin lymphoma. ABVD is a common treatment for Hodgkin lymphoma. Most people are cured with it but some people need more treatment and others may need less. The RATHL trial which has now closed, aims to find out whether a PET scan early in the treatment can tell how well the treatment is working and whether they can stop the bleomycin for people whose scan shows there is no active lymphoma. ABVD includes a drug called bleomycin. It can cause lung damage and doctors want to see if some people can safely have less of it. For people whose lymphoma is still active on the PET scan the trial also aims to find out if changing to a more intensive chemotherapy helps.
The EuroNet PHL-LP1 study is looking at treatment for children and young people (under the age of 18) with nodular lymphocyte predominant type Hodgkin lymphoma. Doctors think that children with this type of lymphoma may be able to have less chemotherapy than people with classical types of Hodgkin lymphoma. And some may be able to have surgery alone and not need any chemotherapy at all. In this study, the researchers want to find out whether this group of patients need to have any further treatment after surgery to remove their lymphoma.
You can click on the drug name links above to find out more about the specific side effects of each drug. You can find details of trials for Hodgkin lymphoma on our clinical trials database.
Doctors use scans to assess the need for treatment or how well treatment has worked. There are trials looking at
A scan called a PET scan can show up areas of active cancer in the body. This may help doctors know how well treatment for Hodgkin lymphoma has worked. Doctors usually treat early stage Hodgkin lymphoma with chemotherapy and radiotherapy. At the moment there is no way of knowing how well chemotherapy has worked. So all patients go on to have radiotherapy. Doctors think that some patients may be having radiotherapy without really needing it.
The RAPID trial has found that using a PET scan after chemotherapy for early Hodgkin lymphoma can help identify people with an excellent outlook, and so avoid the need for radiotherapy. However, the trial team need to follow up the people who took part in the trial for a longer time to confirm that PET scans can help with decisions about radiotherapy. And that not having radiotherapy leads to fewer long term side effects and improved overall survival compared to giving radiotherapy to every patient.
The RATHL trial is looking at how PET scans might help to decide treatment for people with more advanced Hodgkin lymphoma (stage 2B, 3 or 4). After 2 cycles of ABVD chemotherapy, the people taking part have a PET scan. Doctors hope that this scan will tell them who can then safely be given less chemotherapy, and who needs more intensive chemotherapy, and possibly radiotherapy. This trial has closed and we are waiting for the results.
Cancer Research UK is funding the MELT study. The study has now closed to recruitment and is looking at a new type of magnetic resonance imaging (MRI) scan. It wants to find out how good the scan is at assessing Hodgkin lymphoma and its response to treatment in children and young people. We will publish the results when they become available.
These trials for Hodgkin lymphoma are listed on our clinical trials database.
Monoclonal antibodies target proteins called receptors found on some Hodgkin lymphoma cells. Sometimes monoclonal antibodies are attached to chemotherapy drugs or radioactive molecules so that this anti cancer treatment can be delivered straight to the cancer cells. This is called targeted treatment.
CHT25 is a monoclonal antibody that targets the CD25 receptor found on some lymphoma cells. I stands for Iodine-131. So I-CHT25 is the CHT25 antibody attached to a radioactive iodine molecule. The aim of the treatment is that the CHT25 binds to the CD25 receptors on the lymphoma cells and the radioactivity kills the cells. An early phase 1 trial found a safe dose of I-CHT25 that didn’t cause serious side effects. They also found that the drug helped about two thirds of the people in this trial. The researchers are now planning a phase 2 trial.
Brentuximab is a monoclonal antibody that targets CD30 that is found on most Hodgkin lymphoma cells. Brentuximab has a chemotherapy attached to it called vedotin. So, brentuximab attaches to the CD30 receptor delivering the chemotherapy directly to the cell.
The BREVITY trial is looking at brentuximab for people with Hodgkin lymphoma who are unable to have chemotherapy. This may be because they are too unwell or have a medical condition which means they can't have chemotherapy. The researchers want to find out if this drug works well as a first treatment for Hodgkin lymphoma, and to learn more about the side effects. This trial has now closed and we are waiting for the results.
The All Wales Medicines Strategy Group have recommended Brentuximab for people in Wales who have Hodgkin lymphoma with CD30 receptors. It is for Hodgkin lymphoma which hasn't gone away or has come back after a stem cell transplant or at least 2 courses of chemotherapy. They have not recommended brentuximab for people with anaplastic large cell lymphoma. The National Institute for Health and Care Excellence (NICE) and the Scottish Medicines Consortium (SMC) have not made any recommendations about the use of Brentuximab in England and Scotland.
Doctors are also researching another monoclonal antibody called nivolumab. One trial is looking at nivolumab for people with Hodgkin lymphoma that has come back after a stem cell transplant using their own cells (autologous stem cell transplant).
The KEYNOTE 087 trial is looking at another monoclonal antibody called pembrolizumab for Hodgkin lymphoma that has come back or didn't respond to previous treatment. This trial has now closed and we are waiting for the results.
Doctors are using a new type of biological therapy called panobinostat. Panobinostat is also known as LBH589 and it aims to stop cancer growing by blocking enzymes called deacetylases (pronounced dee-as-et-isle-azes). It is a type of deacetylase inhibitor. Cells need these enzymes to grow and divide. Blocking them may stop cancer growing.
A trial looked at panobinostat for Hodgkin lymphoma that had come back after a stem cell transplant, or had not responded to treatment. This was a phase 2 study. From the results, the trial team concluded that panobinostat could help these groups of people. Common side effects included a drop in blood cells (causing increased risk of infection, bruising and bleeding), diarrhoea or constipation, feeling or being sick, and tiredness (fatigue).
Most stem cell transplants for Hodgkin lymphoma are autologous. This means that your own stem cells are collected and then you have them back after high dose chemotherapy. But doctors are also looking at using allogeneic stem cell transplants, where the cells come from a donor. Patients have high dose chemotherapy and radiotherapy which kills off all of their stem cells. Then they have a drip of the donor's stem cells which starts making blood cells again. For some people this can get rid of their Hodgkin disease. But the donor cells can also attack normal body cells and cause a reaction called graft versus host disease (GVHD). GVHD can make people very ill. Sadly, some patients die from it.
Doctors are looking at mini transplants to try to reduce the side effects of treatment. You have much lower doses of chemotherapy before the transplant, with no radiotherapy. Doctors call this a reduced intensity allogeneic stem cell transplant. Doctors now sometimes use mini stem cell transplants for people with Hodgkin disease that has come back or where treatment did not get rid of it.
The UK Haplo study is looking at using donor stem cells from a family member who is at least a 50% match with the person having the stem cell transplant. In most allogeneic transplants, the donor is someone who is a very close match to the person having the transplant. This is usually a brother or sister. It could also be from a donor who isn't a relative. But doctors can't find a match for about a third of those needing a transplant. An option for these people is a half matched transplant, where the donor is at least 50% match with the person having the transplant. In the past these transplants have been difficult to do. You can react to the donor cells, causing a severe immune response. But researchers think they have found a way to deal with this by using a drug called cyclophosphamide.
The aims of the UK Haplo study are to find out how well high dose cyclophosphamide works with a half matched stem cell transplant, how safe it is, and to learn more about the side effects and quality of life for people having this type of transplant.
The PAIReD trial which has now closed to recruitment, is looking to see if a stem cell transplant works best if it is from a brother or sister or a matched donor. We are waiting for the results.
The RIC UCBT trial is looking at using stem cells collected from the umbilical cords of newborn babies. The umbilical cord stem cells are given to people after a mini transplant. These cord blood transplants are for people who don't have a relative who can be their stem cell donor. Doctors hope that the umbilical cord stem cells will cause fewer side effects than adult stem cells. This trial has now closed to recruitment and we are waiting for the results.
Doctors try to use drugs that do not cause infertility if the person they are treating has not had children or would like to have more in the future. But this isn't always possible. Having high dose chemotherapy with bone marrow or stem cell transplant will almost certainly mean you will be infertile.
The possibility of becoming infertile is one of the major worries for younger people being treated for Hodgkin lymphoma. It is possible for men to have sperm banking before they have chemotherapy so they can still have children. For women, the situation can be more difficult. Sometimes treatment needs to start quickly. And there may not be time beforehand to stimulate and collect eggs and then freeze them as eggs or as embryos. This process takes a couple of weeks at least and can take longer, depending on when your next period is due.
Researchers have been looking into the possibility of removing some ovarian tissue before chemotherapy and then freezing it. The aim is to be able to reimplant the ovarian tissue after treatment is over. Researchers are satisfied that ovarian tissue can be frozen and thawed safely. They are now working on reimplanting it into the body and getting it to work again. There have been at least 2 reports of women giving birth after this treatment. But this is still early research. It will be some time before we know whether ovarian tissue reimplantation works well enough to be made more widely available.
The EuroNet-PHL-C1 trial is looking at treatment for children with Hodgkin lymphoma. The researchers want to see if it's possible to reduce the chance of the children being infertile when they grow up. The children taking part will have chemotherapy, but the doctors will try to avoid giving radiotherapy afterwards, unless you really need it. They also want to find out if using the chemotherapy drug dacarbazine instead of procarbazine will work as well against the Hodgkin lymphoma, but be less likely to make you infertile. The trial has now closed to recruitment and we are waiting for the results.
All of these trials and more are listed on our clinical trials database. Choose 'Hodgkin lymphoma' from the drop down list of cancer types.
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