The introduction of nivolumab has changed the landscape of relapsed/refractory (R/R) classical Hodgkin’s lymphoma (HL) treatment. Despite its clinical importance, this therapy may remain inaccessible for a significant number of patients worldwide, especially in low-income countries, due to its high cost. The recommended dose is usually 3 mg/kg (240 mg flat dose) every 15 days, which incurs a huge financial burden to patients. Currently, this therapy is used for the treatment of adult patients with R/R classical HL after autologous stem cell transplant and treatment with brentuximab vedotin. In one study, the authors used a flat dose of 40 mg of nivolumab every 15 days in R/R classical HL, with an objective response rate of 70%, and 43.3% of patients achieved complete response. Median progression-free survival was 18.4 months with this low- and fixed-dose regimen of 40 mg. This is a case report of a 21-year-old girl, who was previously treated with two lines of therapy and had <1-year disease-free interval after the first line of therapy. She then exhibited progressive disease, which was followed by salvage chemotherapy. She was treated with single-agent low-dose nivolumab, achieving complete response after 2 months of therapy, and was taken up for transplant. This opens up a possible option of low-dose nivolumab for patients with R/R HL as a bridge to transplant.
Mohite et al. (Thu,) studied this question.