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An article published in Blood Advances reviewed past and ongoing clinical trials of adoptive immunotherapy for patients with classic Hodgkin lymphoma (cHL). The article also examined current challenges and strategies specific to improving the development of CAR T-cell therapy for cHL in general and relapsed or refractory cHL in particular. 

The authors gathered data from eight past clinical trials and twenty-two ongoing clinical trials on adoptive immunotherapy for cHL. The data from the past trials included treatment type, clinical trial phase, whether or not lymphodepletion was performed, patient response to treatment, and common toxicities from treatment. The data from the ongoing trials included treatment type, clinical trial phase, dose/conditioning, and study objectives regarding treatment feasibility, safety, tolerability, and efficacy. 

Ultimately, the authors found that adoptive T-cell therapy with Epstein-Barr virus-specific cytotoxic T lymphocytes and CD30 CAR T cells demonstrated significant clinical responses in phase 1 and phase 2 trials of patients with cHL. Other treatments investigated and under investigation include CD19 and CD123 CAR T cells that target the immunosuppressive tumor microenvironment in cHL. 

The authors underscored how knowledge of the biology of cHL and its challenging immunosuppressive tumor microenvironment is vital for developing treatment strategies with adoptive T-cell therapy, especially for patients with relapsed or refractory disease. 

Multiple clinical trials on cHL and adoptive T-cell treatments are currently ongoing and can inform future novel treatments. A call to action is made to explore additional strategies that target supportive cells in the tumor microenvironment or precursor tumor cells. These efforts could lead to more progress in treating cHL with CAR T-cell therapy, similar to the progress that has been made in treating B-cell non-Hodgkin lymphomas with CAR T-cell therapy [1].

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[1] Ho, C., Ruella, M., Levine, B. L., & Svoboda, J. (2021). Adoptive T-cell therapy for Hodgkin lymphoma. Blood Advances, 5(20), 4291–4302. https://doi.org/10.1182/bloodadvances.2021005304

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