Immunotherapy treatment for lymphoma in Germany
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Immunotherapy is one of the most effective treatment options for lymphoma. It is used in combination with chemotherapy and has also become a life-saving treatment for many patients whose tumor has recurred and chemotherapy is no longer working. Some types of immunotherapy are so effective that they can even cure aggressive end-stage lymphomas.
Content
- Types of immunotherapy treatment for lymphoma
- How is immunotherapy different from other treatments?
- When can immunotherapy be prescribed for lymphoma treatment?
- How is immunotherapy treatment for lymphoma performed?
- Benefits of immunotherapy treatment for lymphoma
Types of immunotherapy treatment for lymphoma
All lymphomas are divided into the following two types: Hodgkin's lymphoma and non-Hodgkin's lymphoma.
Options for immunotherapy for Hodgkin's lymphoma include:
- Monoclonal antibodies
- Antibody-drug conjugates
- Immune checkpoint inhibitors (ICIs)
In addition to the groups of drugs listed above, immunotherapy for non-Hodgkin's lymphoma also includes immunomodulators and CAR T-cell therapy, which helps to cope even with advanced stages of the disease when other treatments fail.
How is immunotherapy different from other treatments?
The main difference with immunotherapy treatment for lymphoma is that it works by enhancing the activity of the patient's own immune system. Although there may be an additional cytotoxic effect, the immune mechanism is the main one.
For example, monoclonal antibodies can be used not only for immunotherapy but also for targeted therapy. However, in cases of immunotherapy for lymphoma, antibodies are not used as cytotoxic agents but as "targets" for a subsequent immune attack on cancer cells.
When can immunotherapy be prescribed for lymphoma treatment?
Different types of immunotherapy and different medications have their own indications for use.
Brentuximab vedotin is an antibody-drug conjugate that targets the CD30 molecule, which delivers chemotherapy drugs to cancer cells. It may be used alone or in combination with chemotherapy for Hodgkin's lymphoma in the following situations:
- As a first-line therapy for high-risk children over 2 years of age
- As a first-line therapy at stages III-IV in adults
- In cases of relapse after primary treatment, including after a stem cell transplant
- As prevention of relapse in adults, for one year after stem cell transplant (only in high-risk groups)
This drug is also used as first-line therapy or for relapsed T-cell non-Hodgkin's lymphomas.
Rituximab is a "naked" antibody targeting CD20 molecules. For most types of lymphomas, including lymphogranulomatosis, it is used as one of the main drugs, combined with chemotherapy or radiation therapy.
Other anti-CD20 antibodies can also be used for non-Hodgkin's lymphomas. They are mainly used in addition to chemotherapy or in the absence of response to first-line treatment for chronic lymphocytic leukemia and follicular lymphoma. These drugs include the "naked" antibodies obinutuzumab and ofatumumab, as well as the antibody-drug conjugate ibritumomab tiuxetan.
The following bispecific antibodies that interact with T-cells (CD3 or CD20 antibodies) can also be used for non-Hodgkin's lymphomas:
- Mosunetuzumab can be used for relapsed follicular lymphoma as a third-line therapy
- Epcoritamab can be used for aggressive large B-cell lymphomas if other treatments fail
- Glofitamab can be used for large B-cell lymphomas, including those developed from follicular lymphoma, if other treatment options do not work
Tafasitamab is an anti-CD19 antibody. This is used together with immunomodulators for diffuse large B-cell lymphoma if it has relapsed and a bone marrow transplant is contraindicated.
Loncastuximab tesirine, an antibody-drug conjugate that also targets CD19, is used as third- or later-line therapy for large B-cell lymphomas.
Alemtuzumab is an anti-CD52 antibody used for T-cell lymphomas.
Polatuzumab vedotin is an anti-CD79b antibody and a drug used in combination with rituximab and cytotoxic drugs for diffuse large B-cell lymphoma.
ICIs for Hodgkin's lymphoma may be used for refractory (which cannot be treated with other methods) or recurrent tumors. They are used much less frequently for non-Hodgkin's lymphomas. The main indication is primary mediastinal (thymic) large B-cell lymphoma when other treatments are ineffective.
Thalidomide and lenalidomide are immunomodulators that are used in combination with monoclonal antibodies to treat different types of non-Hodgkin's lymphoma when other treatments fail.
Innovative and extremely effective CAR T-cell therapy can also be used for non-Hodgkin's lymphoma treatment. Doctors in developed countries already use four drugs. They use Yescarta, Kymriah, and Breyanzi for aggressive, relapsing, and aggressive B-cell lymphomas that do not respond to standard therapy. The specialists also use Tecartus for recurrent and unresponsive mantle cell lymphoma.
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How is immunotherapy treatment for lymphoma performed?
In most cases, immunotherapy is a drug therapy option. The procedure is, therefore, an intravenous infusion of a drug that lasts several hours. Some immunotherapy drugs may be injected subcutaneously. The frequency of infusions varies greatly between drugs, with most being administered at intervals of 1 to 3 weeks.
The exception is CAR T-cell therapy. This immunotherapy option requires collecting the patient's immune cells.
First, leukapheresis is performed. While the patient is lying down, the machine selects T-cells from their blood, and this procedure lasts about 3 hours. It may lower calcium levels in the blood, in which case calcium supplements are additionally administered intravenously.
Then comes the laboratory stage, at which doctors modify the immune cells. This stage takes a lot of time, so the procedure for their injection will take place only after 1-2 months. Even earlier, the patient can begin preparatory chemotherapy. It is not a mandatory step.
3 days before the injection of modified cells, lymphodepletion is performed. The patient is given drugs that reduce the number of other immune cells in the blood so that the modified cells have less competition and are more likely to become activated.
Finally, an intravenous infusion of genetically modified immune cells is made. It takes from 10 to 30 minutes. The person is then monitored in the hospital for 1-2 weeks, as they may require symptomatic treatment if side effects develop.
Even in advanced stages of lymphoma, the response rate to treatment reaches 80-90%, and the chance of curing the disease is about 50%.
Benefits of immunotherapy treatment for lymphoma
The benefits of lymphoma immunotherapy are its high efficiency. It can be combined with any other treatment and also often works in situations where classical cytostatic chemotherapy cannot help. And what is more, most immunotherapy methods are much better tolerated than chemotherapy.
Finally, immunotherapy drugs are more convenient for patients, especially those undergoing their treatment abroad. Most types of immunotherapy involve infusions or even subcutaneous injections every few weeks.
Below are the efficiency rates of immunotherapy and other treatments:
| Lymphoma stage | Immunotherapy | Chemotherapy | Targeted therapy | Radiation therapy |
| Localized | 97% | 70-90% | – | 90% |
| Locally advanced | 80% | 60-80% | 40% | – |
| Metastatic | 70% | 50-60% | 20% | – |
You are welcome to use the Booking Health website to undergo immunotherapy in Germany. On our website, you can select a clinic and make an appointment for your treatment. German medical centers offer the latest treatments and drugs that will help cope with even aggressive, advanced, refractory, or recurrent tumors.
You can check prices on the Booking Health website. Our company's employees will help you choose the most suitable hospital with high success rates for lymphoma immunotherapy. When you make an appointment for your treatment through our service, the cost of medical services will be lower due to the absence of additional fees for foreign patients. Our specialists will organize your trip in Germany and provide assistance and support during your stay abroad.
Choose treatment abroad and you will for sure get the best results!
Authors:
The article was edited by medical experts, board certified doctors Dr. Nadezhda Ivanisova and Dr. Vadim Zhiliuk. For the treatment of the conditions referred to in the article, you must consult a doctor; the information in the article is not intended for self-medication!
Our editorial policy, which details our commitment to accuracy and transparency, is available here. Click this link to review our policies.
Sources:
Read:
Cancer immunotherapy in Germany
New Effective Treatments for Stage 4 Cancer (oncology)
The latest oncological advances in the treatment of lymphoma at German hospitals
Adaptive Cell Therapy: CAR T-Cell Therapy