Classical Hodgkin Lymphoma:
Facing Cancer in Young Adulthood

A Point of View by Dr. Arun Balakumaran, Executive Director, Merck

Under a microscope, classical Hodgkin lymphoma looks like any other cancer: cells out of control, crowding out healthy cells. But when we first diagnose classical Hodgkin lymphoma in patients, something is different than with many other cancers: the patients are frequently young, with a median age of 39. For those patients, cancer is an even more unexpected part of their lives.

For young people, their first reaction to the diagnosis can be an immediate willingness to throw everything they have at the disease, knowing that the odds are with them. And, the good news for many patients is that chemotherapy can offer a cure.

The difficult part of the story is that cures are not a given. For 10 to 20 percent of patients, the cancer comes back, and treatment options shrink. Some patients may see success with a stem-cell transplant. But, where that isn’t an option or it doesn’t work and treatments fail to lead to a cure (what physicians call refractory disease), we, as oncologists and hematologists, have a difficult task. We must face a young person – perhaps a recent college graduate starting a family and career, or a parent with young children, and explain that there are limited options left to them.

But, research has shown that certain cancers, including classical Hodgkin lymphoma, have a weak spot: to evade the body’s immune system, these cancers express specific proteins that mask the cancer. Inhibiting those proteins with a new therapeutic approach called immuno-oncology can give the body a chance to fight back. The medical community is now learning about how an immuno-oncology approach can work in this cancer. This knowledge has provided the platform for attacking the cancer in patients who have few options, and Merck is rigorously testing this approach.

Providing patients with another chance to help beat cancer is gratifying. At Merck, our goal is to continue the tradition of progress in classical Hodgkin lymphoma, giving all people battling this cancer yet another opportunity to put up a fight.