Patient has a heavily treated history of nodular sclerosing HL refractory to several lines of treatment including Bv-AVD, ICE, Bv-nivolumab, GND, allogeneic HSCT. Following relapse from allogeneic HSCT he was trialed on lenalidomide and most recently pembrolizumab. His current regimen on pembrolizumab has been discontinued due to manifesting with severe recurrent pancreatitis and arthralgias believed to be immunotherapy toxicity-related. Are there any other options to treat in this patient, acknowledging he wants continued aggressive treatment given his age?
His options are very limited. What kind of disease he have now? Ie how extensive? In such patients I have tried Bendmustine, recycled BV if it has been a while since he used it and does not have bad neuropathy. Sometimes if he have limited disease that can be radiated then I radiate sporadically areas that are felt to be resistent. There are data for some response with Everolimus. One last option to try and send for CART trials, there is one in Baylor and UNC currently.
