Incorporating novel therapies into the treatment of older patients with classic Hodgkin lymphoma

IntroductionOutcomes of older patients with classic Hodgkin lymphoma (cHL) are inferior to those of younger patients secondary to their distinct clinical presentation, unique disease biology, increased burden of medical comorbidity, and poorer tolerance to conventional therapies. Greater attention to the objective parameters underlying patient fitness has led to the recognition of comprehensive geriatric assessments (CGA) as an important method to optimize selection for appropriate therapy intensity. Given the magnified risk associated with traditional chemotherapy in older patients with cHL, the incorporation of the novel agents brentuximab vedotin (BV) and immune checkpoint inhibitors (ICIs) into modern treatment paradigms offers promise for improved outcomes in this population.Areas coveredWe describe historical outcomes in older patients with cHL, the underpinnings of traditional treatment strategies, the evolving therapeutic landscape via integration of novel therapies into the frontline and relapsed/refractory settings, and the importance of contextualizing therapy selection via formal CGAs.Expert opinionNovel therapies have broadened the array of therapeutic options for older patients with cHL eligible for either curative or palliative intent therapy. Further investigation into rational combinations of these drugs, together with ongoing efforts to validate cHL-specific CGAs, aim to improve outcomes for older patients across the spectrum of fitness.