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Immune checkpoint blockade in malignant lymphomas

Objective The objective of this study was to identify the emerging role of immune checkpoint inhibitors in lymphomas. Materials and methods Medline databases (Google Scholar, PubMed, http://www.ekb.eg) and all materials available on the Internet from 2008 till 2015. The initial search presented 10 articles of which seven have met the inclusion criteria. These articles studied the emerging role of immune checkpoint inhibitors in lymphoma. Studies that did not fulfill were excluded. Study quality assessment included whether ethical approval was gained, eligibility criteria specified, appropriate controls, adequate information, and defined assessment measures have been undertaken. Comparisons were made by a structured review with the results tabulated. Results Antibodies blocking immune checkpoints (programmed death 1 ligand, programmed death 1, and cytotoxic T-lymphocyte-associated protein 4) have shown promising results in relapsed/refractory lymphoma. Formal approval of these drugs is being awaited, and the results of combination therapy of checkpoint inhibitors with other treatment modalities, including chemotherapy, small-molecule inhibitors, and other immune therapies. Conclusion Immune therapy with checkpoint inhibitors shows promising results against relapsed/refractory Hodgkin's lymphoma (HL) and non-HL. The efficacy of checkpoint inhibitors against HL is questionable compared with that against non-HL and other solid tumors. Despite these treatment modalities are effective in relapsed/refractory lymphoma, caution is needed due to serious immune-related adverse effects. Results from currently ongoing studies are awaited and will hopefully provide us with better understanding of treatment efficacy as well as increased information about biomarkers of response that will guide in patient selection.