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HENRY KAPLAN MEMORIAL LECTURE: “IMMUNOTHERAPY COMES OF AGE TO TREAT LYMPHOMAS”

Introduction: The advent of Monoclonal Antibodies, first made by the method of Kohler and Milstein, ushered in a new era of treatment for cancer. Originally, the targets for antibodies were on the tumor. More recently, additional targets on the host immune system “Checkpoints” have enter our therapeutic tool kit. Methods: The first target was the idiotype of the B cell tumor surface immunoglobulin. This required a new antibody custom‐made product for each patient. Later, an antibody against the CD20 molecule, originally described by Nadler and Scholssman, was substituted because it was a single product for all patients, even though it is present on all normal mature B cells as well as lymphoma cells. Results: Rituximab and a number of new versions of antibodies against CD20 are included in the standard of care for patients with B cell lymphoma. New targets are emerging and new forms of monoclonal antibodies that bind to two different targets or that carry drugs are in widespread testing. A special version of an engineered T cell that carries a receptor incorporating the recognition unit of an antibody against CD19 (CAR‐T cells) is the latest and most exciting of these engineered therapies. But, once again this is a patient‐specific, customized therapy. Antibodies against the host immune system (i.e. PD1) are rapidly changing the field of cancer treatment and especially of Hodgkin's Disease, where durable response rates in excess of 80% have been observed, even in relapsed/refractory patients. Conclusions: Immunotherapy is now one of the mainstays of treatment for lymphoma. The field is moving rapidly and we can anticipate even newer versions of immune system therapies and combinations with existing targeted and cytotoxic therapies in the future.