Immunotherapy in non-Hodgkin lymphoma

The concept of co-opting an immune response to treat cancer has existed for centuries. Modern advances in our understanding of how the immune system is regulated, how a tumor evolves to evade an immune response, and how the immune system can be manipulated, both pharmacologically as well as genetically, have moved this concept from an ideal to reality, sparking a revolution in cancer therapeutics and the field of immuno-oncology. This review will focus both on cellular therapeutics, and specifically chimeric antigen receptor (CAR) T-cells, as well as immune checkpoint inhibition, in non-Hodgkin lymphoma (NHL). The former has had remarkable efficacy in a large number of patients, whereas the benefit of the latter has been restricted to specific histologies. As we learn more about the tumor microenvironment for each of the NHL histologies, mechanisms of resistance, and predictors of response, we will undoubtedly identify new combinations, or new ways to manipulate the immune system, to improve outcomes in these diseases.