Doxorubicin, vinblastine, dacarbazine and lenalidomide for older Hodgkin lymphoma patients: final results of a German Hodgkin Study Group (GHSG) phase-I trial
| Autor: | Martin Vogelhuber, Boris Böll, Martin Sökler, Michael Pfreundschuh, Peter Borchmann, Michael Fuchs, Indra Thielen, Carolin Bürkle, Bastian von Tresckow, Dennis A. Eichenauer, Annette Plütschow, Michaela Feuring-Buske, Andreas Engert, Johannes Atta |
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| Rok vydání: | 2018 |
| Předmět: |
Oncology
Male medicine.medical_specialty Dacarbazine Bleomycin Vinblastine 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Interquartile range Internal medicine Antineoplastic Combined Chemotherapy Protocols medicine Humans Doxorubicin Lenalidomide Aged Neoplasm Staging Geriatrics business.industry Age Factors Hematology Middle Aged Prognosis Hodgkin Disease Treatment Outcome ABVD chemistry 030220 oncology & carcinogenesis Female business 030215 immunology medicine.drug |
| Zdroj: | British journal of haematology. 185(1) |
| ISSN: | 1365-2141 |
| Popis: | About 30% of all Hodgkin lymphoma (HL) patients are ≥60 years old. As lenalidomide has promising single agent activity in multiple relapsed HL, we replaced bleomycin in ABVD with lenalidomide in this phase-I trial. Patients aged ≥60 years with early-unfavourable- or advanced-stage HL (Eastern Cooperative Oncology Group performance status ≤2, Cumulative Illness Rating Scale for Geriatrics score 0-7) received 4-8 cycles of AVD (doxorubicin, vinblastine, dacarbazine) and lenalidomide in escalation with overdose control. Dose-limiting toxicities (DLTs) included thromboembolism ≥grade 2, severe haematological toxicity, neutropenic fever and prolonged therapy delay. Twenty-five patients with a median age of 68 years were included, 68% had advanced-stage HL. A pre-defined stopping criterion for dose escalation after DLT evaluation of 20/24 patients suggested a recommended phase II dose (RPTD) of 20 mg. DLTs occurred in 10/24 evaluable patients, all treated with ≥20 mg, however, median relative dose intensity was 97% (interquartile range 49-104%). Grade 3 or higher toxicities occurred in all 22 patients at ≥20 mg lenalidomide but no treatment-related deaths occurred. Overall response rate was 80% for all patients (20/25) and 86% (19/22) at ≥20 mg lenalidomide. Three-year estimates for progression-free survival and OS were 69·7% (95% CI: 50·3-89·1%) and 83·8% (95%-CI: 69·3-98·4%), respectively. In conclusion, AVD with lenalidomide 20 mg is feasible and highly effective in older HL patients. |
| Databáze: | OpenAIRE |
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