Early Chemotherapy Intensification With Escalated BEACOPP in Patients With Advanced-Stage Hodgkin Lymphoma With a Positive Interim Positron Emission Tomography/Computed Tomography Scan After Two ABVD Cycles: Long-Term Results of the GITIL/FIL HD 0607 Trial
Autor: | Piera Viero, Simonetta Viviani, Giorgio La Nasa, A. Romano, D. Gottardi, Andrés J.M. Ferreri, Paolo Corradini, Livio Trentin, Alberto Biggi, Federico Fallanca, Maria Cantonetti, G. Gini, Atto Billio, Agostino Chiaravalloti, Giuseppe Prosperini, Davide Rapezzi, A. Mulè, Silvia Bolis, R. Zanotti, Marco Picardi, Chiara Pavoni, Guido Parvis, Corrado Tarella, Paolo Gavarotti, Alessandro Massimo Gianni, Maurizio Miglino, Fabrizio Bergesio, Alessandro Rambaldi, S. Chauvie, Abraham Avigdor, Roberta Battistini, Andrea Gallamini, Michele Gregianin, Andrea Rossi, Corrado Schiavotto, Umberto Ficola, Michele Cimminiello, C. Patti |
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Přispěvatelé: | Gallamini, Andrea, Tarella, Corrado, Viviani, Simonetta, Rossi, Andrea, Patti, Caterina, Mule, Antonino, Picardi, Marco, Romano, Alessandra, Cantonetti, Maria, Nasa, Giorgio La, Trentin, Livio, Bolis, Silvia, Rapezzi, Davide, Battistini, Roberta, Gottardi, Daniela, Gavarotti, Paolo, Corradini, Paolo, Cimminiello, Michele, Schiavotto, Corrado, Parvis, Guido, Zanotti, Roberta, Gini, Guido, Ferreri, Andres J. M., Viero, Piera, Miglino, Maurizio, Billio, Atto, Avigdor, Abraham, Biggi, Alberto, Fallanca, Federico, Ficola, Umberto, Gregianin, Michele, Chiaravalloti, Agostino, Prosperini, Giuseppe, Bergesio, Fabrizio, Chauvie, Stephane, Pavoni, Chiara, Gianni, Alessandro Massimo, Rambaldi, Alessandro |
Jazyk: | angličtina |
Rok vydání: | 2018 |
Předmět: |
0301 basic medicine
BEACOPP Male Cancer Research medicine.medical_treatment Procarbazine 0302 clinical medicine Positron Emission Tomography Computed Tomography Antineoplastic Combined Chemotherapy Protocols Prospective Studies Adolescent Adult Bleomycin Cyclophosphamide Dacarbazine Doxorubicin Etoposide Feasibility Studies Female Hodgkin Disease Humans Lymph Nodes Lymphatic Metastasis Middle Aged Prednisone Radiotherapy Rituximab Survival Analysis Vinblastine Vincristine Young Adult Hepatobiliary disease Oncology 030220 oncology & carcinogenesis Radiology medicine.drug medicine.medical_specialty 03 medical and health sciences medicine Progression-free survival business.industry Settore MED/15 Interim FDG-PET 030104 developmental biology ABVD business Hodgkin lymphoma |
Popis: | Purpose To investigate the progression-free survival (PFS) of patients with advanced Hodgkin lymphoma (HL) after a risk-adapted treatment strategy that was based on a positive positron emission tomography scan performed after two doxorubicin, vinblastine, vincristine, and dacarbazine (ABVD) cycles (PET2). Patients and Methods Patients with advanced-stage (IIB to IVB) HL were consecutively enrolled. After two ABVD cycles, PET2 was performed and centrally reviewed according to the Deauville five-point scale. Patients with a positive PET2 were randomly assigned to four cycles of escalated bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone (BEACOPP) followed by four cycles of standard BEACOPP with or without rituximab. Patients with a negative PET2 continued ABVD, and those with a large nodal mass at diagnosis (≥ 5 cm) in complete remission with a negative PET at the end of chemotherapy were randomly assigned to radiotherapy or no further treatment. The primary end point was 3-year PFS. Results Of 782 enrolled patients, 150 (19%) had a positive and 630 (81%) a negative PET2. The 3-year PFS of all patients was 82%. The 3-year PFS of those with a positive and negative PET2 was 60% and 87%, respectively ( P < .001). The 3-year PFS of patients with a positive PET2 assigned to BEACOPP with or without rituximab was 63% versus 57% ( P = .53). In 296 patients with both interim and post-ABVD–negative PET who had a large nodal mass at diagnosis, radiotherapy was randomly added after chemotherapy without a significant PFS improvement (97% v 93%, respectively; P = .29). The 3-year overall survival of all 782 patients was 97% (99% and 89% for PET2 negative and positive, respectively). Conclusion The PET-driven switch from ABVD to escalated BEACOPP is feasible and effective in high-risk patients with advanced-stage HL. |
Databáze: | OpenAIRE |
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