Details

Autor(en) / Beteiligte

• Stephens, Deborah M.
• Li, Hongli
• Schöder, Heiko
• Straus, David J.
• Moskowitz, Craig H.
• LeBlanc, Michael
• Rimsza, Lisa M.
• Bartlett, Nancy L.
• Evens, Andrew M.
• LaCasce, Ann S.
• Barr, Paul M.
• Knopp, Michael V.
• Hsi, Eric D.
• Leonard, John P.
• Kahl, Brad S.
• Smith, Sonali M.
• Friedberg, Jonathan W.

Titel

Five-year follow-up of SWOG S0816: limitations and values of a PET-adapted approach with stage III/IV Hodgkin lymphoma

Ist Teil von

• Blood, 2019-10, Vol.134 (15), p.1238-1246

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2019

Link zum Volltext

Quelle

Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals

Beschreibungen/Notizen

• Patients with advanced-stage Hodgkin lymphoma (HL) demonstrated excellent 2-year progression-free survival (PFS) after receiving positron emission tomography (PET)–adapted therapy on SWOG S0816. Patients received 2 cycles of doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD). Patients achieving complete response (CR) on PET scan following cycle 2 of ABVD (PET2) continued 4 additional cycles of ABVD. Patients not achieving CR on PET2 were switched to escalated bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone (eBEACOPP) for 6 cycles. After a median follow-up of 5.9 years, a subset of 331 eligible patients with central review of PET2 was analyzed. PET2 was negative in 82% and positive in 18%. For all patients, the estimated 5-year PFS and OS was 74% (95% confidence interval [CI], 69%-79%) and 94% (95% CI, 91%-96%), respectively. For PET2− and PET2+ patients, the 5-year PFS was 76% (95% CI, 70%-81%) and 66% (95% CI, 52%-76%), respectively. Seven (14%) and 6 (2%) patients reported second cancers after treatment with eBEACOPP and ABVD, respectively (P = .001). Long-term OS of HL patients treated on S0816 remains high. Nearly 25% of PET2− patients experienced relapse events, demonstrating limitations ABVD therapy and of the negative predictive value of PET2. In PET2+ patients who received eBEACOPP, PFS was favorable, but was associated with a high rate of second malignancies compared with historical controls. Our results emphasize the importance of long-term follow-up, and the need for more efficacious and less toxic therapeutic approaches for advanced-stage HL patients. This trial was registered at www.clinicaltrials.gov as #NCT00822120. •Nearly 25% of PET2− patients relapsed, demonstrating limitations of frontline ABVD and low negative predictive value of PET2.•In patients with a positive PET2 who received eBEACOPP, PFS was favorable, but was associated with a high rate of second cancers. [Display omitted]