The study also showed that the 5-year failure-free survival was 85% for patients on ABVD versus 79% for those on Stanford V (HR=0.68; 95% CI: 0.37-1.25; P=0.22). The 5-year overall survival for ABVD was 96% compared with 92% for Stanford V (HR=0.49; 95% CI: 0.16-1.47; P=0.19). The findings suggest that there is no significant difference between the two treatment arms.1
In regard to safety, the incidence of grade 3 to 4 neutropenia was similar between ABVD and Stanford V arms. Researchers observed a higher incidence of grade 3 lymphopenia (83% vs. 46%; P<0.001) and grade 3 to 4 sensory neuropathy (7% vs. 1%) in the Stanford V arm compared with the ABVD arm.1
Current clinical practice guidelines by the National Comprehensive Cancer Network (NCCN) already recommend ABVD for four cycles or the Stanford V regimen for 12 weeks for the treatment of patients with stage 1 and stage 2 unfavorable (bulky mediastinal disease or larger than 10 cm adenopathy with or without B symptoms) Hodgkin lymphoma.
Selected patients younger than 60 may also receive escalated bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone (BEACOPP) for 2 cycles plus ABVD for two cycles with involved site radiation therapy (ISRT).3
The use of ABVD in this patient population is a category 1 recommendation, while the Stanford V is a category 2A recommendation.3
However, the authors of this study conclude that “both regimens are acceptable treatment options for these patients” with bulky mediastinal disease.1
- Advani RH, Hong F, Fisher RI, et al. Randomized phase III trial comparing ABVD plus radiotherapy with the Stanford V regimen in patients with stages 1 or II locally extensive, bulky mediastinal Hodgkin lymphoma: a subset analysis of the North American Intergroup E2496 trial. J Clin Oncol. April 20, 2015. [Epub ahead of print]. pii: pii: JCO.2014.57.8138.
- What are the key statistics about Hodgkin lymphoma? American Cancer Society. Available at: http://www.cancer.org/cancer/hodgkindisease/detailedguide/hodgkin-disease-key-statistics. Updated March 4, 2015. Accessed April 22, 2015.
- NCCN Clinical Practice Guidelines in Oncology. Hodgkin Lymphoma. V2.2015. Available at: http://www.nccn.org/professionals/physician_gls/pdf/hodgkins.pdf. Accessed April 22, 2015.