In patients with advanced Hodgkin lymphoma (HL), bleomycin and vincristine cause significant toxicity that leads to dose reaction or discontinuation.
According to a report from the German Hodgkin Study Group and published online first this week in the Journal of Clinical Oncology, discontinuation of HL does not impact clinical outcomes in patients with advanced HL.
The HD12 and HD15 trials assessed 3,309 patients with advanced HL, who were previously treated with BEACOPP (bleomycin, etoposide, adriamycin, cyclophosphamide, vincristine, procarbazine, and prednisone). There were 17.6% and 32.6% of the patients who discontinued bleomycin and vincristine, respectively.
Results showed that whether patients received less than or equal to four cycles or greater than four cycles of bleomycin, there was no significant difference in progression-free survival (PFS) or overall survival (OS). Five-year PFS difference was 1.7% (95% CI: −4.2, 7.6) and OS difference was 1.5% (95% CI: −2.6, 5.5).
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Moreover, there was no significant difference whether patients received less than or equal to three cycles or greater than three cycles of vincristine. Five-year PFS difference was −1.3 (95% CI: 5.6, 3.1) and 5-year OS difference was −0.1% (95% CI: −3.1, 2.9).
The findings suggest that discontinuing bleomycin and vincristine due to intolerable adverse effects does not impact its efficacy of treatment for HL.
- Haverkamp H, Boll B, Eichenauer DA, et al. Impact of bleomycin and vincristine dose reductions in patients with advanced Hodgkin lymphoma treated with BEACOPP: an analysis of the German Hodgkin Study Group HD12 and HD15 trials. J Clin Oncol. 2015. [epub ahead of print]. doi: 10.1200/JCO.2014.60.4264.