The following article features coverage from the American Society of Hematology 2019 meeting. Click here to read more of Cancer Therapy Advisor‘s conference coverage.

For patients with early unfavorable Hodgkin lymphoma, disease control may be improved with a dose-intensified regimen of 2 cycles of escalated BEACOPP (bleomycin, etoposide, adriamycin, cyclophosphamide, vincristine, procarbazine, and prednisone) followed by 2 cycles of ABVD (adriamycin, bleomycin, vinblastine, and dacarbazine), according to long-term follow-up data from the German Hodgkin Study Group HD14 Trial.

The trial results were reported at the 61st American Society of Hematology (ASH) Annual Meeting and Exposition in Orlando, Florida.

The trial enrolled 1550 patients with early unfavorable Hodgkin Lymphoma between January 2003 and July 2008 who were aged 60 or younger. Patients were randomly assigned to receive either 4 cycles of ABVD or a dose-intensified regimen of 2 cycles of escalated BEACOPP followed by 2 cycles of ABVD. All patients also received 30 Gy involved-field radiotherapy (IFRT).

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At a median follow-up of 97 months, patients on dose-intensified arm had significantly fewer cancer recurrences (hazard ratio [HR], 0.0521; 95% CI, 0.386–0.704; P <.0001) and an improved 10-year progression-free survival compared with patients on the 4 cycles of ABVD arm (91.2%; 95% CI, 89.0%-93.4% vs 85.6%; 95% CI, 82.9%-88.4%).


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However, no difference in overall survival was seen between the dose-intensified arm and the 4 cycles of ABVD arm (94%; 95% CI, 92.3%-95.8% vs 94.1%; 95% CI, 92.3%-96%).

In term of toxicity, 0.1% of patients on the 4 cycles of ABVD arm and 0.6% of patients on the dose-intensified arm died from study treatment. Also, 1% of patients on the 4 cycles of ABVD arm and 0.6% of patients on the dose-intensified arm died from the toxicity of salvage therapy.

In all, 4.7% of patients on the 4 cycles of ABVD arm and 6.4% of patients on the dose-intensified arm had a second malignancy (P =.86), and these incidence rates were higher than in the general German population.

The dose-intensified regimen “spares a significant number of patients from the burden of cancer recurrence and additional treatment without increased long-term toxicity,” the study authors asserted. They concluded that the dose-intensified regimen remains the German Hodgkin Study Group standard for patients with early unfavorable Hodgkin lymphoma who are aged 60 or younger.

Read more of Cancer Therapy Advisor‘s coverage of ASH’s annual meeting by visiting the conference page.

Reference

  1. Gillessen S, Plütschow A, Fuchs M, et al. Dose-intensification in early unfavorable Hodgkin lymphoma: Long-term follow up of the German Hodgkin Study Group (GHSG) HD14 Trial. Presented at: 61st American Society of Hematology (ASH) Annual Meeting and Exposition; December 7-10, 2019; Orlando, FL. Abstract 129.