TY - JOUR
T1 - CALGB 50604
T2 - Risk-adapted treatment of nonbulky early-stage Hodgkin lymphoma based on interim PET
AU - Straus, David J.
AU - Jung, Sin Ho
AU - Pitcher, Brandelyn
AU - Kostakoglu, Lale
AU - Grecula, John C.
AU - Hsi, Eric D.
AU - Schöder, Heiko
AU - Popplewell, Leslie L.
AU - Chang, Julie E.
AU - Moskowitz, Craig H.
AU - Wagner-Johnston, Nina
AU - Leonard, John P.
AU - Friedberg, Jonathan W.
AU - Kahl, Brad S.
AU - Cheson, Bruce D.
AU - Bartlett, Nancy L.
N1 - Publisher Copyright:
© 2018 by The American Society of Hematology.
PY - 2018/9/6
Y1 - 2018/9/6
N2 - A negative interim positron emission tomography/computerized tomography (PET/CT) after 1 to 3 cycles of doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) in patients with newly diagnosed, nonbulky stage I or II Hodgkin lymphoma (HL) predicts a low relapse rate. This phase 2 trial was designed to determine if a population of patients with early-stage disease can be treated with short-course ABVD without radiation therapy (RT) on the basis of a negative interim PET/CT, thereby limiting the risks of treatment. Between 15 May 2010 and 21 February 2013, 164 previously untreated patients with nonbulky stage I/II HL were enrolled, and 149 were included in the final analysis. Patients received 2 cycles of ABVD followed by PET. Deauville scores 1 to 3 were negative (£ liver uptake) based on central review. PET2 patients received 2 more cycles of ABVD, and PET1 patients received 2 cycles of dose-intense bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone (escalated BEACOPP) plus 3060-cGy involved-field RT. The primary objective was to determine 3-year progression-free survival (PFS) for the PET2 group. One hundred thirty-five patients (91%) were interim PET2, and 14 patients (9%) were PET1. With median follow-up time of 3.8 years, the estimated 3-year PFS was 91% for the PET2 group and 66% for the PET1 group (hazard ratio, 3.84; 95% confidence interval, 1.50-9.84; P 5 .011). There was 1 death as a result of suicide. Four cycles of ABVD resulted in durable remissions for a majority of patients with early-stage nonbulky HL and a negative interim PET.
AB - A negative interim positron emission tomography/computerized tomography (PET/CT) after 1 to 3 cycles of doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) in patients with newly diagnosed, nonbulky stage I or II Hodgkin lymphoma (HL) predicts a low relapse rate. This phase 2 trial was designed to determine if a population of patients with early-stage disease can be treated with short-course ABVD without radiation therapy (RT) on the basis of a negative interim PET/CT, thereby limiting the risks of treatment. Between 15 May 2010 and 21 February 2013, 164 previously untreated patients with nonbulky stage I/II HL were enrolled, and 149 were included in the final analysis. Patients received 2 cycles of ABVD followed by PET. Deauville scores 1 to 3 were negative (£ liver uptake) based on central review. PET2 patients received 2 more cycles of ABVD, and PET1 patients received 2 cycles of dose-intense bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone (escalated BEACOPP) plus 3060-cGy involved-field RT. The primary objective was to determine 3-year progression-free survival (PFS) for the PET2 group. One hundred thirty-five patients (91%) were interim PET2, and 14 patients (9%) were PET1. With median follow-up time of 3.8 years, the estimated 3-year PFS was 91% for the PET2 group and 66% for the PET1 group (hazard ratio, 3.84; 95% confidence interval, 1.50-9.84; P 5 .011). There was 1 death as a result of suicide. Four cycles of ABVD resulted in durable remissions for a majority of patients with early-stage nonbulky HL and a negative interim PET.
UR - http://www.scopus.com/inward/record.url?scp=85052873587&partnerID=8YFLogxK
U2 - 10.1182/blood-2018-01-827246
DO - 10.1182/blood-2018-01-827246
M3 - Article
C2 - 30049811
AN - SCOPUS:85052873587
SN - 0006-4971
VL - 132
SP - 1013
EP - 1021
JO - Blood
JF - Blood
IS - 10
ER -