Format

Send to

Choose Destination
Blood. 2019 Oct 10;134(15):1238-1246. doi: 10.1182/blood.2019000719.

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

Author information

1
Division of Hematology and Hematologic Malignancies, University of Utah, Salt Lake City, UT.
2
SWOG Statistical Center, Seattle, WA.
3
Memorial Sloan Kettering Cancer Center, New York, NY.
4
Mayo Clinic, Scottsdale, AZ.
5
Oncology Division, Washington University in St. Louis, St. Louis, MO.
6
Rutgers Cancer Institute of New Jersey, New Brunswick, NJ.
7
Dana-Farber Cancer Institute, Boston, MA.
8
Division of Hematology/Oncology, University of Rochester, Rochester NY.
9
Division of Hematology, The Ohio State University, Columbus, OH.
10
Cleveland Clinic, Cleveland, OH.
11
Weill Cornell Medical Center, New York, NY; and.
12
Section of Hematology/Oncology, University of Chicago, Chicago, IL.

Abstract

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.

PMID:
31331918
PMCID:
PMC6788007
[Available on 2020-10-10]
DOI:
10.1182/blood.2019000719

Supplemental Content

Full text links

Icon for Silverchair Information Systems
Loading ...
Support Center