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Escalated-dose BEACOPP in the treatment of patients with advanced-stage Hodgkin's lymphoma: 10 years of follow-up of the GHSG HD9 study

Official URL:https://doi.org/10.1200/JCO.2008.19.8820
PubMed:View item in PubMed
Creators Name:Engert, A. and Diehl, V. and Franklin, J. and Lohri, A. and Doerken, B. and Ludwig, W.D. and Koch, P. and Haenel, M. and Pfreundschuh, M. and Wilhelm, M. and Truemper, L. and Aulitzky, W.E. and Bentz, M. and Rummel, M. and Sezer, O. and Mueller-Hermelink, H.K. and Hasenclever, D. and Loeffler, M.
Journal Title:Journal of Clinical Oncology
Journal Abbreviation:J Clin Oncol
Volume:27
Number:27
Page Range:4548-4554
Date:20 September 2009
Keywords:Antineoplastic Combined Chemotherapy Protocols, Bleomycin, Cyclophosphamide, Dacarbazine, Drug Dose-Response Relationship, Doxorubicin, Etoposide, Follow-Up Studies, Hodgkin Disease, Prednisone, Procarbazine, Treatment Outcome, Vinblastine, Vincristine
Abstract:PURPOSE: The HD9 trial of the German Hodgkin Study Group compared two different doses (baseline and escalated) of the bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone (BEACOPP) chemotherapy regimen in 1,196 patients with advanced-stage Hodgkin's lymphoma (HL). The previous analysis with 5 years median follow-up had indicated improved tumor control with BEACOPP escalated. Since the long-term safety and efficacy of this regimen has been debated, we report the 10-year follow-up. PATIENTS AND METHODS: Patients received one of three chemotherapy regimens: eight cycles of cyclophosphamide, vincristine, procarbazine, and prednisone (COPP) alternating with doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD); eight cycles of BEACOPP baseline; or eight cycles of BEACOPP escalated. RESULTS: Median follow-up was 111 months. At 10 years, freedom from treatment failure (FFTF) was 64%, 70%, and 82% with OS rates of 75%, 80%, and 86% for patients treated with COPP/ABVD (arm A), BEACOPP baseline (arm B), and BEACOPP escalated (arm C), respectively (P < .001). BEACOPP escalated was significantly better than BEACOPP baseline in terms of FFTF (P < .0001) and OS (P = .0053). A total of 74 second malignancies (6.2%) were documented, including acute myeloid leukemia (0.4%, 1.5%, and 3.0%), non-Hodgkin's lymphoma (2.7%, 1.7%, and 1.0%), and solid tumors (2.7%, 3.4%, and 1.9%). The corresponding overall secondary malignancy rates were 5.7%, 6.6%, and 6.0%, respectively. CONCLUSION: The 10-year follow-up of the HD9 trial demonstrates a stabilized significant improvement in long-term FFTF and OS for BEACOPP escalated in advanced-stage HL. These results challenge ABVD as standard of care for this patient population.
ISSN:0732-183X
Publisher:American Society of Clinical Oncology (U.S.A.)
Item Type:Article

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