Early Chemotherapy Intensification With Escalated BEACOPP in Patients With Advanced-Stage Hodgkin Lymphoma With a Positive Interim Positron Emission Tomography/Computed Tomography Scan After Two ABVD Cycles: Long-Term Results of the GITIL/FIL HD 0607 Trial

被引：159

作者：

Gallamini, Andrea ^{[2
]}

Tarella, Corrado ^{[3
]}

Viviani, Simonetta ^{[6
]}

Rossi, Andrea ^{[1
]}

Patti, Caterina ^{[10
]}

Mule, Antonino ^{[10
]}

Picardi, Marco ^{[12
]}

Romano, Alessandra ^{[13
]}

Cantonetti, Maria ^{[14
]}

La Nasa, Giorgio ^{[17
]}

Trentin, Livio ^{[18
]}

Bolis, Silvia ^{[19
]}

Rapezzi, Davide ^{[20
]}

Battistini, Roberta ^{[15
]}

Gottardi, Daniela ^{[4
]}

Gavarotti, Paolo ^{[5
]}

Corradini, Paolo ^{[6
,7
]}

Cimminiello, Michele ^{[21
]}

Schiavotto, Corrado ^{[22
]}

Parvis, Guido ^{[23
]}

Zanotti, Roberta ^{[24
]}

Gini, Guido ^{[25
]}

Ferreri, Andres J. M. ^{[8
]}

Viero, Piera ^{[26
]}

Miglino, Maurizio ^{[27
]}

Billio, Atto ^{[28
]}

Avigdor, Abraham ^{[30
]}

Biggi, Alberto ^{[20
]}

Fallanca, Federico ^{[8
]}

Ficola, Umberto ^{[11
]}

Gregianin, Michele ^{[29
]}

Chiaravalloti, Agostino ^{[16
]}

Prosperini, Giuseppe ^{[9
]}

Bergesio, Fabrizio ^{[20
]}

Chauvie, Stephane ^{[20
]}

Pavoni, Chiara ^{[1
]}

Gianni, Alessandro Massimo ^{[7
]}

Rambaldi, Alessandro ^{[1
,7
]}

机构：

[1] Azienda Socio Sanit Terr Papa Giovanni XXIII, Piazza OMS 1, I-24027 Bergamo, Italy

[2] Ctr Antoine Lacassagne, Nice, France

[3] Ist Europeo Oncol, Turin, Italy

[4] Osped Mauriziano Umberto I Torino, Turin, Italy

[5] Azienda Osped Univ Citta Salute & Sci Torino, Turin, Italy

[6] Fdn Ist Ricovero & Cura Carattere Sci, Ist Nazl Tumori, Milan, Italy

[7] Univ Milan, Milan, Italy

[8] Osped San Raffaele, Ist Ricovero & Cura Carattere Sci, Milan, Italy

[9] Ist Ric Farmacol Mario Negri, Ist Ricovero & Cura Carattere Sci, Milan, Italy

[10] Azienda Villa Sofia Cervello, Palermo, Italy

[11] La Maddalena, Palermo, Italy

[12] Univ Federico II, Naples, Italy

[13] Osped Ferrarotto, Catania, Italy

[14] Policlin Tor Vergata, Rome, Italy

[15] Osped San Camillo, Rome, Italy

[16] Univ Tor Vergata, Rome, Italy

[17] Osped Roberto Binaghi Cagliari, Cagliari, Italy

[18] Univ Padua, Padua, Italy

[19] Osped San Gerardo, Monza, Italy

[20] Azienda Osped Santa Croce & Carle, Cuneo, Italy

[21] Osped San Carlo Borromeo Milano, Potenza, Italy

[22] Presidio Osped San Bortolo, Vicenza, Italy

[23] Azienda Osped San Luigi, Orbassano, Italy

[24] Azienda Osped Univ Integrata, Verona, Italy

[25] Nuovo Osped Torrette, Ancona, Italy

[26] Osped Angelo, Venice, Italy

[27] Azienda Osped Univ San Martino, Genoa, Italy

[28] Osped Cent Bolzano, Bolzano, Italy

[29] Osped San Giacomo Augusta, Castelfranco Veneto, Italy

[30] Chaim Sheba Med Ctr, Tel Hashomer, Israel

来源：

JOURNAL OF CLINICAL ONCOLOGY | 2018年 / 36卷 / 05期

关键词：

PROGRESSION-FREE SURVIVAL; INTERNATIONAL PROGNOSTIC SCORE; RESPONSE-ADAPTED THERAPY; RECEIVED DOSE INTENSITY; OPEN-LABEL; INTERGROUP TRIAL; CLINICAL-TRIALS; FDG-PET; DISEASE; RISK;

D O I：

10.1200/JCO.2017.75.2543

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 [肿瘤学];

摘要：

PurposeTo investigate the progression-free survival (PFS) of patients with advanced Hodgkin lymphoma (HL) after a risk-adapted treatment strategy that was based on a positive positron emission tomography scan performed after two doxorubicin, vinblastine, vincristine, and dacarbazine (ABVD) cycles (PET2).Patients and MethodsPatients with advanced-stage (IIB to IVB) HL were consecutively enrolled. After two ABVD cycles, PET2 was performed and centrally reviewed according to the Deauville five-point scale. Patients with a positive PET2 were randomly assigned to four cycles of escalated bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone (BEACOPP) followed by four cycles of standard BEACOPP with or without rituximab. Patients with a negative PET2 continued ABVD, and those with a large nodal mass at diagnosis ( 5 cm) in complete remission with a negative PET at the end of chemotherapy were randomly assigned to radiotherapy or no further treatment. The primary end point was 3-year PFS.ResultsOf 782 enrolled patients, 150 (19%) had a positive and 630 (81%) a negative PET2. The 3-year PFS of all patients was 82%. The 3-year PFS of those with a positive and negative PET2 was 60% and 87%, respectively (P < .001). The 3-year PFS of patients with a positive PET2 assigned to BEACOPP with or without rituximab was 63% versus 57% (P = .53). In 296 patients with both interim and post-ABVD-negative PET who had a large nodal mass at diagnosis, radiotherapy was randomly added after chemotherapy without a significant PFS improvement (97% v 93%, respectively; P = .29). The 3-year overall survival of all 782 patients was 97% (99% and 89% for PET2 negative and positive, respectively).ConclusionThe PET-driven switch from ABVD to escalated BEACOPP is feasible and effective in high-risk patients with advanced-stage HL.

引用

页码：454 / +

页数：12

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