BEACOPP, a new dose-escalated and accelerated regimen, is at least as effective as COPP/ABVD in patients with advanced-stage Hodgkin's lymphoma: Interim report from a trial of the German Hodgkin's Lymphoma Study Group

被引：143

作者：

Diehl, V ^{[1
]}

Franklin, J ^{[1
]}

Hasenclever, D ^{[1
]}

Tesch, H ^{[1
]}

Pfreundschuh, M ^{[1
]}

Lathan, B ^{[1
]}

Paulus, U ^{[1
]}

Sieber, M ^{[1
]}

Rueffer, JU ^{[1
]}

Sextro, M ^{[1
]}

Engert, A ^{[1
]}

Wolf, J ^{[1
]}

Hermann, R ^{[1
]}

Holmer, L ^{[1
]}

Stappert-Jahn, U ^{[1
]}

Winnerlein-Trump, E ^{[1
]}

Wulf, G ^{[1
]}

Krause, S ^{[1
]}

Glunz, A ^{[1
]}

von Kalle, K ^{[1
]}

Bischoff, H ^{[1
]}

Haedicke, C ^{[1
]}

Duehmke, E ^{[1
]}

Georgii, A ^{[1
]}

Loeffler, M ^{[1
]}

机构：

[1] Univ Cologne, Dept Internal Med, Cologne, Germany

来源：

JOURNAL OF CLINICAL ONCOLOGY | 1998年 / 16卷 / 12期

关键词：

D O I：

10.1200/JCO.1998.16.12.3810

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Purpose: The HD9 trial aims to evaluate whether moderate dose escalation and/or acceleration of standard polychemotherapy is beneficial for advanced-stage Hodgkin's disease (HD). Two variants of a novel bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone (BEACOPP) scheme (standard and escalated dose) are compared with cyclophosphamide, vincristine, procarbazine, and prednisone (COPP)/doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD). Patients and Methods: The randomized,three-arm trial recruited patients in stages IIB and IIIA with risk factors and stages IIIB and IV. BEACOPP in baseline dose contains all drug dosages of COPP/ABVD (except vincristine and procarbazine) rearranged in a shorter, 3-week cycle. Escalated BEACOPP uses higher doses of cyclophosphamide, doxorubicin, and etoposide with granulocyte colony-stimulating factor (G-CSF) support. After eight chemotherapy cycles, initial bulky and residual disease is irradiated. The trial is monitored and analyzed by means of a sequential strategy. Results: An interim analysis with 505 assessable patients and a median follow-up of 23 months showed a significant inferiority (according to sequential monitoring strategy) of the COPP/ABVD regimen in progression rate and freedom from treatment failure (FFTF) compared with the pooled results of both BEACOPP variants. The 24-month FFTF rate was 75% for COPP/ABVD and 84% for BEACOPP pooled (P = .034). There was 12% progressive disease with COPP/ABVD and 6% with BEACOPP pooled. Differences in survival were not significant in sequential analysis. The acute toxicity of baseline BEACOPP resembled that of COPP/ABVD; escalated BEACOPP showed increased but manageable hematologic toxicity. Conclusion: Combined with local irradiation, BEACOPP in one or both variants shows superior disease control compared with COPP/ABVD, with acceptable acute toxicity. Further follow-up is required to assess the effect of dosage and the effect on survival and late toxicities. (C) 1998 by American Society of Clinical Oncology.

引用

页码：3810 / 3821

页数：12

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