Interim Positron Emission Tomography Response-Adapted Therapy in Advanced-Stage Hodgkin Lymphoma: Final Results of the Phase II Part of the HD0801 Study

被引：125

作者：

Zinzani, Pier Luigi ^{[1
]}

Broccoli, Alessandro ^{[1
]}

Gioia, Daniela Maria ^{[2
]}

Castagnoli, Antonio ^{[4
]}

Ciccone, Giovannino ^{[5
,6
]}

Evangelista, Andrea ^{[5
,6
]}

Santoro, Armando ^{[9
]}

Ricardi, Umberto ^{[7
]}

Bonfichi, Maurizio ^{[11
]}

Brusamolino, Ercole ^{[9
,11
]}

Rossi, Giuseppe ^{[12
]}

Anastasia, Antonella ^{[9
,12
]}

Zaja, Francesco ^{[13
]}

Vitolo, Umberto ^{[5
]}

Pavone, Vincenzo ^{[14
]}

Pulsoni, Alessandro ^{[15
]}

Rigacci, Luigi ^{[16
]}

Gaidano, Gianluca ^{[17
]}

Stelitano, Caterina ^{[19
]}

Salvi, Flavia ^{[3
]}

Rusconi, Chiara ^{[10
]}

Tani, Monica ^{[20
]}

Freilone, Roberto ^{[8
]}

Pregno, Patrizia ^{[5
]}

Borsatti, Eugenio ^{[21
]}

Sacchetti, Gian Mauro ^{[18
]}

Argnani, Lisa ^{[1
]}

Levis, Alessandro ^{[2
]}

机构：

[1] St Orsola Malpighi Univ Hosp, Inst Hematol L&A Seragnoli, Bologna, Italy

[2] Fdn Italiana Linfomi Onlus, Rome, Italy

[3] SS Antonio & Biagio Hosp, Alessandria, Italy

[4] Azienda Osped Prato, Prato, Italy

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

[6] Ctr Prevenz Oncol Piemonte, Turin, Italy

[7] Univ Turin, I-10124 Turin, Italy

[8] Stabilimento Ospitaliero Ivrea, Turin, Italy

[9] Ist Clin Humanitas, Milan, Italy

[10] Azienda Osped Niguarda Ca Granda, Milan, Italy

[11] Ist Ricovero & Cura Carattere Sci Policlin San Ma, Pavia, Italy

[12] Spedali Civil Brescia, I-25125 Brescia, Italy

[13] Santa Maria Misericordia Hosp, Udine, Italy

[14] Azienda Osped Cardinal Panico, Tricase, Italy

[15] Univ Roma La Sapienza, Piazzale Aldo Moro 5, I-00185 Rome, Italy

[16] Azienda Osped Careggi, Florence, Italy

[17] Amedeo Avogadro Univ, Turin, Italy

[18] Univ Hosp Maggiore Carita, Novara, Italy

[19] Azienda Osped Bianchi Melacrino Morelli, Reggio Di Calabria, Italy

[20] Santa Maria Croci Hosp, Ravenna, Italy

[21] Ctr Riferimento Oncol, Aviano, Italy

来源：

JOURNAL OF CLINICAL ONCOLOGY | 2016年 / 34卷 / 12期

关键词：

PROGNOSTIC SCORE; 2; CYCLES; BEACOPP; PET; REGIMEN; ABVD; CHEMOTHERAPY; STANDARD; DISEASE; SURVIVAL;

D O I：

10.1200/JCO.2015.63.0699

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 [肿瘤学];

摘要：

Purpose The clinical impact of positron emission tomography (PET) evaluation performed early during first-line therapy in patients with advanced-stage Hodgkin lymphoma, in terms of providing a rationale to shift patients who respond poorly onto a more intensive regimen (PET response-adapted therapy), remains to be confirmed. Patients and Methods The phase II part of the multicenter HD0801 study involved 519 patients with advanced-stage de novo Hodgkin lymphoma who received an initial treatment with doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) and who underwent an early ifosfamide-containing salvage treatment followed by stem-cell transplantation if they showed a positive PET evaluation after two cycles of chemotherapy (PET2). The primary end point was 2-year progression-free survival calculated for both PET2-negative patients (who completed a full six cycles of ABVD treatment) and PET2-positive patients. Overall survival was a secondary end point. Results In all, 103 of the 512 evaluable patients were PET2 positive. Among them, 81 received the scheduled salvage regimen with transplantation, 15 remained on ABVD (physician's decision, mostly because of minimally positive PET2), five received an alternative treatment, and two were excluded because of diagnostic error. On intention-to-treat analysis, the 2-year progression-free survival was 76% for PET2-positive patients (regardless of the salvage treatment they received) and 81% for PET2-negative patients. Conclusion Patients with advanced-stage Hodgkin lymphoma for whom treatment was at high risk of failing appear to benefit from early treatment intensification with autologous transplantation, as indicated by the possibility of successful salvage treatment in more than 70% of PET2-positive patients through obtaining the same 2-year progression-free survival as the PET2-negative subgroup. (C) 2016 by American Society of Clinical Oncology

引用

页码：1376 / +

页数：13

共 26 条

[1]

Two cycles of escalated BEACOPP followed by four cycles of ABVD utilizing early-interim PET/CT scan is an effective regimen for advanced high-risk Hodgkin's lymphoma [J].

Avigdor, A. ;

Bulvik, S. ;

Levi, I. ;

Dann, E. J. ;

Shemtov, N. ;

Perez-Avraham, G. ;

Shimoni, A. ;

Nagler, A. ;

Ben-Bassat, I. ;

Polliack, A. .

ANNALS OF ONCOLOGY, 2010, 21 (01) :126-132

[2]

Eight Cycles of Escalated-Dose BEACOPP Compared With Four Cycles of Escalated-Dose BEACOPP Followed by Four Cycles of Baseline-Dose BEACOPP With or Without Radiotherapy in Patients With Advanced-Stage Hodgkin's Lymphoma: Final Analysis of the HD12 Trial of the German Hodgkin Study Group [J].

Borchmann, Peter ;

Haverkamp, Heinz ;

Diehl, Volker ;

Cerny, Thomas ;

Markova, Jana ;

Ho, Anthony D. ;

Eich, Hans-Theodor ;

Mueller-Hermelink, Hans Konrad ;

Kanz, Lothar ;

Greil, Richard ;

Rank, Andreas ;

Paulus, Ursula ;

Smardova, Lenka ;

Huber, Christoph ;

Doerken, Bernd ;

Nerl, Christoph ;

Krause, Stefan W. ;

Mueller, Rolf-Peter ;

Fuchs, Michael ;

Engert, Andreas .

JOURNAL OF CLINICAL ONCOLOGY, 2011, 29 (32) :4234-4242

[3]

Revised response criteria for malignant lymphoma [J].

Cheson, Bruce D. ;

Pfistner, Beate ;

Juweid, Malik E. ;

Gascoyne, Randy D. ;

Specht, Lena ;

Horning, Sandra J. ;

Coiffier, Bertrand ;

Fisher, Richard I. ;

Hagenbeek, Anton ;

Zucca, Emanuele ;

Rosen, Steven T. ;

Stroobants, Sigrid ;

Lister, T. Andrew ;

Hoppe, Richard T. ;

Dreyling, Martin ;

Tobinai, Kensei ;

Vose, Julie M. ;

Connors, Joseph M. ;

Federico, Massimo ;

Diehl, Volker .

JOURNAL OF CLINICAL ONCOLOGY, 2007, 25 (05) :579-586

[4]

Risk-adapted BEACOPP regimen can reduce the cumulative dose of chemotherapy for standard and high-risk Hodgkin lymphoma with no impairment of outcome [J].

Dann, Eldad J. ;

Bar-Shalom, Rachel ;

Tamir, Ada ;

Haim, Nissim ;

Ben-Shachar, Menachem ;

Avivi, Irit ;

Zuckerman, Tzila ;

Kirschbaum, Mark ;

Goor, Odelia ;

Libster, Diana ;

Rowe, Jacob M. ;

Epelbaum, Ron .

BLOOD, 2007, 109 (03) :905-909

[5]

A 10-year experience with treatment of high and standard risk Hodgkin disease: Six cycles of tailored BEACOPP, with interim scintigraphy, are effective and female fertility is preserved [J].

Dann, Eldad J. ;

Blumenfeld, Zeev ;

Bar-Shalom, Rachel ;

Avivi, Irit ;

Ben-Shachar, Menachem ;

Goor, Odelia ;

Libster, Diana ;

Gaitini, Diana ;

Rowe, Jacob M. ;

Epelbaum, Ron .

AMERICAN JOURNAL OF HEMATOLOGY, 2012, 87 (01) :32-36

[6]

Escalated-Dose BEACOPP in the Treatment of Patients With Advanced-Stage Hodgkin's Lymphoma: 10 Years of Follow-Up of the GHSG HD9 Study [J].

Engert, Andreas ;

Diehl, Volker ;

Franklin, Jeremy ;

Lohri, Andreas ;

Doerken, Bernd ;

Ludwig, Wolf-Dieter ;

Koch, Peter ;

Haenel, Mathias ;

Pfreundschuh, Michael ;

Wilhelm, Martin ;

Truemper, Lorenz ;

Aulitzky, Walter-Erich ;

Bentz, Martin ;

Rummel, Mathias ;

Sezer, Orhan ;

Mueller-Hermelink, Hans-Konrad ;

Hasenclever, Dirk ;

Loeffler, Markus .

JOURNAL OF CLINICAL ONCOLOGY, 2009, 27 (27) :4548-4554

[7]

ABVD Compared With BEACOPP Compared With CEC for the Initial Treatment of Patients With Advanced Hodgkin's Lymphoma: Results From the HD2000 Gruppo Italiano per lo Studio dei Linfomi Trial [J].

Federico, Massimo ;

Luminari, Stefano ;

Iannitto, Emilio ;

Polimeno, Giuseppe ;

Marcheselli, Luigi ;

Montanini, Antonella ;

La Sala, Antonio ;

Merli, Francesco ;

Stelitano, Caterina ;

Pozzi, Samantha ;

Scalone, Renato ;

Di Renzo, Nicola ;

Musto, Pellegrino ;

Baldini, Luca ;

Cervetti, Giulia ;

Angrilli, Francesco ;

Mazza, Patrizio ;

Brugiatelli, Maura ;

Gobbi, Paolo G. .

JOURNAL OF CLINICAL ONCOLOGY, 2009, 27 (05) :805-811

[8]

Early interim 2-[18F]Fluoro-2-Deoxy-D-Glucose positron emission tomography is prognostically superior to international prognostic score in advanced-stage Hodgkin's lymphoma:: A report from a joint Italian-Danish study [J].

Gallamini, Andrea ;

Hutchings, Martin ;

Rigacci, Luigi ;

Specht, Lena ;

Merli, Francesco ;

Hansen, Mads ;

Patti, Caterina ;

Loft, Annika ;

Di Raimondo, Francesco ;

D'Amore, Francesco ;

Biggi, Alberto ;

Vitolo, Umberto ;

Stelitano, Caterina ;

Sancetta, Rosario ;

Trentin, Livio ;

Luminari, Stefano ;

Iannitto, Emilio ;

Viviani, Simonetta ;

Pierri, Ivana ;

Levis, Alessandro .

JOURNAL OF CLINICAL ONCOLOGY, 2007, 25 (24) :3746-3752

[9]

Gallamini A, 2006, HAEMATOLOGICA, V91, P475

[10]

Early chemotherapy intensification with BEACOPP in advanced-stage Hodgkin lymphoma patients with a interim-PET positive after two ABVD courses [J].

Gallamini, Andrea ;

Patti, Caterina ;

Viviani, Simonetta ;

Rossi, Andrea ;

Fiore, Francesca ;

Di Raimondo, Francesco ;

Cantonetti, Maria ;

Stelitano, Caterina ;

Feldman, Tatyana ;

Gavarotti, Paolo ;

Sorasio, Roberto ;

Mule, Antonino ;

Leone, Monica ;

Rambaldi, Alessandro ;

Biggi, Alberto ;

Barrington, Sally ;

Fallanca, Federico ;

Ficola, Umberto ;

Chauvie, Stephane ;

Gianni, Alessandro Massimo .

BRITISH JOURNAL OF HAEMATOLOGY, 2011, 152 (05) :551-560

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