ETOPOSIDE, VINBLASTINE, AND DOXORUBICIN - AN ACTIVE REGIMEN FOR THE TREATMENT OF HODGKINS-DISEASE IN RELAPSE FOLLOWING MOPP

Purpose: To evaluate the activity and toxicity of combined etoposide, vinblastine, and doxorubicin (EVA) in advanced Hodgkin's disease (HD) in relapse from or refractory to mechlorethamine, vincristine, procarbazine, and prednisone (MOPP). Patients and Methods: Eligible patients were more than 15 years of age and had received only one prior course of MOPP and were in relapse with measurable disease. The EVA regimen (etoposide 100 mg/m(2) intravenously [1V] on days 1, 2, and 3; vinblastine 6 mg/m(2) IV on day 1; and doxorubicin 50 mg/m(2) IV on day 1) was administered every 28 days for a minimum of four and a maximum of six cycles, Patients were restaged at 3 and 6 months. Results: forty-five eligible patients were treated, with an overall response rate of 73%, There were 40% camplete responses (CRs) and 33% partial responses (PRs), The median follow-up time is 42 months, The median time to treatment failure (TTF) is 10 months, with 31% continuing progression-free. Eighteen patients achieved a second CR, with only seven recurrences in that group, Failure-free survival and overall survival were significantly better in patients whose first MOPP-induced remission was longer than 12 months and who were free of B symptoms at relapse. Toxicity was primarily myelosuppression, which resulted in two toxic deaths, Pulmonary toxicity was not observed. Conclusion: EVA is an effective second-line regimen for the treatment of HD in relapse following MOPP chemotherapy. J Clin Oncol 13:2005-2011. (C) 1995 by American Society of Clinical Oncology.