Eight Cycles of ABVD Versus Four Cycles of BEACOPP(escalated) Plus Four Cycles of BEACOPP(baseline) in Stage III to IV, International Prognostic Score >= 3, High-Risk Hodgkin Lymphoma: First Results of the Phase III EORTC 20012 Intergroup Trial

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Eight Cycles of ABVD Versus Four Cycles of BEACOPP(escalated) Plus Four Cycles of BEACOPP(baseline) in Stage III to IV, International Prognostic Score >= 3, High-Risk Hodgkin Lymphoma : First Results of the Phase III EORTC 20012 Intergroup Trial

Carde, Patrice (author): Gustave Roussy Canc Campus, F-94805 Villejuif, France.

Karrasch, Matthias (author): European Org Res & Treatment, Canc Headquarters, Brussels, Belgium.

Fortpied, Catherine (author): European Org Res & Treatment, Canc Headquarters, Brussels, Belgium.

Brice, Pauline (author): Hop St Louis, Paris, France.

Khaled, Hussein (author): Natl Canc Inst, Cairo, Egypt.

Casasnovas, Olivier (author): Ctr Hosp Univ CHU Dijon, Dijon, France.

Caillot, Denis (author): Ctr Hosp Univ CHU Dijon, Dijon, France.

Gaillard, Isabelle (author): CHU Henri Mondor, F-94010 Creteil, France.

Bologna, Serge (author): Ctr Hosp Reg Univ CHR Nancy, Nancy, France.

Ferme, Christophe (author): Gustave Roussy Canc Campus, F-94805 Villejuif, France.

Lugtenburg, Pieternella Johanna (author): Erasmus MC, Inst Canc, Rotterdam, Netherlands.

Morschhauser, Frank (author): CHR Lille, Lille, France.

Aurer, Igor (author): Univ Hosp Ctr Zagreb, Zagreb, Croatia.

Coiffier, Bertrand (author): CHU Lyon, Lyon, France.

Meyer, Ralph (author): Juravinski Canc Ctr, Hamilton, ON, Canada.

Seftel, Matthew (author): Canc Care Manitoba, Winnipeg, MB, Canada.

Wolf, Max (author): Peter MacCallum Canc Inst, East Melbourne, Vic, Australia.

Glimelius, Bengt (author): Uppsala universitet,Experimentell och klinisk onkologi

Sureda, Anna (author): Hosp Santa Creu & Sant Pau, Barcelona, Spain.

Mounier, Nicolas (author): Hop Archet, Nice, France.

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Gustave Roussy Canc Campus, F-94805 Villejuif, France European Org Res & Treatment, Canc Headquarters, Brussels, Belgium. (creator_code:org_t)

2016
2016
English.
In: Journal of Clinical Oncology. - 0732-183X .- 1527-7755. ; 34:17, s. 2028-

Related links:: https://urn.kb.se/re...; show more...; https://doi.org/10.1...; show less...

Journal article (peer-reviewed)

Abstract Subject headings

Purpose To compare patients with high-risk stage III to IV Hodgkin lymphoma (HL) in the phase III European Organisation for Research and Treatment of Cancer 20012 Intergroup trial (Comparison of Two Combination Chemotherapy Regimens in Treating Patients With Stage III or Stage IV Hodgkin's Lymphoma) who were randomly assigned to either doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) or to bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone (BEACOPP). Patients and Methods Patients with clinical stage III or IV HL, International Prognostic Score of 3 or higher, and age 60 years or younger received ABVD for eight cycles (ABVD(8)) or escalated-dose BEACOPP (BEACOPP(escalated)) for four cycles followed by baseline BEACOPP (BEACOPP(baseline)) for four cycles (BEACOPP(4+4)) without radiotherapy. Primary end points were event-free survival (EFS), treatment discontinuation, no complete response (CR) or unconfirmed complete response (CRu) after eight cycles, progression, relapse, or death. Secondary end points were CR rate, overall survival (OS), quality of life, secondary malignancies, and disease-free survival in CR/CRu patients. Results Between 2002 and 2010, 549 patients were randomly assigned to ABVD(8) (n = 275) or BEACOPP(4+4) (n = 274). Other characteristics included median age, 35 years; male, 75%; stage IV, 74%; "B" symptoms, 81%; and International Prognostic Score >= 4, 59%. WHO performance status was 0 (34%), 1 (48%), or 2 (17%). Median follow-upwas 3.6 years. CR/CRu was 82.5% in both arms. At 4 years, EFS was 63.7% for ABVD(8) versus 69.3% for BEACOPP(4+4) (hazard ratio [HR], 0.86; 95% CI, 0.64 to 1.15; P = .312); disease-free survival was 85.8% versus 91.0% (HR, 0.59; 95% CI, 0.33 to 1.06; P = .076), and OS was 86.7% versus 90.3% (HR, 0.71; 95% CI, 0.42 to 1.21; P = .208). Death as a result of toxicity occurred in six and five patients, early discontinuation (before cycle 5) in 12 and 26 patients, treatment crossovers in five and 10 patients, and secondary malignancies in eight and 10 patients in the ABVD(8) and BEACOPP(4+4) arms, respectively. Conclusion ABVD(8) and BEACOPP(4+4) resulted in similar EFS and OS in patients with high-risk advanced-stage HL. Because BEACOPP(4+4) did not demonstrate a favorable effectiveness or toxicity ratio compared with ABVD(8), treatment burden, immediate and late toxicities, and associated costs must be considered before selecting one of these regimens on which to build future treatment strategies.

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Eight Cycles of ABVD Versus Four Cycles of BEACOPP(escalated) Plus Four Cycles of BEACOPP(baseline) in Stage III to IV, International Prognostic Score >= 3, High-Risk Hodgkin Lymphoma : First Results of the Phase III EORTC 20012 Intergroup Trial

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