Review of Treatment Options for the Management of Advanced Stage Hodgkin Lymphoma
Abstract
:Simple Summary
Abstract
1. Introduction
2. ABVD versus BEACOPP
3. PET-Adapted Treatment
4. New Drugs
4.1. Brentuximab Vedotin
4.2. Checkpoint Inhibitors
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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EORTC/LYSA | GHSG | |
---|---|---|
Risk factors | Mediastinum-to-thorax ratio ≥ 0.35 | Mediastinal mass larger than 1/3 of the maximum thoracic width (A) |
Age ≥ 50 years | Extranodal disease (B) | |
ESR > 50 mm/h without B symptoms or >30 mm/h with B symptoms | ESR > 50 mm/h without B symptoms or >30 mm/h with B symptoms (C) | |
Involvement of ≥4 out of 5 supradiaphragmatic nodal areas | Involvement of ≥3 out of 11 nodal areas on both sides of the diaphragm (D) | |
Treatment group | ||
Earlystage | I–II without risk factors | I–II without risk factors |
Intermediate stage | I–II ≥ 1 risk factors | I–IIA with ≥1 risk factors. IIB with risk factors C and/or D, but not A/B |
Advanced stage | III–IV | IIB with risk factors A and/or B, III/IV |
Trial | Regimen | No. of Pts | PFS (%) | OS (%) | No. of Second Cancers |
---|---|---|---|---|---|
EORTC 20012 Intergroup Trial [7] | ABVD × 8 | 275 | 73 (4y) | 87 (4y) | 14 (5.1%) |
BEACOPPesc × 4, then BEACOPPstd × 4 | 274 | 83 (4y) | 90 (4y) | 25 (9.3%) | |
HD2000 Trial [8,9] | ABVD × 6 | 99 | 69 (10y) | 85 (10y) | 1 (1.0%) |
BEACOPPesc × 4, then BEACOPPstd × 2 | 98 | 75 (10y) | 84 (10y) | 6 (6.7%) | |
CEC × 6 | 98 | 76 (10y) | 86 (10y) | 6 (6.7%) | |
LYSA H34 Trial [10] | ABVD × 8 | 80 | 75 (5y) | 92 (5y) | 7 (9.1%) |
BEACOPPesc × 4, then ≥ BEACOPP × 4 | 70 | 93 (5y) | 99 (5y) | 2 (2.9%) | |
Viviani et al. [11] | ABVD × 6–8, then reinduction and HDT/ASCT if less than CR or PD | 168 | 73 (7y) | 84 (7y) | 4 (2.4%) |
BEACOPPesc × 4, then BEACOPP × 4, then reinduction and HDT/ASCT if less than CR or PD | 163 | 85 (7y) | 89 (7y) | 3 (1.8%) |
Trial | Regimen | No. of Pts | Stage III/IV (%) | PFS (%) | OS (%) |
---|---|---|---|---|---|
GHSG HD18 Trial [24] | BEACOPPesc × 2, if PET-2+, randomization to BEACOPPesc × 4–6 | 219 | 78 | 91 (3y) | 97 (3y) |
BEACOPPesc ×2, if PET-2+ randomization to BEACOPPesc + rituximab × 4–6 | 220 | 75 | 93 (3y) | 94 (3y) | |
LYSA AHL2011 Trial [25] | BEACOPPesc × 2, if PET-2–, ABVD × 4 | 319 | 88 | 88 (2y) | 96 (5y) |
BEACOPPesc × 2, if PET+, BEACOPPesc × 4 | 49 | ||||
BEACOPPesc × 6 (no PET adaptation) | 401 | 92 (2y) | 95 (5y) | ||
RATHL Trial [26] | ABVD × 2, if PET-2–, randomization to AVD × 4 | 470 | 59 | 86 (3y) | 97 (3y) |
ABVD × 2 , if PET-2–, randomization to ABVD × 4 | 465 | 58 | 84 (3y) | 98 (3y) | |
ABVD × 2, if PET-2+, BEACOPPesc × 4 or BEACOPP-14 × 6 | 172 | 58 | 66 (3y) | 88 (3y) | |
US Intergroup SWOG Trial S0816 [27] | ABVD × 2, if PET-2–, for ABVD × 4 | 370 | 100 | 82 (2y) | NA |
ABVD × 2, if PET-2+, for BEACOPPesc × 6 | 55 | 64 (2y) | NA |
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Vellemans, H.; André, M.P.E. Review of Treatment Options for the Management of Advanced Stage Hodgkin Lymphoma. Cancers 2021, 13, 3745. https://doi.org/10.3390/cancers13153745
Vellemans H, André MPE. Review of Treatment Options for the Management of Advanced Stage Hodgkin Lymphoma. Cancers. 2021; 13(15):3745. https://doi.org/10.3390/cancers13153745
Chicago/Turabian StyleVellemans, Hélène, and Marc P. E. André. 2021. "Review of Treatment Options for the Management of Advanced Stage Hodgkin Lymphoma" Cancers 13, no. 15: 3745. https://doi.org/10.3390/cancers13153745
APA StyleVellemans, H., & André, M. P. E. (2021). Review of Treatment Options for the Management of Advanced Stage Hodgkin Lymphoma. Cancers, 13(15), 3745. https://doi.org/10.3390/cancers13153745