Reduced-Intensity Chemo Effective in Hodgkin's
(HealthDay News) – Treating patients with advanced-stage Hodgkin's lymphoma with a reduced-intensity, six-cycle BEACOPPescalated chemotherapy regimen is more effective and less toxic than eight cycles of the same regimen, according to a study published online April 4 in The Lancet.
Andreas Engert, MD, of the University Hospital of Cologne in Köln, Germany, and colleagues conducted a multicenter, open-label, parallel-group, non-inferiority trial involving 2,126 intention-to-treat patients with newly diagnosed advanced stage Hodgkin's lymphoma. Patients were treated with eight cycles of reduced-intensity BEACOPPescalated (8×Besc; 705 patients), six cycles of BEACOPPescalated (6×Besc;711 patients), or eight cycles of BEACOPP14 (8×B14; 710 patients). Patients who had a persistent mass after completing chemotherapy were treated with 30Gy radiation.
The researchers found that the five-year freedom from treatment failure rates were 84.4% for 8×Besc, 89.3% for 6×Besc, and 85.4% for 8×B14, indicating that freedom from treatment failure was non-inferior in the 6×Besc and 8×B14 groups compared with 8×Besc. The overall survival was significantly better for 6×Besc than for 8×Besc (91.9% for 8×Besc, 95.3% for 6×Besc, and 94.5% for 8×B14). The higher mortality in the 8×Besc group was mainly attributable to treatment-related adverse events (2.1%, 0.8%, and 0.8%, respectively) and secondary malignancies (1.8%, 0.7%, and 1.1%, respectively). At one year, the negative predictive value for tumor recurrence using positron emission tomography (PET), an independent end point, was 94.1%.
"Treatment with six cycles of BEACOPPescalated followed by PET-guided radiotherapy was more effective in terms of freedom from treatment failure and less toxic than eight cycles of the same chemotherapy regimen," the authors write.