Early chemotherapy intensification with BEACOPP in advanced-stage Hodgkin lymphoma patients with a interim-PET positive after two ABVD courses
Andrea Gallamini, Caterina Patti, Simonetta Viviani, Andrea Rossi, Francesca Fiore, Francesco Di Raimondo, Maria Cantonetti, Caterina Stelitano, Tatyana Feldman, Paolo Gavarotti, Roberto Sorasio, Antonino Mulè, Monica Leone, Alessandro Rambaldi, Alberto Biggi, Sally Barrington, Federico Fallanca, Umberto Ficola, Stéphane Chauvie, Alessandro Massimo Gianni, Gruppo Italiano Terapie Innovative nei Linfomi (GITIL), Andrea Gallamini, Caterina Patti, Simonetta Viviani, Andrea Rossi, Francesca Fiore, Francesco Di Raimondo, Maria Cantonetti, Caterina Stelitano, Tatyana Feldman, Paolo Gavarotti, Roberto Sorasio, Antonino Mulè, Monica Leone, Alessandro Rambaldi, Alberto Biggi, Sally Barrington, Federico Fallanca, Umberto Ficola, Stéphane Chauvie, Alessandro Massimo Gianni, Gruppo Italiano Terapie Innovative nei Linfomi (GITIL)
Abstract
Interim 2-[18F]Fluoro-2-deoxy-D-glucose Positron Emission Tomography performed after two chemotherapy cycles (PET-2) is the most reliable predictor of treatment outcome in ABVD-treated Hodgkin Lymphoma (HL) patients. We retrospectively analysed the treatment outcome of a therapeutic strategy based on PET-2 results: positive patients switched to BEACOPP, while negative patients continued with ABVD. Between January 2006 and December 2007, 219 newly diagnosed HL patients admitted to nine centres were enrolled; 54 patients, unfit to receive this treatment were excluded from the analysis. PET-2 scans were reviewed by a central panel of nuclear medicine experts, according to the Deauville score (Meignan, 2009). After a median follow up of 34 months (12-52) the 2-year failure free survival (FFS) and overall survival for the entire cohort of 165 patients were 88% and 98%; the FFS was 65% for PET-2 positive and 92% for PET-2 negative patients. For 154 patients in which treatment was correctly given according to PET-2 review, the 2-year FFS was 91%: 62% for PET-2 positive and 95% for PET-2 negative patients.
Conclusions: this strategy, with BEACOPP intensification only in PET-2 positive patients, showed better results than ABVD-treated historic controls, sparing BEACOPP toxicity to the majority of patients.
Trial registration: ClinicalTrials.gov NCT00877747.
© 2011 Blackwell Publishing Ltd.
Source: PubMed