CALGB 50604: Risk-adapted treatment of nonbulky early-stage Hodgkin lymphoma based on interim PET Journal Article

Authors: Straus, D. J.; Jung, S. H.; Pitcher, B.; Kostakoglu, L.; Grecula, J. C.; Hsi, E. D.; Schöder, H.; Popplewell, L. L.; Chang, J. E.; Moskowitz, C. H.; Wagner-Johnston, N.; Leonard, J. P.; Friedberg, J. W.; Kahl, B. S.; Cheson, B. D.; Bartlett, N. L.
Article Title: CALGB 50604: Risk-adapted treatment of nonbulky early-stage Hodgkin lymphoma based on interim PET
Abstract: A negative interim positron emission tomography/computerized tomography (PET/CT) after 1 to 3 cycles of doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) in patients with newly diagnosed, nonbulky stage I or II Hodgkin lymphoma (HL) predicts a low relapse rate. This phase 2 trial was designed to determine if a population of patients with early-stage disease can be treated with short-course ABVD without radiation therapy (RT) on the basis of a negative interim PET/CT, thereby limiting the risks of treatment. Between 15 May 2010 and 21 February 2013, 164 previously untreated patients with nonbulky stage I/II HL were enrolled, and 149 were included in the final analysis. Patients received 2 cycles of ABVD followed by PET. Deauville scores 1 to 3 were negative (£ liver uptake) based on central review. PET2 patients received 2 more cycles of ABVD, and PET1 patients received 2 cycles of dose-intense bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone (escalated BEACOPP) plus 3060-cGy involved-field RT. The primary objective was to determine 3-year progression-free survival (PFS) for the PET2 group. One hundred thirty-five patients (91%) were interim PET2, and 14 patients (9%) were PET1. With median follow-up time of 3.8 years, the estimated 3-year PFS was 91% for the PET2 group and 66% for the PET1 group (hazard ratio, 3.84; 95% confidence interval, 1.50-9.84; P 5 .011). There was 1 death as a result of suicide. Four cycles of ABVD resulted in durable remissions for a majority of patients with early-stage nonbulky HL and a negative interim PET. © 2018 by The American Society of Hematology.
Journal Title: Blood
Volume: 132
Issue: 10
ISSN: 0006-4971
Publisher: American Society of Hematology  
Date Published: 2018-09-06
Start Page: 1013
End Page: 1021
Language: English
DOI: 10.1182/blood-2018-01-827246
PROVIDER: scopus
PMCID: PMC6128083
PUBMED: 30049811
Notes: Article -- Export Date: 1 October 2018 -- Source: Scopus
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MSK Authors
  1. Craig Moskowitz
    367 Moskowitz
  2. Heiko Schoder
    276 Schoder
  3. David J Straus
    204 Straus