Older patients (aged ≥60 years) with previously untreated advanced-stage classical Hodgkin lymphoma: A detailed analysis from the phase III ECHELON-1 study Journal Article


Authors: Evens, A. M.; Connors, J. M.; Younes, A.; Ansell, S. M.; Kim, W. S.; Radford, J.; Feldman, T.; Tuscano, J.; Savage, K. J.; Oki, Y.; Grigg, A.; Pocock, C.; Dlugosz-Danecka, M.; Fenton, K.; Forero-Torres, A.; Liu, R.; Jolin, H.; Gautam, A.; Gallamini, A.
Article Title: Older patients (aged ≥60 years) with previously untreated advanced-stage classical Hodgkin lymphoma: A detailed analysis from the phase III ECHELON-1 study
Abstract: Effective and tolerable treatments are needed for older patients with classical Hodgkin lymphoma. We report results for older patients with classical Hodgkin lymphoma treated in the large phase III ECHELON-1 study of frontline brentuximab vedotin plus doxorubicin, vinblastine, and dacarbazine (A+AVD) versus doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD). Modified progression-free survival per independent review facility for older versus younger patients (aged ≥60 vs. <60 years) was a pre-specified subgroup analysis; as the ECHELON-1 study was not powered for these analyses, reported P-values are descriptive. Of 1,334 enrolled patients, 186 (14%) were aged ≥60 years (A+AVD: n=84, ABVD: n=102); results below refer to this age group. Modified progression-free survival per independent review facility was similar in the two arms at 24 months (A+AVD: 70.3% [95% confidence interval (CI): 58.4–79.4], ABVD: 71.4% [95% CI: 60.5–79.8], hazard ratio (HR)=1.00 [95% CI: 0.58–1.72], P=0.993). After a median follow-up of 60.9 months, 5-year progression-free survival per investigator was 67.1% with A+AVD versus 61.6% with ABVD (HR=0.820 [95% CI: 0.494–1.362], P=0.443). Comparing A+AVD versus ABVD, grade 3/4 peripheral neuropathy occurred in 18% versus 3%; any-grade febrile neutropenia in 37% versus 17%; and any-grade pulmonary toxicity in 2% versus 13%, respectively, with three (3%) pulmonary toxicity-related deaths in patients receiving ABVD (none in those receiving A+AVD). Altogether, A+AVD showed overall similar efficacy to ABVD with survival rates in both arms comparing favorably to those of prior series in older patients with advanced-stage classical Hodgkin lymphoma. Compared to ABVD, A+AVD was associated with higher rates of neuropathy and neutropenia, but lower rates of pulmonary-related toxicity. Trials registered at ClinicalTrials.gov identifiers: NCT01712490; EudraCT number: 2011-005450-60. 2022 Ferrata Storti Foundation
Keywords: aged; neutropenia; doxorubicin; cancer staging; antineoplastic agent; neoplasm staging; dacarbazine; antineoplastic combined chemotherapy protocols; peripheral neuropathy; pathology; vinblastine; hodgkin disease; bleomycin; peripheral nervous system diseases; humans; human
Journal Title: Haematologica
Volume: 107
Issue: 5
ISSN: 0390-6078
Publisher: Ferrata Storti Foundation  
Date Published: 2022-05-01
Start Page: 1086
End Page: 1094
Language: English
DOI: 10.3324/haematol.2021.278438
PUBMED: 34162178
PROVIDER: scopus
PMCID: PMC9052913
DOI/URL:
Notes: Article -- Export Date: 1 June 2022 -- Source: Scopus
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  1. Anas Younes
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