Early Chemotherapy Intensification With Escalated BEACOPP in Patients With Advanced-Stage Hodgkin Lymphoma With a Positive Interim Positron Emission Tomography/Computed Tomography Scan After Two ABVD Cycles: Long-Term Results of the GITIL/FIL HD 0607 Trial

Andrea Gallamini, Corrado Tarella, Simonetta Viviani, Andrea Rossi, Caterina Patti, Antonino Mulé, Marco Picardi, Alessandra Romano, Maria Cantonetti, Giorgio La Nasa, Livio Trentin, Silvia Bolis, Davide Rapezzi, Roberta Battistini, Daniela Gottardi, Paolo Gavarotti, Paolo Corradini, Michele Cimminiello, Corrado Schiavotto, Guido ParvisRoberta Zanotti, Guido Gini, Andrés J M Ferreri, Piera Viero, Maurizio Miglino, Atto Billio, Abraham Avigdor, Alberto Biggi, Federico Fallanca, Umberto Ficola, Michele Gregianin, Agostino Chiaravalloti, Giuseppe Prosperini, Fabrizio Bergesio, Stephane Chauvie, Chiara Pavoni, Alessandro Massimo Gianni, Alessandro Rambaldi

Research output: Contribution to journalArticle

Abstract

Purpose To investigate the progression-free survival (PFS) of patients with advanced Hodgkin lymphoma (HL) after a risk-adapted treatment strategy that was based on a positive positron emission tomography scan performed after two doxorubicin, vinblastine, vincristine, and dacarbazine (ABVD) cycles (PET2). Patients and Methods Patients with advanced-stage (IIB to IVB) HL were consecutively enrolled. After two ABVD cycles, PET2 was performed and centrally reviewed according to the Deauville five-point scale. Patients with a positive PET2 were randomly assigned to four cycles of escalated bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone (BEACOPP) followed by four cycles of standard BEACOPP with or without rituximab. Patients with a negative PET2 continued ABVD, and those with a large nodal mass at diagnosis (≥ 5 cm) in complete remission with a negative PET at the end of chemotherapy were randomly assigned to radiotherapy or no further treatment. The primary end point was 3-year PFS. Results Of 782 enrolled patients, 150 (19%) had a positive and 630 (81%) a negative PET2. The 3-year PFS of all patients was 82%. The 3-year PFS of those with a positive and negative PET2 was 60% and 87%, respectively ( P < .001). The 3-year PFS of patients with a positive PET2 assigned to BEACOPP with or without rituximab was 63% versus 57% ( P = .53). In 296 patients with both interim and post-ABVD-negative PET who had a large nodal mass at diagnosis, radiotherapy was randomly added after chemotherapy without a significant PFS improvement (97% v 93%, respectively; P = .29). The 3-year overall survival of all 782 patients was 97% (99% and 89% for PET2 negative and positive, respectively). Conclusion The PET-driven switch from ABVD to escalated BEACOPP is feasible and effective in high-risk patients with advanced-stage HL.

Original languageEnglish
Pages (from-to)454-462
Number of pages9
JournalJournal of clinical oncology : official journal of the American Society of Clinical Oncology
Volume36
Issue number5
DOIs
Publication statusPublished - Feb 10 2018

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Hodgkin Disease
Drug Therapy
Disease-Free Survival
Vincristine
Doxorubicin
Positron Emission Tomography Computed Tomography
Radiotherapy
Procarbazine
Dacarbazine
Vinblastine
Bleomycin
Etoposide
Prednisone
Positron-Emission Tomography
Cyclophosphamide
Survival

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Early Chemotherapy Intensification With Escalated BEACOPP in Patients With Advanced-Stage Hodgkin Lymphoma With a Positive Interim Positron Emission Tomography/Computed Tomography Scan After Two ABVD Cycles : Long-Term Results of the GITIL/FIL HD 0607 Trial. / Gallamini, Andrea; Tarella, Corrado; Viviani, Simonetta; Rossi, Andrea; Patti, Caterina; Mulé, Antonino; Picardi, Marco; Romano, Alessandra; Cantonetti, Maria; La Nasa, Giorgio; Trentin, Livio; Bolis, Silvia; Rapezzi, Davide; Battistini, Roberta; Gottardi, Daniela; Gavarotti, Paolo; Corradini, Paolo; Cimminiello, Michele; Schiavotto, Corrado; Parvis, Guido; Zanotti, Roberta; Gini, Guido; Ferreri, Andrés J M; Viero, Piera; Miglino, Maurizio; Billio, Atto; Avigdor, Abraham; Biggi, Alberto; Fallanca, Federico; Ficola, Umberto; Gregianin, Michele; Chiaravalloti, Agostino; Prosperini, Giuseppe; Bergesio, Fabrizio; Chauvie, Stephane; Pavoni, Chiara; Gianni, Alessandro Massimo; Rambaldi, Alessandro.

In: Journal of clinical oncology : official journal of the American Society of Clinical Oncology, Vol. 36, No. 5, 10.02.2018, p. 454-462.

Research output: Contribution to journalArticle

Gallamini, A, Tarella, C, Viviani, S, Rossi, A, Patti, C, Mulé, A, Picardi, M, Romano, A, Cantonetti, M, La Nasa, G, Trentin, L, Bolis, S, Rapezzi, D, Battistini, R, Gottardi, D, Gavarotti, P, Corradini, P, Cimminiello, M, Schiavotto, C, Parvis, G, Zanotti, R, Gini, G, Ferreri, AJM, Viero, P, Miglino, M, Billio, A, Avigdor, A, Biggi, A, Fallanca, F, Ficola, U, Gregianin, M, Chiaravalloti, A, Prosperini, G, Bergesio, F, Chauvie, S, Pavoni, C, Gianni, AM & Rambaldi, A 2018, 'Early Chemotherapy Intensification With Escalated BEACOPP in Patients With Advanced-Stage Hodgkin Lymphoma With a Positive Interim Positron Emission Tomography/Computed Tomography Scan After Two ABVD Cycles: Long-Term Results of the GITIL/FIL HD 0607 Trial', Journal of clinical oncology : official journal of the American Society of Clinical Oncology, vol. 36, no. 5, pp. 454-462. https://doi.org/10.1200/JCO.2017.75.2543
Gallamini, Andrea ; Tarella, Corrado ; Viviani, Simonetta ; Rossi, Andrea ; Patti, Caterina ; Mulé, Antonino ; Picardi, Marco ; Romano, Alessandra ; Cantonetti, Maria ; La Nasa, Giorgio ; Trentin, Livio ; Bolis, Silvia ; Rapezzi, Davide ; Battistini, Roberta ; Gottardi, Daniela ; Gavarotti, Paolo ; Corradini, Paolo ; Cimminiello, Michele ; Schiavotto, Corrado ; Parvis, Guido ; Zanotti, Roberta ; Gini, Guido ; Ferreri, Andrés J M ; Viero, Piera ; Miglino, Maurizio ; Billio, Atto ; Avigdor, Abraham ; Biggi, Alberto ; Fallanca, Federico ; Ficola, Umberto ; Gregianin, Michele ; Chiaravalloti, Agostino ; Prosperini, Giuseppe ; Bergesio, Fabrizio ; Chauvie, Stephane ; Pavoni, Chiara ; Gianni, Alessandro Massimo ; Rambaldi, Alessandro. / Early Chemotherapy Intensification With Escalated BEACOPP in Patients With Advanced-Stage Hodgkin Lymphoma With a Positive Interim Positron Emission Tomography/Computed Tomography Scan After Two ABVD Cycles : Long-Term Results of the GITIL/FIL HD 0607 Trial. In: Journal of clinical oncology : official journal of the American Society of Clinical Oncology. 2018 ; Vol. 36, No. 5. pp. 454-462.
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title = "Early Chemotherapy Intensification With Escalated BEACOPP in Patients With Advanced-Stage Hodgkin Lymphoma With a Positive Interim Positron Emission Tomography/Computed Tomography Scan After Two ABVD Cycles: Long-Term Results of the GITIL/FIL HD 0607 Trial",
abstract = "Purpose To investigate the progression-free survival (PFS) of patients with advanced Hodgkin lymphoma (HL) after a risk-adapted treatment strategy that was based on a positive positron emission tomography scan performed after two doxorubicin, vinblastine, vincristine, and dacarbazine (ABVD) cycles (PET2). Patients and Methods Patients with advanced-stage (IIB to IVB) HL were consecutively enrolled. After two ABVD cycles, PET2 was performed and centrally reviewed according to the Deauville five-point scale. Patients with a positive PET2 were randomly assigned to four cycles of escalated bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone (BEACOPP) followed by four cycles of standard BEACOPP with or without rituximab. Patients with a negative PET2 continued ABVD, and those with a large nodal mass at diagnosis (≥ 5 cm) in complete remission with a negative PET at the end of chemotherapy were randomly assigned to radiotherapy or no further treatment. The primary end point was 3-year PFS. Results Of 782 enrolled patients, 150 (19{\%}) had a positive and 630 (81{\%}) a negative PET2. The 3-year PFS of all patients was 82{\%}. The 3-year PFS of those with a positive and negative PET2 was 60{\%} and 87{\%}, respectively ( P < .001). The 3-year PFS of patients with a positive PET2 assigned to BEACOPP with or without rituximab was 63{\%} versus 57{\%} ( P = .53). In 296 patients with both interim and post-ABVD-negative PET who had a large nodal mass at diagnosis, radiotherapy was randomly added after chemotherapy without a significant PFS improvement (97{\%} v 93{\%}, respectively; P = .29). The 3-year overall survival of all 782 patients was 97{\%} (99{\%} and 89{\%} for PET2 negative and positive, respectively). Conclusion The PET-driven switch from ABVD to escalated BEACOPP is feasible and effective in high-risk patients with advanced-stage HL.",
author = "Andrea Gallamini and Corrado Tarella and Simonetta Viviani and Andrea Rossi and Caterina Patti and Antonino Mul{\'e} and Marco Picardi and Alessandra Romano and Maria Cantonetti and {La Nasa}, Giorgio and Livio Trentin and Silvia Bolis and Davide Rapezzi and Roberta Battistini and Daniela Gottardi and Paolo Gavarotti and Paolo Corradini and Michele Cimminiello and Corrado Schiavotto and Guido Parvis and Roberta Zanotti and Guido Gini and Ferreri, {Andr{\'e}s J M} and Piera Viero and Maurizio Miglino and Atto Billio and Abraham Avigdor and Alberto Biggi and Federico Fallanca and Umberto Ficola and Michele Gregianin and Agostino Chiaravalloti and Giuseppe Prosperini and Fabrizio Bergesio and Stephane Chauvie and Chiara Pavoni and Gianni, {Alessandro Massimo} and Alessandro Rambaldi",
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TY - JOUR

T1 - Early Chemotherapy Intensification With Escalated BEACOPP in Patients With Advanced-Stage Hodgkin Lymphoma With a Positive Interim Positron Emission Tomography/Computed Tomography Scan After Two ABVD Cycles

T2 - Long-Term Results of the GITIL/FIL HD 0607 Trial

AU - Gallamini, Andrea

AU - Tarella, Corrado

AU - Viviani, Simonetta

AU - Rossi, Andrea

AU - Patti, Caterina

AU - Mulé, Antonino

AU - Picardi, Marco

AU - Romano, Alessandra

AU - Cantonetti, Maria

AU - La Nasa, Giorgio

AU - Trentin, Livio

AU - Bolis, Silvia

AU - Rapezzi, Davide

AU - Battistini, Roberta

AU - Gottardi, Daniela

AU - Gavarotti, Paolo

AU - Corradini, Paolo

AU - Cimminiello, Michele

AU - Schiavotto, Corrado

AU - Parvis, Guido

AU - Zanotti, Roberta

AU - Gini, Guido

AU - Ferreri, Andrés J M

AU - Viero, Piera

AU - Miglino, Maurizio

AU - Billio, Atto

AU - Avigdor, Abraham

AU - Biggi, Alberto

AU - Fallanca, Federico

AU - Ficola, Umberto

AU - Gregianin, Michele

AU - Chiaravalloti, Agostino

AU - Prosperini, Giuseppe

AU - Bergesio, Fabrizio

AU - Chauvie, Stephane

AU - Pavoni, Chiara

AU - Gianni, Alessandro Massimo

AU - Rambaldi, Alessandro

PY - 2018/2/10

Y1 - 2018/2/10

N2 - Purpose To investigate the progression-free survival (PFS) of patients with advanced Hodgkin lymphoma (HL) after a risk-adapted treatment strategy that was based on a positive positron emission tomography scan performed after two doxorubicin, vinblastine, vincristine, and dacarbazine (ABVD) cycles (PET2). Patients and Methods Patients with advanced-stage (IIB to IVB) HL were consecutively enrolled. After two ABVD cycles, PET2 was performed and centrally reviewed according to the Deauville five-point scale. Patients with a positive PET2 were randomly assigned to four cycles of escalated bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone (BEACOPP) followed by four cycles of standard BEACOPP with or without rituximab. Patients with a negative PET2 continued ABVD, and those with a large nodal mass at diagnosis (≥ 5 cm) in complete remission with a negative PET at the end of chemotherapy were randomly assigned to radiotherapy or no further treatment. The primary end point was 3-year PFS. Results Of 782 enrolled patients, 150 (19%) had a positive and 630 (81%) a negative PET2. The 3-year PFS of all patients was 82%. The 3-year PFS of those with a positive and negative PET2 was 60% and 87%, respectively ( P < .001). The 3-year PFS of patients with a positive PET2 assigned to BEACOPP with or without rituximab was 63% versus 57% ( P = .53). In 296 patients with both interim and post-ABVD-negative PET who had a large nodal mass at diagnosis, radiotherapy was randomly added after chemotherapy without a significant PFS improvement (97% v 93%, respectively; P = .29). The 3-year overall survival of all 782 patients was 97% (99% and 89% for PET2 negative and positive, respectively). Conclusion The PET-driven switch from ABVD to escalated BEACOPP is feasible and effective in high-risk patients with advanced-stage HL.

AB - Purpose To investigate the progression-free survival (PFS) of patients with advanced Hodgkin lymphoma (HL) after a risk-adapted treatment strategy that was based on a positive positron emission tomography scan performed after two doxorubicin, vinblastine, vincristine, and dacarbazine (ABVD) cycles (PET2). Patients and Methods Patients with advanced-stage (IIB to IVB) HL were consecutively enrolled. After two ABVD cycles, PET2 was performed and centrally reviewed according to the Deauville five-point scale. Patients with a positive PET2 were randomly assigned to four cycles of escalated bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone (BEACOPP) followed by four cycles of standard BEACOPP with or without rituximab. Patients with a negative PET2 continued ABVD, and those with a large nodal mass at diagnosis (≥ 5 cm) in complete remission with a negative PET at the end of chemotherapy were randomly assigned to radiotherapy or no further treatment. The primary end point was 3-year PFS. Results Of 782 enrolled patients, 150 (19%) had a positive and 630 (81%) a negative PET2. The 3-year PFS of all patients was 82%. The 3-year PFS of those with a positive and negative PET2 was 60% and 87%, respectively ( P < .001). The 3-year PFS of patients with a positive PET2 assigned to BEACOPP with or without rituximab was 63% versus 57% ( P = .53). In 296 patients with both interim and post-ABVD-negative PET who had a large nodal mass at diagnosis, radiotherapy was randomly added after chemotherapy without a significant PFS improvement (97% v 93%, respectively; P = .29). The 3-year overall survival of all 782 patients was 97% (99% and 89% for PET2 negative and positive, respectively). Conclusion The PET-driven switch from ABVD to escalated BEACOPP is feasible and effective in high-risk patients with advanced-stage HL.

U2 - 10.1200/JCO.2017.75.2543

DO - 10.1200/JCO.2017.75.2543

M3 - Article

C2 - 29360414

VL - 36

SP - 454

EP - 462

JO - Journal of Clinical Oncology

JF - Journal of Clinical Oncology

SN - 0732-183X

IS - 5

ER -