TY - JOUR
T1 - Early serum TARC reduction predicts prognosis in advanced-stage Hodgkin lymphoma patients treated with a PET-adapted strategy.
AU - Viviani, Simonetta
AU - Mazzocchi, Arabella
AU - Pavoni, Chiara
AU - Taverna, Francesca
AU - Rossi, Andrea
AU - Patti, Caterina
AU - Romano, Alessandra
AU - Trentin, Livio
AU - Sorasio, Roberto
AU - Guidetti, Anna
AU - Gottardi, Daniela
AU - Tarella, Corrado
AU - Cimminiello, Michele
AU - Zanotti, Roberta
AU - Farina, Lucia
AU - Ferreri, Andrés José Maria
AU - Galbiati, Marina
AU - Corradini, Paolo
AU - Gianni, Alessandro Massimo
AU - Gallamini, Andrea
AU - Rambaldi, Alessandro
N1 - Place: England
PY - 2020/10/1
Y1 - 2020/10/1
N2 - Among patients with advanced-stage classical Hodgkin lymphoma (cHL) receiving ABVD chemotherapy, PET performed after the first two treatment cycles (PET-2) has prognostic value. However, 152 will experience treatment failure. Here we prospectively evaluated serum thymus and activation-regulated chemokine (TARC) levels, to improve risk assessment in patients treated according to HD0607 PET-driven trial (NCT00795613). In 266 patients with available serum samples, who have agreed to participate in a sub-study for assessment of the role of TARC monitoring, serum TARC levels were measured at baseline and at time of PET-2 by commercially available ELISA test kits. The primary end-point was to evaluate the association between TARC after 2 ABVD cycles and PFS. Median TARC-2 values were significantly higher in PET-2-positive patients compared to PET-2-negative patients (P = .001), and in patients with treatment failure compared to those in continuous CR (P = .01). The 4-year PFS significantly differed between patients with TARC-2 textgreater800 pg/mL vs ≤800 pg/mL (646 P = .0001). Moreover, among PET-2-negative patients, elevated TARC-2 identified those with a worse prognosis (749 P = .01). In multivariable analysis, TARC-2 textgreater800 pg/mL was a significant independent predictor of PFS in the whole study population (HR 2.39, P = .004) and among the PET-2-negative patients (HR 2.49, P = .02). In conclusion, our results indicate that TARC-2 serum levels above 800 pg/mL suggest the need for a stringent follow-up in PET-2-negative patients, and the evaluation of new drugs in PET-2-positive, who will likely fail to respond to intensification with escalated BEACOPP.
AB - Among patients with advanced-stage classical Hodgkin lymphoma (cHL) receiving ABVD chemotherapy, PET performed after the first two treatment cycles (PET-2) has prognostic value. However, 152 will experience treatment failure. Here we prospectively evaluated serum thymus and activation-regulated chemokine (TARC) levels, to improve risk assessment in patients treated according to HD0607 PET-driven trial (NCT00795613). In 266 patients with available serum samples, who have agreed to participate in a sub-study for assessment of the role of TARC monitoring, serum TARC levels were measured at baseline and at time of PET-2 by commercially available ELISA test kits. The primary end-point was to evaluate the association between TARC after 2 ABVD cycles and PFS. Median TARC-2 values were significantly higher in PET-2-positive patients compared to PET-2-negative patients (P = .001), and in patients with treatment failure compared to those in continuous CR (P = .01). The 4-year PFS significantly differed between patients with TARC-2 textgreater800 pg/mL vs ≤800 pg/mL (646 P = .0001). Moreover, among PET-2-negative patients, elevated TARC-2 identified those with a worse prognosis (749 P = .01). In multivariable analysis, TARC-2 textgreater800 pg/mL was a significant independent predictor of PFS in the whole study population (HR 2.39, P = .004) and among the PET-2-negative patients (HR 2.49, P = .02). In conclusion, our results indicate that TARC-2 serum levels above 800 pg/mL suggest the need for a stringent follow-up in PET-2-negative patients, and the evaluation of new drugs in PET-2-positive, who will likely fail to respond to intensification with escalated BEACOPP.
M3 - Article
JO - The Lancet Haematology
JF - The Lancet Haematology
SN - 2352-3026
IS - 4
ER -