Long-term follow-up analysis of HD9601 trial comparing ABVD versus Stanford V versus MOPP/EBV/ CAD in patients with newly diagnosed advanced-stage Hodgkin's lymphoma: A study from the Intergruppo Italiano Linfomi

Teodoro Chisesi, Monica Bellei, Stefano Luminari, Antonella Montanini, Luigi Marcheselli, Alessandro Levis, Paolo Gobbi, Umberto Vitolo, Caterina Stelitano, Vincenzo Pavone, Francesco Merli, Marina Liberati, Luca Baldini, Roberto Bordonaro, Emanuela Anna Pesce, Massimo Federico

Research output: Contribution to journalArticle

Abstract

Purpose: The Intergruppo Italiano Linfomi HD9601 trial compared doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) versus doxorubicin, vinblastine, mechloretamine, vincristine, bleomycin, etoposide, and prednisone (Stanford V [StV]) versus the combination of mechlorethamine, vincristine, procarbazine, prednisone (MOPP) with epidoxorubicin, bleomycin, vinblastine (EBV), lomustine, doxorubicin, and vindesine (CAD) (MOPP/EBV/CAD [MEC]) for the initial treatment of advanced-stage Hodgkin's lymphoma to select which regimen would best support a reduced radiotherapy program (limited to two or fewer sites of either previous bulky or partially remitting disease). Superiority of ABVD and MEC to StV was demonstrated. We report analysis of long-term outcome and toxicity. Patients and Methods: Patients with stage IIB, III, or IV were randomly assigned among six cycles of ABVD, three cycles of StV, and six cycles of MEC; radiotherapy was administered in 76, 71, and 50 patients in the three arms, respectively. Results: Currently, the median follow-up is 86 months; in the prolonged observation period, eight additional failures, including two relapses, both in the StV arm, and six additional deaths in complete response were recorded. The 10-year overall survival rates were 87%, 80%, and 78% for ABVD, MEC, and StV, respectively (P = .4). The 10-year failure-free survival was 75%, 74%, and 49% in the ABVD, MEC, and StV arms, respectively (P <.001). The 10-year disease-free survival of patients treated or not with radiotherapy (RT) showed no difference for ABVD or MEC (85% v 80% and 93% v 68%), and a statistically significant difference for StV (76% v 33%; P = .004). No significant long-term toxicity was recorded. Conclusion: The long-term analysis confirmed ABVD and MEC superiority to StV. The use of RT after StV was established as mandatory. ABVD is still to be considered as the standard treatment with a good balance between efficacy and toxicity.

Original languageEnglish
Pages (from-to)4227-4233
Number of pages7
JournalJournal of Clinical Oncology
Volume29
Issue number32
DOIs
Publication statusPublished - Nov 10 2011

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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    Chisesi, T., Bellei, M., Luminari, S., Montanini, A., Marcheselli, L., Levis, A., Gobbi, P., Vitolo, U., Stelitano, C., Pavone, V., Merli, F., Liberati, M., Baldini, L., Bordonaro, R., Pesce, E. A., & Federico, M. (2011). Long-term follow-up analysis of HD9601 trial comparing ABVD versus Stanford V versus MOPP/EBV/ CAD in patients with newly diagnosed advanced-stage Hodgkin's lymphoma: A study from the Intergruppo Italiano Linfomi. Journal of Clinical Oncology, 29(32), 4227-4233. https://doi.org/10.1200/JCO.2010.30.9799