Long-term overall survival and toxicities of ABVD vs BEACOPP in advanced Hodgkin lymphoma: A pooled analysis of four randomized trials

Marc P E André; Patrice Carde; Simonetta Viviani; Monica Bellei; Catherine Fortpied; Martin Hutchings; Alessandro M Gianni; Pauline Brice; Olivier Casasnovas; Paolo G Gobbi; Pier Luigi Zinzani; Jehan Dupuis; Emilio Iannitto; Alessandro Rambaldi; Josette Brière; Laurianne Clément-Filliatre; Marian Heczko; Pinuccia Valagussa; Jonathan Douxfils; Julien Depaus; Massimo Federico; Nicolas Mounier

doi:10.1002/cam4.3298

Long-term overall survival and toxicities of ABVD vs BEACOPP in advanced Hodgkin lymphoma: A pooled analysis of four randomized trials

Marc P E André, Patrice Carde, Simonetta Viviani, Monica Bellei, Catherine Fortpied, Martin Hutchings, Alessandro M Gianni, Pauline Brice, Olivier Casasnovas, Paolo G Gobbi, Pier Luigi Zinzani, Jehan Dupuis, Emilio Iannitto, Alessandro Rambaldi, Josette Brière, Laurianne Clément-Filliatre, Marian Heczko, Pinuccia Valagussa, Jonathan Douxfils, Julien DepausMassimo Federico, Nicolas Mounier

Research output: Contribution to journal › Article › peer-review

Abstract

PURPOSE: We explored the potential overall survival (OS) benefit of bleomycin, etoposide, doxorubicin (Adriamycin), cyclophosphamide, vincristine (Oncovin), procarbazine, and prednisone (BEACOPP) over doxorubicin (Adriamycin), bleomycin, vinblastine, and dacarbazine (ABVD) in a pooled analysis of four randomized trials.

PATIENTS AND METHODS: Primary objective was to evaluate the OS impact of BEACOPP using individual patient data. Secondary objectives were progression-free survival (PFS), secondary cancers, and use of autologous stem cell transplantation (ASCT).

RESULTS: About 1227 patients were included. The 7-year OS was 84.3% (95% CI 80.8-87.2) for ABVD vs 87.7% (95% CI 84.5-90.2) for BEACOPP. Two follow-up periods were identified based on survival curves and hazard ratio (HR) over time. For the first 18 months, there was no difference. For the second period of ≥18 months, ABVD patients had a higher death risk (HRABVD vs BEACOPP = 1.59; 95% CI 1.09-2.33). A Cox model stratified by trial and evaluating the effect of treatment and International Prognostic Index (IPI) score as fixed effects showed that both were statistically significant (treatment, P = .0185; IPI score, P = .0107). The 7-year PFS was 71.1% (95% CI 67.1-74.6) for ABVD vs 81.1% (95% CI 77.5-84.2) for BEACOPP (P < .001). After ABVD, 25 secondary cancers (4.0%) were reported with no myelodysplasia (MDS)/acute myeloid leukemia (AML) compared to 36 (6.5%) after BEACOPP, which included 13 patients with MDS/AML. Following ABVD, 86 patients (13.8%) received ASCT vs 39 (6.4%) for BEACOPP.

CONCLUSIONS: This analysis showed a slight improvement in OS for BEACOPP and confirmed a PFS benefit. Frontline use of BEACOPP instead of ABVD increased secondary leukemia incidence but halved the requirement for ASCT.

Original language	English
Pages (from-to)	6565-6575
Number of pages	11
Journal	Cancer Med.
Volume	9
Issue number	18
DOIs	https://doi.org/10.1002/cam4.3298
Publication status	Published - Sep 2020

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André, M. P. E., Carde, P., Viviani, S., Bellei, M., Fortpied, C., Hutchings, M., Gianni, A. M., Brice, P., Casasnovas, O., Gobbi, P. G., Zinzani, P. L., Dupuis, J., Iannitto, E., Rambaldi, A., Brière, J., Clément-Filliatre, L., Heczko, M., Valagussa, P., Douxfils, J., ... Mounier, N. (2020). Long-term overall survival and toxicities of ABVD vs BEACOPP in advanced Hodgkin lymphoma: A pooled analysis of four randomized trials. Cancer Med., 9(18), 6565-6575. https://doi.org/10.1002/cam4.3298

Long-term overall survival and toxicities of ABVD vs BEACOPP in advanced Hodgkin lymphoma : A pooled analysis of four randomized trials. / André, Marc P E; Carde, Patrice; Viviani, Simonetta; Bellei, Monica; Fortpied, Catherine; Hutchings, Martin; Gianni, Alessandro M; Brice, Pauline; Casasnovas, Olivier; Gobbi, Paolo G; Zinzani, Pier Luigi; Dupuis, Jehan; Iannitto, Emilio; Rambaldi, Alessandro; Brière, Josette; Clément-Filliatre, Laurianne; Heczko, Marian; Valagussa, Pinuccia; Douxfils, Jonathan; Depaus, Julien; Federico, Massimo; Mounier, Nicolas.

In: Cancer Med., Vol. 9, No. 18, 09.2020, p. 6565-6575.

Research output: Contribution to journal › Article › peer-review

André, MPE, Carde, P, Viviani, S, Bellei, M, Fortpied, C, Hutchings, M, Gianni, AM, Brice, P, Casasnovas, O, Gobbi, PG, Zinzani, PL, Dupuis, J, Iannitto, E, Rambaldi, A, Brière, J, Clément-Filliatre, L, Heczko, M, Valagussa, P, Douxfils, J, Depaus, J, Federico, M & Mounier, N 2020, 'Long-term overall survival and toxicities of ABVD vs BEACOPP in advanced Hodgkin lymphoma: A pooled analysis of four randomized trials', Cancer Med., vol. 9, no. 18, pp. 6565-6575. https://doi.org/10.1002/cam4.3298

André, Marc P E ; Carde, Patrice ; Viviani, Simonetta ; Bellei, Monica ; Fortpied, Catherine ; Hutchings, Martin ; Gianni, Alessandro M ; Brice, Pauline ; Casasnovas, Olivier ; Gobbi, Paolo G ; Zinzani, Pier Luigi ; Dupuis, Jehan ; Iannitto, Emilio ; Rambaldi, Alessandro ; Brière, Josette ; Clément-Filliatre, Laurianne ; Heczko, Marian ; Valagussa, Pinuccia ; Douxfils, Jonathan ; Depaus, Julien ; Federico, Massimo ; Mounier, Nicolas. / Long-term overall survival and toxicities of ABVD vs BEACOPP in advanced Hodgkin lymphoma : A pooled analysis of four randomized trials. In: Cancer Med. 2020 ; Vol. 9, No. 18. pp. 6565-6575.

@article{14c85f19680945bc981a4d0cafe70867,

title = "Long-term overall survival and toxicities of ABVD vs BEACOPP in advanced Hodgkin lymphoma: A pooled analysis of four randomized trials",

abstract = "PURPOSE: We explored the potential overall survival (OS) benefit of bleomycin, etoposide, doxorubicin (Adriamycin), cyclophosphamide, vincristine (Oncovin), procarbazine, and prednisone (BEACOPP) over doxorubicin (Adriamycin), bleomycin, vinblastine, and dacarbazine (ABVD) in a pooled analysis of four randomized trials.PATIENTS AND METHODS: Primary objective was to evaluate the OS impact of BEACOPP using individual patient data. Secondary objectives were progression-free survival (PFS), secondary cancers, and use of autologous stem cell transplantation (ASCT).RESULTS: About 1227 patients were included. The 7-year OS was 84.3% (95% CI 80.8-87.2) for ABVD vs 87.7% (95% CI 84.5-90.2) for BEACOPP. Two follow-up periods were identified based on survival curves and hazard ratio (HR) over time. For the first 18 months, there was no difference. For the second period of ≥18 months, ABVD patients had a higher death risk (HRABVD vs BEACOPP = 1.59; 95% CI 1.09-2.33). A Cox model stratified by trial and evaluating the effect of treatment and International Prognostic Index (IPI) score as fixed effects showed that both were statistically significant (treatment, P = .0185; IPI score, P = .0107). The 7-year PFS was 71.1% (95% CI 67.1-74.6) for ABVD vs 81.1% (95% CI 77.5-84.2) for BEACOPP (P < .001). After ABVD, 25 secondary cancers (4.0%) were reported with no myelodysplasia (MDS)/acute myeloid leukemia (AML) compared to 36 (6.5%) after BEACOPP, which included 13 patients with MDS/AML. Following ABVD, 86 patients (13.8%) received ASCT vs 39 (6.4%) for BEACOPP.CONCLUSIONS: This analysis showed a slight improvement in OS for BEACOPP and confirmed a PFS benefit. Frontline use of BEACOPP instead of ABVD increased secondary leukemia incidence but halved the requirement for ASCT.",

author = "Andr{\'e}, {Marc P E} and Patrice Carde and Simonetta Viviani and Monica Bellei and Catherine Fortpied and Martin Hutchings and Gianni, {Alessandro M} and Pauline Brice and Olivier Casasnovas and Gobbi, {Paolo G} and Zinzani, {Pier Luigi} and Jehan Dupuis and Emilio Iannitto and Alessandro Rambaldi and Josette Bri{\`e}re and Laurianne Cl{\'e}ment-Filliatre and Marian Heczko and Pinuccia Valagussa and Jonathan Douxfils and Julien Depaus and Massimo Federico and Nicolas Mounier",

note = "{\textcopyright} 2020 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.",

year = "2020",

month = sep,

doi = "10.1002/cam4.3298",

language = "English",

volume = "9",

pages = "6565--6575",

journal = "Cancer Med.",

issn = "2045-7634",

number = "18",

}

TY - JOUR

T1 - Long-term overall survival and toxicities of ABVD vs BEACOPP in advanced Hodgkin lymphoma

T2 - A pooled analysis of four randomized trials

AU - André, Marc P E

AU - Carde, Patrice

AU - Viviani, Simonetta

AU - Bellei, Monica

AU - Fortpied, Catherine

AU - Hutchings, Martin

AU - Gianni, Alessandro M

AU - Brice, Pauline

AU - Casasnovas, Olivier

AU - Gobbi, Paolo G

AU - Zinzani, Pier Luigi

AU - Dupuis, Jehan

AU - Iannitto, Emilio

AU - Rambaldi, Alessandro

AU - Brière, Josette

AU - Clément-Filliatre, Laurianne

AU - Heczko, Marian

AU - Valagussa, Pinuccia

AU - Douxfils, Jonathan

AU - Depaus, Julien

AU - Federico, Massimo

AU - Mounier, Nicolas

PY - 2020/9

Y1 - 2020/9

N2 - PURPOSE: We explored the potential overall survival (OS) benefit of bleomycin, etoposide, doxorubicin (Adriamycin), cyclophosphamide, vincristine (Oncovin), procarbazine, and prednisone (BEACOPP) over doxorubicin (Adriamycin), bleomycin, vinblastine, and dacarbazine (ABVD) in a pooled analysis of four randomized trials.PATIENTS AND METHODS: Primary objective was to evaluate the OS impact of BEACOPP using individual patient data. Secondary objectives were progression-free survival (PFS), secondary cancers, and use of autologous stem cell transplantation (ASCT).RESULTS: About 1227 patients were included. The 7-year OS was 84.3% (95% CI 80.8-87.2) for ABVD vs 87.7% (95% CI 84.5-90.2) for BEACOPP. Two follow-up periods were identified based on survival curves and hazard ratio (HR) over time. For the first 18 months, there was no difference. For the second period of ≥18 months, ABVD patients had a higher death risk (HRABVD vs BEACOPP = 1.59; 95% CI 1.09-2.33). A Cox model stratified by trial and evaluating the effect of treatment and International Prognostic Index (IPI) score as fixed effects showed that both were statistically significant (treatment, P = .0185; IPI score, P = .0107). The 7-year PFS was 71.1% (95% CI 67.1-74.6) for ABVD vs 81.1% (95% CI 77.5-84.2) for BEACOPP (P < .001). After ABVD, 25 secondary cancers (4.0%) were reported with no myelodysplasia (MDS)/acute myeloid leukemia (AML) compared to 36 (6.5%) after BEACOPP, which included 13 patients with MDS/AML. Following ABVD, 86 patients (13.8%) received ASCT vs 39 (6.4%) for BEACOPP.CONCLUSIONS: This analysis showed a slight improvement in OS for BEACOPP and confirmed a PFS benefit. Frontline use of BEACOPP instead of ABVD increased secondary leukemia incidence but halved the requirement for ASCT.

AB - PURPOSE: We explored the potential overall survival (OS) benefit of bleomycin, etoposide, doxorubicin (Adriamycin), cyclophosphamide, vincristine (Oncovin), procarbazine, and prednisone (BEACOPP) over doxorubicin (Adriamycin), bleomycin, vinblastine, and dacarbazine (ABVD) in a pooled analysis of four randomized trials.PATIENTS AND METHODS: Primary objective was to evaluate the OS impact of BEACOPP using individual patient data. Secondary objectives were progression-free survival (PFS), secondary cancers, and use of autologous stem cell transplantation (ASCT).RESULTS: About 1227 patients were included. The 7-year OS was 84.3% (95% CI 80.8-87.2) for ABVD vs 87.7% (95% CI 84.5-90.2) for BEACOPP. Two follow-up periods were identified based on survival curves and hazard ratio (HR) over time. For the first 18 months, there was no difference. For the second period of ≥18 months, ABVD patients had a higher death risk (HRABVD vs BEACOPP = 1.59; 95% CI 1.09-2.33). A Cox model stratified by trial and evaluating the effect of treatment and International Prognostic Index (IPI) score as fixed effects showed that both were statistically significant (treatment, P = .0185; IPI score, P = .0107). The 7-year PFS was 71.1% (95% CI 67.1-74.6) for ABVD vs 81.1% (95% CI 77.5-84.2) for BEACOPP (P < .001). After ABVD, 25 secondary cancers (4.0%) were reported with no myelodysplasia (MDS)/acute myeloid leukemia (AML) compared to 36 (6.5%) after BEACOPP, which included 13 patients with MDS/AML. Following ABVD, 86 patients (13.8%) received ASCT vs 39 (6.4%) for BEACOPP.CONCLUSIONS: This analysis showed a slight improvement in OS for BEACOPP and confirmed a PFS benefit. Frontline use of BEACOPP instead of ABVD increased secondary leukemia incidence but halved the requirement for ASCT.

U2 - 10.1002/cam4.3298

DO - 10.1002/cam4.3298

M3 - Article

C2 - 32710498

VL - 9

SP - 6565

EP - 6575

JO - Cancer Med.

JF - Cancer Med.

SN - 2045-7634

IS - 18

ER -

Long-term overall survival and toxicities of ABVD vs BEACOPP in advanced Hodgkin lymphoma: A pooled analysis of four randomized trials

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