Long-term results of the HD2000 trial comparing ABVD versus BEACOPP versus COPP-EBV-CAD in untreated patients with advanced hodgkin lymphoma

A study by fondazione Italiana Linfomi

Francesco Merli, Stefano Luminari, Paolo Gobbi, Nicola Cascavilla, Caterina Mammi, Fiorella Ilariucci, Caterina Stelitano, Maurizio Musso, Luca Baldini, Sara Galimberti, F. Angrilli, G. Polimeno, Potito Rosario Scalzulli, Angela Ferrari, Luigi Marcheselli, Massimo Federico

Research output: Contribution to journalArticle

Abstract

Purpose The randomized HD2000 trial compared six cycles of ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine), four escalated plus two standard cycles of BEACOPP (bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone), and six cycles of COPPEBV- CAD (cyclophosphamide, lomustine, vindesine, melphalan, prednisone, epidoxorubicin, vincristine, procarbazine, vinblastine, and bleomycin; CEC) in patients with advanced-stage Hodgkin lymphoma. After a median follow-up of 42 months, patients who received BEACOPP were reported to have experienced better progression-free survival (PFS) but not better overall survival (OS) results than those receiving ABVD. Wehere report a post hoc analysis of this trial after a median follow-up of 10 years. Patients and Methods Three hundred seven patients were enrolled, 295 of whom were evaluable. At the time of our analysis, the median follow-up for the entire group was 120 months (range, 4 to 169 months). Results The 10-year PFS results for the ABVD, BEACOPP, and CEC arms were 69%, 75%, and 76%, respectively; corresponding OS results were 85%, 84%, and 86%. Overall, 13 second malignancies were reported: one in the ABVD arm and six each in the BEACOPP and CEC arms. The cumulative risk of developing secondmalignancies at 10 years was 0.9%, 6.6%, and 6% with ABVD, BEACOPP, and CEC, respectively; the risk with either BEACOPP or CEC was significantly higher than that reported with ABVD (P = .027 and .02, respectively). Conclusion With these mature results, we confirm that patients with advanced Hodgkin lymphoma have similar OS results when treated with ABVD, BEACOPP, or CEC. However, with longer follow-up, we were not able to confirm the superiority of BEACOPP over ABVD in terms of PFS, mainly because of higher mortality rates resulting from second malignancies observed after treatment with BEACOPP and CEC.

Original languageEnglish
Pages (from-to)1175-1181
Number of pages7
JournalJournal of Clinical Oncology
Volume34
Issue number11
DOIs
Publication statusPublished - Apr 10 2016

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Human Herpesvirus 4
Hodgkin Disease
Bleomycin
Procarbazine
Disease-Free Survival
Second Primary Neoplasms
Vinblastine
Vincristine
Prednisone
Doxorubicin
Cyclophosphamide
Survival
Vindesine
Lomustine
Dacarbazine
Melphalan
Etoposide
Mortality
Therapeutics

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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Long-term results of the HD2000 trial comparing ABVD versus BEACOPP versus COPP-EBV-CAD in untreated patients with advanced hodgkin lymphoma : A study by fondazione Italiana Linfomi. / Merli, Francesco; Luminari, Stefano; Gobbi, Paolo; Cascavilla, Nicola; Mammi, Caterina; Ilariucci, Fiorella; Stelitano, Caterina; Musso, Maurizio; Baldini, Luca; Galimberti, Sara; Angrilli, F.; Polimeno, G.; Scalzulli, Potito Rosario; Ferrari, Angela; Marcheselli, Luigi; Federico, Massimo.

In: Journal of Clinical Oncology, Vol. 34, No. 11, 10.04.2016, p. 1175-1181.

Research output: Contribution to journalArticle

Merli, Francesco ; Luminari, Stefano ; Gobbi, Paolo ; Cascavilla, Nicola ; Mammi, Caterina ; Ilariucci, Fiorella ; Stelitano, Caterina ; Musso, Maurizio ; Baldini, Luca ; Galimberti, Sara ; Angrilli, F. ; Polimeno, G. ; Scalzulli, Potito Rosario ; Ferrari, Angela ; Marcheselli, Luigi ; Federico, Massimo. / Long-term results of the HD2000 trial comparing ABVD versus BEACOPP versus COPP-EBV-CAD in untreated patients with advanced hodgkin lymphoma : A study by fondazione Italiana Linfomi. In: Journal of Clinical Oncology. 2016 ; Vol. 34, No. 11. pp. 1175-1181.
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title = "Long-term results of the HD2000 trial comparing ABVD versus BEACOPP versus COPP-EBV-CAD in untreated patients with advanced hodgkin lymphoma: A study by fondazione Italiana Linfomi",
abstract = "Purpose The randomized HD2000 trial compared six cycles of ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine), four escalated plus two standard cycles of BEACOPP (bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone), and six cycles of COPPEBV- CAD (cyclophosphamide, lomustine, vindesine, melphalan, prednisone, epidoxorubicin, vincristine, procarbazine, vinblastine, and bleomycin; CEC) in patients with advanced-stage Hodgkin lymphoma. After a median follow-up of 42 months, patients who received BEACOPP were reported to have experienced better progression-free survival (PFS) but not better overall survival (OS) results than those receiving ABVD. Wehere report a post hoc analysis of this trial after a median follow-up of 10 years. Patients and Methods Three hundred seven patients were enrolled, 295 of whom were evaluable. At the time of our analysis, the median follow-up for the entire group was 120 months (range, 4 to 169 months). Results The 10-year PFS results for the ABVD, BEACOPP, and CEC arms were 69{\%}, 75{\%}, and 76{\%}, respectively; corresponding OS results were 85{\%}, 84{\%}, and 86{\%}. Overall, 13 second malignancies were reported: one in the ABVD arm and six each in the BEACOPP and CEC arms. The cumulative risk of developing secondmalignancies at 10 years was 0.9{\%}, 6.6{\%}, and 6{\%} with ABVD, BEACOPP, and CEC, respectively; the risk with either BEACOPP or CEC was significantly higher than that reported with ABVD (P = .027 and .02, respectively). Conclusion With these mature results, we confirm that patients with advanced Hodgkin lymphoma have similar OS results when treated with ABVD, BEACOPP, or CEC. However, with longer follow-up, we were not able to confirm the superiority of BEACOPP over ABVD in terms of PFS, mainly because of higher mortality rates resulting from second malignancies observed after treatment with BEACOPP and CEC.",
author = "Francesco Merli and Stefano Luminari and Paolo Gobbi and Nicola Cascavilla and Caterina Mammi and Fiorella Ilariucci and Caterina Stelitano and Maurizio Musso and Luca Baldini and Sara Galimberti and F. Angrilli and G. Polimeno and Scalzulli, {Potito Rosario} and Angela Ferrari and Luigi Marcheselli and Massimo Federico",
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T1 - Long-term results of the HD2000 trial comparing ABVD versus BEACOPP versus COPP-EBV-CAD in untreated patients with advanced hodgkin lymphoma

T2 - A study by fondazione Italiana Linfomi

AU - Merli, Francesco

AU - Luminari, Stefano

AU - Gobbi, Paolo

AU - Cascavilla, Nicola

AU - Mammi, Caterina

AU - Ilariucci, Fiorella

AU - Stelitano, Caterina

AU - Musso, Maurizio

AU - Baldini, Luca

AU - Galimberti, Sara

AU - Angrilli, F.

AU - Polimeno, G.

AU - Scalzulli, Potito Rosario

AU - Ferrari, Angela

AU - Marcheselli, Luigi

AU - Federico, Massimo

PY - 2016/4/10

Y1 - 2016/4/10

N2 - Purpose The randomized HD2000 trial compared six cycles of ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine), four escalated plus two standard cycles of BEACOPP (bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone), and six cycles of COPPEBV- CAD (cyclophosphamide, lomustine, vindesine, melphalan, prednisone, epidoxorubicin, vincristine, procarbazine, vinblastine, and bleomycin; CEC) in patients with advanced-stage Hodgkin lymphoma. After a median follow-up of 42 months, patients who received BEACOPP were reported to have experienced better progression-free survival (PFS) but not better overall survival (OS) results than those receiving ABVD. Wehere report a post hoc analysis of this trial after a median follow-up of 10 years. Patients and Methods Three hundred seven patients were enrolled, 295 of whom were evaluable. At the time of our analysis, the median follow-up for the entire group was 120 months (range, 4 to 169 months). Results The 10-year PFS results for the ABVD, BEACOPP, and CEC arms were 69%, 75%, and 76%, respectively; corresponding OS results were 85%, 84%, and 86%. Overall, 13 second malignancies were reported: one in the ABVD arm and six each in the BEACOPP and CEC arms. The cumulative risk of developing secondmalignancies at 10 years was 0.9%, 6.6%, and 6% with ABVD, BEACOPP, and CEC, respectively; the risk with either BEACOPP or CEC was significantly higher than that reported with ABVD (P = .027 and .02, respectively). Conclusion With these mature results, we confirm that patients with advanced Hodgkin lymphoma have similar OS results when treated with ABVD, BEACOPP, or CEC. However, with longer follow-up, we were not able to confirm the superiority of BEACOPP over ABVD in terms of PFS, mainly because of higher mortality rates resulting from second malignancies observed after treatment with BEACOPP and CEC.

AB - Purpose The randomized HD2000 trial compared six cycles of ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine), four escalated plus two standard cycles of BEACOPP (bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone), and six cycles of COPPEBV- CAD (cyclophosphamide, lomustine, vindesine, melphalan, prednisone, epidoxorubicin, vincristine, procarbazine, vinblastine, and bleomycin; CEC) in patients with advanced-stage Hodgkin lymphoma. After a median follow-up of 42 months, patients who received BEACOPP were reported to have experienced better progression-free survival (PFS) but not better overall survival (OS) results than those receiving ABVD. Wehere report a post hoc analysis of this trial after a median follow-up of 10 years. Patients and Methods Three hundred seven patients were enrolled, 295 of whom were evaluable. At the time of our analysis, the median follow-up for the entire group was 120 months (range, 4 to 169 months). Results The 10-year PFS results for the ABVD, BEACOPP, and CEC arms were 69%, 75%, and 76%, respectively; corresponding OS results were 85%, 84%, and 86%. Overall, 13 second malignancies were reported: one in the ABVD arm and six each in the BEACOPP and CEC arms. The cumulative risk of developing secondmalignancies at 10 years was 0.9%, 6.6%, and 6% with ABVD, BEACOPP, and CEC, respectively; the risk with either BEACOPP or CEC was significantly higher than that reported with ABVD (P = .027 and .02, respectively). Conclusion With these mature results, we confirm that patients with advanced Hodgkin lymphoma have similar OS results when treated with ABVD, BEACOPP, or CEC. However, with longer follow-up, we were not able to confirm the superiority of BEACOPP over ABVD in terms of PFS, mainly because of higher mortality rates resulting from second malignancies observed after treatment with BEACOPP and CEC.

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