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CALGB 50604: risk-adapted treatment of nonbulky early-stage Hodgkin lymphoma based on interim PET.

Publication ,  Journal Article
Straus, DJ; Jung, S-H; Pitcher, B; Kostakoglu, L; Grecula, JC; Hsi, ED; Schöder, H; Popplewell, LL; Chang, JE; Moskowitz, CH; Leonard, JP ...
Published in: Blood
September 6, 2018

A negative interim positron emission tomography/computerized tomography (PET/CT) after 1 to 3 cycles of doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) in patients with newly diagnosed, nonbulky stage I or II Hodgkin lymphoma (HL) predicts a low relapse rate. This phase 2 trial was designed to determine if a population of patients with early-stage disease can be treated with short-course ABVD without radiation therapy (RT) on the basis of a negative interim PET/CT, thereby limiting the risks of treatment. Between 15 May 2010 and 21 February 2013, 164 previously untreated patients with nonbulky stage I/II HL were enrolled, and 149 were included in the final analysis. Patients received 2 cycles of ABVD followed by PET. Deauville scores 1 to 3 were negative (≤ liver uptake) based on central review. PET- patients received 2 more cycles of ABVD, and PET+ patients received 2 cycles of dose-intense bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone (escalated BEACOPP) plus 3060-cGy involved-field RT. The primary objective was to determine 3-year progression-free survival (PFS) for the PET- group. One hundred thirty-five patients (91%) were interim PET-, and 14 patients (9%) were PET+ With median follow-up time of 3.8 years, the estimated 3-year PFS was 91% for the PET- group and 66% for the PET+ group (hazard ratio, 3.84; 95% confidence interval, 1.50-9.84; P = .011). There was 1 death as a result of suicide. Four cycles of ABVD resulted in durable remissions for a majority of patients with early-stage nonbulky HL and a negative interim PET. This trial was registered at www.clinicaltrials.gov as #NCT01132807.

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Published In

Blood

DOI

EISSN

1528-0020

Publication Date

September 6, 2018

Volume

132

Issue

10

Start / End Page

1013 / 1021

Location

United States

Related Subject Headings

  • Vincristine
  • Vinblastine
  • Survival Rate
  • Procarbazine
  • Prednisone
  • Positron Emission Tomography Computed Tomography
  • Neoplasm Staging
  • Middle Aged
  • Male
  • Immunology
 

Citation

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Straus, D. J., Jung, S.-H., Pitcher, B., Kostakoglu, L., Grecula, J. C., Hsi, E. D., … Bartlett, N. L. (2018). CALGB 50604: risk-adapted treatment of nonbulky early-stage Hodgkin lymphoma based on interim PET. Blood, 132(10), 1013–1021. https://doi.org/10.1182/blood-2018-01-827246
Straus, David J., Sin-Ho Jung, Brandelyn Pitcher, Lale Kostakoglu, John C. Grecula, Eric D. Hsi, Heiko Schöder, et al. “CALGB 50604: risk-adapted treatment of nonbulky early-stage Hodgkin lymphoma based on interim PET.Blood 132, no. 10 (September 6, 2018): 1013–21. https://doi.org/10.1182/blood-2018-01-827246.
Straus DJ, Jung S-H, Pitcher B, Kostakoglu L, Grecula JC, Hsi ED, et al. CALGB 50604: risk-adapted treatment of nonbulky early-stage Hodgkin lymphoma based on interim PET. Blood. 2018 Sep 6;132(10):1013–21.
Straus, David J., et al. “CALGB 50604: risk-adapted treatment of nonbulky early-stage Hodgkin lymphoma based on interim PET.Blood, vol. 132, no. 10, Sept. 2018, pp. 1013–21. Pubmed, doi:10.1182/blood-2018-01-827246.
Straus DJ, Jung S-H, Pitcher B, Kostakoglu L, Grecula JC, Hsi ED, Schöder H, Popplewell LL, Chang JE, Moskowitz CH, Wagner-Johnston N, Leonard JP, Friedberg JW, Kahl BS, Cheson BD, Bartlett NL. CALGB 50604: risk-adapted treatment of nonbulky early-stage Hodgkin lymphoma based on interim PET. Blood. 2018 Sep 6;132(10):1013–1021.

Published In

Blood

DOI

EISSN

1528-0020

Publication Date

September 6, 2018

Volume

132

Issue

10

Start / End Page

1013 / 1021

Location

United States

Related Subject Headings

  • Vincristine
  • Vinblastine
  • Survival Rate
  • Procarbazine
  • Prednisone
  • Positron Emission Tomography Computed Tomography
  • Neoplasm Staging
  • Middle Aged
  • Male
  • Immunology