ASH Clinical News Advances in Hematology Research & Patient Care: Hi | Page 18

CLINICAL NEWS
Hôpital Le Bocage in Dijon, France, and colleagues reported the
results of a positron emission testing (PET)-driven treatment strategy for identifying Hodgkin lymphoma patients who could safely
de-escalate BEACOPPesc and switch to ABVD therapy. They found
that PET imaging performed early in the treatment course can be
safely used to guide subsequent treatment modifications.
In addition to further confirming the prognostic value of interim PET imaging, “this approach allows us to significantly reduce
treatment-related immediate toxicity in most patients and provides
a similar outcome compared with standard BEACOPPesc treatment,” Dr. Casanovas said during his presentation of the results.
In this phase III trial, which included patients with high-risk
(meaning stage IIB or Ann Arbor stage III-IV) Hodgkin lymphoma,
Dr. Casanovas and investigators compared a PET-driven treatment
strategy with a standard treatment regimen. All patients received
two cycles of BEACOPPesc, then underwent PET imaging. In the
PET arm (401 patients), patients who were PET-positive received
four additional cycles of BEACOPPesc; if PET-negative, patients
instead received four cycles of ABVD. In the standard treatment
arm (381 patients), patients received six cycles of BEACOPPesc
regardless of PET status.
Patient characteristics were “well-balanced” in both arms, the
authors noted. The median age among patients was 30 years (range =
16-60 years), and the majority (60%) had stage IV Hodgkin lymphoma.
After two cycles of BEACOPPesc, rates of PET-positive status
were similar between both groups: 48 patients (12%) in the standard
treatment arm and 49 patients (13%) in the experimental arm.
These 49 patients continued with four additional cycles of BEACOPPesc, while the remaining patients in the experimental arm
switched to four cycles of ABVD.
Use of the response-adapted strategy did not significantly alter
two-year progression-free survival rates (PFS; the study’s primary
endpoint), Dr. Casanovas reported. After a median follow-up of 16.3
months (range = 0.1-37.4 months), the estimated two-year PFS in
both arms were similar: 91.6 percent in the standard arm and 88.3
percent in the PET-driven