Advanced Hodgkin lymphoma: 5-year data show limited PET2 predictive power

  • Stephens DM & al.
  • Blood
  • 22 Jul 2019

  • curated by David Reilly
  • Univadis Clinical Summaries
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Takeaway

  • In a 5-year follow-up of the response-adapted SWOG S0816 study in patients with newly diagnosed (ND) advanced-stage Hodgkin lymphoma (HL), negative positron emission tomography 2 (PET2) demonstrated low predictive value for PFS.

Why this matters

  • SWOG S0816 was the first study of its kind to be published in this setting.

Study design

  • Results of SWOG S0816 at a median follow-up of 5.9 (range, 0.2-8.3) years in 331 patients with ND advanced-stage HL with evaluable PET2.
  • All patients had received 2 cycles of doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD).
  • Patients who achieved complete response (CR) at PET2 (Deauville score ≤3) received 4 more cycles of ABVD; others received 6 cycles of escalated bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone (eBEACOPP).
  • Funding: NIH; National Cancer Institute; National Clinical Trials Network.

Key results

  • 5-year estimated PFS:
    • 24% of PET2-negative patients experienced a progression event; thus, 5-year PFS was 76% (95% CI, 70%-81%).
    • In PET2-positive patients: 5-year PFS was 66% (95% CI, 52%-76%).
  • 14% of eBEACOPP-treated patients experienced a second primary malignancy vs 2% with ABVD (P=.001).
  • 5-year OS was 94% (95% CI, 91%-96%).

Limitations

  • Retrospective data.