TY - JOUR
T1 - Older patients (aged ≥60 years) with previously untreated advanced-stage classical Hodgkin the phase lymphoma
T2 - III ECHELON-1 a detailed study analysis from the phase III ECHELON-1 study
AU - Evens, Andrew M.
AU - Connors, Joseph M.
AU - Younes, Anas
AU - Ansell, Stephen M.
AU - Kim, Won Seog
AU - Radford, John
AU - Feldman, Tatyana
AU - Tuscano, Joseph
AU - Savage, Kerry J.
AU - Oki, Yasuhiro
AU - Grigg, Andrew
AU - Pocock, Christopher
AU - Dlugosz-Danecka, Monika
AU - Fenton, Keenan
AU - Forero-Torres, Andres
AU - Liu, Rachael
AU - Jolin, Hina
AU - Gautam, Ashish
AU - Gallamini, Andrea
N1 - Publisher Copyright:
2022 Ferrata Storti Foundation
PY - 2022/5
Y1 - 2022/5
N2 - Effective and tolerable treatments are needed for older patients with classical Hodgkin lymphoma. We report results for older patients with classical Hodgkin lymphoma treated in the large phase III ECHELON-1 study of frontline brentuximab vedotin plus doxorubicin, vinblastine, and dacarbazine (A+AVD) versus doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD). Modified progression-free survival per independent review facility for older versus younger patients (aged ≥60 vs. <60 years) was a pre-specified subgroup analysis; as the ECHELON-1 study was not powered for these analyses, reported P-values are descriptive. Of 1,334 enrolled patients, 186 (14%) were aged ≥60 years (A+AVD: n=84, ABVD: n=102); results below refer to this age group. Modified progression-free survival per independent review facility was similar in the two arms at 24 months (A+AVD: 70.3% [95% confidence interval (CI): 58.4–79.4], ABVD: 71.4% [95% CI: 60.5–79.8], hazard ratio (HR)=1.00 [95% CI: 0.58–1.72], P=0.993). After a median follow-up of 60.9 months, 5-year progression-free survival per investigator was 67.1% with A+AVD versus 61.6% with ABVD (HR=0.820 [95% CI: 0.494–1.362], P=0.443). Comparing A+AVD versus ABVD, grade 3/4 peripheral neuropathy occurred in 18% versus 3%; any-grade febrile neutropenia in 37% versus 17%; and any-grade pulmonary toxicity in 2% versus 13%, respectively, with three (3%) pulmonary toxicity-related deaths in patients receiving ABVD (none in those receiving A+AVD). Altogether, A+AVD showed overall similar efficacy to ABVD with survival rates in both arms comparing favorably to those of prior series in older patients with advanced-stage classical Hodgkin lymphoma. Compared to ABVD, A+AVD was associated with higher rates of neuropathy and neutropenia, but lower rates of pulmonary-related toxicity. Trials registered at ClinicalTrials.gov identifiers: NCT01712490; EudraCT number: 2011-005450-60.
AB - Effective and tolerable treatments are needed for older patients with classical Hodgkin lymphoma. We report results for older patients with classical Hodgkin lymphoma treated in the large phase III ECHELON-1 study of frontline brentuximab vedotin plus doxorubicin, vinblastine, and dacarbazine (A+AVD) versus doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD). Modified progression-free survival per independent review facility for older versus younger patients (aged ≥60 vs. <60 years) was a pre-specified subgroup analysis; as the ECHELON-1 study was not powered for these analyses, reported P-values are descriptive. Of 1,334 enrolled patients, 186 (14%) were aged ≥60 years (A+AVD: n=84, ABVD: n=102); results below refer to this age group. Modified progression-free survival per independent review facility was similar in the two arms at 24 months (A+AVD: 70.3% [95% confidence interval (CI): 58.4–79.4], ABVD: 71.4% [95% CI: 60.5–79.8], hazard ratio (HR)=1.00 [95% CI: 0.58–1.72], P=0.993). After a median follow-up of 60.9 months, 5-year progression-free survival per investigator was 67.1% with A+AVD versus 61.6% with ABVD (HR=0.820 [95% CI: 0.494–1.362], P=0.443). Comparing A+AVD versus ABVD, grade 3/4 peripheral neuropathy occurred in 18% versus 3%; any-grade febrile neutropenia in 37% versus 17%; and any-grade pulmonary toxicity in 2% versus 13%, respectively, with three (3%) pulmonary toxicity-related deaths in patients receiving ABVD (none in those receiving A+AVD). Altogether, A+AVD showed overall similar efficacy to ABVD with survival rates in both arms comparing favorably to those of prior series in older patients with advanced-stage classical Hodgkin lymphoma. Compared to ABVD, A+AVD was associated with higher rates of neuropathy and neutropenia, but lower rates of pulmonary-related toxicity. Trials registered at ClinicalTrials.gov identifiers: NCT01712490; EudraCT number: 2011-005450-60.
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U2 - 10.3324/haematol.2021.278438
DO - 10.3324/haematol.2021.278438
M3 - Article
C2 - 34162178
AN - SCOPUS:85129251976
SN - 0390-6078
VL - 107
SP - 1086
EP - 1094
JO - Haematologica
JF - Haematologica
IS - 5
ER -