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Older patients (aged ≥60 years) with previously untreated advanced-stage classical Hodgkin lymphoma: a detailed analysis from the phase III ECHELON-1 study

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...

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Autores principales: Evens, Andrew M., Connors, Joseph M., Younes, Anas, Ansell, Stephen M., Kim, Won Seog, Radford, John, Feldman, Tatyana, Tuscano, Joseph, Savage, Kerry J., Oki, Yasuhiro, Grigg, Andrew, Pocock, Christopher, Dlugosz-Danecka, Monika, Fenton, Keenan, Forero-Torres, Andres, Liu, Rachael, Jolin, Hina, Gautam, Ashish, Gallamini, Andrea
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Fondazione Ferrata Storti 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9052913/
https://www.ncbi.nlm.nih.gov/pubmed/34162178
http://dx.doi.org/10.3324/haematol.2021.278438
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author Evens, Andrew M.
Connors, Joseph M.
Younes, Anas
Ansell, Stephen M.
Kim, Won Seog
Radford, John
Feldman, Tatyana
Tuscano, Joseph
Savage, Kerry J.
Oki, Yasuhiro
Grigg, Andrew
Pocock, Christopher
Dlugosz-Danecka, Monika
Fenton, Keenan
Forero-Torres, Andres
Liu, Rachael
Jolin, Hina
Gautam, Ashish
Gallamini, Andrea
author_facet Evens, Andrew M.
Connors, Joseph M.
Younes, Anas
Ansell, Stephen M.
Kim, Won Seog
Radford, John
Feldman, Tatyana
Tuscano, Joseph
Savage, Kerry J.
Oki, Yasuhiro
Grigg, Andrew
Pocock, Christopher
Dlugosz-Danecka, Monika
Fenton, Keenan
Forero-Torres, Andres
Liu, Rachael
Jolin, Hina
Gautam, Ashish
Gallamini, Andrea
author_sort Evens, Andrew M.
collection PubMed
description 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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spelling pubmed-90529132022-05-13 Older patients (aged ≥60 years) with previously untreated advanced-stage classical Hodgkin lymphoma: a detailed analysis from the phase III ECHELON-1 study Evens, Andrew M. Connors, Joseph M. Younes, Anas Ansell, Stephen M. Kim, Won Seog Radford, John Feldman, Tatyana Tuscano, Joseph Savage, Kerry J. Oki, Yasuhiro Grigg, Andrew Pocock, Christopher Dlugosz-Danecka, Monika Fenton, Keenan Forero-Torres, Andres Liu, Rachael Jolin, Hina Gautam, Ashish Gallamini, Andrea Haematologica Article 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. Fondazione Ferrata Storti 2021-06-24 /pmc/articles/PMC9052913/ /pubmed/34162178 http://dx.doi.org/10.3324/haematol.2021.278438 Text en Copyright© 2022 Ferrata Storti Foundation https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution Noncommercial License (by-nc 4.0) which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.
spellingShingle Article
Evens, Andrew M.
Connors, Joseph M.
Younes, Anas
Ansell, Stephen M.
Kim, Won Seog
Radford, John
Feldman, Tatyana
Tuscano, Joseph
Savage, Kerry J.
Oki, Yasuhiro
Grigg, Andrew
Pocock, Christopher
Dlugosz-Danecka, Monika
Fenton, Keenan
Forero-Torres, Andres
Liu, Rachael
Jolin, Hina
Gautam, Ashish
Gallamini, Andrea
Older patients (aged ≥60 years) with previously untreated advanced-stage classical Hodgkin lymphoma: a detailed analysis from the phase III ECHELON-1 study
title Older patients (aged ≥60 years) with previously untreated advanced-stage classical Hodgkin lymphoma: a detailed analysis from the phase III ECHELON-1 study
title_full Older patients (aged ≥60 years) with previously untreated advanced-stage classical Hodgkin lymphoma: a detailed analysis from the phase III ECHELON-1 study
title_fullStr Older patients (aged ≥60 years) with previously untreated advanced-stage classical Hodgkin lymphoma: a detailed analysis from the phase III ECHELON-1 study
title_full_unstemmed Older patients (aged ≥60 years) with previously untreated advanced-stage classical Hodgkin lymphoma: a detailed analysis from the phase III ECHELON-1 study
title_short Older patients (aged ≥60 years) with previously untreated advanced-stage classical Hodgkin lymphoma: a detailed analysis from the phase III ECHELON-1 study
title_sort older patients (aged ≥60 years) with previously untreated advanced-stage classical hodgkin lymphoma: a detailed analysis from the phase iii echelon-1 study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9052913/
https://www.ncbi.nlm.nih.gov/pubmed/34162178
http://dx.doi.org/10.3324/haematol.2021.278438
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