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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...
Autores principales: | , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Fondazione Ferrata Storti
2021
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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. |
format | Online Article Text |
id | pubmed-9052913 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Fondazione Ferrata Storti |
record_format | MEDLINE/PubMed |
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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