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ABVD versus BEACOPP for Hodgkin's lymphoma when high-dose salvage is planned.
N Engl J Med 2011; 365(3):203-12NEJM

Abstract

BACKGROUND

BEACOPP, an intensified regimen consisting of bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone, has been advocated as the new standard of treatment for advanced Hodgkin's lymphoma, in place of the combination of doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD).

METHODS

We randomly assigned 331 patients with previously untreated and unfavorable Hodgkin's lymphoma (stage IIB, III, or IV, or an international prognostic score of ≥3 on a scale of 0 to 7, with higher scores indicating increased risk), to receive either BEACOPP or ABVD, each followed by local radiotherapy when indicated. Patients with residual or progressive disease after the initial therapy were to be treated according to a state-of-the-art high-dose salvage program. The median follow-up period was 61 months.

RESULTS

The 7-year rate of freedom from first progression was 85% among patients who had received initial treatment with BEACOPP and 73% among those who had received initial treatment with ABVD (P=0.004), and the 7-year rate of event-free survival was 78% and 71%, respectively (P=0.15). A total of 65 patients (20 in the BEACOPP group, and 45 in the ABVD group) went on to receive the intended high-dose salvage regimen. As of the cutoff date, 3 of the 20 patients in the BEACOPP group and 15 of the 45 in the ABVD group who had had progressive disease or relapse after the initial therapy were alive and free of disease. After completion of the overall planned treatment, including salvage therapy, the 7-year rate of freedom from a second progression was 88% in the BEACOPP group and 82% in the ABVD group (P=0.12), and the 7-year rate of overall survival was 89% and 84%, respectively (P=0.39). Severe adverse events occurred more frequently in the BEACOPP group than in the ABVD group.

CONCLUSIONS

Treatment with BEACOPP, as compared with ABVD, resulted in better initial tumor control, but the long-term clinical outcome did not differ significantly between the two regimens. (Funded by Fondazione Michelangelo; ClinicalTrials.gov number, NCT01251107.).

Authors+Show Affiliations

Milan Cancer Institute, Milan, Italy.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21774708

Citation

Viviani, Simonetta, et al. "ABVD Versus BEACOPP for Hodgkin's Lymphoma when High-dose Salvage Is Planned." The New England Journal of Medicine, vol. 365, no. 3, 2011, pp. 203-12.
Viviani S, Zinzani PL, Rambaldi A, et al. ABVD versus BEACOPP for Hodgkin's lymphoma when high-dose salvage is planned. N Engl J Med. 2011;365(3):203-12.
Viviani, S., Zinzani, P. L., Rambaldi, A., Brusamolino, E., Levis, A., Bonfante, V., ... Gianni, A. M. (2011). ABVD versus BEACOPP for Hodgkin's lymphoma when high-dose salvage is planned. The New England Journal of Medicine, 365(3), pp. 203-12. doi:10.1056/NEJMoa1100340.
Viviani S, et al. ABVD Versus BEACOPP for Hodgkin's Lymphoma when High-dose Salvage Is Planned. N Engl J Med. 2011 Jul 21;365(3):203-12. PubMed PMID: 21774708.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - ABVD versus BEACOPP for Hodgkin's lymphoma when high-dose salvage is planned. AU - Viviani,Simonetta, AU - Zinzani,Pier Luigi, AU - Rambaldi,Alessandro, AU - Brusamolino,Ercole, AU - Levis,Alessandro, AU - Bonfante,Valeria, AU - Vitolo,Umberto, AU - Pulsoni,Alessandro, AU - Liberati,Anna Marina, AU - Specchia,Giorgina, AU - Valagussa,Pinuccia, AU - Rossi,Andrea, AU - Zaja,Francesco, AU - Pogliani,Enrico M, AU - Pregno,Patrizia, AU - Gotti,Manuel, AU - Gallamini,Andrea, AU - Rota Scalabrini,Delia, AU - Bonadonna,Gianni, AU - Gianni,Alessandro M, AU - ,, AU - ,, AU - ,, PY - 2011/7/22/entrez PY - 2011/7/22/pubmed PY - 2011/7/29/medline SP - 203 EP - 12 JF - The New England journal of medicine JO - N. Engl. J. Med. VL - 365 IS - 3 N2 - BACKGROUND: BEACOPP, an intensified regimen consisting of bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone, has been advocated as the new standard of treatment for advanced Hodgkin's lymphoma, in place of the combination of doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD). METHODS: We randomly assigned 331 patients with previously untreated and unfavorable Hodgkin's lymphoma (stage IIB, III, or IV, or an international prognostic score of ≥3 on a scale of 0 to 7, with higher scores indicating increased risk), to receive either BEACOPP or ABVD, each followed by local radiotherapy when indicated. Patients with residual or progressive disease after the initial therapy were to be treated according to a state-of-the-art high-dose salvage program. The median follow-up period was 61 months. RESULTS: The 7-year rate of freedom from first progression was 85% among patients who had received initial treatment with BEACOPP and 73% among those who had received initial treatment with ABVD (P=0.004), and the 7-year rate of event-free survival was 78% and 71%, respectively (P=0.15). A total of 65 patients (20 in the BEACOPP group, and 45 in the ABVD group) went on to receive the intended high-dose salvage regimen. As of the cutoff date, 3 of the 20 patients in the BEACOPP group and 15 of the 45 in the ABVD group who had had progressive disease or relapse after the initial therapy were alive and free of disease. After completion of the overall planned treatment, including salvage therapy, the 7-year rate of freedom from a second progression was 88% in the BEACOPP group and 82% in the ABVD group (P=0.12), and the 7-year rate of overall survival was 89% and 84%, respectively (P=0.39). Severe adverse events occurred more frequently in the BEACOPP group than in the ABVD group. CONCLUSIONS: Treatment with BEACOPP, as compared with ABVD, resulted in better initial tumor control, but the long-term clinical outcome did not differ significantly between the two regimens. (Funded by Fondazione Michelangelo; ClinicalTrials.gov number, NCT01251107.). SN - 1533-4406 UR - https://www.unboundmedicine.com/medline/citation/21774708/ABVD_versus_BEACOPP_for_Hodgkin's_lymphoma_when_high_dose_salvage_is_planned_ L2 - http://www.nejm.org/doi/full/10.1056/NEJMoa1100340?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -