PET-adapted therapy for advanced Hodgkin lymphoma – systematic review

Amitai, Irina; Gurion, Ronit; Vidal, Liat; Dann, Eldad J.; Raanani, Pia; Gafter‐Gvili, Anat

doi:10.1080/0284186x.2018.1426877

Cited by 10 publications

(5 citation statements)

References 38 publications

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“…Finally, as with previous studies, though PET2-positivity was clearly associated with a higher rate of treatment failures and early progressions, overall, patients with HL had excellent long-term outcomes regardless of PET2 status. Similar results were demonstrated previously, with an overall survival at 2 years ranging from 88 to 98% and at 5 years ranging from 85 to 95% [ 32 ].…”

Section: Discussionsupporting

confidence: 91%

Outcomes of Patients with Positive Interim Positron Emission Tomography (PET) Continuing ABVD in the Clinical Setting

Zheng

Gupta

Goyal

et al. 2023

Cancers

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Recent prospective clinical trial data suggest that patients with Hodgkin’s lymphoma who continue treatment with ABVD, despite failing to attain a complete metabolic response on interim PET (PET2+), may fare better than previously published. We describe the outcomes of PET2+ patients who continued ABVD and compare the performance of a quantitative measure based on the lesion-to-liver SUV ratio (LLS qPET2+) to that of the subjective Deauville criteria (dvPET2+). We analyzed all patients with newly diagnosed advanced-stage Hodgkin lymphoma treated with frontline ABVD at the Memorial Sloan Kettering Cancer Center between 2008 and 2017. Eligibility was set to correspond with the RATHL inclusion criteria. Images were reviewed by two nuclear medicine physicians and discordant cases were resolved with a third expert in consensus. qPET2+ was defined as LLS ≥ 1.3. We identified 227 patients of whom 25% (57) were qPET2+, but only 14% (31) were dvPET2+. Forty-eight patients (84%) continued ABVD with a 3-year PFS of 70% for qPET2+ and 64% for dvPET2+. In conclusion, interim PET interpretation in clinical practice may be associated with a higher rate of scans deemed positive. Irrespective of the criteria for PET2 positivity, a subset of patients may continue ABVD without a dismal outcome.

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Section: Discussionsupporting

confidence: 91%

Outcomes of Patients with Positive Interim Positron Emission Tomography (PET) Continuing ABVD in the Clinical Setting

Zheng

Gupta

Goyal

et al. 2023

Cancers

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“…One must ask oneself if the design of the study in this setting was proper and/or ethical since the PET-positive patients are usually salvaged with BEACOPPesc and have better outcomes with 4-year PFS rate being around 70%, although it was nor will be tested in randomized controlled trials. 27…”

Section: European Association Of Hematology Meeting 2018mentioning

confidence: 99%

“…These reflected the poor outcome in these patients with 2‐year mPFS rate being 57.5% in experimental arm and 42% in control arm with HR being 0.6. One must ask oneself if the design of the study in this setting was proper and/or ethical since the PET‐positive patients are usually salvaged with BEACOPPesc and have better outcomes with 4‐year PFS rate being around 70%, although it was nor will be tested in randomized controlled trials …”

Section: What Have We Learned From Echelon‐1?mentioning

confidence: 99%

FDA's and EMA's approval of brentuximab vedotin for advanced Hodgkin lymphoma: Another player in the town?

Milunović

Jakobac

Kursar

et al. 2019

European J of Haematology

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ECHELON-1 study is a randomized open-labeled controlled trial investigating whether addition of brentuximab vedotin to chemotherapy offers benefit over the standard chemotherapy regimen in advanced Hodgkin lymphoma. After a median follow-up of 24.6 months, it has met its primary endpoint the reduction of modified progression-free survival being 23 percent. However, the beneficial effects have not been seen across all subgroups leading to further questions. The main aim of this review is to tackle these questions to provide the reader with in-depth insight of pros and cons of this novel, promising but ultimately controversial regimen. K E Y W O R D Sbrentuximab vedotin, Hodgkin lymphoma, induction chemotherapy, monoclonal antibodies

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“…In addition to four studies reporting patients' response to PET responseadapted therapy [60,61,68,73,78], two recent SLRs have investigated PET and HL; one on interim PET results and prognosis concluded that negative interim PET results have a large advantage in terms of OS (moderate certainty evidence) [134]. A review of PET-adapted therapy for HL recommended a PET treatment approach as standard of care for advanced HL [135].…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of front-line treatments for advanced Hodgkin lymphoma: a systematic literature review

Dalal

Gupta²,

Price³

et al. 2020

Expert Review of Hematology

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Objective: To assess evidence on the safety and efficacy of ABVD (doxorubicin [Adriamycin®], bleomycin, vinblastine, and dacarbazine), BEACOPP (bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone), and A+AVD (brentuximab vedotin, with doxorubicin, vinblastine, and dacarbazine) for advanced-stage Hodgkin lymphoma (HL). Methods: A systematic literature review (SLR) was conducted on 29 July 2016 (updated 26 July 2018) to identify randomized controlled trials (RCTs) and non-RCTs assessing the treatment of newly-diagnosed advanced-stage HL with ABVD and BEACOPP (and their variants), and A+AVD. Results: The SLR identified 62 RCTs and 42 non-RCTs. Five-year overall survival rates for ABVD and BEACOPP were 60-97% and 84-99%, and 5-year progression-free survival rates were 58-81% and 83-96%, respectively. Both regimens were associated with tolerability issues and side effects. Discontinuation or dose reduction of bleomycin resulted in fewer adverse events, without significantly affecting efficacy. A head-to-head trial demonstrated improved efficacy for A+AVD vs ABVD, with an acceptable tolerability profile. No data from head-to-head trials comparing A+AVD with BEACOPP were available, and an indirect treatment comparison was not feasible. Conclusion: New therapies, such as A+AVD, maintain the efficacy observed with current treatments, and may provide a more tolerable treatment option for patients with advanced-stage HL.

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PET-adapted therapy for advanced Hodgkin lymphoma – systematic review

Abstract: This systematic review of PET-adapted therapy, mainly based on RCTs, suggests that a change to the treatment paradigm is appropriate in advanced HL.

Cited by 10 publications

References 38 publications

Outcomes of Patients with Positive Interim Positron Emission Tomography (PET) Continuing ABVD in the Clinical Setting

Outcomes of Patients with Positive Interim Positron Emission Tomography (PET) Continuing ABVD in the Clinical Setting

FDA's and EMA's approval of brentuximab vedotin for advanced Hodgkin lymphoma: Another player in the town?

Efficacy and safety of front-line treatments for advanced Hodgkin lymphoma: a systematic literature review

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