SAFETY AND EFFICACY ANALYSIS OF ELDERLY PATIENTS TREATED WITHIN THE <scp>GATLA HL</scp>‐05 CLINICAL TRIAL: <scp>PET</scp> ADAPTED THERAPY AFTER 3 CYCLES OF <scp>ABVD</scp> FOR ALL STAGES OF <scp>H</scp>ODGKIN LYMPHOMA

Ciliberti, Esteban; Fernández, Inmaculada; Kurgansky, Nicolas Matias; Prates, Virginia; Zoppegno, Lucia; Negri, Pedro; Milone, Giuseppe; Cerutti, Ider; Zabaljauregui, Soledad; Mariano, Rodrigo; Grecco, Horacio Fernández; Saba, Silvia; Sackmann, Federico; Castano, Vanesa; Remaggi, Guillermina; Cabrejo, María; Rudoy, Silvia; Roveri, E.; Cabane, V.; Gumpel, C.; Taus, R.; Casale, M.; Sakamoto, Francisco; Pavlovsky, A J

doi:10.1002/hon.2438_26

Cited by 2 publications

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“…The study suggests that iPET is useful in guidance of the treatment goal, i.e., to continue with curative intent or palliative care. This notion is further confirmed by the sub analysis of the GATLA LH-05 trial [ 47 , 48 ]. Treatment with three cycles of ABVD and iPET CMR had excellent outcomes, with median PFS and OS not reached.…”

Section: Does Abvd Regimen Treatment Have a Role In Elderly Patients ...mentioning

confidence: 67%

“…The BV-bendamustine regimen must be delivered with great caution along with adequate supportive care [ 73 ]. The use of the interim-PET-CT-based approach is attractive due to the possible omission of bleomycin in later cycles after initiating treatment with ABVD, and other modifications made in the case of positive iPET results (palliation or enrollment into a clinical trial) [ 48 ].…”

Section: Conclusion: Is There Evidence-based Medicine In the Treatmen...mentioning

confidence: 99%

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Clinical Dilemmas in the Treatment of Elderly Patients Suffering from Hodgkin Lymphoma: A Review

et al. 2022

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Elderly patients make up a significant number of cases of newly diagnosed Hodgkin lymphoma. However, unlike in young patients, the outcomes of elderly patients are poor, and they are under-represented in phase III trials. Prior to treatment initiation, geriatric assessment should ideally be performed to address the patient’s fitness and decide whether to pursue a curative or palliative approach. The ABVD regimen is poorly tolerated in unfit patients, with high treatment-related mortality. Alternative chemotherapy approaches have been explored, with mixed results obtained concerning their feasibility and toxicity in phase II trials. The introduction of brentuximab vedotin-based regimens led to a paradigm shift in first- and further-line treatment of elderly Hodgkin lymphoma patients, providing adequate disease control within a broader patient population. As far as checkpoint inhibitors are concerned, we are only just beginning to understand the role in the treatment of this population. In relapsed/refractory settings there are few options, ranging from autologous stem cell transplantation in selected patients to pembrolizumab, but unfortunately, palliative care is the most common modality. Importantly, published studies are frequently burdened with numerous biases (such as low numbers of patients, selection bias and lack of geriatric assessment), leading to low level of evidence. Furthermore, there are few ongoing studies on this topic. Thus, elderly Hodgkin lymphoma patients are hard to treat and represent an unmet need in hematologic oncology. In conclusion, treatment needs to be personalized and tailored on a case-by-case basis. In this article, we outline treatment options for elderly Hodgkin lymphoma patients.

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Section: Does Abvd Regimen Treatment Have a Role In Elderly Patients ...mentioning

confidence: 67%

Section: Conclusion: Is There Evidence-based Medicine In the Treatmen...mentioning

confidence: 99%

Clinical Dilemmas in the Treatment of Elderly Patients Suffering from Hodgkin Lymphoma: A Review

et al. 2022

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“…Increasing cycle numbers of ABVD has also been shown to increase grade III/IV toxicities in older patients 66 . Analysis of 43 older patients treated within the GATLA‐HL05 trial for all stages of HL with a PET‐adapted approach to stop treatment after three cycles of ABVD revealed a low incidence of toxicity and excellent three‐year PFS (88%), similar to younger patients in the same trial 67 …”

Section: Management Of Hodgkin Lymphoma In Elderly Patientsmentioning

confidence: 82%

“…66 Analysis of 43 older patients treated within the GATLA-HL05 trial for all stages of HL with a PET-adapted approach to stop treatment after three cycles of ABVD revealed a low incidence of toxicity and excellent three-year PFS (88%), similar to younger patients in the same trial. 67 A prospective randomised trial comparing vinblastine, cyclophosphamide, procarbazine, etoposide, mitoxantrone, bleomycin and prednisolone (VEPEM-B) with ABVD in fit elderly patients closed early with only 54 patients recruited. 68 The PFS and OS results for VEPEM-B appeared inferior and although the numbers were too small for statistical significance, they do not support a change in practice to use this regimen as a standard of care in the elderly.…”

Section: A Nage M E N T Of Hodgk I N Ly M Phom a I N E L Der Ly Patie...mentioning

confidence: 99%

Guideline for the first‐line management of Classical Hodgkin Lymphoma — A British Society for Haematology guideline

et al. 2022

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This guideline was compiled according to the British Society for Haematology (BSH) process at BSH Guidelines Process 2016 (b-s-h.org.uk). The Grading of Recommendations Assessment, Development and Evaluation (GRADE) nomenclature was used to evaluate levels of evidence and to assess the strength of recommendations. The GRADE criteria can be found at http://www.grade worki nggro up.org. Recommendations are based on a review of the literature using Medline, PubMed/ Medline and Cochrane searches beginning from 2013 up to January 2021. The following search terms were used: [Hodgkin lymphoma OR Hodgkin disease] NOT non-Hodgkin; AND [chemotherapy OR radiotherapy]; AND [elderly]; AND [teenage OR adolescent OR young adult]; AND [pregnancy]. Filters were applied to include only publications written in English, studies carried out in humans, clinical conferences, congresses, clinical trials, clinical studies, meta-analyses, multicentre studies and randomised controlled trials. References pre-2013 were taken from the previous version of this guideline. 1 Review of the manuscript was performed by the British Society for Haematology (BSH) Guidelines Committee Haematology Oncology Taskforce, the BSH Guidelines Committee and the Haematology Oncology sounding board of BSH.

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SAFETY AND EFFICACY ANALYSIS OF ELDERLY PATIENTS TREATED WITHIN THE GATLA HL‐05 CLINICAL TRIAL: PET ADAPTED THERAPY AFTER 3 CYCLES OF ABVD FOR ALL STAGES OF HODGKIN LYMPHOMA

Cited by 2 publications

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Clinical Dilemmas in the Treatment of Elderly Patients Suffering from Hodgkin Lymphoma: A Review

Clinical Dilemmas in the Treatment of Elderly Patients Suffering from Hodgkin Lymphoma: A Review

Guideline for the first‐line management of Classical Hodgkin Lymphoma — A British Society for Haematology guideline

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