The Impact of Protocol Assignment for Older Adolescents with Hodgkin Lymphoma

Pieters, Richard S.; Wagner, Henry; Baker, Stephen P.; Morano, Karen; Ulin, Kenneth; Cicchetti, M. Giulia; Bishop–Jodoin, Maryann; Fitzgerald, Thomas J.

doi:10.3389/fonc.2014.00317

Cited by 10 publications

(5 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Today, radiation is delivered to only small defined areas and with different doses for adult and pediatric patients, with many adult protocols still using ;36 Gy and pediatric protocols using 15 to 25.5 Gy. 27,28 As efforts are made to decrease toxicity of therapy, an interim PET-adapted response has been incorporated into most adult and pediatric protocols to allow for the complete elimination of radiation therapy for patients with an "adequate early response," as defined by the protocol. However, because radiation therapy is efficacious for HL, between 30% and 100% of patients still receive radiation as part of their curative regimen in many protocols.…”

Section: The Aya Population: No Home For the Bulk Of Patientsmentioning

confidence: 99%

The management of Hodgkin lymphoma in adolescents and young adults: burden of disease or burden of choice?

Flerlage

Metzger

Bhakta

2018

Blood

View full text Add to dashboard Cite

Adolescents and young adults (AYAs) comprise the largest age group affected by Hodgkin lymphoma (HL). Despite excellent overall survival of AYA patients with HL due to advances in treatment regimens, therapy-associated late effects continue to be a concern in HL survivors, especially for younger patients who have decades of life remaining. Since the first clinical trial for HL with chemotherapy in 1964, subsequent protocols have attempted to reduce chemotherapy-induced toxicities and yet maintain high overall survival rates. Today, new analytic methods applied to data from survivorship cohorts, such as the recently described cumulative burden of disease metric, can be used to inform changes for future protocols. Although pediatric and adult trial consortia have followed this process, the AYA population, an age cohort split between pediatric and adult health care services, faces many barriers to care and is the least likely to be enrolled in clinical trials. AYA patients with HL theoretically have a choice to be treated in pediatric or adult protocols when presented with these options. Recent efforts by the National Clinical Trials Network, the Children's Oncology Group, and others have been made to ensure that the burden of choice for the AYA population is not greater than the burden of disease.

show abstract

Section: The Aya Population: No Home For the Bulk Of Patientsmentioning

confidence: 99%

The management of Hodgkin lymphoma in adolescents and young adults: burden of disease or burden of choice?

Flerlage

Metzger

Bhakta

2018

Blood

View full text Add to dashboard Cite

show abstract

“…7 In general, pediatric radiotherapy approaches utilize lower doses (15-25Gy) and fields (involved field or node). 14 The impact of improvements in radiotherapy planning with PET and CT guided planning and the restriction of radiation to slow responding sites of disease is being evaluated in a recently completed COG trial (NCT01026220). Furthermore, the use of proton therapy is being assessed in a COG trial for high-risk HL (NCT02166463), which may allow further reductions in normal tissue exposure by minimizing the exit dose.…”

Section: Lessons From Recent Clinical Trials In Children and Adolescementioning

confidence: 99%

Hodgkin lymphoma in children and adolescents: improving the therapeutic index

Kelly

2015

Blood

View full text Add to dashboard Cite

Hodgkin lymphoma (HL) is a highly curable form of childhood cancer, with estimated 5 year survival rates exceeding 98%. However, the establishment of a “standard of care” approach to its management is complicated by the recognition that long-term overall survival declines in part from delayed effects of therapy and that there continue to be subgroups of patients at risk for relapse for which prognostic criteria cannot adequately define. This challenge has resulted in the development of various strategies aimed at identifying the optimal balance between maintaining overall survival and avoidance of long-term morbidity of therapy, often representing strategies quite different from those used for adults with HL. More precise risk stratification and methods for assessing the chemosensitivity of HL through imaging studies and biomarkers are in evolution. Recent advances in the understanding of the biology of HL have led to the introduction of targeted therapies in both the frontline and relapsed settings. However, significant barriers exist in the development of new combination therapies, necessitating collaborative studies across pediatric HL research consortia and in conjunction with adult groups for the adolescent and young adult (AYA) population with HL.

show abstract

“…7 In general, pediatric radiotherapy approaches utilize lower doses and fields (involved field or node). 14 The impact of improvements in radiotherapy planning with PET and CT guided planning and the restriction of radiation to slow responding sites of disease is being evaluated in a recently completed COG trial (NCT01026220). Furthermore, the use of proton therapy is being assessed in a COG trial for high-risk HL (NCT02166463), which may allow further reductions in normal tissue exposure by minimizing the exit dose.…”

Section: Lessons From Recent Clinical Trials In Children and Adolescementioning

confidence: 99%

Hodgkin lymphoma in children and adolescents: improving the therapeutic index

Kelly

2015

Hematology

View full text Add to dashboard Cite

Hodgkin lymphoma (HL) is a highly curable form of childhood cancer, with estimated 5 year survival rates exceeding 98%. However, the establishment of a "standard of care" approach to its management is complicated by the recognition that long-term overall survival declines in part from delayed effects of therapy and that there continue to be subgroups of patients at risk for relapse for which prognostic criteria cannot adequately define. This challenge has resulted in the development of various strategies aimed at identifying the optimal balance between maintaining overall survival and avoidance of long-term morbidity of therapy, often representing strategies quite different from those used for adults with HL. More precise risk stratification and methods for assessing the chemosensitivity of HL through imaging studies and biomarkers are in evolution. Recent advances in the understanding of the biology of HL have led to the introduction of targeted therapies in both the frontline and relapsed settings. However, significant barriers exist in the development of new combination therapies, necessitating collaborative studies across pediatric HL research consortia and in conjunction with adult groups for the adolescent and young adult (AYA) population with HL.

show abstract

The Impact of Protocol Assignment for Older Adolescents with Hodgkin Lymphoma

Cited by 10 publications

References 24 publications

The management of Hodgkin lymphoma in adolescents and young adults: burden of disease or burden of choice?

The management of Hodgkin lymphoma in adolescents and young adults: burden of disease or burden of choice?

Hodgkin lymphoma in children and adolescents: improving the therapeutic index

Hodgkin lymphoma in children and adolescents: improving the therapeutic index

Contact Info

Product

Resources

About