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

Abstract

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.

Clinical, Diagnostic and Prognostic Characteristics of Primary Cutaneous Gamma Delta T-cell Lymphomas

“…Over the last two decades, the use of targeted and biomarker-driven therapies in peripheral T-cell lymphoma increased [ 48 , 49 ]. Several agents targeting cell surface receptors have been used, including brentuximab, a CD30-directed therapy used in patients with Hodgkin lymphoma and systemic anaplastic large cell lymphoma [ 50 ]. Brentuximab was investigated with some efficacy in cases of CD30-positive PCDGTL [ 51 , 52 ].…”

Impact of the first COVID-19 lockdown in Germany on the rate of acute infections during intensive chemotherapy for Hodgkin lymphoma

“…Acute infections and fever under chemotherapy are an important cause of morbidity and mortality in hematologic malignancies [1][2][3][4][5][6][7][8]. For patients with advanced-stage Hodgkin lymphoma (HL) in particular, treatment-related morbidity rates of up to 66% can be observed, depending on the chemotherapy's intensity [3,4,9,10]: treatmentrelated Common Terminology Criteria for Adverse Events (CTCAE) Grade 3/4 infections are documented in up to 17% of the patients and febrile neutropenia in 33% of the patients [10]. Therefore, prophylactic anti-infective medication is prescribed frequently, although evidence for positive effects in patients with lymphatic malignancies is limited [5,8].…”

Biomodulatory Treatment Regimen, MEPED, Rescues Relapsed and Refractory Classic Hodgkin’s Disease

“…Modern anthracycline-based treatment regimens with or without radiation currently cure beyond 80% of patients, especially in low-risk situations and in early stages of disease. Patients with high risk/advanced stages on the other hand are only cured in 70% of cases (Rathore und Kadin 2010;Dalal et al, 2020). While chemotherapy can also be used in patients >60 years of age with good treatment results, some of the elderly patients do not tolerate ABVD, the least aggressive and commonly used chemotherapeutic treatment approach for this age group.…”