Ten years’ experience with four cycles of bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, prednisone, procarbazine (BEACOPP)-escalated followed by four cycles of baseline-dose BEACOPP in patients with advanced stage Hodgkin lymphoma: a single-center, retrospective study

Abstract

The HD-9 trial showed that eight cycles of BEACOPP (bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, prednisone, procarbazine)-escalated led to significant improvements in response rate, progression-free survival and overall survival over COPP/ABVD (cyclophosphamide, vincristine, prednisone, procarbazine/doxorubicin, bleomycin, vinblastine, dacarbazine) therapy. This monocentric retrospective study was performed to evaluate 10 years of experience with four cycles of BEACOPP-escalated and four cycles of BEACOPP-baseline outside of clinical trials. The outcomes were assessed in 78 patients with newly diagnosed advanced stage Hodgkin lymphoma. A complete response after chemotherapy ± radiotherapy was achieved in 75 patients (96%). At the median follow-up of 74 months, the actuarial 5- and 10-year freedom from treatment failure (FFTF) rates were 91% and 89%, and actuarial 5- and 10-year overall survival rates for the entire group were 93% and 90%, respectively. These results suggest that the combination of escalated and baseline BEACOPP chemotherapy is feasible in routine practice with good efficacy and acceptable toxicity.

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

“…Reported 5-year PFS in non-RCTs for standard ABVD ranged from 58% to 81% [92,119]. Among the non-RCTs evaluating different combinations of BEACOPP BASE /BEACOPP ESC , the 5-year OS ranged from 84% to 97% [80,120] and the 10-year OS was 90% [84]. This compares with data from RCTs in which 5-year OS ranged from 90% to 99% [23,46].…”

“…Patients receiving bleomycin also experienced a higher incidence of Grade 3/4 dyspnea in one RCT (ABVD vs Stanford V, 17% vs 0%, respectively) [41] and one non-RCT (A+ABVD vs A+AVD, 12% vs 4%, respectively) [101]. Pneumonitis was reported in two RCTs [41,68] and three non-RCTs [84,98,101]. Any-grade pneumonitis ranged from 0% to 5% [68,84,98,101,102,124].…”

“…Pneumonitis was reported in two RCTs [41,68] and three non-RCTs [84,98,101]. Any-grade pneumonitis ranged from 0% to 5% [68,84,98,101,102,124]. Grade 3/4 pneumonitis was reported by 8% of patients who received ABVD vs 0% who received Stanford V [41].…”

“…The incidence of secondary malignancies ranged from 0-15% and 0.61-14% for ABVD-and BEACOPP-containing treatments, respectively ( Supplementary Table 19 Limited evidence on secondary malignancies was available from non-RCTs in advanced HL, with one study reporting three cases of large B-cell lymphoma with a BEACOPP treatment regimen [84]. In the ABVD-containing treatment regimens, secondary malignancies included NHL, melanoma, colorectal cancer, lung cancer, breast cancer, second lymphoma, lymphoblastic leukemia, and carcinoma of the tongue [83,95].…”

Effect of chemotherapy alone with adult chemotherapy regimens on prognosis of children and adolescents with Hodgkin's disease

“…Adults with HD are treated mainly with ABVD (11), COPP (12), BEACOPP (13) or Stanford V chemotherapy (14). Because these chemotherapy regimens were first used in adults, they are traditionally called adult regimens.…”