The preferred regimen for patients with advanced stage Hodgkin lymphoma remains a question debated among physicians who treat this patient population, said Alison J. Moskowitz, MD.
One of the most important prognostic factors of how a patient will respond to therapy is a PET scan after receiving doxorubicin (Adriamycin), bleomycin, vinblastine, and dacarbazine (ABVD). Interim PET-CT scanning was successfully used to adapt treatment regimens in patients with advanced classical Hodgkin lymphoma, according to the results of the international RATHL trial. Although the results fell short of the specified noninferiority margin, the omission of bleomycin from the ABVD regimen resulted in a lower incidence of pulmonary toxic events versus continued treatment with ABVD but not in significantly lowered efficacy.
With a median follow up of 41 months, the 3-year progression-free survival (PFS) rate and overall survival rate in the ABVD group was 85.7% (95% CI, 80.7%-87.5%) and 97.6% (95% CI, 95.1%-98.7%), respectively, versus 84.4% (95% CI, 80.7-87.5) and 97.6% (95% CI, 95.6-98.7) in the doxorubicin, vinblastine, and dacarbazine (AVD) arm.1
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