ABVD Remains Best Treatment for Advanced Hodgkin’s Lymphoma

According to the Journal of Clinical Oncology, the chemotherapy regimen ABVD appears to remain the best treatment option for advancedHodgkin’s lymphoma.

Stages IIB–IV Hodgkin’s lymphoma involve cancer that has spread from the site of origin to other sites in the body. Standard treatment for stages IIB-IV Hodgkin’s lymphoma is combination chemotherapy and/or radiation therapy. The standard chemotherapy regimen for these patients has been ABVD: doxorubicin (Adriamycin(R)), bleomycin (Blenoxane(R)), Velban(R) (vinblastine), and dacarbazine (DTIC-Dome(R)). Researchers have been comparing ABVD to other chemotherapy regimens to definitively determine which combination produces the highest cure rates with the fewest side effects.

Researchers from Italy recently reported the final results from a multi-center phase III clinical trial directly comparing three different chemotherapy regimens in the treatment of patients with stages IIB–IV Hodgkin’s lymphoma.

Patients were randomized to receive one of the three chemotherapy regimens:

MOPP-EBV-CAD (nitrogen mustard, vincristine, procarbazine, prednisone, epirubicin, bleomycin, vinblastine, lomustine, melphalan, vindisine—also referred to as MEC)
Stanford V regimen (mustargen, doxorubicin, vinblastine, vincristine, bleomycin, etoposide, prednisone). Patients were treated with radiation therapy if they had residual cancer following chemotherapy or sites of previously “bulky” cancer.

At 5 years, overall survival was similar between the three groups:

90% for those treated with ABVD
89% for those treated with MEC
82% for those treated with Stanford SV
However, at 5 years the rate of patients who did not have cancer progression favored MEC: 89% for MEC, 79% for ABVD, and 55% for SV.

The rate of severe side effects including low levels of blood cells and infection were significantly higher in patients treated with MEC than ABVD or SV. Treatment with MEC (47%) resulted in a lower percentage of patients having to undergo radiation therapy than ABVD (62%) or SV (66%).

The researchers concluded that, for the time being, ABVD should remain the standard of care as initial treatment for patients with stages IIB-IV Hodgkin’s lymphoma.

Of course you should talk with your physicians to see what treatments are best for you.

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