ABVD versus BEACOPP for Hodgkins lymphoma when high-dose salvage is planned Full Text
New England Journal of Medicine, 08/06/2011  Clinical Article

Viviani S et al. – Treatment with BEACOPP, as compared with ABVD, resulted in better initial tumor control, but the long-term clinical outcome did not differ significantly between the two regimens

• Randomly assigned 331 patients with previously untreated and unfavorable Hodgkin's lymphoma (stage IIB, III, or IV, or an international prognostic score of ≥3 on a scale of 0 to 7, with higher scores indicating increased risk), to receive either BEACOPP or ABVD, each followed by local radiotherapy when indicated
• Patients with residual or progressive disease after the initial therapy were to be treated according to a state-of-the-art high-dose salvage program
• Median follow-up period was 61 months

• 7-year rate of freedom from first progression was 85% among patients who had received initial treatment with BEACOPP and 73% among those who had received initial treatment with ABVD (P=0.004), and the 7-year rate of event-free survival was 78% and 71%, (P=0.15)
• Total of 65 patients (20 in BEACOPP group, and 45 in ABVD group) went on to receive the intended high-dose salvage regimen
• As of cutoff date, 3 of 20 patients in the BEACOPP group and 15 of the 45 in the ABVD group who had had progressive disease or relapse after the initial therapy were alive and free of disease
• After completion of the overall planned treatment, including salvage therapy, the 7-year rate of freedom from a second progression was 88% in the BEACOPP group and 82% in the ABVD group (P=0.12), and 7-year rate of OS was 89% and 84%, respectively (P=0.39)
• Severe AEs occurred more frequently in the BEACOPP group than in ABVD group