对高级霍奇金淋巴瘤试验的响应调整疗法的长期随访
Stefano Luminari1,2, Alexander Fossa3, Judith Trotman4
1Hematology, Azienda USL IRCCS of Reggio Emilia, Reggio Emilia, Italy.
概括
使用ABVD的治疗降级对于具有负PET扫描结果的高级霍奇金淋巴瘤患者是不劣的. 对PET阳性患者的升级BEACOPP显示有效性和长期安全性.
科学领域:
- 血液学 血液学 血液学
- 在瘤学瘤学.
- 临床试验 临床试验
背景情况:
- 临床试验往往在二次或共同初级分析之前报告初级终点结果.
- 临床试验更新允许传播研究的后期结果,其中已经报告了主要终点.
研究的目的:
- 为了确认治疗降级的非劣势性 (从ABVD中省略白血素) 对于临时氧葡萄糖正子发射断层扫描 (iPET) 阴性高级霍奇金淋巴瘤患者.
- 评估IPET阳性患者治疗强化 (BEACOPP/BEACOPP14) 的疗效和长期安全性.
主要方法:
- 对针对晚期霍奇金淋巴瘤成年患者的响应适应试验的长期结果的分析.
- 在减缓ABVD/AVD和强化BEACOPP疗法之间,无进展生存 (PFS) 和整体生存 (OS) 的比较.
- 评估第二恶性瘤的累积发病率.
主要成果:
- 所有患者的七年PFS和OS分别为78.2%和91.6%.
- 在ABVD和AVD之间的3年PFS的差异在非劣势差距内.
- 在IPET阳性患者中,7年PFS为65.9%,OS为83.2%. 在7年内,第二次恶性瘤的累积发病率为ABVD/AVD的5.5%,BEACOPP的2.5%.
结论:
- 通过从ABVD中省略白血素来缓解治疗升级,对于iPET阴性高级霍奇金淋巴瘤患者来说是非劣质的.
- 对IPET阳性患者的BEACOPP治疗升级是有效和安全的,没有增加第二恶性瘤的风险.
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