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评估PET引导的BrECADD与EBEACOPP在晚期古典霍奇金淋巴瘤 (HD21) 中的疗效和耐受性:一个随机,多中心,并行,开放的第3期试验

Peter Borchmann¹, Justin Ferdinandus¹, Gundolf Schneider¹

¹Faculty of Medicine, University of Cologne, Cologne, Germany; Department I of Internal Medicine, University Hospital of Cologne, Cologne, Germany; Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf, University Hospital, Düsseldorf, Germany; German Hodgkin Study Group, Cologne, Germany.

Lancet (London, England)

|July 6, 2024

概括

与EBEACOPP相比,Brentuximab vedotin,etoposide,cycclophosphamide,doxorubicin,dacarbazine和dexamethasone (BrECADD) 的耐受性和疗效在晚期的经典霍奇金淋巴瘤中得到了改善. 这种以PET为指导的治疗方案提高了患者的风险益处比率.

科学领域:

癌症学
临床试验
血液学

背景情况:

晚期经典霍奇金淋巴瘤 (cHL) 通过强化化疗获得高治愈率,但引起显著的毒性.
布伦图西马布维多丁,埃托波西德,环胺,多克索鲁比辛,达卡巴和德克萨 (BrECADD) 是一种旨在改善风险效益的新疗法.
两次循环后的正子发射断层扫描 (PET) 图像指导治疗决策.

研究的目的:

为了比较 BrECADD 治疗方案与升级 BEACOPP (eBEACOPP) 治疗新诊断的晚期慢性肝炎患者的耐受性和疗效.
通过减少与治疗相关的发病率,同时保持或改善无进展的生存率,评估BrECADD是否能改善风险与益处的比率.

主要方法:

一个随机的,多中心的3期试验,涉及到晚期cHL的成年人 (≤60岁).
患者被分配到四个或六个eBEACOPP或PET引导的BrECADD周期.
主要终点包括与治疗相关的发病率和无进展生存期 (PFS).

主要成果:

BrECADD显示与治疗相关的发病率显著降低 (42%对59%;p< 0. 0001).
在48个月的随访中位数,BrECADD显示PFS改善 (4年估计为94. 3%与90. 9%;HR为0. 66;p=0. 035).
两组的四年总生存率高且相似 (98. 6% 和 98. 2%).

结论:

在晚期cHL的第一线治疗中,PET引导的BrECADD比EBEACOPP更好地耐受.
BrECADD疗法提供了更高的无进展生存率,使其成为更有效的治疗选择.
这种以PET为导向的方法优化了高级经典霍奇金淋巴瘤的治疗.

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