Universität zu Köln

Kreissl, S., Eichenauer, D. and Borchmann, P. (2014). New developments in the treatment of advanced Hodgkin's lymphoma. Onkologe, 20 (5). S. 457 - 463. NEW YORK: SPRINGER. ISSN 1433-0415

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Abstract

With the current standard of care of the German Hodgkin Study Group (GHSG) consisting of 6 cycles of the BEACOPP(escalated) regimen and radiotherapy of residual lymphomas a parts per thousand yenaEuro parts per thousand 2.5 cm, the overall survival (OS) of patients with advanced Hodgkin's lymphoma (HL) is 95 %. However, minimizing acute and late toxicities without compromising the tumor-specific outcome of patients is the major goal of current clinical research. Defining the correct balance between efficacy and toxicity remains the most important challenge in treatment of HL. This article presents an evidence-based systematic review of the current status of therapy as well as new developments in the treatment of advanced HL. A systematic literature search was carried out and relevant publications as well as new developments in the treatment of advanced HL tested in current trials are summarized. Recent comparisons of the BEACOPP(escalated) and ABVD regimens showed a substantial benefit of BEACOPP(escalated) in terms of progression-free survival (PFS) and OS. In combination with supportive treatment measures, such as obligatory prephase treatment with dexamethasone for patients older than 40 years and prophylactic antibiotic treatment during the time of aplasia, 6 cycles of BEACOPP(escalated) can be considered a safe and feasible therapy. Thus, minimizing acute and late toxicities without compromising the tumor-specific outcome of patients is the major goal of current clinical research. The recruiting GHSG HD18 trial investigates the reduction from 6 to 4 cycles of BEACOPP(escalated) for patients with good, early tumor response as defined by positron emission tomography (PET). Another strategy might be the implementation of targeted drugs into the first-line therapy. This approach is currently being evaluated in the GHSG targeted BEACOPP study (NCT01569204) with the implementation of brentuximab vedotin into two modified BEACOPP regimens. The major goal in the treatment of advanced HL is the implementation of targeted drugs into the first-line therapy. Targeted drugs might replace unspecific cytotoxic drugs, which cause systemic toxicity. Brentuximab vedotin was approved for use in Europe in November 2012 for the treatment of relapsed or refractory HL and is currently being investigated in combination with two modified escalated BEACOPP regimens in advanced stage HL patients in the targeted BEACOPP trial. Hopefully, these new combinations will improve the current standard of care in the treatment of HL regarding both efficacy and tolerability.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Kreissl, S. UNSPECIFIED UNSPECIFIED UNSPECIFIED Eichenauer, D. UNSPECIFIED UNSPECIFIED UNSPECIFIED Borchmann, P. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-439215
DOI:	10.1007/s00761-013-2637-3
Journal or Publication Title:	Onkologe
Volume:	20
Number:	5
Page Range:	S. 457 - 463
Date:	2014
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	1433-0415
Language:	German
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language BRENTUXIMAB VEDOTIN; GONADAL-FUNCTION; TRIAL; ABVD; CHEMOTHERAPY; FERTILITY; SURVIVORS; BEACOPP; SGN-35 Multiple languages Oncology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/43921