Difference between revisions of "Classical Hodgkin lymphoma - historical"
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− | The purpose of this page is to provide references to regimens that are obsolete, outdated, or of historical interest only | + | <span id="BackToTop"></span> |
− | + | <div class="noprint" style="background-color:LightGray; position:fixed; bottom:2%; right:0.25%; padding-left:5px; padding-right:5px; margin: 15px; opacity:0.8; border-style: solid; border-color:DarkGray; border-width: 1px"> | |
+ | [[#top|Back to Top]] | ||
+ | </div> | ||
+ | The purpose of this page is to provide references to regimens that are obsolete, outdated, or of historical interest only. Is there a regimen missing from this list? See the [[Classical_Hodgkin_lymphoma|main cHL page]] for current regimens. | ||
{| class="wikitable" style="float:right; margin-right: 5px;" | {| class="wikitable" style="float:right; margin-right: 5px;" | ||
|- | |- | ||
− | |<div style="background-color: #fee0d1; border: 1px solid #808000; padding: 5px; {{border-radius|16px}}" align="right"><font size="4"><b>{{#ask: [[-Has subobject::{{FULLPAGENAME}}]] | + | |<div style="background-color: #fee0d1; border: 1px solid #808000; padding: 5px; {{border-radius|16px}}" align="right"><font size="4"><b>{{#ask: [[-Has subobject::{{FULLPAGENAME}}]] |?Regimen |limit=10000|format=sum}} [[Tutorial#Regimens|regimens]] on this page</b></font></div> |
− | <div style="background-color: #deebf6; border: 1px solid #808000; padding: 5px; {{border-radius|16px}}"><font size="4"><b>{{#ask: [[-Has subobject::{{FULLPAGENAME}}]] | + | <div style="background-color: #deebf6; border: 1px solid #808000; padding: 5px; {{border-radius|16px}}"><font size="4"><b>{{#ask: [[-Has subobject::{{FULLPAGENAME}}]] |?Variant |limit=10000|format=sum}} [[Tutorial#Variants|variants]] on this page</b></font></div> |
− | |} | + | |} |
− | |||
{{TOC limit|limit=3}} | {{TOC limit|limit=3}} | ||
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=Untreated= | =Untreated= | ||
− | + | ==ABVDm {{#subobject:3065be|Regimen=1}}== | |
− | == | + | ABVDm: '''<u>A</u>'''driamycin (Doxorubicin), '''<u>B</u>'''leomycin, '''<u>V</u>'''inblastine, '''<u>D</u>'''acarbazine, '''<u>m</u>'''ethylprednisolone |
− | {| class="wikitable" style=" | + | <div class="toccolours" style="background-color:#ee6b6e"> |
+ | ===Regimen {{#subobject:c39ab4|Variant=1}}=== | ||
+ | {| class="wikitable sortable" style="width: 100%; text-align:center;" | ||
+ | !style="width: 20%"|Study | ||
+ | !style="width: 20%"|Dates of enrollment | ||
+ | !style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]] | ||
+ | !style="width: 20%"|Comparator | ||
+ | !style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]] | ||
+ | |- | ||
+ | |[https://doi.org/10.1182/blood-2003-05-1611 Le Maignan et al. 2003 (H90-NM)] | ||
+ | |1990-1996 | ||
+ | | style="background-color:#1a9851" |Phase 3 (C) | ||
+ | |[[#EBVMm_999|EBVMm]] | ||
+ | | style="background-color:#ffffbf" |Did not meet primary endpoint of OS | ||
|- | |- | ||
− | |||
|} | |} | ||
+ | ''Note: the manuscript states that the drugs were given on days 1 & 14, which is clearly incorrect.'' | ||
+ | <div class="toccolours" style="background-color:#b3e2cd"> | ||
+ | ====Chemotherapy==== | ||
+ | *[[Doxorubicin (Adriamycin)]] 25 mg/m<sup>2</sup> IV once per day on days 1 & 15 | ||
+ | *[[Bleomycin (Blenoxane)]] 10 mg/m<sup>2</sup> IV once per day on days 1 & 15 | ||
+ | *[[Vinblastine (Velban)]] 6 mg/m<sup>2</sup> IV once per day on days 1 & 15 | ||
+ | *[[Dacarbazine (DTIC)]] 375 mg/m<sup>2</sup> IV once per day on days 1 & 15 | ||
+ | ====Glucocorticoid therapy==== | ||
+ | *[[Methylprednisolone (Solumedrol)]] 120 mg/m<sup>2</sup> IV once per day on days 1 & 15 | ||
+ | '''28-day cycle for 3 cycles''' | ||
+ | </div></div> | ||
+ | ===References=== | ||
+ | # '''H90-NM:''' Le Maignan C, Desablens B, Delwail V, Dib M, Berthou C, Vigier M, Ghandour C, Atmani S, Casassus P, Maisonneuve H, Le Mevel A, Traulle C, Bernard M, Briere J, Colonna P, Andrieu JM. Three cycles of adriamycin, bleomycin, vinblastine, and dacarbazine (ABVD) or epirubicin, bleomycin, vinblastine, and methotrexate (EBVM) plus extended field radiation therapy in early and intermediate Hodgkin disease: 10-year results of a randomized trial. Blood. 2004 Jan 1;103(1):58-66. Epub 2003 Aug 7. [https://doi.org/10.1182/blood-2003-05-1611 link to original article] '''dosing details in manuscript have been reviewed by our editors''' [https://pubmed.ncbi.nlm.nih.gov/12907440/ PubMed] | ||
− | + | ==COMP {{#subobject:8ee324|Regimen=1}}== | |
− | + | COMP: '''<u>C</u>'''yclophosphamide, '''<u>O</u>'''ncovin (Vincristine), '''<u>M</u>'''ethotrexate, '''<u>P</u>'''rednisone | |
− | ===Regimen {{#subobject: | + | <div class="toccolours" style="background-color:#ee6b6e"> |
− | {| class="wikitable" style="width: | + | ===Regimen {{#subobject:48feb0|Variant=1}}=== |
− | !style="width: | + | {| class="wikitable sortable" style="width: 60%; text-align:center;" |
− | !style="width: | + | !style="width: 33%"|Study |
− | + | !style="width: 33%"|Dates of enrollment | |
− | !style="width: | + | !style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]] |
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
− | |||
|- | |- | ||
− | | | + | |[https://aacrjournals.org/cancerres/article/27/7/1258/476610/Intensive-Combination-Chemotherapy-and-X Moxley et al. 1967] |
− | |style="background-color:# | + | |1963 to not reported |
+ | | style="background-color:#ffffbe" |Pilot | ||
|- | |- | ||
|} | |} | ||
+ | <div class="toccolours" style="background-color:#b3e2cd"> | ||
====Chemotherapy==== | ====Chemotherapy==== | ||
− | *[[ | + | *[[Cyclophosphamide (Cytoxan)]] 600 mg/m<sup>2</sup> IV once per day on days 1 & 8 |
− | *[[Vincristine (Oncovin)]] | + | *[[Vincristine (Oncovin)]] 1.2 mg/m<sup>2</sup> IV once per day on days 1 & 8 |
− | *[[ | + | *[[Methotrexate (MTX)]] 30 mg/m<sup>2</sup> IM once per day on days 1, 4, 8, 11 |
− | *[[Prednisone (Sterapred)]] | + | ====Glucocorticoid therapy==== |
− | + | *[[Prednisone (Sterapred)]] 60 mg/m<sup>2</sup> PO once per day on days 1 to 14 | |
+ | '''21-day cycle for 3 cycles''' | ||
+ | </div></div> | ||
===References=== | ===References=== | ||
− | # | + | # Moxley JH 3rd, De Vita VT, Brace K, Frei E 3rd. Intensive combination chemotherapy and X-irradiation in Hodgkin's disease. Cancer Res. 1967 Jul;27(7):1258-63. [https://aacrjournals.org/cancerres/article/27/7/1258/476610/Intensive-Combination-Chemotherapy-and-X link to original article] '''dosing details in manuscript have been reviewed by our editors''' [https://pubmed.ncbi.nlm.nih.gov/4952914/ PubMed] |
==COPP/ABVD {{#subobject:92a2c8|Regimen=1}}== | ==COPP/ABVD {{#subobject:92a2c8|Regimen=1}}== | ||
− | |||
− | |||
− | |||
− | |||
COPP/ABVD: '''<u>C</u>'''yclophosphamide, '''<u>O</u>'''ncovin (Vincristine), '''<u>P</u>'''rocarbazine, '''<u>P</u>'''rednisone alternating with '''<u>A</u>'''driamycin (Doxorubicin), '''<u>B</u>'''leomycin, '''<u>V</u>'''inblastine, '''<u>D</u>'''acarbazine | COPP/ABVD: '''<u>C</u>'''yclophosphamide, '''<u>O</u>'''ncovin (Vincristine), '''<u>P</u>'''rocarbazine, '''<u>P</u>'''rednisone alternating with '''<u>A</u>'''driamycin (Doxorubicin), '''<u>B</u>'''leomycin, '''<u>V</u>'''inblastine, '''<u>D</u>'''acarbazine | ||
<br>C-MOPP/ABVD: '''<u>C</u>'''yclophospha'''<u>M</u>'''ide, '''<u>O</u>'''ncovin (Vincristine), '''<u>P</u>'''rocarbazine, '''<u>P</u>'''rednisone alternating with '''<u>A</u>'''driamycin (Doxorubicin), '''<u>B</u>'''leomycin, '''<u>V</u>'''inblastine, '''<u>D</u>'''acarbazine | <br>C-MOPP/ABVD: '''<u>C</u>'''yclophospha'''<u>M</u>'''ide, '''<u>O</u>'''ncovin (Vincristine), '''<u>P</u>'''rocarbazine, '''<u>P</u>'''rednisone alternating with '''<u>A</u>'''driamycin (Doxorubicin), '''<u>B</u>'''leomycin, '''<u>V</u>'''inblastine, '''<u>D</u>'''acarbazine | ||
− | === | + | <div class="toccolours" style="background-color:#ee6b6e"> |
− | {| class="wikitable" style="width: 100%; text-align:center;" | + | ===Regimen variant #1, 4 cycles {{#subobject:771e81|Variant=1}}=== |
− | !style="width: | + | {| class="wikitable sortable" style="width: 100%; text-align:center;" |
− | !style="width: | + | !style="width: 20%"|Study |
− | !style="width: | + | !style="width: 20%"|Dates of enrollment |
− | !style="width: | + | !style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]] |
+ | !style="width: 20%"|Comparator | ||
+ | !style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]] | ||
+ | |- | ||
+ | |[https://doi.org/10.1200/JCO.2002.20.2.476 Sieber et al. 2002 (GHSG HD5)] | ||
+ | |1988-1993 | ||
+ | |style="background-color:#1a9851"|Phase 3 (C) | ||
+ | |[[#COPP.2FABV.2FIMEP_999|COPP/ABV/IMEP]] | ||
+ | |style="background-color:#ffffbf"|Did not meet co-primary endpoint of OS | ||
|- | |- | ||
− | |[ | + | |[https://doi.org/10.1093/annonc/mdh046 Sieber et al. 2004 (GHSG HD6)] |
− | |style="background-color:#1a9851"|Phase | + | |1988-1993 |
− | |COPP/ABV/IMEP | + | |style="background-color:#1a9851"|Phase 3 (C) |
− | |style="background-color:#ffffbf"| | + | |[[#COPP.2FABV.2FIMEP_999|COPP/ABV/IMEP]] |
+ | |style="background-color:#ffffbf"|Did not meet primary endpoint of FFTF | ||
|- | |- | ||
− | |[ | + | |[https://doi.org/10.1200/JCO.2003.03.023 Engert et al. 2003 (GHSG HD8)] |
− | |style="background-color:#91cf61"|Non-randomized | + | |1993-1998 |
+ | |style="background-color:#91cf61"|Non-randomized part of RCT | ||
|style="background-color:#d3d3d3"| | |style="background-color:#d3d3d3"| | ||
|style="background-color:#d3d3d3"| | |style="background-color:#d3d3d3"| | ||
|- | |- | ||
− | |[ | + | |} |
− | |style="background-color:# | + | <div class="toccolours" style="background-color:#b3e2cd"> |
− | | | + | ====Chemotherapy, COPP portion (cycles 1 & 3)==== |
− | |style="background-color:# | + | *[[Cyclophosphamide (Cytoxan)]] 650 mg/m<sup>2</sup> IV once per day on days 1 & 8 |
+ | *[[Vincristine (Oncovin)]] 1.4 mg/m<sup>2</sup> (maximum dose of 2 mg) IV once per day on days 1 & 8 | ||
+ | *[[Procarbazine (Matulane)]] 100 mg/m<sup>2</sup> PO once per day on days 1 to 14 | ||
+ | ====Glucocorticoid therapy, COPP portion (cycles 1 & 3)==== | ||
+ | *[[Prednisone (Sterapred)]] 40 mg/m<sup>2</sup> PO once per day on days 1 to 14 | ||
+ | ====Chemotherapy, ABVD portion (cycles 2 & 4)==== | ||
+ | *[[Doxorubicin (Adriamycin)]] 25 mg/m<sup>2</sup> IV once per day on days 1 & 15 | ||
+ | *[[Bleomycin (Blenoxane)]] 10 mg/m<sup>2</sup> IV once per day on days 1 & 15 | ||
+ | *[[Vinblastine (Velban)]] 6 mg/m<sup>2</sup> IV once per day on days 1 & 15 | ||
+ | *[[Dacarbazine (DTIC)]] 375 mg/m<sup>2</sup> IV once per day on days 1 & 15 | ||
+ | '''28-day cycle for 4 cycles''' | ||
+ | </div> | ||
+ | <div class="toccolours" style="background-color:#cbd5e7"> | ||
+ | ====Subsequent treatment==== | ||
+ | *GHSG HD5 & GHSG HD6: [[Classical_Hodgkin_lymphoma#Radiation_therapy_2|EFRT]] consolidation | ||
+ | *GHSG HD8: [[Classical_Hodgkin_lymphoma#Radiation_therapy_2|EFRT]] versus [[Classical_Hodgkin_lymphoma#Radiation_therapy_2|IFRT]] consolidation | ||
+ | </div></div><br> | ||
+ | <div class="toccolours" style="background-color:#ee6b6e"> | ||
+ | ===Regimen variant #2, 6 cycles {{#subobject:6d7f98|Variant=1}}=== | ||
+ | {| class="wikitable sortable" style="width: 60%; text-align:center;" | ||
+ | !style="width: 33%"|Study | ||
+ | !style="width: 33%"|Dates of enrollment | ||
+ | !style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]] | ||
+ | |- | ||
+ | |[https://doi.org/10.1093/oxfordjournals.annonc.a059357 Diehl et al. 1995 (GHSG HD3)] | ||
+ | |1984-01 to 1988-02 | ||
+ | |style="background-color:#91cf61"|Non-randomized part of RCT | ||
|- | |- | ||
|} | |} | ||
− | ====Chemotherapy, COPP portion==== | + | <div class="toccolours" style="background-color:#b3e2cd"> |
− | *[[Cyclophosphamide (Cytoxan)]] | + | ====Chemotherapy, COPP portion (cycles 1, 3, 5)==== |
− | *[[Vincristine (Oncovin)]] | + | *[[Cyclophosphamide (Cytoxan)]] 650 mg/m<sup>2</sup> IV once per day on days 1 & 8 |
− | *[[Procarbazine (Matulane)]] | + | *[[Vincristine (Oncovin)]] 1.4 mg/m<sup>2</sup> (maximum dose of 2 mg) IV once per day on days 1 & 8 |
− | *[[Prednisone (Sterapred)]] | + | *[[Procarbazine (Matulane)]] 100 mg/m<sup>2</sup> PO once per day on days 1 to 14 |
− | + | ====Glucocorticoid therapy, COPP portion (cycles 1, 3, 5)==== | |
− | + | *[[Prednisone (Sterapred)]] 40 mg/m<sup>2</sup> PO once per day on days 1 to 14 | |
− | + | ====Chemotherapy, ABVD portion (cycles 2, 4, 6)==== | |
− | ====Chemotherapy, ABVD portion==== | + | *[[Doxorubicin (Adriamycin)]] 25 mg/m<sup>2</sup> IV once per day on days 1 & 15 |
− | *[[Doxorubicin (Adriamycin)]] | + | *[[Bleomycin (Blenoxane)]] 10 mg/m<sup>2</sup> IV once per day on days 1 & 15 |
− | *[[Bleomycin (Blenoxane)]] | + | *[[Vinblastine (Velban)]] 6 mg/m<sup>2</sup> IV once per day on days 1 & 15 |
− | *[[Vinblastine (Velban)]] | + | *[[Dacarbazine (DTIC)]] 375 mg/m<sup>2</sup> IV once per day on days 1 & 15 |
− | *[[Dacarbazine (DTIC)]] | + | '''28-day cycle for 6 cycles''' |
− | + | </div> | |
− | '''28-day cycle for | + | <div class="toccolours" style="background-color:#cbd5e7"> |
====Subsequent treatment==== | ====Subsequent treatment==== | ||
− | * | + | *[[#COPP.2FABVD|COPP/ABVD]] continuation x 1 (8 cycles total) versus [[#Radiation_therapy|IFRT]] consolidation |
− | + | </div></div><br> | |
− | + | <div class="toccolours" style="background-color:#ee6b6e"> | |
− | === | + | ===Regimen variant #3, 10 cycles {{#subobject:faa63|Variant=1}}=== |
− | {| class="wikitable" style="width: 100%; text-align:center;" | + | {| class="wikitable sortable" style="width: 100%; text-align:center;" |
− | !style="width: | + | !style="width: 20%"|Study |
− | !style="width: | + | !style="width: 20%"|Dates of enrollment |
− | !style="width: | + | !style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]] |
− | !style="width: | + | !style="width: 20%"|Comparator |
− | + | !style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]] | |
− | |||
− | |||
− | |||
− | |||
|- | |- | ||
− | |[ | + | |[https://doi.org/10.1093/jjco/hyd036 Takenaka et al. 2000 (JCOG 8905)] |
− | |style="background-color:#91cf61"|Phase | + | |1989-1993 |
+ | |style="background-color:#91cf61"|Phase 2 | ||
|style="background-color:#d3d3d3"| | |style="background-color:#d3d3d3"| | ||
|style="background-color:#d3d3d3"| | |style="background-color:#d3d3d3"| | ||
|- | |- | ||
− | |[ | + | |[https://doi.org/10.1200/jco.1998.16.12.3810 Diehl et al. 1998 (GHSG HD9)] |
− | |style="background-color:#1a9851"|Phase | + | |1993-1998 |
− | |[[ | + | |style="background-color:#1a9851"|Phase 3 (C) |
− | |style="background-color:#ffffbf"| | + | |1. [[Classical_Hodgkin_lymphoma#BEACOPP_2|BEACOPP]]<br>2. [[Classical_Hodgkin_lymphoma#eBEACOPP_2|eBEACOPP]] |
+ | |style="background-color:#fc8d59"|Seems to have inferior OS | ||
+ | |- | ||
+ | |[https://doi.org/10.1093/annonc/mdi023 Ballova et al. 2005 (GHSG HD9elderly)] | ||
+ | |1993-1998 | ||
+ | |style="background-color:#1a9851"|Phase 3 (C) | ||
+ | |[[Classical_Hodgkin_lymphoma#BEACOPP_2|BEACOPP]] | ||
+ | |style="background-color:#ffffbf"|Did not meet co-primary endpoint of OS | ||
|- | |- | ||
|} | |} | ||
− | ====Chemotherapy, COPP portion==== | + | <div class="toccolours" style="background-color:#b3e2cd"> |
+ | ====Chemotherapy, COPP portion (cycles 1, 3, 5, 7, 9)==== | ||
*[[Cyclophosphamide (Cytoxan)]] 500 mg/m<sup>2</sup> IV once per day on days 1 & 8 | *[[Cyclophosphamide (Cytoxan)]] 500 mg/m<sup>2</sup> IV once per day on days 1 & 8 | ||
− | *[[Vincristine (Oncovin)]] 1.4 mg/m<sup>2</sup> (maximum of 2 mg | + | *[[Vincristine (Oncovin)]] 1.4 mg/m<sup>2</sup> (maximum dose of 2 mg) IV once per day on days 1 & 8 |
− | *[[Procarbazine (Matulane)]] 100 mg/m<sup>2</sup> (maximum of 150 mg | + | *[[Procarbazine (Matulane)]] 100 mg/m<sup>2</sup> (maximum dose of 150 mg) PO once per day on days 1 to 14 |
+ | ====Glucocorticoid therapy, COPP portion (cycles 1, 3, 5, 7, 9)==== | ||
*[[Prednisone (Sterapred)]] 40 mg/m<sup>2</sup> PO once per day on days 1 to 3, 8 to 10 | *[[Prednisone (Sterapred)]] 40 mg/m<sup>2</sup> PO once per day on days 1 to 3, 8 to 10 | ||
− | + | ====Chemotherapy, ABVD portion (cycles 2, 4, 6, 8, 10)==== | |
− | |||
− | |||
− | ====Chemotherapy, ABVD portion==== | ||
*[[Doxorubicin (Adriamycin)]] 25 mg/m<sup>2</sup> IV once per day on days 1 & 15 | *[[Doxorubicin (Adriamycin)]] 25 mg/m<sup>2</sup> IV once per day on days 1 & 15 | ||
− | *[[Bleomycin (Blenoxane)]] 9 mg/m<sup>2</sup> (maximum of 15 mg | + | *[[Bleomycin (Blenoxane)]] 9 mg/m<sup>2</sup> (maximum dose of 15 mg) IV once per day on days 1 & 15 |
− | *[[Vinblastine (Velban)]] 6 mg/m<sup>2</sup> (maximum of 10 mg | + | *[[Vinblastine (Velban)]] 6 mg/m<sup>2</sup> (maximum dose of 10 mg) IV once per day on days 1 & 15 |
*[[Dacarbazine (DTIC)]] 250 mg/m<sup>2</sup> IV once per day on days 1 & 15 | *[[Dacarbazine (DTIC)]] 250 mg/m<sup>2</sup> IV once per day on days 1 & 15 | ||
− | + | '''28-day cycle for 10 cycles''' | |
− | '''28-day cycle for | + | </div> |
+ | <div class="toccolours" style="background-color:#cbd5e7"> | ||
====Subsequent treatment==== | ====Subsequent treatment==== | ||
− | * | + | *JCOG 8905 & GHSG HD9, patients with bulky (at least 10 cm maximum diameter) disease: [[Classical_Hodgkin_lymphoma#Radiation_therapy_2|IFRT]] x 3000 cGy consolidation |
+ | *GHSG HD9elderly, initial bulky disease (single lymph node involvement or a conglomerate mass of at least 5 cm in any diameter): [[Classical_Hodgkin_lymphoma#Radiation_therapy_2|IFRT]] x 3000 cGy consolidation | ||
+ | *GHSG HD9elderly, residual tumor after chemotherapy: [[Classical_Hodgkin_lymphoma#Radiation_therapy_2|IFRT]] x 4000 cGy consolidation | ||
+ | </div> | ||
+ | <div class="toccolours" style="background-color:#fff2ae"> | ||
− | ====Dose modifications==== | + | ====Dose and schedule modifications==== |
*Treatment was postponed for at least 1 week or until recovery if: | *Treatment was postponed for at least 1 week or until recovery if: | ||
− | **Pretreatment ANC was less than 1500/ | + | **Pretreatment ANC was less than 1500/μL |
**Platelet count was less than 100 x 10<sup>9</sup>/L | **Platelet count was less than 100 x 10<sup>9</sup>/L | ||
**AST/S-GOT was greater than 100 IU/L | **AST/S-GOT was greater than 100 IU/L | ||
Line 147: | Line 209: | ||
*Bleomycin was stopped if the PaO2 was less than 70 mmHg or if it decreased more than 10 mmHg from the previous measurement | *Bleomycin was stopped if the PaO2 was less than 70 mmHg or if it decreased more than 10 mmHg from the previous measurement | ||
*Note: Dacarbazine 250 mg/m<sup>2</sup> was used at this dose reduction based on experiences in a pilot study in which there was severe emesis with 375 mg/m<sup>2</sup>. | *Note: Dacarbazine 250 mg/m<sup>2</sup> was used at this dose reduction based on experiences in a pilot study in which there was severe emesis with 375 mg/m<sup>2</sup>. | ||
+ | </div></div> | ||
===References=== | ===References=== | ||
− | # '''GHSG | + | # '''GHSG HD3:''' Diehl V, Loeffler M, Pfreundschuh M, Ruehl U, Hasenclever D, Nisters-Backes H, Sieber M, Smith K, Tesch H, Geilen W, Adler M, Bartels H, Brandenburg U, Diezler P, Doelken G, Enzian J, Fuchs R, Gassmann W, Gerhartz H, Hagenaukamp U, Hecht T, Hiller E, Hinkelbein H, Lathan B, Kirchner H, Kuehn G, Kuerten H, Loos U, Makoski B, Oertel W, Petsch S, Pfab R, Pflueger H, Planker M, Rohioff R, Sack H, Samandari S, Sauer R, Schalk K, Schmitz G, Schoppe W, Schwieder G, Szepesi S, Teichmann J, Wilhelmy W, Worst P, Fischer R, Georgii A, Huebner E, Schwarze EW; German Hodgkin's Study Group. Further chemotherapy versus low-dose involved-field radiotherapy as consolidation of complete remission after six cycles of alternating chemotherapy in patients with advance Hodgkin's disease. Ann Oncol. 1995 Nov;6(9):901-10. [https://doi.org/10.1093/oxfordjournals.annonc.a059357 link to original article] '''dosing details in manuscript have been reviewed by our editors''' [https://pubmed.ncbi.nlm.nih.gov/8624293/ PubMed] |
− | + | # '''GHSG HD9:''' Diehl V, Franklin J, Hasenclever D, Tesch H, Pfreundschuh M, Lathan B, Paulus U, Sieber M, Rueffer JU, Sextro M, Engert A, Wolf J, Hermann R, Holmer L, Stappert-Jahn U, Winnerlein-Trump E, Wulf G, Krause S, Glunz A, von Kalle K, Bischoff H, Haedicke C, Duehmke E, Georgii A, Loeffler M. BEACOPP, a new dose-escalated and accelerated regimen, is at least as effective as COPP/ABVD in patients with advanced-stage Hodgkin's lymphoma: interim report from a trial of the German Hodgkin's Lymphoma Study Group. J Clin Oncol. 1998 Dec;16(12):3810-21. [https://doi.org/10.1200/jco.1998.16.12.3810 link to original article]'''dosing details in manuscript have been reviewed by our editors''' [https://pubmed.ncbi.nlm.nih.gov/9850026/ PubMed] | |
− | ## '''Update:''' | + | ## '''Update:''' Diehl V, Franklin J, Pfreundschuh M, Lathan B, Paulus U, Hasenclever D, Tesch H, Herrmann R, Dörken B, Müller-Hermelink HK, Dühmke E, Loeffler M; German Hodgkin's Lymphoma Study Group. Standard and increased-dose BEACOPP chemotherapy compared with COPP-ABVD for advanced Hodgkin's disease. N Engl J Med. 2003 Jun 12;348(24):2386-95. [https://doi.org/10.1056/NEJMoa022473 link to original article]'''dosing details in abstract have been reviewed by our editors''' [https://pubmed.ncbi.nlm.nih.gov/12802024/ PubMed] |
− | ## '''Update:''' | + | ## '''Update:''' Engert A, Diehl V, Franklin J, Lohri A, Dörken B, Ludwig WD, Koch P, Hänel M, Pfreundschuh M, Wilhelm M, Trümper L, Aulitzky WE, Bentz M, Rummel M, Sezer O, Müller-Hermelink HK, Hasenclever D, Löffler M. Escalated-dose BEACOPP in the treatment of patients with advanced-stage Hodgkin's lymphoma: 10 years of follow-up of the GHSG HD9 study. J Clin Oncol. 2009 Sep 20;27(27):4548-54. Epub 2009 Aug 24. [https://doi.org/10.1200/jco.2008.19.8820 link to original article] [https://pubmed.ncbi.nlm.nih.gov/19704068/ PubMed] |
− | # ''' | + | ## '''Pooled update:''' von Tresckow B, Kreissl S, Dipl-Math HG, Bröckelmann PJ, Pabst T, Fridrik M, Rummel M, Jung W, Thiemer J, Sasse S, Bürkle C, Baues C, Diehl V, Engert A, Borchmann P; German Hodgkin Study Group. Intensive treatment strategies in advanced-stage Hodgkin's lymphoma (HD9 and HD12): analysis of long-term survival in two randomised trials. Lancet Haematol. 2018 Oct 01;5(10):e462-73. [https://doi.org/10.1016/S2352-3026(18)30140-6 link to original article] [https://pubmed.ncbi.nlm.nih.gov/30290903/ PubMed] |
− | # ''' | + | # '''JCOG 8905:''' Takenaka T, Mikuni C, Miura A, Sasaki T, Suzuki H, Hotta T, Hirano M, Fukuhara S, Sugiyama H, Nasu K, Dohi H, Kozuru M, Tomonaga M, Tajima K, Niimi M, Fukuda H, Mukai K, Shimoyama M; Lymphoma Study Group of the Japan Clinical Oncology Group. Alternating combination chemotherapy C-MOPP (cyclophosphamide, vincristine, procarbazine, prednisone) and ABVd (adriamycin, bleomycin, vinblastine, dacarbazine) in clinical stage II-IV Hodgkin's disease: a multicenter phase II study (JCOG 8905). Jpn J Clin Oncol. 2000 Mar;30(3):146-52. [https://doi.org/10.1093/jjco/hyd036 link to original article] '''dosing details in abstract have been reviewed by our editors''' [https://pubmed.ncbi.nlm.nih.gov/10798542/ PubMed] |
− | # '''GHSG | + | # '''GHSG HD5:''' Sieber M, Tesch H, Pfistner B, Rueffer U, Lathan B, Brosteanu O, Paulus U, Koch T, Pfreundschuh M, Loeffler M, Engert A, Josting A, Wolf J, Hasenclever D, Franklin J, Duehmke E, Georgii A, Schalk KP, Kirchner H, Doelken G, Munker R, Koch P, Herrmann R, Greil R, Anselmo AP, Diehl V. Rapidly alternating COPP/ABV/IMEP is not superior to conventional alternating COPP/ABVD in combination with extended-field radiotherapy in intermediate-stage Hodgkin's lymphoma: final results of the German Hodgkin's Lymphoma Study Group Trial HD5. J Clin Oncol. 2002 Jan 15;20(2):476-84. [https://doi.org/10.1200/JCO.2002.20.2.476 link to original article] '''dosing details in manuscript have been reviewed by our editors''' [https://pubmed.ncbi.nlm.nih.gov/11786577/ PubMed] |
− | + | # '''GHSG HD8:''' Engert A, Schiller P, Josting A, Herrmann R, Koch P, Sieber M, Boissevain F, De Wit M, Mezger J, Duhmke E, Willich N, Muller RP, Schmidt BF, Renner H, Muller-Hermelink HK, Pfistner B, Wolf J, Hasenclever D, Loffler M, Diehl V; German Hodgkin's Lymphoma Study Group. Involved-field radiotherapy is equally effective and less toxic compared with extended-field radiotherapy after four cycles of chemotherapy in patients with early-stage unfavorable Hodgkin's lymphoma: results of the HD8 trial of the German Hodgkin's Lymphoma Study Group. J Clin Oncol. 2003 Oct 1;21(19):3601-8. Epub 2003 Aug 11. [https://doi.org/10.1200/JCO.2003.03.023 link to original article] '''dosing details in abstract have been reviewed by our editors''' [https://pubmed.ncbi.nlm.nih.gov/12913100/ PubMed] | |
− | ## '''Update:''' Sasse S, | + | ## '''Update:''' Sasse S, Klimm B, Görgen H, Fuchs M, Heyden-Honerkamp A, Lohri A, Koch O, Wilhelm M, Trenn G, Finke J, Müller RP, Diehl V, Eich HT, Borchmann P, Engert A; German Hodgkin Study Group (GHSG). Comparing long-term toxicity and efficacy of combined modality treatment including extended- or involved-field radiotherapy in early-stage Hodgkin's lymphoma. Ann Oncol. 2012 Nov;23(11):2953-9. Epub 2012 Jul 5. [https://doi.org/10.1093/annonc/mds110 link to original article] [https://pubmed.ncbi.nlm.nih.gov/22767583/ PubMed] |
− | # ''' | + | ## '''Update:''' Sasse S, Bröckelmann PJ, Goergen H, Plütschow A, Müller H, Kreissl S, Buerkle C, Borchmann S, Fuchs M, Borchmann P, Diehl V, Engert A. Long-term follow-up of contemporary treatment in early-stage Hodgkin lymphoma: updated analyses of the German Hodgkin Study Group HD7, HD8, HD10, and HD11 trials. J Clin Oncol. 2017 Jun 20;35(18):1999-2007. Epub 2017 Apr 18. [https://doi.org/10.1200/JCO.2016.70.9410 link to original article] [https://pubmed.ncbi.nlm.nih.gov/28418763/ PubMed] |
− | # '''GHSG | + | # '''GHSG HD6:''' Sieber M, Tesch H, Pfistner B, Rueffer U, Paulus U, Munker R, Hermann R, Doelken G, Koch P, Oertel J, Roller S, Worst P, Bischof H, Glunz A, Greil R, von Kalle K, Schalk KP, Hasenclever D, Brosteanu O, Duehmke E, Georgii A, Engert A, Loeffler M, Diehl V, Mueller RP, Willich N, Fischer R, Hansmann ML, Stein H, Schober T, Koch B; German Hodgkin's Lymphoma Study Group. Treatment of advanced Hodgkin's disease with COPP/ABV/IMEP versus COPP/ABVD and consolidating radiotherapy: final results of the German Hodgkin's Lymphoma Study Group HD6 trial. Ann Oncol. 2004 Feb;15(2):276-82. [https://doi.org/10.1093/annonc/mdh046 link to original article] [https://pubmed.ncbi.nlm.nih.gov/14760122/ PubMed] |
+ | # '''GHSG HD9elderly:''' Ballova V, Rüffer JU, Haverkamp H, Pfistner B, Müller-Hermelink HK, Dühmke E, Worst P, Wilhelmy M, Naumann R, Hentrich M, Eich HT, Josting A, Löffler M, Diehl V, Engert A. A prospectively randomized trial carried out by the German Hodgkin Study Group (GHSG) for elderly patients with advanced Hodgkin's disease comparing BEACOPP baseline and COPP-ABVD (study HD9elderly). Ann Oncol. 2005 Jan;16(1):124-31. [https://doi.org/10.1093/annonc/mdi023 link to original article]'''dosing details in abstract have been reviewed by our editors''' [https://pubmed.ncbi.nlm.nih.gov/15598949/ PubMed] | ||
− | ==CVPP {{#subobject: | + | ==CVPP (Cyclophosphamide) {{#subobject:becy99|Regimen=1}}== |
− | {| class="wikitable" style=" | + | CVPP: '''<u>C</u>'''yclophosphamide, '''<u>V</u>'''inblastine, '''<u>P</u>'''rocarbazine, '''<u>P</u>'''rednisone |
+ | <div class="toccolours" style="background-color:#ee6b6e"> | ||
+ | ===Regimen {{#subobject:cy1c98|Variant=1}}=== | ||
+ | {| class="wikitable sortable" style="width: 100%; text-align:center;" | ||
+ | !style="width: 20%"|Study | ||
+ | !style="width: 20%"|Dates of enrollment | ||
+ | !style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]] | ||
+ | !style="width: 20%"|Comparator | ||
+ | !style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]] | ||
+ | |- | ||
+ | |[https://doi.org/10.1093/jnci/80.18.1466 Pavlovsky et al. 1988] | ||
+ | |1977-1986 | ||
+ | |style="background-color:#1a9851"|Randomized (E-de-esc) | ||
+ | |[[#CVPP_.26_888|CVPP & RT]] | ||
+ | | style="background-color:#d73027" |Inferior FFS<sup>1</sup> | ||
+ | |- | ||
+ | |[https://doi.org/10.1200/JCO.1997.15.7.2652 Pavlovsky et al. 1997] | ||
+ | |1986 to not reported | ||
+ | |style="background-color:#1a9851"|Randomized (C) | ||
+ | |[[#AOPE_999|AOPE]] | ||
+ | |style="background-color:#91cf60"|Seems to have superior CR rate | ||
+ | |- | ||
+ | |[https://doi.org/10.1002/(SICI)1096-911X(199712)29:6%3C544::AID-MPO5%3E3.0.CO;2-K Sackmann-Muriel et al. 1997] | ||
+ | |1987-1994 | ||
+ | |style="background-color:#1a9851"|Randomized (C) | ||
+ | |[[#AOPE_999|AOPE]] | ||
+ | |style="background-color:#91cf60"|Seems to have superior EFS | ||
|- | |- | ||
− | |||
|} | |} | ||
+ | ''<sup>1</sup>No advantage was seen for either arm in the favorable prognosis group, whereas this arm had inferior DFS for the unfavorable prognosis group.'' | ||
+ | <div class="toccolours" style="background-color:#b3e2cd"> | ||
+ | ====Chemotherapy==== | ||
+ | *[[Cyclophosphamide (Cytoxan)]] 600 mg/m<sup>2</sup> IV once per day on days 1 & 8 | ||
+ | *[[Vinblastine (Velban)]] 6 mg/m<sup>2</sup> IV once per day on days 1 & 8 | ||
+ | *[[Procarbazine (Matulane)]] 100 mg/m<sup>2</sup> PO once per day on days 1 to 14 | ||
+ | ====Glucocorticoid therapy==== | ||
+ | *[[Prednisone (Sterapred)]] 40 mg/m<sup>2</sup> PO once per day on days 1 to 14 | ||
+ | '''1-month cycle for 6 cycles''' | ||
+ | </div></div> | ||
+ | ===References=== | ||
+ | # Pavlovsky S, Maschio M, Santarelli MT, Sackmann Muriel F, Corrado C, Garcia I, Schwartz L, Montero C, Lobo Sanahuja F, Magnasco O, Raha R, Cavagnaro F. Randomized trial of chemotherapy versus chemotherapy plus radiotherapy for stage I-II Hodgkin's disease. J Natl Cancer Inst. 1988 Nov 16;80(18):1466-73. [https://doi.org/10.1093/jnci/80.18.1466 link to original article] [https://pubmed.ncbi.nlm.nih.gov/3184196/ PubMed] | ||
+ | ## '''Update:''' Pavlovsky S, Santarelli MT, Sackmann Muriel F, Fernández I, Garcia I, Schwartz L, Montero C, Sanahuja FL, Magnasco H, Costa A, Corrado C, Raha R, Bezares R. Randomized trial of chemotherapy versus chemotherapy plus radiotherapy for stage III-IV A & B Hodgkin's disease. Ann Oncol. 1992 Jul;3(7):533-7. [https://doi.org/10.1093/oxfordjournals.annonc.a058255 link to original article] [https://pubmed.ncbi.nlm.nih.gov/1498073/ PubMed] | ||
+ | # Pavlovsky S, Schvartzman E, Lastiri F, Magnasco H, Corrado C, Raslawski E, Cancela ME, Ardaiz MC, Cerutti I, Rosso A, Bruno S, Aranguren PN, Salvarezza A, Donato H, Dibar E, Zirone S; GATLA. Randomized trial of CVPP for three versus six cycles in favorable-prognosis and CVPP versus AOPE plus radiotherapy in intermediate-prognosis untreated Hodgkin's disease. J Clin Oncol. 1997 Jul;15(7):2652-8. [https://doi.org/10.1200/JCO.1997.15.7.2652 link to original article] [https://pubmed.ncbi.nlm.nih.gov/9215837/ PubMed] | ||
+ | # Sackmann-Muriel F, Zubizarreta P, Gallo G, Scopinaro M, Alderete D, Alfaro E, Casak S, Chantada G, Felice MS, Quinteros R. Hodgkin disease in children: results of a prospective randomized trial in a single institution in Argentina. Med Pediatr Oncol. 1997 Dec;29(6):544-52. [https://doi.org/10.1002/(SICI)1096-911X(199712)29:6%3C544::AID-MPO5%3E3.0.CO;2-K link to original article] '''dosing details in manuscript have been reviewed by our editors''' [https://pubmed.ncbi.nlm.nih.gov/9324342/ PubMed] | ||
− | + | ==Doxorubicin & Vinblastine {{#subobject:66828f|Regimen=1}}== | |
+ | <div class="toccolours" style="background-color:#ee6b6e"> | ||
+ | ===Regimen {{#subobject:597e32|Variant=1}}=== | ||
+ | {| class="wikitable sortable" style="width: 100%; text-align:center;" | ||
+ | !style="width: 20%"|Study | ||
+ | !style="width: 20%"|Dates of enrollment | ||
+ | !style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]] | ||
+ | !style="width: 20%"|Comparator | ||
+ | !style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]] | ||
+ | |- | ||
+ | |[https://doi.org/10.1200/JCO.2001.19.22.4238 Press et al. 2001 (SWOG S9133)] | ||
+ | |1992-2000 | ||
+ | |style="background-color:#1a9851"|Phase 3 (E-esc) | ||
+ | |[[#Radiation_therapy_888|STLI]] | ||
+ | | style="background-color:#1a9850" |Superior PFS (secondary endpoint) | ||
+ | |- | ||
+ | |} | ||
+ | ''Note: this is a component of a sequential treatment protocol; to our knowledge there are no references to support using it as a stand-alone treatment.'' | ||
+ | <div class="toccolours" style="background-color:#b3e2cd"> | ||
+ | ====Chemotherapy==== | ||
+ | *[[Doxorubicin (Adriamycin)]] 25 mg/m<sup>2</sup> IV once per day on days 1 & 15 | ||
+ | *[[Vinblastine (Velban)]] 6 mg/m<sup>2</sup> IV once per day on days 1 & 15 | ||
+ | '''28-day cycle for 3 cycles''' | ||
+ | </div> | ||
+ | <div class="toccolours" style="background-color:#cbd5e7"> | ||
+ | ====Subsequent treatment==== | ||
+ | *[[#Radiation_therapy|STLI]] consolidation | ||
+ | </div></div> | ||
+ | ===References=== | ||
+ | # '''SWOG S9133:''' Press OW, LeBlanc M, Lichter AS, Grogan TM, Unger JM, Wasserman TH, Gaynor ER, Peterson BA, Miller TP, Fisher RI. Phase III randomized intergroup trial of subtotal lymphoid irradiation versus doxorubicin, vinblastine, and subtotal lymphoid irradiation for stage IA to IIA Hodgkin's disease. J Clin Oncol. 2001 Nov 15;19(22):4238-44. [https://doi.org/10.1200/JCO.2001.19.22.4238 link to original article] '''dosing details in manuscript have been reviewed by our editors''' [https://pubmed.ncbi.nlm.nih.gov/11709567/ PubMed] [https://clinicaltrials.gov/study/NCT00002495 NCT00002495] | ||
− | ===Regimen {{#subobject: | + | ==Mechlorethamine monotherapy {{#subobject:3674c2|Regimen=1}}== |
− | {| class="wikitable" style="width: 100%; text-align:center;" | + | <div class="toccolours" style="background-color:#ee6b6e"> |
− | !style="width: | + | ===Regimen {{#subobject:2761c1|Variant=1}}=== |
− | !style="width: | + | {| class="wikitable sortable" style="width: 100%; text-align:center;" |
− | !style="width: | + | !style="width: 20%"|Study |
− | !style="width: | + | !style="width: 20%"|Dates of enrollment |
+ | !style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]] | ||
+ | !style="width: 20%"|Comparator | ||
+ | !style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]] | ||
+ | |- | ||
+ | |[https://doi.org/10.1001/jama.1946.02870380008004 Goodman et al. 1946] | ||
+ | |Not reported | ||
+ | | style="background-color:#91cf61" |Non-randomized | ||
+ | | style="background-color:#d3d3d3" | | ||
+ | | style="background-color:#d3d3d3" | | ||
+ | |- | ||
+ | |[https://doi.org/10.1001/jama.1946.02870400011003 Jacobson et al. 1946] | ||
+ | |1943-1945 | ||
+ | | style="background-color:#91cf61" |Non-randomized | ||
+ | | style="background-color:#d3d3d3" | | ||
+ | | style="background-color:#d3d3d3" | | ||
|- | |- | ||
− | + | |[https://doi.org/10.7326/0003-4819-27-4-529 Wintrobe et al. 1947] | |
− | | | + | |Not reported |
− | | | + | | style="background-color:#91cf61" |Non-randomized |
− | |style="background-color:# | + | | style="background-color:#d3d3d3" | |
+ | | style="background-color:#d3d3d3" | | ||
|- | |- | ||
− | |2 | + | |[https://doi.org/10.7326/0003-4819-30-2-381 Meyer & Overmiller 1949] |
− | |style="background-color:# | + | |1946-1947 |
+ | | style="background-color:#91cf61" |Non-randomized | ||
+ | | style="background-color:#d3d3d3" | | ||
+ | | style="background-color:#d3d3d3" | | ||
|- | |- | ||
− | | | + | |[https://doi.org/10.1001/jama.1968.03140060016005 Jacobs et al. 1968] |
− | |style="background-color:#ffffbf"| | + | |1960-1963 |
+ | | style="background-color:#1a9851" |Randomized (C) | ||
+ | |[[#Cyclophosphamide_monotherapy_999|Cyclophosphamide]] | ||
+ | | style="background-color:#ffffbf" |Did not meet primary endpoint of ORR | ||
|- | |- | ||
|} | |} | ||
+ | ''Note: These references are of major historic interest as they are the first systemic chemotherapy trials in humans. Note that some of these early trials used nitrogen mustards other than mechlorethamine but are grouped here for simplicity.'' | ||
+ | <div class="toccolours" style="background-color:#b3e2cd"> | ||
====Chemotherapy==== | ====Chemotherapy==== | ||
− | *[[ | + | *[[Mechlorethamine (Mustargen)]] |
− | + | </div></div> | |
− | |||
− | |||
− | |||
===References=== | ===References=== | ||
− | # | + | # Goodman LS, Wintrobe MM, Dameshek W, Goodman MJ, Gilman A, McLennan MT. Nitrogen mustard therapy; use of methyl-bis (beta-chloroethyl) amine hydrochloride and tris (beta-chloroethyl) amine hydrochloride for Hodgkin's disease, lymphosarcoma, leukemia and certain allied and miscellaneous disorders. J Am Med Assoc. 1946 Sep 21;132:126-32. [https://doi.org/10.1001/jama.1946.02870380008004 link to original article] [https://pubmed.ncbi.nlm.nih.gov/20997191/ PubMed] |
+ | # Jacobson LO, Spurr CL, Guzman-Barron ES, Smith T, Lushbaugh C, Dick GF. Nitrogen mustard therapy; studies on the effect of methyl-bis (beta-chloroethyl) amine hydrochloride on neoplastic diseases and allied disorders of the hemopoietic system. J Am Med Assoc. 1946 Oct 5;132:263-71. [https://doi.org/10.1001/jama.1946.02870400011003 link to original article] [https://pubmed.ncbi.nlm.nih.gov/20997209/ PubMed] | ||
+ | # Wintrobe MM, Huguley CM Jr, McLennan MT, Penna de Carvalho Lima L. Nitrogen mustard as a therapeutic agent for Hodgkin's disease, lymphosarcoma and leukemia. Ann Intern Med. 1947 Oct;27(4):529-40. [https://doi.org/10.7326/0003-4819-27-4-529 link to original article] [https://pubmed.ncbi.nlm.nih.gov/20268426/ PubMed] | ||
+ | # Meyer AH, Overmiller WC. The use of nitrogen mustard in Hodgkin's disease and lymphosarcoma. Ann Intern Med. 1949 Feb;30(2):381-6. [https://doi.org/10.7326/0003-4819-30-2-381 link to original article] [https://pubmed.ncbi.nlm.nih.gov/18109292/ PubMed] | ||
+ | # Jacobs EM, Peters FC, Luce JK, Zippin C, Wood DA. Mechlorethamine HCl and cyclophosphamide in the treatment of Hodgkin's disease and the lymphomas. JAMA. 1968 Feb 5;203(6):392-8. [https://doi.org/10.1001/jama.1968.03140060016005 link to original article] [https://pubmed.ncbi.nlm.nih.gov/4865234/ PubMed] | ||
− | == | + | ==NOVP {{#subobject:230457|Regimen=1}}== |
− | {| class="wikitable" style=" | + | NOVP: '''<u>N</u>'''ovantrone (Mitoxantrone), '''<u>O</u>'''ncovin (Vincristine), '''<u>V</u>'''inblastine, '''<u>P</u>'''rednisone |
+ | <div class="toccolours" style="background-color:#ee6b6e"> | ||
+ | ===Regimen {{#subobject:5bf81f|Variant=1}}=== | ||
+ | {| class="wikitable sortable" style="width: 60%; text-align:center;" | ||
+ | !style="width: 33%"|Study | ||
+ | !style="width: 33%"|Dates of enrollment | ||
+ | !style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]] | ||
+ | |- | ||
+ | |[https://pubmed.ncbi.nlm.nih.gov/2259922 Hagemeister et al. 1990] | ||
+ | |1988-06 to 1989-12 | ||
+ | |style="background-color:#91cf61"|Phase 2 | ||
|- | |- | ||
− | |||
|} | |} | ||
− | + | ''Note: The original manuscript is not available online; a physical copy was reviewed and does not contain dosing details.'' | |
+ | <div class="toccolours" style="background-color:#b3e2cd"> | ||
+ | ====Chemotherapy==== | ||
+ | *[[Mitoxantrone (Novantrone)]] dose not specified | ||
+ | *[[Vincristine (Oncovin)]] dose not specified | ||
+ | *[[Vinblastine (Velban)]] dose not specified | ||
+ | ====Glucocorticoid therapy==== | ||
+ | *[[Prednisone (Sterapred)]] dose not specified | ||
+ | </div></div> | ||
+ | ===References=== | ||
+ | # Hagemeister FB, Cabanillas F, Velásquez WS, Meistrich ML, Liang JC, McLaughlin P, Redman JR, Romaguera JE, Rodríguez MA, Swan F Jr, Fuller LM. NOVP: a novel chemotherapeutic regimen with minimal toxicity for treatment of Hodgkin's disease. Semin Oncol. 1990 Dec;17(6 Suppl 10):34-8. '''does not contain dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/2259922/ PubMed] | ||
− | ===Regimen {{#subobject: | + | ==Vinblastine monotherapy {{#subobject:b1c2da|Regimen=1}}== |
− | {| class="wikitable" style="width: 100%; text-align:center;" | + | <div class="toccolours" style="background-color:#ee6b6e"> |
− | !style="width: | + | ===Regimen {{#subobject:48bfd8|Variant=1}}=== |
− | !style="width: | + | {| class="wikitable sortable" style="width: 100%; text-align:center;" |
− | !style="width: | + | !style="width: 20%"|Study |
− | !style="width: | + | !style="width: 20%"|Dates of enrollment |
+ | !style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]] | ||
+ | !style="width: 20%"|Comparator | ||
+ | !style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]] | ||
|- | |- | ||
− | |[ | + | |[https://doi.org/10.1001/jama.1966.03100010139062 Stutzman et al. 1966] |
− | | style="background-color:#1a9851" | | + | |1963-1964 |
− | |[[ | + | |style="background-color:#1a9851"|Randomized (E-switch-ic) |
− | | style="background-color:#1a9850" |Superior | + | |[[#Cyclophosphamide_monotherapy_888|Cyclophosphamide]] |
+ | | style="background-color:#1a9850" |Superior ORR | ||
|- | |- | ||
− | | | + | |} |
− | + | <div class="toccolours" style="background-color:#b3e2cd"> | |
− | | | + | ====Chemotherapy==== |
− | | style=" | + | *[[Vinblastine (Velban)]] 0.15 mg/kg IV once on day 1 |
+ | '''7-day cycles''' | ||
+ | </div></div> | ||
+ | ===References=== | ||
+ | # Stutzman L, Ezdinli EZ, Stutzman MA. Vinblastine sulfate vs cyclophosphamide in the therapy for lymphoma. JAMA. 1966 Jan 17;195(3):173-8. [https://doi.org/10.1001/jama.1966.03100010139062 link to original article] '''dosing details in manuscript have been reviewed by our editors''' [https://pubmed.ncbi.nlm.nih.gov/5322863/ PubMed] | ||
+ | |||
+ | =Untreated, advanced stage= | ||
+ | ==BCVPP {{#subobject:75779b|Regimen=1}}== | ||
+ | BCVPP: '''<u>B</u>'''CNU (Carmustine), '''<u>C</u>'''yclophosphamide, '''<u>V</u>'''inblastine, '''<u>P</u>'''rocarbazine, '''<u>P</u>'''rednisone | ||
+ | <div class="toccolours" style="background-color:#ee6b6e"> | ||
+ | ===Regimen {{#subobject:ab3db2|Variant=1}}=== | ||
+ | {| class="wikitable sortable" style="width: 100%; text-align:center;" | ||
+ | !style="width: 20%"|Study | ||
+ | !style="width: 20%"|Dates of enrollment | ||
+ | !style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]] | ||
+ | !style="width: 20%"|Comparator | ||
+ | !style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]] | ||
|- | |- | ||
− | | | + | |[https://doi.org/10.1002/1097-0142%28197811%2942%3A5%3C2101%3A%3AAID-CNCR2820420504%3E3.0.CO%3B2-M Durant et al. 1978] |
− | | style="background-color:# | + | |1971-1975 |
+ | | style="background-color:#91cf61" |Non-randomized part of RCT | ||
+ | | style="background-color:#d3d3d3" | | ||
+ | | style="background-color:#d3d3d3" | | ||
|- | |- | ||
− | |[ | + | |[https://doi.org/10.7326/0003-4819-101-4-447 Bakemeier et al. 1984] |
− | | style="background-color:#1a9851" |Phase | + | |1972-1976 |
− | |[[ | + | |style="background-color:#1a9851"|Phase 3 (E-esc) |
− | | style="background-color:# | + | |[[Classical_Hodgkin_lymphoma#MOPP|MOPP]] |
+ | |style="background-color:#ffffbf"|Did not meet endpoint of CR rate<sup>1</sup> | ||
|- | |- | ||
− | |[ | + | |} |
− | | style="background-color:# | + | ''<sup>1</sup>For patients achieving CR, this regimen seemed to have comparatively superior survival.'' |
− | | | + | <div class="toccolours" style="background-color:#b3e2cd"> |
− | | style=" | + | ====Chemotherapy==== |
+ | *[[Carmustine (BCNU)]] 100 mg/m<sup>2</sup> IV once on day 1 | ||
+ | *[[Cyclophosphamide (Cytoxan)]] 600 mg/m<sup>2</sup> IV once on day 1 | ||
+ | *[[Vinblastine (Velban)]] 5 mg/m<sup>2</sup> IV once on day 1 | ||
+ | *[[Procarbazine (Matulane)]] 50 mg/m<sup>2</sup> PO twice per day on days 1 to 10 | ||
+ | ====Glucocorticoid therapy==== | ||
+ | *[[Prednisone (Sterapred)]] 60 mg/m<sup>2</sup>/day PO on days 1 to 10 | ||
+ | '''28-day cycle for 6 cycles''' | ||
+ | </div> | ||
+ | <div class="toccolours" style="background-color:#cbd5e8"> | ||
+ | ====Subsequent treatment==== | ||
+ | *Durant et al. 1978, responders: [[Classical_Hodgkin_lymphoma_-_null_regimens#Observation_2|No further therapy]] vs [[#BCVPP|BCVPP]] continuation x 6 vs [[Classical_Hodgkin_lymphoma#MOPP|MOPP]] x 6 | ||
+ | </div></div> | ||
+ | ===References=== | ||
+ | # Durant JR, Gams RA, Velez-Garcia E, Bartolucci A, Wirtschafter D, Dorfman R. BCNU, velban, cyclophosphamide, procarbazine, and prednisone (BVCPP) in advanced Hodgkin's disease. Cancer. 1978 Nov;42(5):2101-10. [https://doi.org/10.1002/1097-0142%28197811%2942%3A5%3C2101%3A%3AAID-CNCR2820420504%3E3.0.CO%3B2-M link to original article] '''dosing details in manuscript have been reviewed by our editors''' [https://pubmed.ncbi.nlm.nih.gov/719600/ PubMed] | ||
+ | # Bakemeier RF, Anderson JR, Costello W, Rosner G, Horton J, Glick JH, Hines JD, Berard CW, DeVita VT Jr; [[Study_Groups#ECOG|ECOG]]. BCVPP chemotherapy for advanced Hodgkin's disease: evidence for greater duration of complete remission, greater survival, and less toxicity than with a MOPP regimen: results of the Eastern Cooperative Oncology Group study. Ann Intern Med. 1984 Oct;101(4):447-56. [https://doi.org/10.7326/0003-4819-101-4-447 link to original article] [https://pubmed.ncbi.nlm.nih.gov/6089632/ PubMed] | ||
+ | |||
+ | ==ChlVPP/PABIOE {{#subobject:8ee324|Regimen=1}}== | ||
+ | ChlVPP/PABIOE: '''<u>Chl</u>'''orambucil, '''<u>V</u>'''inblastine, '''<u>P</u>'''rocarbazine, '''<u>P</u>'''rednisone alternating with '''<u>P</u>'''rednisolone, '''<u>A</u>'''driamycin (Doxorubicin), '''<u>B</u>'''leomycin, '''<u>O</u>'''ncovin (Vincristine), '''<u>E</u>'''toposide | ||
+ | <div class="toccolours" style="background-color:#ee6b6e"> | ||
+ | ===Regimen {{#subobject:48feb0|Variant=1}}=== | ||
+ | {| class="wikitable sortable" style="width: 100%; text-align:center;" | ||
+ | !style="width: 20%"|Study | ||
+ | !style="width: 20%"|Dates of enrollment | ||
+ | !style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]] | ||
+ | !style="width: 20%"|Comparator | ||
+ | !style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]] | ||
|- | |- | ||
− | |[ | + | |[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2363648/ Hancock et al. 2001] |
− | | style="background-color:#1a9851" | | + | |1992-1996 |
− | |[[ | + | | style="background-color:#1a9851" |Randomized (C) |
− | | style="background-color:# | + | |[[#PABIOE_999|PABIOE]] |
+ | | style="background-color:#1a9850" |Superior OS | ||
|- | |- | ||
|} | |} | ||
− | + | <div class="toccolours" style="background-color:#b3e2cd"> | |
− | ====Chemotherapy, | + | ====Chemotherapy, ChlVPP portion (cycles 1, 3, 5, 7)==== |
− | *[[ | + | *[[Chlorambucil (Leukeran)]] 6 mg/m<sup>2</sup> (maximum dose of 10 mg) PO once per day on days 1 to 14 |
− | *[[ | + | *[[Vinblastine (Velban)]] 6 mg/m<sup>2</sup> (maximum dose of 10 mg) IV once per day on days 1 & 8 |
− | *[[Procarbazine (Matulane)]] | + | *[[Procarbazine (Matulane)]] 100 mg/m<sup>2</sup> (maximum dose of 200 mg) PO once per day on days 1 to 14 |
− | *[[ | + | ====Glucocorticoid therapy, ChlVPP portion (cycles 1, 3, 5, 7)==== |
− | ====Chemotherapy, | + | *[[Prednisolone (Millipred)]] 40 mg/m<sup>2</sup> (maximum dose of 60 mg) PO once per day on days 1 to 14 |
− | *[[Doxorubicin (Adriamycin)]] | + | ====Glucocorticoid therapy, PABIOE portion (cycles 2, 4, 6, 8)==== |
− | *[[Bleomycin (Blenoxane)]] | + | *[[Prednisolone (Millipred)]] 40 mg/m<sup>2</sup> (maximum dose of 60 mg) PO once per day on days 1 to 10 |
− | *[[ | + | ====Chemotherapy, PABIOE portion (cycles 2, 4, 6, 8)==== |
− | *[[ | + | *[[Doxorubicin (Adriamycin)]] 40 mg/m<sup>2</sup> IV once on day 1 |
+ | *[[Bleomycin (Blenoxane)]] 10 units/m<sup>2</sup> (route not specified) once per day on days 1 & 8 | ||
+ | *[[Vincristine (Oncovin)]] 1.4 mg/m<sup>2</sup> (maximum dose of 2 mg) IV once per day on days 1 & 8 | ||
+ | *[[Etoposide (Vepesid)]] 200 mg/m<sup>2</sup> PO once per day on days 1 to 3 | ||
+ | '''28-day cycle alternating with 21-day cycle for 8 cycles (ChlVPP x 4; PABIOE x 4)''' | ||
+ | </div></div> | ||
===References=== | ===References=== | ||
− | # | + | # Hancock BW, Gregory WM, Cullen MH, Hudson GV, Burton A, Selby P, Maclennan KA, Jack A, Bessell EM, Smith P, Linch DC; British National Lymphoma Investigation; Central Lymphoma Group. ChlVPP alternating with PABlOE is superior to PABlOE alone in the initial treatment of advanced Hodgkin's disease: results of a British National Lymphoma Investigation/Central Lymphoma Group randomized controlled trial. Br J Cancer. 2001 May 18;84(10):1293-300. [https://doi.org/10.1054/bjoc.2001.1778 link to orginal article] [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2363648/ link to PMC article] '''dosing details in manuscript have been reviewed by our editors''' [https://pubmed.ncbi.nlm.nih.gov/11355937/ PubMed] |
− | + | # '''UKLG LY09:''' Johnson PW, Radford JA, Cullen MH, Sydes MR, Walewski J, Jack AS, MacLennan KA, Stenning SP, Clawson S, Smith P, Ryder D, Hancock BW; United Kingdom Lymphoma Group. Comparison of ABVD and alternating or hybrid multidrug regimens for the treatment of advanced Hodgkin's lymphoma: results of the United Kingdom Lymphoma Group LY09 Trial (ISRCTN97144519). J Clin Oncol. 2005 Dec 20;23(36):9208-18. Epub 2005 Nov 28. [https://doi.org/10.1200/JCO.2005.03.2151 link to original article] '''dosing details in manuscript have been reviewed by our editors''' [https://pubmed.ncbi.nlm.nih.gov/16314615/ PubMed] [https://clinicaltrials.gov/study/NCT00003421 NCT00003421] | |
− | + | ## '''Subgroup analysis:''' Johnson PW, Sydes MR, Hancock BW, Cullen M, Radford JA, Stenning SP. Consolidation radiotherapy in patients with advanced Hodgkin's lymphoma: survival data from the UKLG LY09 randomized controlled trial (ISRCTN97144519). J Clin Oncol. 2010 Jul 10;28(20):3352-9. Epub 2010 May 24. [https://doi.org/10.1200/JCO.2009.26.0323 link to original article] [https://pubmed.ncbi.nlm.nih.gov/20498402/ PubMed] | |
− | |||
− | |||
− | |||
− | |||
− | # ''' | ||
− | == | + | ==COPP (CCNU) {{#subobject:86879b|Regimen=1}}== |
− | {| class="wikitable" style=" | + | COPP: '''<u>C</u>'''CNU (Lomustine), '''<u>O</u>'''ncovin (Vincristine), '''<u>P</u>'''rocarbazine, '''<u>P</u>'''rednisone |
+ | <div class="toccolours" style="background-color:#ee6b6e"> | ||
+ | ===Regimen {{#subobject:cf3db2|Variant=1}}=== | ||
+ | {| class="wikitable sortable" style="width: 100%; text-align:center;" | ||
+ | !style="width: 20%"|Study | ||
+ | !style="width: 20%"|Dates of enrollment | ||
+ | !style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]] | ||
+ | !style="width: 20%"|Comparator | ||
+ | !style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]] | ||
+ | |- | ||
+ | |rowspan=3|[https://doi.org/10.1002/1097-0142(19800815)46:4%3C654::AID-CNCR2820460405%3E3.0.CO;2-A Cooper et al. 1980] | ||
+ | |rowspan=3|1972-1975 | ||
+ | |rowspan=3 style="background-color:#1a9851"|Phase 3 (E-switch-ic) | ||
+ | |1. [[#CVPP|CVPP]] | ||
+ | |style="background-color:#ffffbf"|Did not meet endpoint of OS | ||
+ | |- | ||
+ | |2. [[Classical_Hodgkin_lymphoma#MOPP|MOPP]] | ||
+ | |style="background-color:#ffffbf"|Did not meet endpoint of OS | ||
+ | |- | ||
+ | |3. [[#MVPP|MVPP]] | ||
+ | |style="background-color:#ffffbf"|Did not meet endpoint of OS | ||
|- | |- | ||
− | |||
|} | |} | ||
+ | <div class="toccolours" style="background-color:#b3e2cd"> | ||
+ | ====Chemotherapy==== | ||
+ | *[[Lomustine (CCNU)]] 75 mg/m<sup>2</sup> PO once on day 1 | ||
+ | *[[Vincristine (Oncovin)]] 1.4 mg/m<sup>2</sup> IV once per day on days 1 & 8 | ||
+ | *[[Procarbazine (Matulane)]] 100 mg/m<sup>2</sup> PO once per day on days 1 to 14 | ||
+ | ====Glucocorticoid therapy==== | ||
+ | *[[Prednisone (Sterapred)]] as follows: | ||
+ | **Cycles 1, 3, 5: 40 mg/m<sup>2</sup> PO once per day on days 1 to 14 | ||
+ | '''28-day cycle for 6 cycles''' | ||
+ | </div></div> | ||
+ | ===References=== | ||
+ | # Cooper MR, Pajak TF, Nissen NI, Stutzman L, Brunner K, Cuttner J, Falkson G, Grunwald H, Bank A, Leone L, Seligman BR, Silver RT, Weiss RB, Haurani F, Blom J, Spurr CL, Glidewell OJ, Gottlieb AJ, Holland JF. A new effective four-drug combination of CCNU (1-[2-chloroethyl]-3-cyclohexyl-1-nitrosourea) (NSC-79038), vinblastine, prednisone, and procarbazine for the treatment of advanced Hodgkin's disease. Cancer. 1980 Aug 15;46(4):654-62. [https://doi.org/10.1002/1097-0142(19800815)46:4%3C654::AID-CNCR2820460405%3E3.0.CO;2-A link to original article] '''dosing details in manuscript have been reviewed by our editors''' [https://pubmed.ncbi.nlm.nih.gov/7397630/ PubMed] | ||
− | + | ==CVPP {{#subobject:be8f99|Regimen=1}}== | |
− | + | CVPP: '''<u>C</u>'''CNU (Lomustine), '''<u>V</u>'''inblastine, '''<u>P</u>'''rocarbazine, '''<u>P</u>'''rednisone | |
− | ===Regimen {{#subobject: | + | <div class="toccolours" style="background-color:#ee6b6e"> |
− | {| class="wikitable" style="width: 100%; text-align:center;" | + | ===Regimen {{#subobject:e71c98|Variant=1}}=== |
− | !style="width: | + | {| class="wikitable sortable" style="width: 100%; text-align:center;" |
− | !style="width: | + | !style="width: 20%"|Study |
− | !style="width: | + | !style="width: 20%"|Dates of enrollment |
− | !style="width: | + | !style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]] |
+ | !style="width: 20%"|Comparator | ||
+ | !style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]] | ||
|- | |- | ||
− | |rowspan=3|[https:// | + | |rowspan=3|[https://doi.org/10.1002/1097-0142(19800815)46:4%3C654::AID-CNCR2820460405%3E3.0.CO;2-A Cooper et al. 1980] |
− | |rowspan=3 style="background-color:#1a9851"|Phase | + | |rowspan=3|1972-1975 |
+ | |rowspan=3 style="background-color:#1a9851"|Phase 3 (E-switch-ic) | ||
|1. [[#COPP_.28CCNU.29|COPP]] | |1. [[#COPP_.28CCNU.29|COPP]] | ||
− | |style="background-color:#ffffbf"|Seems not | + | |style="background-color:#ffffbf"|Did not meet endpoint of OS |
+ | |- | ||
+ | |2. [[Classical_Hodgkin_lymphoma#MOPP|MOPP]] | ||
+ | |style="background-color:#91cf60"|Seems to have superior CR rate | ||
+ | |- | ||
+ | |3. [[#MVPP|MVPP]] | ||
+ | |style="background-color:#ffffbf"|Did not meet endpoint of OS | ||
+ | |- | ||
+ | |} | ||
+ | <div class="toccolours" style="background-color:#b3e2cd"> | ||
+ | ====Chemotherapy==== | ||
+ | *[[Lomustine (CCNU)]] 75 mg/m<sup>2</sup> PO once on day 1 | ||
+ | *[[Vinblastine (Velban)]] 4 mg/m<sup>2</sup> IV once per day on days 1 & 8 | ||
+ | *[[Procarbazine (Matulane)]] 100 mg/m<sup>2</sup> PO once per day on days 1 to 14 | ||
+ | ====Glucocorticoid therapy==== | ||
+ | *[[Prednisone (Sterapred)]] as follows: | ||
+ | **Cycles 1, 3, 5: 40 mg/m<sup>2</sup> PO once per day on days 1 to 14 | ||
+ | '''28-day cycle for 6 cycles''' | ||
+ | </div></div> | ||
+ | ===References=== | ||
+ | # Cooper MR, Pajak TF, Nissen NI, Stutzman L, Brunner K, Cuttner J, Falkson G, Grunwald H, Bank A, Leone L, Seligman BR, Silver RT, Weiss RB, Haurani F, Blom J, Spurr CL, Glidewell OJ, Gottlieb AJ, Holland JF. A new effective four-drug combination of CCNU (1-[2-chloroethyl]-3-cyclohexyl-1-nitrosourea) (NSC-79038), vinblastine, prednisone, and procarbazine for the treatment of advanced Hodgkin's disease. Cancer. 1980 Aug 15;46(4):654-62. [https://doi.org/10.1002/1097-0142(19800815)46:4%3C654::AID-CNCR2820460405%3E3.0.CO;2-A link to original article] '''dosing details in manuscript have been reviewed by our editors''' [https://pubmed.ncbi.nlm.nih.gov/7397630/ PubMed] | ||
+ | |||
+ | ==LOPP {{#subobject:f2a168|Regimen=1}}== | ||
+ | LOPP: '''<u>L</u>'''eukeran (Chlorambucil), '''<u>O</u>'''ncovin (Vincristine), '''<u>P</u>'''rocarbazine, '''<u>P</u>'''rednisone | ||
+ | <div class="toccolours" style="background-color:#ee6b6e"> | ||
+ | ===Regimen {{#subobject:bfcf5a|Variant=1}}=== | ||
+ | {| class="wikitable sortable" style="width: 100%; text-align:center;" | ||
+ | !style="width: 20%"|Study | ||
+ | !style="width: 20%"|Dates of enrollment | ||
+ | !style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]] | ||
+ | !style="width: 20%"|Comparator | ||
+ | !style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]] | ||
|- | |- | ||
− | | | + | |[https://doi.org/10.1016/s0167-8140(86)80032-9 Hancock 1986] |
− | |style="background-color:#ffffbf"| | + | |1979 to not reported |
+ | | style="background-color:#1a9851" |Randomized (E-switch-ic) | ||
+ | |[[Classical_Hodgkin_lymphoma#MOPP|MOPP]] | ||
+ | | style="background-color:#ffffbf" |Did not meet endpoint of CR rate | ||
|- | |- | ||
− | | | + | |[https://doi.org/10.1200/JCO.1992.10.8.1252 Hancock et al. 1992] |
− | |style="background-color:# | + | |1983-1989 |
+ | | style="background-color:#1a9851" |Randomized (C) | ||
+ | |[[#LOPP.2FEVAP|LOPP/EVAP]] | ||
+ | | style="background-color:#fc8d59" |Seems to have inferior OS | ||
|- | |- | ||
|} | |} | ||
+ | <div class="toccolours" style="background-color:#b3e2cd"> | ||
====Chemotherapy==== | ====Chemotherapy==== | ||
− | *[[ | + | *[[Chlorambucil (Leukeran)]] 10 mg PO once per day on days 1 to 10 |
− | *[[ | + | *[[Vincristine (Oncovin)]] 1.4 mg/m<sup>2</sup> (maximum dose of 2 mg) IV once per day on days 1 & 8 |
− | *[[Procarbazine (Matulane)]] | + | *[[Procarbazine (Matulane)]] 100 mg/m<sup>2</sup> (maximum dose of 200 mg) PO once per day on days 1 to 10 |
− | *[[Prednisone (Sterapred)]] | + | ====Glucocorticoid therapy==== |
+ | *[[Prednisone (Sterapred)]] 25 mg/m<sup>2</sup> (maximum dose of 60 mg) PO once per day on days 1 to 14 | ||
+ | '''28-day cycle for 8 cycles''' | ||
+ | </div></div> | ||
+ | ===References=== | ||
+ | # Hancock BW; British National Lymphoma Investigation. Randomised study of MOPP (mustine, Oncovin, procarbazine, prednisone) against LOPP (Leukeran substituted for mustine) in advanced Hodgkin's disease. Radiother Oncol. 1986 Nov;7(3):215-21. [https://doi.org/10.1016/s0167-8140(86)80032-9 link to original article] [https://pubmed.ncbi.nlm.nih.gov/3544084/ PubMed] | ||
+ | ## '''Update:''' Hancock BW, Vaughan Hudson G, Vaughan Hudson B, Haybittle JL, Bennett MH, MacLennan KA, Jelliffe AM; BNLI. British National Lymphoma Investigation randomised study of MOPP (mustine, Oncovin, procarbazine, prednisolone) against LOPP (Leukeran substituted for mustine) in advanced Hodgkin's disease--long term results. Br J Cancer. 1991 Apr;63(4):579-82. [https://doi.org/10.1038/bjc.1991.134 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1972355/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/2021542/ PubMed] | ||
+ | # Hancock BW, Vaughan Hudson G, Vaughan Hudson B, Bennett MH, MacLennan KA, Haybittle JL, Anderson L, Linch DC; BNLI. LOPP alternating with EVAP is superior to LOPP alone in the initial treatment of advanced Hodgkin's disease: results of a British National Lymphoma Investigation trial. J Clin Oncol. 1992 Aug;10(8):1252-8. [https://doi.org/10.1200/JCO.1992.10.8.1252 link to original article] '''dosing details in manuscript have been reviewed by our editors''' [https://pubmed.ncbi.nlm.nih.gov/1634914/ PubMed] | ||
+ | ==LOPP/EVAP {{#subobject:22b023|Regimen=1}}== | ||
+ | LOPP/EVAP: '''<u>L</u>'''eukeran (Chlorambucil), '''<u>O</u>'''ncovin (Vincristine), '''<u>P</u>'''rocarbazine, '''<u>P</u>'''rednisone alternating with '''<u>E</u>'''toposide, '''<u>V</u>'''inblastine, '''<u>A</u>'''driamycin (Doxorubicin), '''<u>P</u>'''rednisone | ||
+ | <div class="toccolours" style="background-color:#ee6b6e"> | ||
+ | ===Regimen {{#subobject:53f4da|Variant=1}}=== | ||
+ | {| class="wikitable sortable" style="width: 100%; text-align:center;" | ||
+ | !style="width: 20%"|Study | ||
+ | !style="width: 20%"|Dates of enrollment | ||
+ | !style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]] | ||
+ | !style="width: 20%"|Comparator | ||
+ | !style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]] | ||
+ | |- | ||
+ | |[https://doi.org/10.1200/JCO.1992.10.8.1252 Hancock et al. 1992] | ||
+ | |1983-1989 | ||
+ | | style="background-color:#1a9851" |Randomized (E-switch-ic) | ||
+ | |[[#LOPP|LOPP]] | ||
+ | | style="background-color:#91cf60" |Seems to have superior OS | ||
+ | |- | ||
+ | |[https://doi.org/10.1093/annonc/5.suppl_2.s117 Hancock et al. 1994] | ||
+ | |1990-1991 | ||
+ | | style="background-color:#1a9851" |Randomized (C) | ||
+ | |[[#LOPP-EVA_999|LOPP-EVA]] | ||
+ | | style="background-color:#1a9850" |Superior CR rate | ||
+ | |- | ||
+ | |} | ||
+ | <div class="toccolours" style="background-color:#b3e2cd"> | ||
+ | ====Chemotherapy, LOPP portion (cycles 1, 3, 5, 7)==== | ||
+ | *[[Chlorambucil (Leukeran)]] 10 mg PO once per day on days 1 to 10 | ||
+ | *[[Vincristine (Oncovin)]] 1.4 mg/m<sup>2</sup> (maximum dose of 2 mg) IV once per day on days 1 & 8 | ||
+ | *[[Procarbazine (Matulane)]] 100 mg/m<sup>2</sup> (maximum dose of 200 mg) PO once per day on days 1 to 10 | ||
+ | ====Glucocorticoid therapy, LOPP portion (cycles 1, 3, 5, 7)==== | ||
+ | *[[Prednisone (Sterapred)]] 25 mg/m<sup>2</sup> (maximum dose of 60 mg) PO once per day on days 1 to 14 | ||
+ | ====Chemotherapy, EVAP portion (cycles 2, 4, 6, 8)==== | ||
+ | *[[Etoposide (Vepesid)]] 150 mg/m<sup>2</sup> (maximum dose of 200 mg) PO once per day on days 1 to 3 | ||
+ | *[[Vinblastine (Velban)]] 6 mg/m<sup>2</sup> (maximum dose of 10 mg) IV once per day on days 1 & 8 | ||
+ | *[[Doxorubicin (Adriamycin)]] 25 mg/m<sup>2</sup> IV once per day on days 1 & 8 | ||
+ | ====Glucocorticoid therapy, EVAP portion (cycles 2, 4, 6, 8)==== | ||
+ | *[[Prednisone (Sterapred)]] 25 mg/m<sup>2</sup> (maximum dose of 60 mg) PO once per day on days 1 to 14 | ||
+ | '''28-day cycle for 8 cycles (LOPP x 4; EVAP x 4)''' | ||
+ | </div></div> | ||
===References=== | ===References=== | ||
− | # | + | # Hancock BW, Vaughan Hudson G, Vaughan Hudson B, Bennett MH, MacLennan KA, Haybittle JL, Anderson L, Linch DC; BNLI. LOPP alternating with EVAP is superior to LOPP alone in the initial treatment of advanced Hodgkin's disease: results of a British National Lymphoma Investigation trial. J Clin Oncol. 1992 Aug;10(8):1252-8. [https://doi.org/10.1200/JCO.1992.10.8.1252 link to original article] '''dosing details in manuscript have been reviewed by our editors''' [https://pubmed.ncbi.nlm.nih.gov/1634914/ PubMed] |
+ | # Hancock BW, Vaughan Hudson G, Vaughan Hudson B, Linch DC, Anderson L, MacLennan KA; BNLI. Hybrid LOPP/EVA is not better than LOPP alternating with EVAP: a prematurely terminated British National Lymphoma Investigation randomized trial. Ann Oncol. 1994;5 Suppl 2:117-20. [https://doi.org/10.1093/annonc/5.suppl_2.s117 link to original article] [https://pubmed.ncbi.nlm.nih.gov/8204511/ PubMed] | ||
− | == | + | ==MOPP/ABVD {{#subobject:f28468|Regimen=1}}== |
− | {| class="wikitable" style=" | + | MOPP/ABVD: '''<u>M</u>'''ustargen (Mechlorethamine), '''<u>O</u>'''ncovin (Vincristine), '''<u>P</u>'''rocarbazine, '''<u>P</u>'''rednisone alternating with '''<u>A</u>'''driamycin (Doxorubicin), '''<u>B</u>'''leomycin, '''<u>V</u>'''inblastine, '''<u>D</u>'''acarbazine |
+ | <div class="toccolours" style="background-color:#ee6b6e"> | ||
+ | ===Regimen variant #1, 12 cycles, uncapped vincristine {{#subobject:5b28f5|Variant=1}}=== | ||
+ | {| class="wikitable sortable" style="width: 100%; text-align:center;" | ||
+ | !style="width: 20%"|Study | ||
+ | !style="width: 20%"|Dates of enrollment | ||
+ | !style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]] | ||
+ | !style="width: 20%"|Comparator | ||
+ | !style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]] | ||
+ | |- | ||
+ | |[https://doi.org/10.1056/NEJM198204013061303 Santoro et al. 1982] | ||
+ | |1974-1980 | ||
+ | | style="background-color:#1a9851" |Phase 3 (E-switch-ic) | ||
+ | |[[Classical_Hodgkin_lymphoma#MOPP|MOPP]] | ||
+ | | style="background-color:#1a9850" |Superior PFS | ||
+ | |- | ||
+ | |[https://doi.org/10.1200/jco.1996.14.5.1421 Viviani et al. 1996] | ||
+ | |1982-1990 | ||
+ | | style="background-color:#1a9851" |Phase 3 (C) | ||
+ | |[[#MOPP-ABVD_999|MOPP-ABVD]] | ||
+ | | style="background-color:#ffffbf" |Did not meet endpoint of CR rate | ||
+ | |- | ||
+ | |} | ||
+ | <div class="toccolours" style="background-color:#b3e2cd"> | ||
+ | ====Chemotherapy, MOPP portion (cycles 1, 3, 5, 7, 9, 11)==== | ||
+ | *[[Mechlorethamine (Mustargen)]] 6 mg/m<sup>2</sup> IV once per day on days 1 & 8 | ||
+ | *[[Vincristine (Oncovin)]] 1.4 mg/m<sup>2</sup> IV once per day on days 1 & 8 | ||
+ | *[[Procarbazine (Matulane)]] 100 mg/m<sup>2</sup> PO once per day on days 1 to 14 | ||
+ | ====Glucocorticoid therapy, MOPP portion (cycles 1, 3, 5, 7, 9, 11)==== | ||
+ | *[[Prednisone (Sterapred)]] as follows: | ||
+ | **Cycles 1 & 7: 40 mg/m<sup>2</sup> PO once per day on days 1 to 14 | ||
+ | ====Chemotherapy, ABVD portion (cycles 2, 4, 6, 8, 10, 12)==== | ||
+ | *[[Doxorubicin (Adriamycin)]] 25 mg/m<sup>2</sup> IV push once per day on days 1 & 15 | ||
+ | *[[Bleomycin (Blenoxane)]] 10 mg/m<sup>2</sup> IV push once per day on days 1 & 15 | ||
+ | *[[Vinblastine (Velban)]] 6 mg/m<sup>2</sup> IV push once per day on days 1 & 15 | ||
+ | *[[Dacarbazine (DTIC)]] 375 mg/m<sup>2</sup> IV push once per day on days 1 & 15 | ||
+ | '''28-day cycle for at least 12 cycles''' | ||
+ | </div></div><br> | ||
+ | <div class="toccolours" style="background-color:#ee6b6e"> | ||
+ | ===Regimen variant #2, 12 cycles, capped vincristine {{#subobject:5bcjk3|Variant=1}}=== | ||
+ | {| class="wikitable sortable" style="width: 100%; text-align:center;" | ||
+ | !style="width: 20%"|Study | ||
+ | !style="width: 20%"|Dates of enrollment | ||
+ | !style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]] | ||
+ | !style="width: 20%"|Comparator | ||
+ | !style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]] | ||
+ | |- | ||
+ | | rowspan="2" |[https://doi.org/10.1056/NEJM199211193272102 Canellos et al. 1992 (CALGB 8251)] | ||
+ | |rowspan=2|1982 to not reported | ||
+ | | rowspan="2" style="background-color:#1a9851" |Phase 3 (E-switch-ic) | ||
+ | |1. [[Classical_Hodgkin_lymphoma#ABVD_3|ABVD]] | ||
+ | | style="background-color:#ffffbf" |Did not meet primary endpoint of CR rate<sup>1</sup> | ||
+ | |- | ||
+ | |2. [[Classical_Hodgkin_lymphoma#MOPP|MOPP]] | ||
+ | | style="background-color:#91cf60" |Seems to have superior EFS<sup>1</sup> (secondary endpoint) | ||
+ | |- | ||
+ | |} | ||
+ | ''<sup>1</sup>Reported efficacy for CALGB 8251 is based on the 2009 update.''<br> | ||
+ | ''Note: full dosing details are not available in the manuscript, which stated that the Milan Cancer Institute scheme was used for ABVD dosing.'' | ||
+ | <div class="toccolours" style="background-color:#b3e2cd"> | ||
+ | ====Chemotherapy, MOPP portion (cycles 1, 3, 5, 7, 9, 11)==== | ||
+ | *[[Mechlorethamine (Mustargen)]] 6 mg/m<sup>2</sup> IV once per day on days 1 & 8 | ||
+ | *[[Vincristine (Oncovin)]] 1.4 mg/m<sup>2</sup> (maximum dose of 2 mg) IV once per day on days 1 & 8 | ||
+ | *[[Procarbazine (Matulane)]] 100 mg/m<sup>2</sup> PO once per day on days 1 to 14 | ||
+ | ====Glucocorticoid therapy, MOPP portion (cycles 1, 3, 5, 7, 9, 11)==== | ||
+ | *[[Prednisone (Sterapred)]] as follows: | ||
+ | **Cycles 1 & 7: 40 mg/m<sup>2</sup> PO once per day on days 1 to 14 | ||
+ | ====Chemotherapy, ABVD portion (cycles 2, 4, 6, 8, 10, 12)==== | ||
+ | *[[Doxorubicin (Adriamycin)]] 25 mg/m<sup>2</sup> IV push once per day on days 1 & 15 | ||
+ | *[[Bleomycin (Blenoxane)]] 10 mg/m<sup>2</sup> IV push once per day on days 1 & 15 | ||
+ | *[[Vinblastine (Velban)]] 6 mg/m<sup>2</sup> IV push once per day on days 1 & 15 | ||
+ | *[[Dacarbazine (DTIC)]] 375 mg/m<sup>2</sup> IV push once per day on days 1 & 15 | ||
+ | '''28-day cycle for 12 cycles''' | ||
+ | </div></div><br> | ||
+ | <div class="toccolours" style="background-color:#ee6b6e"> | ||
+ | ===Regimen variant #3, 12 cycles, capped vincristine, alternate prednisone dosing {{#subobject:ac5cf5|Variant=1}}=== | ||
+ | {| class="wikitable sortable" style="width: 100%; text-align:center;" | ||
+ | !style="width: 20%"|Study | ||
+ | !style="width: 20%"|Dates of enrollment | ||
+ | !style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]] | ||
+ | !style="width: 20%"|Comparator | ||
+ | !style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]] | ||
+ | |- | ||
+ | |[https://doi.org/10.1200/JCO.1998.16.3.897 Hutchinson et al. 1998 (CCG-521)] | ||
+ | |1986-1990 | ||
+ | | style="background-color:#1a9851" |Phase 3 (C) | ||
+ | |[[Classical_Hodgkin_lymphoma#ABVD_3|ABVD]], then [[Classical_Hodgkin_lymphoma#Radiation_therapy_2|RT]] | ||
+ | | style="background-color:#fee08b" |Might have inferior EFS | ||
+ | |- | ||
+ | |} | ||
+ | <div class="toccolours" style="background-color:#b3e2cd"> | ||
+ | ====Chemotherapy, MOPP portion (cycles 1, 3, 5, 7, 9, 11)==== | ||
+ | *[[Mechlorethamine (Mustargen)]] 6 mg/m<sup>2</sup> IV push once per day on days 1 & 8 | ||
+ | *[[Vincristine (Oncovin)]] 1.5 mg/m<sup>2</sup> (maximum dose of 2 mg) IV push once per day on days 1 & 8 | ||
+ | *[[Procarbazine (Matulane)]] 100 mg/m<sup>2</sup> PO once per day on days 1 to 14 | ||
+ | ====Glucocorticoid therapy, MOPP portion (cycles 1, 3, 5, 7, 9, 11)==== | ||
+ | *[[Prednisone (Sterapred)]] 40 mg/m<sup>2</sup> PO once per day on days 1 to 14, in 3 divided doses per day | ||
+ | ====Chemotherapy, ABVD portion (cycles 2, 4, 6, 8, 10, 12)==== | ||
+ | *[[Doxorubicin (Adriamycin)]] 25 mg/m<sup>2</sup> IV push once per day on days 1 & 15 | ||
+ | *[[Bleomycin (Blenoxane)]] 10 mg/m<sup>2</sup> IV slow push once per day on days 1 & 15 | ||
+ | *[[Vinblastine (Velban)]] 6 mg/m<sup>2</sup> IV push once per day on days 1 & 15 | ||
+ | *[[Dacarbazine (DTIC)]] 375 mg/m<sup>2</sup> IV push once per day on days 1 & 15 | ||
+ | '''28-day cycle for 12 cycles''' | ||
+ | </div></div><br> | ||
+ | <div class="toccolours" style="background-color:#ee6b6e"> | ||
+ | ===Regimen variant #4, 8 cycles {{#subobject:5b2u35|Variant=1}}=== | ||
+ | {| class="wikitable sortable" style="width: 100%; text-align:center;" | ||
+ | !style="width: 20%"|Study | ||
+ | !style="width: 20%"|Dates of enrollment | ||
+ | !style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]] | ||
+ | !style="width: 20%"|Comparator | ||
+ | !style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]] | ||
+ | |- | ||
+ | |[https://doi.org/10.1200/jco.1997.15.4.1638 Connor et al. 1997 (NCIC-CTG HD4)] | ||
+ | |1984-1989 | ||
+ | | style="background-color:#1a9851" |Phase 3 (C) | ||
+ | |[[Classical_Hodgkin_lymphoma#MOPP-ABV_3|MOPP-ABV]] | ||
+ | | style="background-color:#ffffbf" |Did not meet co-primary endpoint of OS | ||
|- | |- | ||
− | |||
|} | |} | ||
− | + | <div class="toccolours" style="background-color:#b3e2cd"> | |
− | ===Regimen {{#subobject: | + | ====Chemotherapy, MOPP portion (cycles 1, 3, 5, 7)==== |
− | {| class="wikitable" style="width: 100%; text-align:center;" | + | *[[Mechlorethamine (Mustargen)]] 6 mg/m<sup>2</sup> IV once per day on days 1 & 8 |
− | !style="width: | + | *[[Vincristine (Oncovin)]] 1.4 mg/m<sup>2</sup> (maximum dose of 2 mg) IV once per day on days 1 & 8 |
− | !style="width: | + | *[[Procarbazine (Matulane)]] 100 mg/m<sup>2</sup> PO once per day on days 1 to 14 |
+ | ====Glucocorticoid therapy, MOPP portion (cycles 1, 3, 5, 7)==== | ||
+ | *[[Prednisone (Sterapred)]] as follows: | ||
+ | **Cycles 1 & 5: 40 mg/m<sup>2</sup> PO once per day on days 1 to 14 | ||
+ | ====Chemotherapy, ABVD portion (cycles 2, 4, 6, 8)==== | ||
+ | *[[Doxorubicin (Adriamycin)]] 25 mg/m<sup>2</sup> IV push once per day on days 1 & 15 | ||
+ | *[[Bleomycin (Blenoxane)]] 10 mg/m<sup>2</sup> IV push once per day on days 1 & 15 | ||
+ | *[[Vinblastine (Velban)]] 6 mg/m<sup>2</sup> IV push once per day on days 1 & 15 | ||
+ | *[[Dacarbazine (DTIC)]] 375 mg/m<sup>2</sup> IV push once per day on days 1 & 15 | ||
+ | '''28-day cycle for 8 cycles''' | ||
+ | </div></div><br> | ||
+ | <div class="toccolours" style="background-color:#ee6b6e"> | ||
+ | ===Regimen variant #5, 8 cycles, lower-dose ABVD {{#subobject:5bhgac|Variant=1}}=== | ||
+ | {| class="wikitable sortable" style="width: 100%; text-align:center;" | ||
+ | !style="width: 20%"|Study | ||
+ | !style="width: 20%"|Dates of enrollment | ||
+ | !style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]] | ||
+ | !style="width: 20%"|Comparator | ||
+ | !style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]] | ||
|- | |- | ||
− | |[https:// | + | |[https://doi.org/10.1200/jco.1994.12.2.279 Somers et al. 1994] |
− | |style="background-color:# | + | |1981-1986 |
+ | | style="background-color:#1a9851" |Phase 3 (E-switch-ic) | ||
+ | |[[Classical_Hodgkin_lymphoma#MOPP|MOPP]] x 8 | ||
+ | | style="background-color:#91cf60" |Seems to have superior FFS | ||
|- | |- | ||
|} | |} | ||
− | ====Chemotherapy==== | + | ''Note: Each portion is given twice before alternating (AABBAABB pattern). ABVD doses are per the "Milan scheme".'' |
− | *[[ | + | <div class="toccolours" style="background-color:#b3e2cd"> |
− | *[[Vincristine (Oncovin)]] | + | ====Chemotherapy, MOPP portion (cycles 1, 2, 5, 6)==== |
− | *[[Vinblastine (Velban)]] | + | *[[Mechlorethamine (Mustargen)]] 6 mg/m<sup>2</sup> IV once per day on days 1 & 8 |
− | *[[ | + | *[[Vincristine (Oncovin)]] 1.4 mg/m<sup>2</sup> (maximum dose of 2 mg) IV once per day on days 1 & 8 |
− | + | *[[Procarbazine (Matulane)]] 100 mg/m<sup>2</sup> PO once per day on days 1 to 14 | |
+ | ====Glucocorticoid therapy, MOPP portion (cycles 1, 2, 5, 6)==== | ||
+ | *[[Prednisone (Sterapred)]] 25 mg/m<sup>2</sup> PO once per day on days 1 to 14 | ||
+ | ====Chemotherapy, ABVD portion (cycles 3, 4, 7, 8)==== | ||
+ | *[[Doxorubicin (Adriamycin)]] 25 mg/m<sup>2</sup> IV push once per day on days 1 & 15 | ||
+ | *[[Bleomycin (Blenoxane)]] 6 mg/m<sup>2</sup> IV push once per day on days 1 & 15 | ||
+ | *[[Vinblastine (Velban)]] 6 mg/m<sup>2</sup> IV push once per day on days 1 & 15 | ||
+ | *[[Dacarbazine (DTIC)]] 250 mg/m<sup>2</sup> IV push once per day on days 1 & 15 | ||
+ | '''28-day cycle for 8 cycles''' | ||
+ | </div></div> | ||
===References=== | ===References=== | ||
− | # | + | # Santoro A, Bonadonna G, Bonfante V, Valagussa P. Alternating drug combinations in the treatment of advanced Hodgkin's disease. N Engl J Med. 1982 Apr 1;306(13):770-5. [https://doi.org/10.1056/NEJM198204013061303 link to original article] '''dosing details in manuscript have been reviewed by our editors''' [https://pubmed.ncbi.nlm.nih.gov/6174865/ PubMed] |
+ | ## '''Update:''' Bonadonna G, Valagussa P, Santoro A. Alternating non-cross-resistant combination chemotherapy or MOPP in stage IV Hodgkin's disease: a report of 8-year results. Ann Intern Med. 1986 Jun;104(6):739-46. [https://doi.org/10.7326/0003-4819-104-6-739 link to original article] [https://pubmed.ncbi.nlm.nih.gov/2422994/ PubMed] | ||
+ | # '''CALGB 8251:''' Canellos GP, Anderson JR, Propert KJ, Nissen N, Cooper MR, Henderson ES, Green MR, Gottlieb A, Peterson BA. Chemotherapy of advanced Hodgkin's disease with MOPP, ABVD, or MOPP alternating with ABVD. N Engl J Med. 1992 Nov 19;327(21):1478-84. [https://doi.org/10.1056/NEJM199211193272102 link to original article] '''contains partial dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/1383821/ PubMed] | ||
+ | ## '''Update:''' Canellos GP, Niedzwiecki D. Long-term follow-up of Hodgkin's disease trial. N Engl J Med. 2002 May 2;346(18):1417-8. [https://doi.org/10.1056/NEJM200205023461821 link to original article] [https://pubmed.ncbi.nlm.nih.gov/11986425/ PubMed] | ||
+ | ## '''Update:''' Canellos GP, Niedzwiecki D, Johnson JL. Long-term follow-up of survival in Hodgkin's lymphoma. N Engl J Med. 2009 Dec 10;361(24):2390-1. [https://doi.org/10.1056/NEJMc0906731 link to original article] [https://pubmed.ncbi.nlm.nih.gov/20007568/ PubMed] | ||
+ | # Somers R, Carde P, Henry-Amar M, Tarayre M, Thomas J, Hagenbeek A, Monconduit M, de Pauw BE, Breed WP, Verdonck L, Burgers JMV, Eghbali H, Zittoun R; [[Study_Groups#EORTC|EORTC]]. A randomized study in stage IIIB and IV Hodgkin's disease comparing eight courses of MOPP versus an alteration of MOPP with ABVD: a European Organisation for Research and Treatment of Cancer Lymphoma Cooperative Group and Groupe Pierre-et-Marie-Curie controlled clinical trial. J Clin Oncol. 1994 Feb;12(2):279-87. [https://doi.org/10.1200/jco.1994.12.2.279 link to original article] '''dosing details in manuscript have been reviewed by our editors''' [https://pubmed.ncbi.nlm.nih.gov/7509381/ PubMed] | ||
+ | # Viviani S, Bonadonna G, Santoro A, Bonfante V, Zanini M, Devizzi L, Soncini F, Valagussa P. Alternating versus hybrid MOPP and ABVD combinations in advanced Hodgkin's disease: ten-year results. J Clin Oncol. 1996 May;14(5):1421-30. [https://doi.org/10.1200/jco.1996.14.5.1421 link to original article] '''does not contain dosing details''' [https://pubmed.ncbi.nlm.nih.gov/8622055/ PubMed] | ||
+ | # '''NCIC-CTG HD4:''' Connors JM, Klimo P, Adams G, Burns BF, Cooper I, Meyer RM, O'Reilly SE, Pater J, Quirt I, Sadura A, Shustik C, Skillings J, Sutcliffe S, Verma S, Yoshida S, Zee B. Treatment of advanced Hodgkin's disease with chemotherapy--comparison of MOPP/ABV hybrid regimen with alternating courses of MOPP and ABVD: a report from the National Cancer Institute of Canada clinical trials group. J Clin Oncol. 1997 Apr;15(4):1638-45. Erratum in: J Clin Oncol 1997 Jul;15(7):2762. [https://doi.org/10.1200/jco.1997.15.4.1638 link to original article] '''dosing details in manuscript have been reviewed by our editors''' [https://pubmed.ncbi.nlm.nih.gov/9193364/ PubMed] | ||
+ | # '''CCG-521:''' Hutchinson RJ, Fryer CJ, Davis PC, Nachman J, Krailo MD, O'Brien RT, Collins RD, Whalen T, Reardon D, Trigg ME, Gilchrist GS. MOPP or radiation in addition to ABVD in the treatment of pathologically staged advanced Hodgkin's disease in children: results of the Children's Cancer Group Phase III Trial. J Clin Oncol. 1998 Mar;16(3):897-906. [https://doi.org/10.1200/JCO.1998.16.3.897 link to original article] '''dosing details in manuscript have been reviewed by our editors''' [https://pubmed.ncbi.nlm.nih.gov/9508171/ PubMed] | ||
− | == | + | ==MVPP {{#subobject:b01f3a|Regimen=1}}== |
− | {| class="wikitable" style=" | + | MVPP: '''<u>M</u>'''echlorethamine, '''<u>V</u>'''inblastine, '''<u>P</u>'''rocarbazine, '''<u>P</u>'''rednisone |
+ | <div class="toccolours" style="background-color:#ee6b6e"> | ||
+ | ===Regimen {{#subobject:312fd8|Variant=1}}=== | ||
+ | {| class="wikitable sortable" style="width: 100%; text-align:center;" | ||
+ | !style="width: 20%"|Study | ||
+ | !style="width: 20%"|Dates of enrollment | ||
+ | !style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]] | ||
+ | !style="width: 20%"|Comparator | ||
+ | !style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]] | ||
+ | |- | ||
+ | |rowspan=3|[https://doi.org/10.1002/1097-0142(19800815)46:4%3C654::AID-CNCR2820460405%3E3.0.CO;2-A Cooper et al. 1980] | ||
+ | |rowspan=3|1972-1975 | ||
+ | |rowspan=3 style="background-color:#1a9851"|Phase 3 (E-switch-ic) | ||
+ | |1. [[#COPP_.28CCNU.29|COPP]] | ||
+ | |style="background-color:#ffffbf"|Did not meet endpoint of OS | ||
+ | |- | ||
+ | |2. [[#CVPP|CVPP]] | ||
+ | |style="background-color:#ffffbf"|Did not meet endpoint of OS | ||
+ | |- | ||
+ | |3. [[Classical_Hodgkin_lymphoma#MOPP|MOPP]] | ||
+ | |style="background-color:#ffffbf"|Did not meet endpoint of OS | ||
|- | |- | ||
− | |||
|} | |} | ||
+ | <div class="toccolours" style="background-color:#b3e2cd"> | ||
+ | ====Chemotherapy==== | ||
+ | *[[Mechlorethamine (Mustargen)]] 6 mg/m<sup>2</sup> IV once per day on days 1 & 8 | ||
+ | *[[Vinblastine (Velban)]] 4 mg/m<sup>2</sup> IV once per day on days 1 & 8 | ||
+ | *[[Procarbazine (Matulane)]] 100 mg/m<sup>2</sup> PO once per day on days 1 to 14 | ||
+ | ====Glucocorticoid therapy==== | ||
+ | *[[Prednisone (Sterapred)]] as follows: | ||
+ | **Cycles 1, 3, 5: 40 mg/m<sup>2</sup> PO once per day on days 1 to 14 | ||
+ | '''28-day cycle for 6 cycles''' | ||
+ | </div></div> | ||
+ | ===References=== | ||
+ | # Cooper MR, Pajak TF, Nissen NI, Stutzman L, Brunner K, Cuttner J, Falkson G, Grunwald H, Bank A, Leone L, Seligman BR, Silver RT, Weiss RB, Haurani F, Blom J, Spurr CL, Glidewell OJ, Gottlieb AJ, Holland JF. A new effective four-drug combination of CCNU (1-[2-chloroethyl]-3-cyclohexyl-1-nitrosourea) (NSC-79038), vinblastine, prednisone, and procarbazine for the treatment of advanced Hodgkin's disease. Cancer. 1980 Aug 15;46(4):654-62. [https://doi.org/10.1002/1097-0142(19800815)46:4%3C654::AID-CNCR2820460405%3E3.0.CO;2-A link to original article] '''dosing details in manuscript have been reviewed by our editors''' [https://pubmed.ncbi.nlm.nih.gov/7397630/ PubMed] | ||
+ | ==SCAB {{#subobject:344883|Regimen=1}}== | ||
SCAB: '''<u>S</u>'''treptozocin, '''<u>C</u>'''CNU (Lomustine), '''<u>A</u>'''driamycin (Doxorubicin), '''<u>B</u>'''leomycin | SCAB: '''<u>S</u>'''treptozocin, '''<u>C</u>'''CNU (Lomustine), '''<u>A</u>'''driamycin (Doxorubicin), '''<u>B</u>'''leomycin | ||
− | + | <div class="toccolours" style="background-color:#ee6b6e"> | |
===Regimen {{#subobject:a68d3b|Variant=1}}=== | ===Regimen {{#subobject:a68d3b|Variant=1}}=== | ||
− | {| class="wikitable" style="width: | + | {| class="wikitable sortable" style="width: 60%; text-align:center;" |
− | !style="width: | + | !style="width: 33%"|Study |
− | !style="width: | + | !style="width: 33%"|Dates of enrollment |
+ | !style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]] | ||
|- | |- | ||
− | |[https:// | + | |[https://doi.org/10.1002/1097-0142(19810115)47:2%3C224::AID-CNCR2820470203%3E3.0.CO;2-6 Diggs et al. 1981] |
+ | |1976-1978 | ||
|style="background-color:#91cf61"|Non-randomized | |style="background-color:#91cf61"|Non-randomized | ||
|- | |- | ||
|} | |} | ||
+ | <div class="toccolours" style="background-color:#b3e2cd"> | ||
+ | ====Chemotherapy==== | ||
+ | *[[Streptozocin (Zanosar)]] 500 mg/m<sup>2</sup> IV once per day on days 1 to 5 | ||
+ | *[[Lomustine (CCNU)]] 100 mg/m<sup>2</sup> PO once on day 1 | ||
+ | *[[Doxorubicin (Adriamycin)]] 45 mg/m<sup>2</sup> IV once on day 1 | ||
+ | *[[Bleomycin (Blenoxane)]] 15 mg/m<sup>2</sup> IM once per day on days 1 to 7 | ||
+ | '''1-month cycles''' | ||
+ | </div></div> | ||
+ | ===References=== | ||
+ | # Diggs CH, Wiernik PH, Sutherland JC. Treatment of advanced untreated Hodgkin's disease with SCAB--an alternative to MOPP. Cancer. 1981 Jan 15;47(2):224-8. [https://doi.org/10.1002/1097-0142(19810115)47:2%3C224::AID-CNCR2820470203%3E3.0.CO;2-6 link to original article] '''dosing details in manuscript have been reviewed by our editors''' [https://pubmed.ncbi.nlm.nih.gov/6161689/ PubMed] | ||
+ | ## '''Update:''' Wiernik PH, Schiffer CA. Long-term follow-up of advanced Hodgkin's disease patients treated with a combination of streptozotocin, lomustine (CCNU), doxorubicin and bleomycin (SCAB). J Cancer Res Clin Oncol. 1988;114(1):105-7. [https://doi.org/10.1007/bf00390494 link to original article] [https://pubmed.ncbi.nlm.nih.gov/2450876/ PubMed] | ||
+ | |||
+ | ==VEBEP {{#subobject:d7a2a6|Regimen=1}}== | ||
+ | VEBEP: '''<u>V</u>'''epesid (Etoposide), '''<u>E</u>'''pirubicin, '''<u>B</u>'''leomycin, '''<u>E</u>'''ndoxan (Cyclophosphamide), '''<u>P</u>'''rednisolone | ||
+ | <div class="toccolours" style="background-color:#ee6b6e"> | ||
+ | ===Regimen {{#subobject:91297e|Variant=1}}=== | ||
+ | {| class="wikitable sortable" style="width: 60%; text-align:center;" | ||
+ | !style="width: 33%"|Study | ||
+ | !style="width: 33%"|Dates of enrollment | ||
+ | !style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]] | ||
+ | |- | ||
+ | |[https://pubmed.ncbi.nlm.nih.gov/10526668 Viviani et al. 1999] | ||
+ | |1990-09 to 1993-03 | ||
+ | | style="background-color:#91cf61" |Phase 2 | ||
+ | |- | ||
+ | |} | ||
+ | ''Note: The full manuscript is not available online for review.'' | ||
+ | <div class="toccolours" style="background-color:#b3e2cd"> | ||
====Chemotherapy==== | ====Chemotherapy==== | ||
− | *[[ | + | *[[Etoposide (Vepesid)]] |
− | *[[ | + | *[[Epirubicin (Ellence)]] |
− | |||
*[[Bleomycin (Blenoxane)]] | *[[Bleomycin (Blenoxane)]] | ||
− | + | *[[Cyclophosphamide (Cytoxan)]] | |
+ | ====Glucocorticoid therapy==== | ||
+ | *[[Prednisolone (Millipred)]] | ||
+ | </div></div> | ||
===References=== | ===References=== | ||
− | # | + | # Viviani S, Bonfante V, Santoro A, Zanini M, Devizzi L, Di Russo AD, Soncini F, Villani F, Ragni G, Valagussa P, Bonadonna G. Long-term results of an intensive regimen: VEBEP plus involved-field radiotherapy in advanced Hodgkin's disease. Cancer J Sci Am. 1999 Sep-Oct;5(5):275-82. [https://pubmed.ncbi.nlm.nih.gov/10526668/ PubMed] '''does not contain dosing details in abstract''' |
− | |||
− | = | + | =Maintenance after upfront therapy= |
− | + | ==BCG vaccine monotherapy {{#subobject:e1fd72|Regimen=1}}== | |
− | == | + | <div class="toccolours" style="background-color:#ee6b6e"> |
− | {| class="wikitable" style=" | + | ===Regimen {{#subobject:52ca75|Variant=1}}=== |
+ | {| class="wikitable sortable" style="width: 100%; text-align:center;" | ||
+ | ! style="width: 20%" |Study | ||
+ | ! style="width: 20%" |Dates of enrollment | ||
+ | ! style="width: 20%" |[[Levels_of_Evidence#Evidence|Evidence]] | ||
+ | ! style="width: 20%" |Comparator | ||
+ | ! style="width: 20%" |[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]] | ||
+ | |- | ||
+ | |[https://doi.org/10.1056/NEJM197412052912305 Sokal et al. 1974] | ||
+ | |1965-1967 | ||
+ | | style="background-color:#91cf61" |Randomized, fewer than 20 pts in this subgroup (E-esc) | ||
+ | |[[Classical_Hodgkin_lymphoma_-_null_regimens#Observation_3|Observation]] | ||
+ | | style="background-color:#1a9850" |Superior PFS | ||
|- | |- | ||
− | |||
|} | |} | ||
+ | ''Note: this study was open to patients with "malignant lymphoma" but the majority had Hodgkin disease.'' | ||
+ | <div class="toccolours" style="background-color:#b3e2cd"> | ||
+ | ====Immunotherapy==== | ||
+ | *[[BCG vaccine]] | ||
+ | </div></div> | ||
+ | ===References=== | ||
+ | #Sokal JE, Aungst CW, Snyderman M. Delay in progression of malignant lymphoma after BCG vaccination. N Engl J Med. 1974 Dec 5;291(23):1226-30. [https://doi.org/10.1056/NEJM197412052912305 link to original article] [https://pubmed.ncbi.nlm.nih.gov/4609380/ PubMed] | ||
+ | =Relapsed or refractory, salvage therapy = | ||
+ | ==ABDIC {{#subobject:c5c5ab|Regimen=1}}== | ||
ABDIC: '''<u>A</u>'''driamycin (Doxorubicin), '''<u>B</u>'''leomycin, '''<u>DI</u>'''C (Dacarbazine), '''<u>C</u>'''CNU (Lomustine), Prednisone | ABDIC: '''<u>A</u>'''driamycin (Doxorubicin), '''<u>B</u>'''leomycin, '''<u>DI</u>'''C (Dacarbazine), '''<u>C</u>'''CNU (Lomustine), Prednisone | ||
− | + | <div class="toccolours" style="background-color:#ee6b6e"> | |
===Regimen {{#subobject:4ba1e1|Variant=1}}=== | ===Regimen {{#subobject:4ba1e1|Variant=1}}=== | ||
− | {| class="wikitable" style="width: | + | {| class="wikitable sortable" style="width: 60%; text-align:center;" |
− | !style="width: | + | !style="width: 33%"|Study |
− | !style="width: | + | !style="width: 33%"|Dates of enrollment |
+ | !style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]] | ||
|- | |- | ||
− | |[https:// | + | |[https://doi.org/10.1002/1097-0142(19801201)46:11%3C2349::AID-CNCR2820461105%3E3.0.CO;2-V Rodgers et al. 1980] |
− | |style="background-color:#91cf61"|Phase | + | |1974-1978 |
+ | | style="background-color:#91cf61" |Phase 2 | ||
|- | |- | ||
|} | |} | ||
+ | <div class="toccolours" style="background-color:#b3e2cd"> | ||
====Chemotherapy==== | ====Chemotherapy==== | ||
− | *[[Doxorubicin (Adriamycin)]] | + | *[[Doxorubicin (Adriamycin)]] 45 mg/m<sup>2</sup> IV once on day 1 |
− | *[[Bleomycin (Blenoxane)]] | + | *[[Bleomycin (Blenoxane)]] 5 mg/m<sup>2</sup> IV once per day on days 1 & 5 |
− | *[[Dacarbazine (DTIC)]] | + | *[[Dacarbazine (DTIC)]] 200 mg/m<sup>2</sup> IV once per day on days 1 to 5 |
− | *[[Lomustine ( | + | *[[Lomustine (CCNU)]] 50 mg/m<sup>2</sup> PO once on day 1 |
− | *[[Prednisone (Sterapred)]] | + | ====Glucocorticoid therapy==== |
− | + | *[[Prednisone (Sterapred)]] 40 mg/m<sup>2</sup> PO once per day on days 1 to 5 | |
+ | '''28-day cycles''' | ||
+ | </div></div> | ||
===References=== | ===References=== | ||
− | # Rodgers RW, Gamble JF, Loh KK, Shullenberger CC. Adriamycin, bleomycin, DIC, CCNU, and prednisone (ABDIC) chemotherapy in MOPP-resistant Hodgkin's disease. Cancer. 1980 Dec 1;46(11):2349-55. [https:// | + | #Rodgers RW, Gamble JF, Loh KK, Shullenberger CC. Adriamycin, bleomycin, DIC, CCNU, and prednisone (ABDIC) chemotherapy in MOPP-resistant Hodgkin's disease. Cancer. 1980 Dec 1;46(11):2349-55. [https://doi.org/10.1002/1097-0142(19801201)46:11%3C2349::AID-CNCR2820461105%3E3.0.CO;2-V link to original article] '''dosing details in manuscript have been reviewed by our editors''' [https://pubmed.ncbi.nlm.nih.gov/6159961/ PubMed] |
− | ## '''Update:''' Tannir N, Hagemeister F, Velasquez W, Cabanillas F. Long-term follow-up with ABDIC salvage chemotherapy of MOPP-resistant Hodgkin's disease. J Clin Oncol. 1983 Jul;1(7):432-9. [ | + | ##'''Update:''' Tannir N, Hagemeister F, Velasquez W, Cabanillas F. Long-term follow-up with ABDIC salvage chemotherapy of MOPP-resistant Hodgkin's disease. J Clin Oncol. 1983 Jul;1(7):432-9. [https://doi.org/10.1200/jco.1983.1.7.432 link to original article] [https://pubmed.ncbi.nlm.nih.gov/6199478/ PubMed] |
==ABVD {{#subobject:c5a35d|Regimen=1}}== | ==ABVD {{#subobject:c5a35d|Regimen=1}}== | ||
− | |||
− | |||
− | |||
− | |||
ABVD: '''<u>A</u>'''driamycin (Doxorubicin), '''<u>B</u>'''leomycin, '''<u>V</u>'''inblastine, '''<u>D</u>'''acarbazine | ABVD: '''<u>A</u>'''driamycin (Doxorubicin), '''<u>B</u>'''leomycin, '''<u>V</u>'''inblastine, '''<u>D</u>'''acarbazine | ||
− | + | <div class="toccolours" style="background-color:#ee6b6e"> | |
===Regimen {{#subobject:ae32ee|Variant=1}}=== | ===Regimen {{#subobject:ae32ee|Variant=1}}=== | ||
− | {| class="wikitable" style="width: | + | {| class="wikitable sortable" style="width: 60%; text-align:center;" |
− | !style="width: | + | !style="width: 33%"|Study |
− | !style="width: | + | !style="width: 33%"|Dates of enrollment |
+ | !style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]] | ||
|- | |- | ||
− | |[https:// | + | |[https://doi.org/10.7326/0003-4819-101-4-440 Harker et al. 1984] |
− | |style="background-color:#91cf61"| | + | |1973-1982 |
+ | | style="background-color:#91cf61" |Non-randomized | ||
|- | |- | ||
− | |[https:// | + | |[https://doi.org/10.1002/1097-0142(197806)41:6%3C2107::AID-CNCR2820410606%3E3.0.CO;2-L Krikorian et al. 1978] |
− | |style="background-color:#91cf61"| | + | |1975-06-19 to 1976-12-22 |
+ | | style="background-color:#91cf61" |Phase 2 | ||
|- | |- | ||
− | |[ | + | |[https://doi.org/10.1007/bf00254081 Santoro & Bonadonna 1979] |
− | |style="background-color:#91cf61"|Non-randomized | + | |Not reported |
+ | | style="background-color:#91cf61" |Non-randomized | ||
|- | |- | ||
− | |[ | + | |[https://doi.org/10.7326/0003-4819-96-2-139 Santoro et al. 1982a] |
− | |style="background-color:#91cf61"|Non-randomized | + | |Not reported in abstract |
+ | | style="background-color:#91cf61" |Non-randomized | ||
|- | |- | ||
|} | |} | ||
− | ''This is for historical interest only; ABVD is no longer used in the salvage setting.'' | + | ''Note: This is for historical interest only; ABVD is no longer used in the salvage setting.'' |
+ | <div class="toccolours" style="background-color:#b3e2cd"> | ||
====Chemotherapy==== | ====Chemotherapy==== | ||
− | *[[Doxorubicin (Adriamycin)]] | + | *[[Doxorubicin (Adriamycin)]] 25 mg/m<sup>2</sup> IV once on day 1 |
− | *[[Bleomycin (Blenoxane)]] | + | *[[Bleomycin (Blenoxane)]] 10 mg/m<sup>2</sup> IV once on day 1 |
− | *[[Vinblastine (Velban)]] | + | *[[Vinblastine (Velban)]] 6 mg/m<sup>2</sup> IV once on day 1 |
− | *[[Dacarbazine (DTIC)]] | + | *[[Dacarbazine (DTIC)]] 375 mg/m<sup>2</sup> IV once on day 1 |
− | + | '''14-day cycles''' | |
+ | </div></div> | ||
===References=== | ===References=== | ||
− | # Krikorian JG, Portlock CS, Rosenberg SA. Treatment of advanced Hodgkin's disease with adriamycin, bleomycin, vinblastine, and imidazole carboxamide (ABVD) after failure of MOPP therapy. Cancer. 1978 Jun;41(6):2107-11. [https:// | + | #Krikorian JG, Portlock CS, Rosenberg SA. Treatment of advanced Hodgkin's disease with adriamycin, bleomycin, vinblastine, and imidazole carboxamide (ABVD) after failure of MOPP therapy. Cancer. 1978 Jun;41(6):2107-11. [https://doi.org/10.1002/1097-0142(197806)41:6%3C2107::AID-CNCR2820410606%3E3.0.CO;2-L link to original article] '''dosing details in manuscript have been reviewed by our editors''' [https://pubmed.ncbi.nlm.nih.gov/77716/ PubMed] |
− | # Santoro A, Bonadonna G. Prolonged disease-free survival in MOPP-resistant Hodgkin's disease after treatment with adriamycin, bleomycin, vinblastine and dacarbazine (ABVD). Cancer Chemother Pharmacol. 1979;2(2):101-5. [https:// | + | #Santoro A, Bonadonna G. Prolonged disease-free survival in MOPP-resistant Hodgkin's disease after treatment with adriamycin, bleomycin, vinblastine and dacarbazine (ABVD). Cancer Chemother Pharmacol. 1979;2(2):101-5. [https://doi.org/10.1007/bf00254081 link to original article] [https://pubmed.ncbi.nlm.nih.gov/93984/ PubMed] |
− | # Santoro A, Bonfante V, Bonadonna G. Salvage chemotherapy with ABVD in MOPP-resistant Hodgkin's disease. Ann Intern Med. 1982 Feb;96(2):139-43. [ | + | #Santoro A, Bonfante V, Bonadonna G. Salvage chemotherapy with ABVD in MOPP-resistant Hodgkin's disease. Ann Intern Med. 1982 Feb;96(2):139-43. [https://doi.org/10.7326/0003-4819-96-2-139 link to original article] [https://pubmed.ncbi.nlm.nih.gov/6174060/ PubMed] |
− | # Harker WG, Kushlan P, Rosenberg SA. Combination chemotherapy for advanced Hodgkin's disease after failure of MOPP: ABVD and B-CAVe. Ann Intern Med. 1984 Oct;101(4):440-6. [ | + | #Harker WG, Kushlan P, Rosenberg SA. Combination chemotherapy for advanced Hodgkin's disease after failure of MOPP: ABVD and B-CAVe. Ann Intern Med. 1984 Oct;101(4):440-6. [https://doi.org/10.7326/0003-4819-101-4-440 link to original article] [https://pubmed.ncbi.nlm.nih.gov/6206757/ PubMed] |
==B-CAVe {{#subobject:41a31c|Regimen=1}}== | ==B-CAVe {{#subobject:41a31c|Regimen=1}}== | ||
− | |||
− | |||
− | |||
− | |||
B-CAVe: '''<u>B</u>'''leomycin, '''<u>C</u>'''CNU (Lomustine), '''<u>A</u>'''driamycin (Doxorubicin), '''<u>V</u>'''inblastin'''<u>e</u>''' | B-CAVe: '''<u>B</u>'''leomycin, '''<u>C</u>'''CNU (Lomustine), '''<u>A</u>'''driamycin (Doxorubicin), '''<u>V</u>'''inblastin'''<u>e</u>''' | ||
− | + | <div class="toccolours" style="background-color:#ee6b6e"> | |
===Regimen {{#subobject:c53f0c|Variant=1}}=== | ===Regimen {{#subobject:c53f0c|Variant=1}}=== | ||
− | {| class="wikitable" style="width: | + | {| class="wikitable sortable" style="width: 60%; text-align:center;" |
− | !style="width: | + | !style="width: 33%"|Study |
− | !style="width: | + | !style="width: 33%"|Dates of enrollment |
+ | !style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]] | ||
|- | |- | ||
− | |[https:// | + | |[https://doi.org/10.1002/1097-0142(197805)41:5%3C1670::AID-CNCR2820410504%3E3.0.CO;2-Y Porzig et al. 1978] |
− | |style="background-color:#91cf61"|Non-randomized | + | |1973-1976 |
+ | | style="background-color:#91cf61" |Non-randomized | ||
|- | |- | ||
− | |[ | + | |[https://doi.org/10.7326/0003-4819-101-4-440 Harker et al. 1984] |
− | |style="background-color:#91cf61"|Non-randomized | + | |1973-1982 |
+ | | style="background-color:#91cf61" |Non-randomized | ||
|- | |- | ||
|} | |} | ||
+ | <div class="toccolours" style="background-color:#b3e2cd"> | ||
====Chemotherapy==== | ====Chemotherapy==== | ||
− | *[[Bleomycin (Blenoxane)]] | + | *[[Bleomycin (Blenoxane)]] 2.5 mg/m<sup>2</sup> IV once per day on days 1, 28, 35 |
− | *[[Lomustine ( | + | *[[Lomustine (CCNU)]] 100 mg/m<sup>2</sup> PO once on day 1 |
− | *[[Doxorubicin (Adriamycin)]] | + | *[[Doxorubicin (Adriamycin)]] 60 mg/m<sup>2</sup> IV once on day 1 |
− | *[[Vinblastine (Velban)]] | + | *[[Vinblastine (Velban)]] 5 mg/m<sup>2</sup> IV once on day 1 |
− | + | '''42-day cycles''' | |
+ | </div></div> | ||
===References=== | ===References=== | ||
− | # Porzig KJ, Portlock CS, Robertson A, Rosenberg SA. Treatment of advanced Hodgkin's disease with B-CAVE following MOPP failure. Cancer. 1978 May;41(5):1670-5. [https:// | + | #Porzig KJ, Portlock CS, Robertson A, Rosenberg SA. Treatment of advanced Hodgkin's disease with B-CAVE following MOPP failure. Cancer. 1978 May;41(5):1670-5. [https://doi.org/10.1002/1097-0142(197805)41:5%3C1670::AID-CNCR2820410504%3E3.0.CO;2-Y link to original article] '''dosing details in manuscript have been reviewed by our editors''' [https://pubmed.ncbi.nlm.nih.gov/77180/ PubMed] |
− | # Harker WG, Kushlan P, Rosenberg SA. Combination chemotherapy for advanced Hodgkin's disease after failure of MOPP: ABVD and B-CAVe. Ann Intern Med. 1984 Oct;101(4):440-6. [ | + | #Harker WG, Kushlan P, Rosenberg SA. Combination chemotherapy for advanced Hodgkin's disease after failure of MOPP: ABVD and B-CAVe. Ann Intern Med. 1984 Oct;101(4):440-6. [https://doi.org/10.7326/0003-4819-101-4-440 link to original article] [https://pubmed.ncbi.nlm.nih.gov/6206757/ PubMed] |
==BVCPP {{#subobject:cb42cf|Regimen=1}}== | ==BVCPP {{#subobject:cb42cf|Regimen=1}}== | ||
− | |||
− | |||
− | |||
− | |||
− | |||
BVCPP: '''<u>B</u>'''CNU (Carmustine), '''<u>V</u>'''inblastine, '''<u>C</u>'''yclophosphamide, '''<u>P</u>'''rocarbazine, '''<u>P</u>'''rednisone | BVCPP: '''<u>B</u>'''CNU (Carmustine), '''<u>V</u>'''inblastine, '''<u>C</u>'''yclophosphamide, '''<u>P</u>'''rocarbazine, '''<u>P</u>'''rednisone | ||
− | + | <div class="toccolours" style="background-color:#ee6b6e"> | |
===Regimen {{#subobject:514e7d|Variant=1}}=== | ===Regimen {{#subobject:514e7d|Variant=1}}=== | ||
− | {| class="wikitable" style="width: | + | {| class="wikitable sortable" style="width: 60%; text-align:center;" |
− | !style="width: | + | !style="width: 33%"|Study |
− | !style="width: | + | !style="width: 33%"|Dates of enrollment |
+ | !style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]] | ||
|- | |- | ||
− | |[https:// | + | |[https://doi.org/10.1002/1097-0142%28197811%2942%3A5%3C2101%3A%3AAID-CNCR2820420504%3E3.0.CO%3B2-M Durant et al. 1978] |
− | |style="background-color:#91cf61"|Non-randomized | + | |1971-1975 |
+ | | style="background-color:#91cf61" |Non-randomized part of RCT | ||
|- | |- | ||
|} | |} | ||
+ | ''Note: It is not clear from the manuscript whether the procarbazine ramp occurred with each cycle or just with the first cycle.'' | ||
+ | <div class="toccolours" style="background-color:#b3e2cd"> | ||
====Chemotherapy==== | ====Chemotherapy==== | ||
− | *[[Carmustine ( | + | *[[Carmustine (BCNU)]] 100 mg/m<sup>2</sup> IV once on day 1 |
− | *[[Vinblastine (Velban)]] | + | *[[Vinblastine (Velban)]] 5 mg/m<sup>2</sup> IV once on day 1 |
− | *[[Cyclophosphamide (Cytoxan)]] | + | *[[Cyclophosphamide (Cytoxan)]] 600 mg/m<sup>2</sup> IV once on day 1 |
− | *[[Procarbazine (Matulane)]] | + | *[[Procarbazine (Matulane)]] 100 mg/m<sup>2</sup> PO once per day on days 1 to 10, "reached by 50 mg increments" |
− | *[[Prednisone (Sterapred)]] | + | ====Glucocorticoid therapy==== |
+ | *[[Prednisone (Sterapred)]] 60 mg/m<sup>2</sup>/day PO on days 1 to 10 | ||
+ | '''28-day cycle for 6 cycles''' | ||
+ | </div> | ||
+ | <div class="toccolours" style="background-color:#cbd5e7"> | ||
====Subsequent treatment==== | ====Subsequent treatment==== | ||
− | * | + | *Durant et al. 1978, patients who achieved CR: [[#Observation|No additional therapy]] versus [[Classical_Hodgkin_lymphoma#MOPP|MOPP]] consolidation x 6 versus [[#BVCPP|BVCPP]] continuation x 6 additional cycles |
− | + | </div></div> | |
===References=== | ===References=== | ||
− | # Durant JR, Gams RA, Velez-Garcia E, Bartolucci A, Wirtschafter D, Dorfman R. BCNU, velban, cyclophosphamide, procarbazine, and prednisone (BVCPP) in advanced Hodgkin's disease. Cancer. 1978 Nov;42(5):2101-10. [https:// | + | #Durant JR, Gams RA, Velez-Garcia E, Bartolucci A, Wirtschafter D, Dorfman R. BCNU, velban, cyclophosphamide, procarbazine, and prednisone (BVCPP) in advanced Hodgkin's disease. Cancer. 1978 Nov;42(5):2101-10. [https://doi.org/10.1002/1097-0142%28197811%2942%3A5%3C2101%3A%3AAID-CNCR2820420504%3E3.0.CO%3B2-M link to original article] '''dosing details in manuscript have been reviewed by our editors''' [https://pubmed.ncbi.nlm.nih.gov/719600/ PubMed] |
− | == | + | ==BVDS {{#subobject:3a24f9|Regimen=1}}== |
− | {| class="wikitable" style=" | + | BVDS: '''<u>B</u>'''leomycin, '''<u>V</u>'''inblastine, '''<u>D</u>'''oxorubicin, '''<u>S</u>'''treptozocin |
+ | <div class="toccolours" style="background-color:#ee6b6e"> | ||
+ | ===Regimen {{#subobject:41d09e|Variant=1}}=== | ||
+ | {| class="wikitable sortable" style="width: 60%; text-align:center;" | ||
+ | !style="width: 33%"|Study | ||
+ | !style="width: 33%"|Dates of enrollment | ||
+ | !style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]] | ||
+ | |- | ||
+ | |[https://doi.org/10.1001/jama.1977.03270280035017 Vinciguerra et al. 1977] | ||
+ | |Not reported | ||
+ | | style="background-color:#ffffbe" |Non-randomized, fewer than 20 pts | ||
|- | |- | ||
− | |||
|} | |} | ||
+ | <div class="toccolours" style="background-color:#b3e2cd"> | ||
+ | ====Chemotherapy==== | ||
+ | *[[Bleomycin (Blenoxane)]] 5 mg/m<sup>2</sup> IV once per day on days 1 & 15 | ||
+ | *[[Vinblastine (Velban)]] 6 mg/m<sup>2</sup> IV once per day on days 1 & 15 | ||
+ | *[[Doxorubicin (Adriamycin)]] 30 mg/m<sup>2</sup> IV once on day 1 | ||
+ | *[[Streptozocin (Zanosar)]] 1500 mg/m<sup>2</sup> IV once per day on days 1 & 15 | ||
+ | '''1-month cycle for at least 12 cycles''' | ||
+ | </div></div> | ||
+ | ===References=== | ||
+ | #Vinciguerra V, Coleman M, Jarowski CI, Degnan TJ, Silver RT. A new combination chemotherapy for resistant Hodgkin disease. JAMA. 1977 Jan 3;237(1):33-5. [https://doi.org/10.1001/jama.1977.03270280035017 link to original article] '''dosing details in manuscript have been reviewed by our editors''' [https://pubmed.ncbi.nlm.nih.gov/62854/ PubMed] | ||
+ | ==CEP {{#subobject:a1a2cc|Regimen=1}}== | ||
CEP: '''<u>C</u>'''CNU (Lomustine), '''<u>E</u>'''toposide, '''<u>P</u>'''rednimustine | CEP: '''<u>C</u>'''CNU (Lomustine), '''<u>E</u>'''toposide, '''<u>P</u>'''rednimustine | ||
− | + | <div class="toccolours" style="background-color:#ee6b6e"> | |
===Regimen {{#subobject:a353e9|Variant=1}}=== | ===Regimen {{#subobject:a353e9|Variant=1}}=== | ||
− | {| class="wikitable" style="width: | + | {| class="wikitable" style="width: 40%; text-align:center;" |
− | !style="width: | + | ! style="width: 25%" |Study |
− | !style="width: | + | ! style="width: 25%" |[[Levels_of_Evidence#Evidence|Evidence]] |
|- | |- | ||
− | |[https:// | + | |[https://pubmed.ncbi.nlm.nih.gov/2420012 Santoro et al. 1986] |
− | |style="background-color:#91cf61"|Non-randomized | + | | style="background-color:#91cf61" |Non-randomized |
|- | |- | ||
|} | |} | ||
+ | <div class="toccolours" style="background-color:#b3e2cd"> | ||
====Chemotherapy==== | ====Chemotherapy==== | ||
− | *[[Lomustine ( | + | *[[Lomustine (CCNU)]] |
*[[Etoposide (Vepesid)]] | *[[Etoposide (Vepesid)]] | ||
*[[Prednimustine (Stereocyt)]] | *[[Prednimustine (Stereocyt)]] | ||
+ | </div></div> | ||
+ | ===References=== | ||
+ | #Santoro A, Viviani S, Valagussa P, Bonfante V, Bonadonna G. CCNU, etoposide, and prednimustine (CEP) in refractory Hodgkin's disease. Semin Oncol. 1986 Mar;13(1 Suppl 1):23-6. [https://pubmed.ncbi.nlm.nih.gov/2420012/ PubMed] | ||
+ | ==CVB {{#subobject:b2b2cc|Regimen=1}}== | ||
+ | CVB: '''<u>C</u>'''CNU (Lomustine), '''<u>V</u>'''inblastine, '''<u>B</u>'''leomycin | ||
+ | <div class="toccolours" style="background-color:#ee6b6e"> | ||
+ | ===Regimen {{#subobject:a464e9|Variant=1}}=== | ||
+ | {| class="wikitable sortable" style="width: 60%; text-align:center;" | ||
+ | !style="width: 33%"|Study | ||
+ | !style="width: 33%"|Dates of enrollment | ||
+ | !style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]] | ||
+ | |- | ||
+ | |[https://doi.org/10.1016/S0140-6736(75)92069-3 Goldman & Dawson 1975] | ||
+ | |1973-1975 | ||
+ | | style="background-color:#91cf61" |Non-randomized | ||
+ | |- | ||
+ | |} | ||
+ | <div class="toccolours" style="background-color:#b3e2cd"> | ||
+ | ====Chemotherapy==== | ||
+ | *[[Lomustine (CCNU)]] 100 mg/m<sup>2</sup> PO once on day 1 | ||
+ | *[[Vinblastine (Velban)]] 6 mg/m<sup>2</sup> IV once per day on days 1 & 8 | ||
+ | *[[Bleomycin (Blenoxane)]] 15 mg IM once per day on days 1 & 8 | ||
+ | '''28-day cycles''' | ||
+ | </div></div> | ||
+ | ===References=== | ||
+ | #Goldman JM, Dawson AA. Combination therapy for advanced resistant Hodgkin's disease. Lancet. 1975 Dec 20;2(7947):1224-7. [https://doi.org/10.1016/S0140-6736(75)92069-3 link to original article] '''dosing details in manuscript have been reviewed by our editors''' [https://pubmed.ncbi.nlm.nih.gov/53720/ PubMed] | ||
+ | ==CVPP {{#subobject:be8f99|Regimen=1}}== | ||
+ | CVPP: '''<u>C</u>'''CNU (Lomustine), '''<u>V</u>'''inblastine, '''<u>P</u>'''rocarbazine, '''<u>P</u>'''rednisone | ||
+ | <div class="toccolours" style="background-color:#ee6b6e"> | ||
+ | ===Regimen {{#subobject:f32d98|Variant=1}}=== | ||
+ | {| class="wikitable sortable" style="width: 100%; text-align:center;" | ||
+ | ! style="width: 20%" |Study | ||
+ | ! style="width: 20%" |Dates of enrollment | ||
+ | ! style="width: 20%" |[[Levels_of_Evidence#Evidence|Evidence]] | ||
+ | ! style="width: 20%" |Comparator | ||
+ | ! style="width: 20%" |[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]] | ||
+ | |- | ||
+ | |[https://doi.org/10.1200/JCO.1986.4.6.838 Vinciguerra et al. 1986] | ||
+ | |1975-1981 | ||
+ | | style="background-color:#1a9851" |Randomized (C) | ||
+ | |1. [[#ABOS_999|ABOS]]<br>2. [[#CVPP.2FABOS_999|CVPP/ABOS]] | ||
+ | | style="background-color:#ffffbf" |Did not meet co-primary endpoints of CR rate/DFS/OS | ||
+ | |- | ||
+ | |} | ||
+ | <div class="toccolours" style="background-color:#b3e2cd"> | ||
+ | ====Chemotherapy==== | ||
+ | *[[Lomustine (CCNU)]] 75 mg/m<sup>2</sup> PO once on day 1 | ||
+ | *[[Vinblastine (Velban)]] 4 mg/m<sup>2</sup> IV once per day on days 1 & 8 | ||
+ | *[[Procarbazine (Matulane)]] 100 mg/m<sup>2</sup> PO once per day on days 1 to 14 | ||
+ | ====Glucocorticoid therapy==== | ||
+ | *[[Prednisone (Sterapred)]] as follows: | ||
+ | **Cycles 1, 4, 7, 10: 40 mg/m<sup>2</sup> PO once per day on days 1 to 14 | ||
+ | '''1-month cycle for 12 cycles''' | ||
+ | </div></div> | ||
===References=== | ===References=== | ||
− | # | + | #Vinciguerra V, Propert KJ, Coleman M, Anderson JR, Stutzman L, Pajak TF, Nissen NI, Frizzera G, Gottlieb A, Holland JF; [[Study_Groups#CALGB|CALGB]]. Alternating cycles of combination chemotherapy for patients with recurrent Hodgkin's disease following radiotherapy: a prospectively randomized study by the Cancer and Leukemia Group B. J Clin Oncol. 1986 Jun;4(6):838-46. [https://doi.org/10.1200/JCO.1986.4.6.838 link to original article] '''dosing details in manuscript have been reviewed by our editors''' [https://pubmed.ncbi.nlm.nih.gov/2423652/ PubMed] |
==SCAB {{#subobject:04355f|Regimen=1}}== | ==SCAB {{#subobject:04355f|Regimen=1}}== | ||
− | {| class="wikitable" style=" | + | SCAB: '''<u>S</u>'''treptozocin, '''<u>C</u>'''CNU (Lomustine), '''<u>A</u>'''driamycin (Doxorubicin), '''<u>B</u>'''leomycin |
+ | <div class="toccolours" style="background-color:#ee6b6e"> | ||
+ | ===Regimen {{#subobject:5c34db|Variant=1}}=== | ||
+ | {| class="wikitable sortable" style="width: 60%; text-align:center;" | ||
+ | !style="width: 33%"|Study | ||
+ | !style="width: 33%"|Dates of enrollment | ||
+ | !style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]] | ||
+ | |- | ||
+ | |[https://doi.org/10.1002/mpo.2950030106 Levi et al. 1977] | ||
+ | |Not reported in abstract | ||
+ | | style="background-color:#ffffbe" |Non-randomized, fewer than 20 pts | ||
|- | |- | ||
− | |||
|} | |} | ||
+ | <div class="toccolours" style="background-color:#b3e2cd"> | ||
+ | ====Chemotherapy==== | ||
+ | *[[Streptozocin (Zanosar)]] 500 mg/m<sup>2</sup> IV once per day on days 1 to 5 | ||
+ | *[[Lomustine (CCNU)]] 100 mg/m<sup>2</sup> PO once on day 1 | ||
+ | *[[Doxorubicin (Adriamycin)]] 45 mg/m<sup>2</sup> IV once on day 1 | ||
+ | *[[Bleomycin (Blenoxane)]] 15 mg/m<sup>2</sup> IM once per day on days 1 & 8 | ||
+ | '''28-day cycles''' | ||
+ | </div></div> | ||
+ | ===References=== | ||
+ | #Levi JA, Wiernik PH, Diggs CH. Combination chemotherapy of advanced previously treated Hodgkin's disease with streptozotocin, CCNU, adriamycin and bleomycin. Med Pediatr Oncol. 1977;3(1):33-40. [https://doi.org/10.1002/mpo.2950030106 link to original article] '''dosing details in abstract have been reviewed by our editors''' [https://pubmed.ncbi.nlm.nih.gov/65727/ PubMed] | ||
− | + | =Relapsed or refractory, further lines of therapy= | |
− | + | ==Carmustine monotherapy {{#subobject:f072cf|Regimen=1}}== | |
− | ===Regimen {{#subobject: | + | <div class="toccolours" style="background-color:#ee6b6e"> |
− | {| class="wikitable" style="width: | + | ===Regimen {{#subobject:d61e28|Variant=1}}=== |
− | !style="width: | + | {| class="wikitable sortable" style="width: 60%; text-align:center;" |
− | !style="width: | + | !style="width: 33%"|Study |
+ | !style="width: 33%"|Dates of enrollment | ||
+ | !style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]] | ||
+ | |- | ||
+ | |[https://doi.org/10.1056/NEJM197108262850902 Young et al. 1971] | ||
+ | |1966 to not reported | ||
+ | | style="background-color:#91cf61" |Non-randomized | ||
+ | |- | ||
+ | |} | ||
+ | <div class="toccolours" style="background-color:#b3e2cd"> | ||
+ | ====Chemotherapy==== | ||
+ | *[[Carmustine (BCNU)]] | ||
+ | </div></div> | ||
+ | ===References=== | ||
+ | #Young RC, DeVita VT Jr, Serpick AA, Canellos GP. Treatment of advanced Hodgkin's disease with (1,3 bis (2-chloroethyl)-1-nitrosourea) BCNU. N Engl J Med. 1971 Aug 26;285(9):475-9. [https://doi.org/10.1056/NEJM197108262850902 link to original article] [https://pubmed.ncbi.nlm.nih.gov/5558887/ PubMed] | ||
+ | ==Doxorubicin & Lomustine {{#subobject:7e7049|Regimen=1}}== | ||
+ | <div class="toccolours" style="background-color:#ee6b6e"> | ||
+ | ===Regimen {{#subobject:e9f038|Variant=1}}=== | ||
+ | {| class="wikitable sortable" style="width: 60%; text-align:center;" | ||
+ | !style="width: 33%"|Study | ||
+ | !style="width: 33%"|Dates of enrollment | ||
+ | !style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]] | ||
|- | |- | ||
− | |[https:// | + | |[https://doi.org/10.1001/jama.1977.03280160053028 Williams & Einhorn 1977] |
− | |style="background-color:#ffffbe"|Non-randomized, | + | |1973-1975 |
+ | | style="background-color:#ffffbe" |Non-randomized, fewer than 20 pts | ||
|- | |- | ||
|} | |} | ||
+ | <div class="toccolours" style="background-color:#b3e2cd"> | ||
====Chemotherapy==== | ====Chemotherapy==== | ||
− | *[[ | + | *[[Doxorubicin (Adriamycin)]] 60 mg/m<sup>2</sup> IV once on day 1, then 45 mg/m<sup>2</sup> IV once on day 22 |
− | *[[Lomustine ( | + | *[[Lomustine (CCNU)]] 100 mg/m<sup>2</sup> PO once on day 1 |
− | + | '''42-day cycle for up to 5 cycles (maximum doxorubicin cumulative dose of 550 mg/m<sup>2</sup>)''' | |
− | |||
+ | </div></div> | ||
===References=== | ===References=== | ||
− | # | + | #Williams SD, Einhorn LH. Combination chemotherapy with doxorubicin and lomustine: treatment of refractory Hodgkin's disease. JAMA. 1977 Oct 10;238(15):1659-61. [https://doi.org/10.1001/jama.1977.03280160053028 link to original article] '''dosing details in manuscript have been reviewed by our editors''' [https://pubmed.ncbi.nlm.nih.gov/578254/ PubMed] |
− | [[Category:Hodgkin lymphoma regimens]] | + | ==Panobinostat monotherapy {{#subobject:ba10d6|Regimen=1}}== |
+ | <div class="toccolours" style="background-color:#ee6b6e"> | ||
+ | ===Regimen {{#subobject:0c34a8|Variant=1}}=== | ||
+ | {| class="wikitable sortable" style="width: 80%; text-align:center;" | ||
+ | !style="width: 25%"|Study | ||
+ | !style="width: 25%"|Dates of enrollment | ||
+ | !style="width: 25%"|[[Levels_of_Evidence#Evidence|Evidence]] | ||
+ | !style="width: 25%"|[[Levels_of_Evidence#Efficacy|Efficacy]] | ||
+ | |- | ||
+ | |[https://doi.org/10.1200/jco.2011.38.1350 Younes et al. 2012 (CLBH589E2214)] | ||
+ | |2008-2009 | ||
+ | | style="background-color:#91cf61" |Phase 2 | ||
+ | |Investigator assessment: 27% <br>Central review: 22% | ||
+ | |- | ||
+ | |} | ||
+ | ''Note: Patients had progressed after auto HSCT and had a median of 4 prior systemic regimens (range 2 to 7).'' | ||
+ | <div class="toccolours" style="background-color:#b3e2cd"> | ||
+ | ====Targeted therapy==== | ||
+ | *[[Panobinostat (Farydak)]] 40 mg PO three times per week (e.g., MWF) | ||
+ | '''21-day cycles''' | ||
+ | </div></div> | ||
+ | ===References=== | ||
+ | # '''CLBH589E2214:''' Younes A, Sureda A, Ben-Yehuda D, Zinzani PL, Ong TC, Prince HM, Harrison SJ, Kirschbaum M, Johnston P, Gallagher J, Le Corre C, Shen A, Engert A. Panobinostat in patients with relapsed/refractory Hodgkin's lymphoma after autologous stem-cell transplantation: results of a phase II study. J Clin Oncol. 2012 Jun 20;30(18):2197-203. Epub 2012 Apr 30. [https://doi.org/10.1200/jco.2011.38.1350 link to original article] '''dosing details in manuscript have been reviewed by our editors''' [https://pubmed.ncbi.nlm.nih.gov/22547596/ PubMed] [https://clinicaltrials.gov/study/NCT00742027 NCT00742027] | ||
+ | ==Sirolimus & Vorinostat {{#subobject:273a59|Regimen=1}}== | ||
+ | <div class="toccolours" style="background-color:#ee6b6e"> | ||
+ | ===Regimen {{#subobject:91d698|Variant=1}}=== | ||
+ | {| class="wikitable sortable" style="width: 60%; text-align:center;" | ||
+ | !style="width: 33%"|Study | ||
+ | !style="width: 33%"|Dates of enrollment | ||
+ | !style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]] | ||
+ | |- | ||
+ | |[https://doi.org/10.1158/1078-0432.ccr-20-1215 Janku et al. 2020 (MDACC 2009-0729)] | ||
+ | |2010-2015 | ||
+ | | style="background-color:#91cf61" |Non-randomized | ||
+ | |- | ||
+ | |} | ||
+ | ''Note: This was a very heavily pre-treated cohort, median of 6 prior therapies; doses here are one level below MTD and are proposed as the ongoing doses to be studied.'' | ||
+ | <div class="toccolours" style="background-color:#b3e2cd"> | ||
+ | ====Immunosuppressive therapy==== | ||
+ | *[[Sirolimus (Rapamune)]] 4 mg PO once per day on days 1 to 28 | ||
+ | ====Targeted therapy==== | ||
+ | *[[Vorinostat (Zolinza)]] as follows: | ||
+ | **Cycle 1: 300 mg PO once per day on days 7 to 28 | ||
+ | **Cycle 2 onwards: 300 mg PO once per day on days 1 to 28 | ||
+ | '''28-day cycles''' | ||
+ | </div></div> | ||
+ | ===References=== | ||
+ | #'''MDACC 2009-0729:''' Janku F, Park H, Call SG, Madwani K, Oki Y, Subbiah V, Hong DS, Naing A, Velez-Bravo VM, Barnes TG, Hagemeister FB, Falchook GS, Karp DD, Wheler JJ, Piha-Paul SA, Garrido-Laguna I, Shpall EJ, Fayad LE, Neelapu SS, Meric-Bernstam F, Kurzrock R, Fanale MA. Safety and Efficacy of Vorinostat Plus Sirolimus or Everolimus in Patients with Relapsed Refractory Hodgkin Lymphoma. Clin Cancer Res. 2020 Nov 1;26(21):5579-5587. Epub 2020 Oct 14. [https://doi.org/10.1158/1078-0432.ccr-20-1215 link to original article] [https://pubmed.ncbi.nlm.nih.gov/33055173/ PubMed] [https://clinicaltrials.gov/study/NCT01087554 NCT01087554] | ||
+ | [[Category:Classical Hodgkin lymphoma regimens]] | ||
[[Category:Historical regimens]] | [[Category:Historical regimens]] | ||
[[Category:Disease-specific pages]] | [[Category:Disease-specific pages]] | ||
[[Category:Aggressive lymphomas]] | [[Category:Aggressive lymphomas]] |
Latest revision as of 23:37, 15 July 2024
The purpose of this page is to provide references to regimens that are obsolete, outdated, or of historical interest only. Is there a regimen missing from this list? See the main cHL page for current regimens.
30 regimens on this page
37 variants on this page
|
Untreated
ABVDm
ABVDm: Adriamycin (Doxorubicin), Bleomycin, Vinblastine, Dacarbazine, methylprednisolone
Regimen
Study | Dates of enrollment | Evidence | Comparator | Comparative Efficacy |
---|---|---|---|---|
Le Maignan et al. 2003 (H90-NM) | 1990-1996 | Phase 3 (C) | EBVMm | Did not meet primary endpoint of OS |
Note: the manuscript states that the drugs were given on days 1 & 14, which is clearly incorrect.
Chemotherapy
- Doxorubicin (Adriamycin) 25 mg/m2 IV once per day on days 1 & 15
- Bleomycin (Blenoxane) 10 mg/m2 IV once per day on days 1 & 15
- Vinblastine (Velban) 6 mg/m2 IV once per day on days 1 & 15
- Dacarbazine (DTIC) 375 mg/m2 IV once per day on days 1 & 15
Glucocorticoid therapy
- Methylprednisolone (Solumedrol) 120 mg/m2 IV once per day on days 1 & 15
28-day cycle for 3 cycles
References
- H90-NM: Le Maignan C, Desablens B, Delwail V, Dib M, Berthou C, Vigier M, Ghandour C, Atmani S, Casassus P, Maisonneuve H, Le Mevel A, Traulle C, Bernard M, Briere J, Colonna P, Andrieu JM. Three cycles of adriamycin, bleomycin, vinblastine, and dacarbazine (ABVD) or epirubicin, bleomycin, vinblastine, and methotrexate (EBVM) plus extended field radiation therapy in early and intermediate Hodgkin disease: 10-year results of a randomized trial. Blood. 2004 Jan 1;103(1):58-66. Epub 2003 Aug 7. link to original article dosing details in manuscript have been reviewed by our editors PubMed
COMP
COMP: Cyclophosphamide, Oncovin (Vincristine), Methotrexate, Prednisone
Regimen
Study | Dates of enrollment | Evidence |
---|---|---|
Moxley et al. 1967 | 1963 to not reported | Pilot |
Chemotherapy
- Cyclophosphamide (Cytoxan) 600 mg/m2 IV once per day on days 1 & 8
- Vincristine (Oncovin) 1.2 mg/m2 IV once per day on days 1 & 8
- Methotrexate (MTX) 30 mg/m2 IM once per day on days 1, 4, 8, 11
Glucocorticoid therapy
- Prednisone (Sterapred) 60 mg/m2 PO once per day on days 1 to 14
21-day cycle for 3 cycles
References
- Moxley JH 3rd, De Vita VT, Brace K, Frei E 3rd. Intensive combination chemotherapy and X-irradiation in Hodgkin's disease. Cancer Res. 1967 Jul;27(7):1258-63. link to original article dosing details in manuscript have been reviewed by our editors PubMed
COPP/ABVD
COPP/ABVD: Cyclophosphamide, Oncovin (Vincristine), Procarbazine, Prednisone alternating with Adriamycin (Doxorubicin), Bleomycin, Vinblastine, Dacarbazine
C-MOPP/ABVD: CyclophosphaMide, Oncovin (Vincristine), Procarbazine, Prednisone alternating with Adriamycin (Doxorubicin), Bleomycin, Vinblastine, Dacarbazine
Regimen variant #1, 4 cycles
Study | Dates of enrollment | Evidence | Comparator | Comparative Efficacy |
---|---|---|---|---|
Sieber et al. 2002 (GHSG HD5) | 1988-1993 | Phase 3 (C) | COPP/ABV/IMEP | Did not meet co-primary endpoint of OS |
Sieber et al. 2004 (GHSG HD6) | 1988-1993 | Phase 3 (C) | COPP/ABV/IMEP | Did not meet primary endpoint of FFTF |
Engert et al. 2003 (GHSG HD8) | 1993-1998 | Non-randomized part of RCT |
Chemotherapy, COPP portion (cycles 1 & 3)
- Cyclophosphamide (Cytoxan) 650 mg/m2 IV once per day on days 1 & 8
- Vincristine (Oncovin) 1.4 mg/m2 (maximum dose of 2 mg) IV once per day on days 1 & 8
- Procarbazine (Matulane) 100 mg/m2 PO once per day on days 1 to 14
Glucocorticoid therapy, COPP portion (cycles 1 & 3)
- Prednisone (Sterapred) 40 mg/m2 PO once per day on days 1 to 14
Chemotherapy, ABVD portion (cycles 2 & 4)
- Doxorubicin (Adriamycin) 25 mg/m2 IV once per day on days 1 & 15
- Bleomycin (Blenoxane) 10 mg/m2 IV once per day on days 1 & 15
- Vinblastine (Velban) 6 mg/m2 IV once per day on days 1 & 15
- Dacarbazine (DTIC) 375 mg/m2 IV once per day on days 1 & 15
28-day cycle for 4 cycles
Regimen variant #2, 6 cycles
Study | Dates of enrollment | Evidence |
---|---|---|
Diehl et al. 1995 (GHSG HD3) | 1984-01 to 1988-02 | Non-randomized part of RCT |
Chemotherapy, COPP portion (cycles 1, 3, 5)
- Cyclophosphamide (Cytoxan) 650 mg/m2 IV once per day on days 1 & 8
- Vincristine (Oncovin) 1.4 mg/m2 (maximum dose of 2 mg) IV once per day on days 1 & 8
- Procarbazine (Matulane) 100 mg/m2 PO once per day on days 1 to 14
Glucocorticoid therapy, COPP portion (cycles 1, 3, 5)
- Prednisone (Sterapred) 40 mg/m2 PO once per day on days 1 to 14
Chemotherapy, ABVD portion (cycles 2, 4, 6)
- Doxorubicin (Adriamycin) 25 mg/m2 IV once per day on days 1 & 15
- Bleomycin (Blenoxane) 10 mg/m2 IV once per day on days 1 & 15
- Vinblastine (Velban) 6 mg/m2 IV once per day on days 1 & 15
- Dacarbazine (DTIC) 375 mg/m2 IV once per day on days 1 & 15
28-day cycle for 6 cycles
Regimen variant #3, 10 cycles
Study | Dates of enrollment | Evidence | Comparator | Comparative Efficacy |
---|---|---|---|---|
Takenaka et al. 2000 (JCOG 8905) | 1989-1993 | Phase 2 | ||
Diehl et al. 1998 (GHSG HD9) | 1993-1998 | Phase 3 (C) | 1. BEACOPP 2. eBEACOPP |
Seems to have inferior OS |
Ballova et al. 2005 (GHSG HD9elderly) | 1993-1998 | Phase 3 (C) | BEACOPP | Did not meet co-primary endpoint of OS |
Chemotherapy, COPP portion (cycles 1, 3, 5, 7, 9)
- Cyclophosphamide (Cytoxan) 500 mg/m2 IV once per day on days 1 & 8
- Vincristine (Oncovin) 1.4 mg/m2 (maximum dose of 2 mg) IV once per day on days 1 & 8
- Procarbazine (Matulane) 100 mg/m2 (maximum dose of 150 mg) PO once per day on days 1 to 14
Glucocorticoid therapy, COPP portion (cycles 1, 3, 5, 7, 9)
- Prednisone (Sterapred) 40 mg/m2 PO once per day on days 1 to 3, 8 to 10
Chemotherapy, ABVD portion (cycles 2, 4, 6, 8, 10)
- Doxorubicin (Adriamycin) 25 mg/m2 IV once per day on days 1 & 15
- Bleomycin (Blenoxane) 9 mg/m2 (maximum dose of 15 mg) IV once per day on days 1 & 15
- Vinblastine (Velban) 6 mg/m2 (maximum dose of 10 mg) IV once per day on days 1 & 15
- Dacarbazine (DTIC) 250 mg/m2 IV once per day on days 1 & 15
28-day cycle for 10 cycles
Subsequent treatment
- JCOG 8905 & GHSG HD9, patients with bulky (at least 10 cm maximum diameter) disease: IFRT x 3000 cGy consolidation
- GHSG HD9elderly, initial bulky disease (single lymph node involvement or a conglomerate mass of at least 5 cm in any diameter): IFRT x 3000 cGy consolidation
- GHSG HD9elderly, residual tumor after chemotherapy: IFRT x 4000 cGy consolidation
Dose and schedule modifications
- Treatment was postponed for at least 1 week or until recovery if:
- Pretreatment ANC was less than 1500/μL
- Platelet count was less than 100 x 109/L
- AST/S-GOT was greater than 100 IU/L
- Total bilirubin was greater than 2
- Vincristine and vinblastine were temporarily discontinued if patients had grade 2 or greater neurotoxicity (e.g. motor weakness, paresthesia, constipation)
- Doxorubicin was discontinued if cardiac LV ejection fraction was less than 50%
- Bleomycin was stopped if the PaO2 was less than 70 mmHg or if it decreased more than 10 mmHg from the previous measurement
- Note: Dacarbazine 250 mg/m2 was used at this dose reduction based on experiences in a pilot study in which there was severe emesis with 375 mg/m2.
References
- GHSG HD3: Diehl V, Loeffler M, Pfreundschuh M, Ruehl U, Hasenclever D, Nisters-Backes H, Sieber M, Smith K, Tesch H, Geilen W, Adler M, Bartels H, Brandenburg U, Diezler P, Doelken G, Enzian J, Fuchs R, Gassmann W, Gerhartz H, Hagenaukamp U, Hecht T, Hiller E, Hinkelbein H, Lathan B, Kirchner H, Kuehn G, Kuerten H, Loos U, Makoski B, Oertel W, Petsch S, Pfab R, Pflueger H, Planker M, Rohioff R, Sack H, Samandari S, Sauer R, Schalk K, Schmitz G, Schoppe W, Schwieder G, Szepesi S, Teichmann J, Wilhelmy W, Worst P, Fischer R, Georgii A, Huebner E, Schwarze EW; German Hodgkin's Study Group. Further chemotherapy versus low-dose involved-field radiotherapy as consolidation of complete remission after six cycles of alternating chemotherapy in patients with advance Hodgkin's disease. Ann Oncol. 1995 Nov;6(9):901-10. link to original article dosing details in manuscript have been reviewed by our editors PubMed
- GHSG HD9: Diehl V, Franklin J, Hasenclever D, Tesch H, Pfreundschuh M, Lathan B, Paulus U, Sieber M, Rueffer JU, Sextro M, Engert A, Wolf J, Hermann R, Holmer L, Stappert-Jahn U, Winnerlein-Trump E, Wulf G, Krause S, Glunz A, von Kalle K, Bischoff H, Haedicke C, Duehmke E, Georgii A, Loeffler M. BEACOPP, a new dose-escalated and accelerated regimen, is at least as effective as COPP/ABVD in patients with advanced-stage Hodgkin's lymphoma: interim report from a trial of the German Hodgkin's Lymphoma Study Group. J Clin Oncol. 1998 Dec;16(12):3810-21. link to original articledosing details in manuscript have been reviewed by our editors PubMed
- Update: Diehl V, Franklin J, Pfreundschuh M, Lathan B, Paulus U, Hasenclever D, Tesch H, Herrmann R, Dörken B, Müller-Hermelink HK, Dühmke E, Loeffler M; German Hodgkin's Lymphoma Study Group. Standard and increased-dose BEACOPP chemotherapy compared with COPP-ABVD for advanced Hodgkin's disease. N Engl J Med. 2003 Jun 12;348(24):2386-95. link to original articledosing details in abstract have been reviewed by our editors PubMed
- Update: Engert A, Diehl V, Franklin J, Lohri A, Dörken B, Ludwig WD, Koch P, Hänel M, Pfreundschuh M, Wilhelm M, Trümper L, Aulitzky WE, Bentz M, Rummel M, Sezer O, Müller-Hermelink HK, Hasenclever D, Löffler M. Escalated-dose BEACOPP in the treatment of patients with advanced-stage Hodgkin's lymphoma: 10 years of follow-up of the GHSG HD9 study. J Clin Oncol. 2009 Sep 20;27(27):4548-54. Epub 2009 Aug 24. link to original article PubMed
- Pooled update: von Tresckow B, Kreissl S, Dipl-Math HG, Bröckelmann PJ, Pabst T, Fridrik M, Rummel M, Jung W, Thiemer J, Sasse S, Bürkle C, Baues C, Diehl V, Engert A, Borchmann P; German Hodgkin Study Group. Intensive treatment strategies in advanced-stage Hodgkin's lymphoma (HD9 and HD12): analysis of long-term survival in two randomised trials. Lancet Haematol. 2018 Oct 01;5(10):e462-73. link to original article PubMed
- JCOG 8905: Takenaka T, Mikuni C, Miura A, Sasaki T, Suzuki H, Hotta T, Hirano M, Fukuhara S, Sugiyama H, Nasu K, Dohi H, Kozuru M, Tomonaga M, Tajima K, Niimi M, Fukuda H, Mukai K, Shimoyama M; Lymphoma Study Group of the Japan Clinical Oncology Group. Alternating combination chemotherapy C-MOPP (cyclophosphamide, vincristine, procarbazine, prednisone) and ABVd (adriamycin, bleomycin, vinblastine, dacarbazine) in clinical stage II-IV Hodgkin's disease: a multicenter phase II study (JCOG 8905). Jpn J Clin Oncol. 2000 Mar;30(3):146-52. link to original article dosing details in abstract have been reviewed by our editors PubMed
- GHSG HD5: Sieber M, Tesch H, Pfistner B, Rueffer U, Lathan B, Brosteanu O, Paulus U, Koch T, Pfreundschuh M, Loeffler M, Engert A, Josting A, Wolf J, Hasenclever D, Franklin J, Duehmke E, Georgii A, Schalk KP, Kirchner H, Doelken G, Munker R, Koch P, Herrmann R, Greil R, Anselmo AP, Diehl V. Rapidly alternating COPP/ABV/IMEP is not superior to conventional alternating COPP/ABVD in combination with extended-field radiotherapy in intermediate-stage Hodgkin's lymphoma: final results of the German Hodgkin's Lymphoma Study Group Trial HD5. J Clin Oncol. 2002 Jan 15;20(2):476-84. link to original article dosing details in manuscript have been reviewed by our editors PubMed
- GHSG HD8: Engert A, Schiller P, Josting A, Herrmann R, Koch P, Sieber M, Boissevain F, De Wit M, Mezger J, Duhmke E, Willich N, Muller RP, Schmidt BF, Renner H, Muller-Hermelink HK, Pfistner B, Wolf J, Hasenclever D, Loffler M, Diehl V; German Hodgkin's Lymphoma Study Group. Involved-field radiotherapy is equally effective and less toxic compared with extended-field radiotherapy after four cycles of chemotherapy in patients with early-stage unfavorable Hodgkin's lymphoma: results of the HD8 trial of the German Hodgkin's Lymphoma Study Group. J Clin Oncol. 2003 Oct 1;21(19):3601-8. Epub 2003 Aug 11. link to original article dosing details in abstract have been reviewed by our editors PubMed
- Update: Sasse S, Klimm B, Görgen H, Fuchs M, Heyden-Honerkamp A, Lohri A, Koch O, Wilhelm M, Trenn G, Finke J, Müller RP, Diehl V, Eich HT, Borchmann P, Engert A; German Hodgkin Study Group (GHSG). Comparing long-term toxicity and efficacy of combined modality treatment including extended- or involved-field radiotherapy in early-stage Hodgkin's lymphoma. Ann Oncol. 2012 Nov;23(11):2953-9. Epub 2012 Jul 5. link to original article PubMed
- Update: Sasse S, Bröckelmann PJ, Goergen H, Plütschow A, Müller H, Kreissl S, Buerkle C, Borchmann S, Fuchs M, Borchmann P, Diehl V, Engert A. Long-term follow-up of contemporary treatment in early-stage Hodgkin lymphoma: updated analyses of the German Hodgkin Study Group HD7, HD8, HD10, and HD11 trials. J Clin Oncol. 2017 Jun 20;35(18):1999-2007. Epub 2017 Apr 18. link to original article PubMed
- GHSG HD6: Sieber M, Tesch H, Pfistner B, Rueffer U, Paulus U, Munker R, Hermann R, Doelken G, Koch P, Oertel J, Roller S, Worst P, Bischof H, Glunz A, Greil R, von Kalle K, Schalk KP, Hasenclever D, Brosteanu O, Duehmke E, Georgii A, Engert A, Loeffler M, Diehl V, Mueller RP, Willich N, Fischer R, Hansmann ML, Stein H, Schober T, Koch B; German Hodgkin's Lymphoma Study Group. Treatment of advanced Hodgkin's disease with COPP/ABV/IMEP versus COPP/ABVD and consolidating radiotherapy: final results of the German Hodgkin's Lymphoma Study Group HD6 trial. Ann Oncol. 2004 Feb;15(2):276-82. link to original article PubMed
- GHSG HD9elderly: Ballova V, Rüffer JU, Haverkamp H, Pfistner B, Müller-Hermelink HK, Dühmke E, Worst P, Wilhelmy M, Naumann R, Hentrich M, Eich HT, Josting A, Löffler M, Diehl V, Engert A. A prospectively randomized trial carried out by the German Hodgkin Study Group (GHSG) for elderly patients with advanced Hodgkin's disease comparing BEACOPP baseline and COPP-ABVD (study HD9elderly). Ann Oncol. 2005 Jan;16(1):124-31. link to original articledosing details in abstract have been reviewed by our editors PubMed
CVPP (Cyclophosphamide)
CVPP: Cyclophosphamide, Vinblastine, Procarbazine, Prednisone
Regimen
Study | Dates of enrollment | Evidence | Comparator | Comparative Efficacy |
---|---|---|---|---|
Pavlovsky et al. 1988 | 1977-1986 | Randomized (E-de-esc) | CVPP & RT | Inferior FFS1 |
Pavlovsky et al. 1997 | 1986 to not reported | Randomized (C) | AOPE | Seems to have superior CR rate |
Sackmann-Muriel et al. 1997 | 1987-1994 | Randomized (C) | AOPE | Seems to have superior EFS |
1No advantage was seen for either arm in the favorable prognosis group, whereas this arm had inferior DFS for the unfavorable prognosis group.
Chemotherapy
- Cyclophosphamide (Cytoxan) 600 mg/m2 IV once per day on days 1 & 8
- Vinblastine (Velban) 6 mg/m2 IV once per day on days 1 & 8
- Procarbazine (Matulane) 100 mg/m2 PO once per day on days 1 to 14
Glucocorticoid therapy
- Prednisone (Sterapred) 40 mg/m2 PO once per day on days 1 to 14
1-month cycle for 6 cycles
References
- Pavlovsky S, Maschio M, Santarelli MT, Sackmann Muriel F, Corrado C, Garcia I, Schwartz L, Montero C, Lobo Sanahuja F, Magnasco O, Raha R, Cavagnaro F. Randomized trial of chemotherapy versus chemotherapy plus radiotherapy for stage I-II Hodgkin's disease. J Natl Cancer Inst. 1988 Nov 16;80(18):1466-73. link to original article PubMed
- Update: Pavlovsky S, Santarelli MT, Sackmann Muriel F, Fernández I, Garcia I, Schwartz L, Montero C, Sanahuja FL, Magnasco H, Costa A, Corrado C, Raha R, Bezares R. Randomized trial of chemotherapy versus chemotherapy plus radiotherapy for stage III-IV A & B Hodgkin's disease. Ann Oncol. 1992 Jul;3(7):533-7. link to original article PubMed
- Pavlovsky S, Schvartzman E, Lastiri F, Magnasco H, Corrado C, Raslawski E, Cancela ME, Ardaiz MC, Cerutti I, Rosso A, Bruno S, Aranguren PN, Salvarezza A, Donato H, Dibar E, Zirone S; GATLA. Randomized trial of CVPP for three versus six cycles in favorable-prognosis and CVPP versus AOPE plus radiotherapy in intermediate-prognosis untreated Hodgkin's disease. J Clin Oncol. 1997 Jul;15(7):2652-8. link to original article PubMed
- Sackmann-Muriel F, Zubizarreta P, Gallo G, Scopinaro M, Alderete D, Alfaro E, Casak S, Chantada G, Felice MS, Quinteros R. Hodgkin disease in children: results of a prospective randomized trial in a single institution in Argentina. Med Pediatr Oncol. 1997 Dec;29(6):544-52. link to original article dosing details in manuscript have been reviewed by our editors PubMed
Doxorubicin & Vinblastine
Regimen
Study | Dates of enrollment | Evidence | Comparator | Comparative Efficacy |
---|---|---|---|---|
Press et al. 2001 (SWOG S9133) | 1992-2000 | Phase 3 (E-esc) | STLI | Superior PFS (secondary endpoint) |
Note: this is a component of a sequential treatment protocol; to our knowledge there are no references to support using it as a stand-alone treatment.
Chemotherapy
- Doxorubicin (Adriamycin) 25 mg/m2 IV once per day on days 1 & 15
- Vinblastine (Velban) 6 mg/m2 IV once per day on days 1 & 15
28-day cycle for 3 cycles
Subsequent treatment
- STLI consolidation
References
- SWOG S9133: Press OW, LeBlanc M, Lichter AS, Grogan TM, Unger JM, Wasserman TH, Gaynor ER, Peterson BA, Miller TP, Fisher RI. Phase III randomized intergroup trial of subtotal lymphoid irradiation versus doxorubicin, vinblastine, and subtotal lymphoid irradiation for stage IA to IIA Hodgkin's disease. J Clin Oncol. 2001 Nov 15;19(22):4238-44. link to original article dosing details in manuscript have been reviewed by our editors PubMed NCT00002495
Mechlorethamine monotherapy
Regimen
Study | Dates of enrollment | Evidence | Comparator | Comparative Efficacy |
---|---|---|---|---|
Goodman et al. 1946 | Not reported | Non-randomized | ||
Jacobson et al. 1946 | 1943-1945 | Non-randomized | ||
Wintrobe et al. 1947 | Not reported | Non-randomized | ||
Meyer & Overmiller 1949 | 1946-1947 | Non-randomized | ||
Jacobs et al. 1968 | 1960-1963 | Randomized (C) | Cyclophosphamide | Did not meet primary endpoint of ORR |
Note: These references are of major historic interest as they are the first systemic chemotherapy trials in humans. Note that some of these early trials used nitrogen mustards other than mechlorethamine but are grouped here for simplicity.
Chemotherapy
References
- Goodman LS, Wintrobe MM, Dameshek W, Goodman MJ, Gilman A, McLennan MT. Nitrogen mustard therapy; use of methyl-bis (beta-chloroethyl) amine hydrochloride and tris (beta-chloroethyl) amine hydrochloride for Hodgkin's disease, lymphosarcoma, leukemia and certain allied and miscellaneous disorders. J Am Med Assoc. 1946 Sep 21;132:126-32. link to original article PubMed
- Jacobson LO, Spurr CL, Guzman-Barron ES, Smith T, Lushbaugh C, Dick GF. Nitrogen mustard therapy; studies on the effect of methyl-bis (beta-chloroethyl) amine hydrochloride on neoplastic diseases and allied disorders of the hemopoietic system. J Am Med Assoc. 1946 Oct 5;132:263-71. link to original article PubMed
- Wintrobe MM, Huguley CM Jr, McLennan MT, Penna de Carvalho Lima L. Nitrogen mustard as a therapeutic agent for Hodgkin's disease, lymphosarcoma and leukemia. Ann Intern Med. 1947 Oct;27(4):529-40. link to original article PubMed
- Meyer AH, Overmiller WC. The use of nitrogen mustard in Hodgkin's disease and lymphosarcoma. Ann Intern Med. 1949 Feb;30(2):381-6. link to original article PubMed
- Jacobs EM, Peters FC, Luce JK, Zippin C, Wood DA. Mechlorethamine HCl and cyclophosphamide in the treatment of Hodgkin's disease and the lymphomas. JAMA. 1968 Feb 5;203(6):392-8. link to original article PubMed
NOVP
NOVP: Novantrone (Mitoxantrone), Oncovin (Vincristine), Vinblastine, Prednisone
Regimen
Study | Dates of enrollment | Evidence |
---|---|---|
Hagemeister et al. 1990 | 1988-06 to 1989-12 | Phase 2 |
Note: The original manuscript is not available online; a physical copy was reviewed and does not contain dosing details.
Chemotherapy
- Mitoxantrone (Novantrone) dose not specified
- Vincristine (Oncovin) dose not specified
- Vinblastine (Velban) dose not specified
Glucocorticoid therapy
- Prednisone (Sterapred) dose not specified
References
- Hagemeister FB, Cabanillas F, Velásquez WS, Meistrich ML, Liang JC, McLaughlin P, Redman JR, Romaguera JE, Rodríguez MA, Swan F Jr, Fuller LM. NOVP: a novel chemotherapeutic regimen with minimal toxicity for treatment of Hodgkin's disease. Semin Oncol. 1990 Dec;17(6 Suppl 10):34-8. does not contain dosing details in manuscript PubMed
Vinblastine monotherapy
Regimen
Study | Dates of enrollment | Evidence | Comparator | Comparative Efficacy |
---|---|---|---|---|
Stutzman et al. 1966 | 1963-1964 | Randomized (E-switch-ic) | Cyclophosphamide | Superior ORR |
References
- Stutzman L, Ezdinli EZ, Stutzman MA. Vinblastine sulfate vs cyclophosphamide in the therapy for lymphoma. JAMA. 1966 Jan 17;195(3):173-8. link to original article dosing details in manuscript have been reviewed by our editors PubMed
Untreated, advanced stage
BCVPP
BCVPP: BCNU (Carmustine), Cyclophosphamide, Vinblastine, Procarbazine, Prednisone
Regimen
Study | Dates of enrollment | Evidence | Comparator | Comparative Efficacy |
---|---|---|---|---|
Durant et al. 1978 | 1971-1975 | Non-randomized part of RCT | ||
Bakemeier et al. 1984 | 1972-1976 | Phase 3 (E-esc) | MOPP | Did not meet endpoint of CR rate1 |
1For patients achieving CR, this regimen seemed to have comparatively superior survival.
Chemotherapy
- Carmustine (BCNU) 100 mg/m2 IV once on day 1
- Cyclophosphamide (Cytoxan) 600 mg/m2 IV once on day 1
- Vinblastine (Velban) 5 mg/m2 IV once on day 1
- Procarbazine (Matulane) 50 mg/m2 PO twice per day on days 1 to 10
Glucocorticoid therapy
- Prednisone (Sterapred) 60 mg/m2/day PO on days 1 to 10
28-day cycle for 6 cycles
Subsequent treatment
- Durant et al. 1978, responders: No further therapy vs BCVPP continuation x 6 vs MOPP x 6
References
- Durant JR, Gams RA, Velez-Garcia E, Bartolucci A, Wirtschafter D, Dorfman R. BCNU, velban, cyclophosphamide, procarbazine, and prednisone (BVCPP) in advanced Hodgkin's disease. Cancer. 1978 Nov;42(5):2101-10. link to original article dosing details in manuscript have been reviewed by our editors PubMed
- Bakemeier RF, Anderson JR, Costello W, Rosner G, Horton J, Glick JH, Hines JD, Berard CW, DeVita VT Jr; ECOG. BCVPP chemotherapy for advanced Hodgkin's disease: evidence for greater duration of complete remission, greater survival, and less toxicity than with a MOPP regimen: results of the Eastern Cooperative Oncology Group study. Ann Intern Med. 1984 Oct;101(4):447-56. link to original article PubMed
ChlVPP/PABIOE
ChlVPP/PABIOE: Chlorambucil, Vinblastine, Procarbazine, Prednisone alternating with Prednisolone, Adriamycin (Doxorubicin), Bleomycin, Oncovin (Vincristine), Etoposide
Regimen
Study | Dates of enrollment | Evidence | Comparator | Comparative Efficacy |
---|---|---|---|---|
Hancock et al. 2001 | 1992-1996 | Randomized (C) | PABIOE | Superior OS |
Chemotherapy, ChlVPP portion (cycles 1, 3, 5, 7)
- Chlorambucil (Leukeran) 6 mg/m2 (maximum dose of 10 mg) PO once per day on days 1 to 14
- Vinblastine (Velban) 6 mg/m2 (maximum dose of 10 mg) IV once per day on days 1 & 8
- Procarbazine (Matulane) 100 mg/m2 (maximum dose of 200 mg) PO once per day on days 1 to 14
Glucocorticoid therapy, ChlVPP portion (cycles 1, 3, 5, 7)
- Prednisolone (Millipred) 40 mg/m2 (maximum dose of 60 mg) PO once per day on days 1 to 14
Glucocorticoid therapy, PABIOE portion (cycles 2, 4, 6, 8)
- Prednisolone (Millipred) 40 mg/m2 (maximum dose of 60 mg) PO once per day on days 1 to 10
Chemotherapy, PABIOE portion (cycles 2, 4, 6, 8)
- Doxorubicin (Adriamycin) 40 mg/m2 IV once on day 1
- Bleomycin (Blenoxane) 10 units/m2 (route not specified) once per day on days 1 & 8
- Vincristine (Oncovin) 1.4 mg/m2 (maximum dose of 2 mg) IV once per day on days 1 & 8
- Etoposide (Vepesid) 200 mg/m2 PO once per day on days 1 to 3
28-day cycle alternating with 21-day cycle for 8 cycles (ChlVPP x 4; PABIOE x 4)
References
- Hancock BW, Gregory WM, Cullen MH, Hudson GV, Burton A, Selby P, Maclennan KA, Jack A, Bessell EM, Smith P, Linch DC; British National Lymphoma Investigation; Central Lymphoma Group. ChlVPP alternating with PABlOE is superior to PABlOE alone in the initial treatment of advanced Hodgkin's disease: results of a British National Lymphoma Investigation/Central Lymphoma Group randomized controlled trial. Br J Cancer. 2001 May 18;84(10):1293-300. link to orginal article link to PMC article dosing details in manuscript have been reviewed by our editors PubMed
- UKLG LY09: Johnson PW, Radford JA, Cullen MH, Sydes MR, Walewski J, Jack AS, MacLennan KA, Stenning SP, Clawson S, Smith P, Ryder D, Hancock BW; United Kingdom Lymphoma Group. Comparison of ABVD and alternating or hybrid multidrug regimens for the treatment of advanced Hodgkin's lymphoma: results of the United Kingdom Lymphoma Group LY09 Trial (ISRCTN97144519). J Clin Oncol. 2005 Dec 20;23(36):9208-18. Epub 2005 Nov 28. link to original article dosing details in manuscript have been reviewed by our editors PubMed NCT00003421
- Subgroup analysis: Johnson PW, Sydes MR, Hancock BW, Cullen M, Radford JA, Stenning SP. Consolidation radiotherapy in patients with advanced Hodgkin's lymphoma: survival data from the UKLG LY09 randomized controlled trial (ISRCTN97144519). J Clin Oncol. 2010 Jul 10;28(20):3352-9. Epub 2010 May 24. link to original article PubMed
COPP (CCNU)
COPP: CCNU (Lomustine), Oncovin (Vincristine), Procarbazine, Prednisone
Regimen
Study | Dates of enrollment | Evidence | Comparator | Comparative Efficacy |
---|---|---|---|---|
Cooper et al. 1980 | 1972-1975 | Phase 3 (E-switch-ic) | 1. CVPP | Did not meet endpoint of OS |
2. MOPP | Did not meet endpoint of OS | |||
3. MVPP | Did not meet endpoint of OS |
Chemotherapy
- Lomustine (CCNU) 75 mg/m2 PO once on day 1
- Vincristine (Oncovin) 1.4 mg/m2 IV once per day on days 1 & 8
- Procarbazine (Matulane) 100 mg/m2 PO once per day on days 1 to 14
Glucocorticoid therapy
- Prednisone (Sterapred) as follows:
- Cycles 1, 3, 5: 40 mg/m2 PO once per day on days 1 to 14
28-day cycle for 6 cycles
References
- Cooper MR, Pajak TF, Nissen NI, Stutzman L, Brunner K, Cuttner J, Falkson G, Grunwald H, Bank A, Leone L, Seligman BR, Silver RT, Weiss RB, Haurani F, Blom J, Spurr CL, Glidewell OJ, Gottlieb AJ, Holland JF. A new effective four-drug combination of CCNU (1-[2-chloroethyl]-3-cyclohexyl-1-nitrosourea) (NSC-79038), vinblastine, prednisone, and procarbazine for the treatment of advanced Hodgkin's disease. Cancer. 1980 Aug 15;46(4):654-62. link to original article dosing details in manuscript have been reviewed by our editors PubMed
CVPP
CVPP: CCNU (Lomustine), Vinblastine, Procarbazine, Prednisone
Regimen
Study | Dates of enrollment | Evidence | Comparator | Comparative Efficacy |
---|---|---|---|---|
Cooper et al. 1980 | 1972-1975 | Phase 3 (E-switch-ic) | 1. COPP | Did not meet endpoint of OS |
2. MOPP | Seems to have superior CR rate | |||
3. MVPP | Did not meet endpoint of OS |
Chemotherapy
- Lomustine (CCNU) 75 mg/m2 PO once on day 1
- Vinblastine (Velban) 4 mg/m2 IV once per day on days 1 & 8
- Procarbazine (Matulane) 100 mg/m2 PO once per day on days 1 to 14
Glucocorticoid therapy
- Prednisone (Sterapred) as follows:
- Cycles 1, 3, 5: 40 mg/m2 PO once per day on days 1 to 14
28-day cycle for 6 cycles
References
- Cooper MR, Pajak TF, Nissen NI, Stutzman L, Brunner K, Cuttner J, Falkson G, Grunwald H, Bank A, Leone L, Seligman BR, Silver RT, Weiss RB, Haurani F, Blom J, Spurr CL, Glidewell OJ, Gottlieb AJ, Holland JF. A new effective four-drug combination of CCNU (1-[2-chloroethyl]-3-cyclohexyl-1-nitrosourea) (NSC-79038), vinblastine, prednisone, and procarbazine for the treatment of advanced Hodgkin's disease. Cancer. 1980 Aug 15;46(4):654-62. link to original article dosing details in manuscript have been reviewed by our editors PubMed
LOPP
LOPP: Leukeran (Chlorambucil), Oncovin (Vincristine), Procarbazine, Prednisone
Regimen
Study | Dates of enrollment | Evidence | Comparator | Comparative Efficacy |
---|---|---|---|---|
Hancock 1986 | 1979 to not reported | Randomized (E-switch-ic) | MOPP | Did not meet endpoint of CR rate |
Hancock et al. 1992 | 1983-1989 | Randomized (C) | LOPP/EVAP | Seems to have inferior OS |
Chemotherapy
- Chlorambucil (Leukeran) 10 mg PO once per day on days 1 to 10
- Vincristine (Oncovin) 1.4 mg/m2 (maximum dose of 2 mg) IV once per day on days 1 & 8
- Procarbazine (Matulane) 100 mg/m2 (maximum dose of 200 mg) PO once per day on days 1 to 10
Glucocorticoid therapy
- Prednisone (Sterapred) 25 mg/m2 (maximum dose of 60 mg) PO once per day on days 1 to 14
28-day cycle for 8 cycles
References
- Hancock BW; British National Lymphoma Investigation. Randomised study of MOPP (mustine, Oncovin, procarbazine, prednisone) against LOPP (Leukeran substituted for mustine) in advanced Hodgkin's disease. Radiother Oncol. 1986 Nov;7(3):215-21. link to original article PubMed
- Update: Hancock BW, Vaughan Hudson G, Vaughan Hudson B, Haybittle JL, Bennett MH, MacLennan KA, Jelliffe AM; BNLI. British National Lymphoma Investigation randomised study of MOPP (mustine, Oncovin, procarbazine, prednisolone) against LOPP (Leukeran substituted for mustine) in advanced Hodgkin's disease--long term results. Br J Cancer. 1991 Apr;63(4):579-82. link to original article link to PMC article PubMed
- Hancock BW, Vaughan Hudson G, Vaughan Hudson B, Bennett MH, MacLennan KA, Haybittle JL, Anderson L, Linch DC; BNLI. LOPP alternating with EVAP is superior to LOPP alone in the initial treatment of advanced Hodgkin's disease: results of a British National Lymphoma Investigation trial. J Clin Oncol. 1992 Aug;10(8):1252-8. link to original article dosing details in manuscript have been reviewed by our editors PubMed
LOPP/EVAP
LOPP/EVAP: Leukeran (Chlorambucil), Oncovin (Vincristine), Procarbazine, Prednisone alternating with Etoposide, Vinblastine, Adriamycin (Doxorubicin), Prednisone
Regimen
Study | Dates of enrollment | Evidence | Comparator | Comparative Efficacy |
---|---|---|---|---|
Hancock et al. 1992 | 1983-1989 | Randomized (E-switch-ic) | LOPP | Seems to have superior OS |
Hancock et al. 1994 | 1990-1991 | Randomized (C) | LOPP-EVA | Superior CR rate |
Chemotherapy, LOPP portion (cycles 1, 3, 5, 7)
- Chlorambucil (Leukeran) 10 mg PO once per day on days 1 to 10
- Vincristine (Oncovin) 1.4 mg/m2 (maximum dose of 2 mg) IV once per day on days 1 & 8
- Procarbazine (Matulane) 100 mg/m2 (maximum dose of 200 mg) PO once per day on days 1 to 10
Glucocorticoid therapy, LOPP portion (cycles 1, 3, 5, 7)
- Prednisone (Sterapred) 25 mg/m2 (maximum dose of 60 mg) PO once per day on days 1 to 14
Chemotherapy, EVAP portion (cycles 2, 4, 6, 8)
- Etoposide (Vepesid) 150 mg/m2 (maximum dose of 200 mg) PO once per day on days 1 to 3
- Vinblastine (Velban) 6 mg/m2 (maximum dose of 10 mg) IV once per day on days 1 & 8
- Doxorubicin (Adriamycin) 25 mg/m2 IV once per day on days 1 & 8
Glucocorticoid therapy, EVAP portion (cycles 2, 4, 6, 8)
- Prednisone (Sterapred) 25 mg/m2 (maximum dose of 60 mg) PO once per day on days 1 to 14
28-day cycle for 8 cycles (LOPP x 4; EVAP x 4)
References
- Hancock BW, Vaughan Hudson G, Vaughan Hudson B, Bennett MH, MacLennan KA, Haybittle JL, Anderson L, Linch DC; BNLI. LOPP alternating with EVAP is superior to LOPP alone in the initial treatment of advanced Hodgkin's disease: results of a British National Lymphoma Investigation trial. J Clin Oncol. 1992 Aug;10(8):1252-8. link to original article dosing details in manuscript have been reviewed by our editors PubMed
- Hancock BW, Vaughan Hudson G, Vaughan Hudson B, Linch DC, Anderson L, MacLennan KA; BNLI. Hybrid LOPP/EVA is not better than LOPP alternating with EVAP: a prematurely terminated British National Lymphoma Investigation randomized trial. Ann Oncol. 1994;5 Suppl 2:117-20. link to original article PubMed
MOPP/ABVD
MOPP/ABVD: Mustargen (Mechlorethamine), Oncovin (Vincristine), Procarbazine, Prednisone alternating with Adriamycin (Doxorubicin), Bleomycin, Vinblastine, Dacarbazine
Regimen variant #1, 12 cycles, uncapped vincristine
Study | Dates of enrollment | Evidence | Comparator | Comparative Efficacy |
---|---|---|---|---|
Santoro et al. 1982 | 1974-1980 | Phase 3 (E-switch-ic) | MOPP | Superior PFS |
Viviani et al. 1996 | 1982-1990 | Phase 3 (C) | MOPP-ABVD | Did not meet endpoint of CR rate |
Chemotherapy, MOPP portion (cycles 1, 3, 5, 7, 9, 11)
- Mechlorethamine (Mustargen) 6 mg/m2 IV once per day on days 1 & 8
- Vincristine (Oncovin) 1.4 mg/m2 IV once per day on days 1 & 8
- Procarbazine (Matulane) 100 mg/m2 PO once per day on days 1 to 14
Glucocorticoid therapy, MOPP portion (cycles 1, 3, 5, 7, 9, 11)
- Prednisone (Sterapred) as follows:
- Cycles 1 & 7: 40 mg/m2 PO once per day on days 1 to 14
Chemotherapy, ABVD portion (cycles 2, 4, 6, 8, 10, 12)
- Doxorubicin (Adriamycin) 25 mg/m2 IV push once per day on days 1 & 15
- Bleomycin (Blenoxane) 10 mg/m2 IV push once per day on days 1 & 15
- Vinblastine (Velban) 6 mg/m2 IV push once per day on days 1 & 15
- Dacarbazine (DTIC) 375 mg/m2 IV push once per day on days 1 & 15
28-day cycle for at least 12 cycles
Regimen variant #2, 12 cycles, capped vincristine
Study | Dates of enrollment | Evidence | Comparator | Comparative Efficacy |
---|---|---|---|---|
Canellos et al. 1992 (CALGB 8251) | 1982 to not reported | Phase 3 (E-switch-ic) | 1. ABVD | Did not meet primary endpoint of CR rate1 |
2. MOPP | Seems to have superior EFS1 (secondary endpoint) |
1Reported efficacy for CALGB 8251 is based on the 2009 update.
Note: full dosing details are not available in the manuscript, which stated that the Milan Cancer Institute scheme was used for ABVD dosing.
Chemotherapy, MOPP portion (cycles 1, 3, 5, 7, 9, 11)
- Mechlorethamine (Mustargen) 6 mg/m2 IV once per day on days 1 & 8
- Vincristine (Oncovin) 1.4 mg/m2 (maximum dose of 2 mg) IV once per day on days 1 & 8
- Procarbazine (Matulane) 100 mg/m2 PO once per day on days 1 to 14
Glucocorticoid therapy, MOPP portion (cycles 1, 3, 5, 7, 9, 11)
- Prednisone (Sterapred) as follows:
- Cycles 1 & 7: 40 mg/m2 PO once per day on days 1 to 14
Chemotherapy, ABVD portion (cycles 2, 4, 6, 8, 10, 12)
- Doxorubicin (Adriamycin) 25 mg/m2 IV push once per day on days 1 & 15
- Bleomycin (Blenoxane) 10 mg/m2 IV push once per day on days 1 & 15
- Vinblastine (Velban) 6 mg/m2 IV push once per day on days 1 & 15
- Dacarbazine (DTIC) 375 mg/m2 IV push once per day on days 1 & 15
28-day cycle for 12 cycles
Regimen variant #3, 12 cycles, capped vincristine, alternate prednisone dosing
Study | Dates of enrollment | Evidence | Comparator | Comparative Efficacy |
---|---|---|---|---|
Hutchinson et al. 1998 (CCG-521) | 1986-1990 | Phase 3 (C) | ABVD, then RT | Might have inferior EFS |
Chemotherapy, MOPP portion (cycles 1, 3, 5, 7, 9, 11)
- Mechlorethamine (Mustargen) 6 mg/m2 IV push once per day on days 1 & 8
- Vincristine (Oncovin) 1.5 mg/m2 (maximum dose of 2 mg) IV push once per day on days 1 & 8
- Procarbazine (Matulane) 100 mg/m2 PO once per day on days 1 to 14
Glucocorticoid therapy, MOPP portion (cycles 1, 3, 5, 7, 9, 11)
- Prednisone (Sterapred) 40 mg/m2 PO once per day on days 1 to 14, in 3 divided doses per day
Chemotherapy, ABVD portion (cycles 2, 4, 6, 8, 10, 12)
- Doxorubicin (Adriamycin) 25 mg/m2 IV push once per day on days 1 & 15
- Bleomycin (Blenoxane) 10 mg/m2 IV slow push once per day on days 1 & 15
- Vinblastine (Velban) 6 mg/m2 IV push once per day on days 1 & 15
- Dacarbazine (DTIC) 375 mg/m2 IV push once per day on days 1 & 15
28-day cycle for 12 cycles
Regimen variant #4, 8 cycles
Study | Dates of enrollment | Evidence | Comparator | Comparative Efficacy |
---|---|---|---|---|
Connor et al. 1997 (NCIC-CTG HD4) | 1984-1989 | Phase 3 (C) | MOPP-ABV | Did not meet co-primary endpoint of OS |
Chemotherapy, MOPP portion (cycles 1, 3, 5, 7)
- Mechlorethamine (Mustargen) 6 mg/m2 IV once per day on days 1 & 8
- Vincristine (Oncovin) 1.4 mg/m2 (maximum dose of 2 mg) IV once per day on days 1 & 8
- Procarbazine (Matulane) 100 mg/m2 PO once per day on days 1 to 14
Glucocorticoid therapy, MOPP portion (cycles 1, 3, 5, 7)
- Prednisone (Sterapred) as follows:
- Cycles 1 & 5: 40 mg/m2 PO once per day on days 1 to 14
Chemotherapy, ABVD portion (cycles 2, 4, 6, 8)
- Doxorubicin (Adriamycin) 25 mg/m2 IV push once per day on days 1 & 15
- Bleomycin (Blenoxane) 10 mg/m2 IV push once per day on days 1 & 15
- Vinblastine (Velban) 6 mg/m2 IV push once per day on days 1 & 15
- Dacarbazine (DTIC) 375 mg/m2 IV push once per day on days 1 & 15
28-day cycle for 8 cycles
Regimen variant #5, 8 cycles, lower-dose ABVD
Study | Dates of enrollment | Evidence | Comparator | Comparative Efficacy |
---|---|---|---|---|
Somers et al. 1994 | 1981-1986 | Phase 3 (E-switch-ic) | MOPP x 8 | Seems to have superior FFS |
Note: Each portion is given twice before alternating (AABBAABB pattern). ABVD doses are per the "Milan scheme".
Chemotherapy, MOPP portion (cycles 1, 2, 5, 6)
- Mechlorethamine (Mustargen) 6 mg/m2 IV once per day on days 1 & 8
- Vincristine (Oncovin) 1.4 mg/m2 (maximum dose of 2 mg) IV once per day on days 1 & 8
- Procarbazine (Matulane) 100 mg/m2 PO once per day on days 1 to 14
Glucocorticoid therapy, MOPP portion (cycles 1, 2, 5, 6)
- Prednisone (Sterapred) 25 mg/m2 PO once per day on days 1 to 14
Chemotherapy, ABVD portion (cycles 3, 4, 7, 8)
- Doxorubicin (Adriamycin) 25 mg/m2 IV push once per day on days 1 & 15
- Bleomycin (Blenoxane) 6 mg/m2 IV push once per day on days 1 & 15
- Vinblastine (Velban) 6 mg/m2 IV push once per day on days 1 & 15
- Dacarbazine (DTIC) 250 mg/m2 IV push once per day on days 1 & 15
28-day cycle for 8 cycles
References
- Santoro A, Bonadonna G, Bonfante V, Valagussa P. Alternating drug combinations in the treatment of advanced Hodgkin's disease. N Engl J Med. 1982 Apr 1;306(13):770-5. link to original article dosing details in manuscript have been reviewed by our editors PubMed
- Update: Bonadonna G, Valagussa P, Santoro A. Alternating non-cross-resistant combination chemotherapy or MOPP in stage IV Hodgkin's disease: a report of 8-year results. Ann Intern Med. 1986 Jun;104(6):739-46. link to original article PubMed
- CALGB 8251: Canellos GP, Anderson JR, Propert KJ, Nissen N, Cooper MR, Henderson ES, Green MR, Gottlieb A, Peterson BA. Chemotherapy of advanced Hodgkin's disease with MOPP, ABVD, or MOPP alternating with ABVD. N Engl J Med. 1992 Nov 19;327(21):1478-84. link to original article contains partial dosing details in manuscript PubMed
- Update: Canellos GP, Niedzwiecki D. Long-term follow-up of Hodgkin's disease trial. N Engl J Med. 2002 May 2;346(18):1417-8. link to original article PubMed
- Update: Canellos GP, Niedzwiecki D, Johnson JL. Long-term follow-up of survival in Hodgkin's lymphoma. N Engl J Med. 2009 Dec 10;361(24):2390-1. link to original article PubMed
- Somers R, Carde P, Henry-Amar M, Tarayre M, Thomas J, Hagenbeek A, Monconduit M, de Pauw BE, Breed WP, Verdonck L, Burgers JMV, Eghbali H, Zittoun R; EORTC. A randomized study in stage IIIB and IV Hodgkin's disease comparing eight courses of MOPP versus an alteration of MOPP with ABVD: a European Organisation for Research and Treatment of Cancer Lymphoma Cooperative Group and Groupe Pierre-et-Marie-Curie controlled clinical trial. J Clin Oncol. 1994 Feb;12(2):279-87. link to original article dosing details in manuscript have been reviewed by our editors PubMed
- Viviani S, Bonadonna G, Santoro A, Bonfante V, Zanini M, Devizzi L, Soncini F, Valagussa P. Alternating versus hybrid MOPP and ABVD combinations in advanced Hodgkin's disease: ten-year results. J Clin Oncol. 1996 May;14(5):1421-30. link to original article does not contain dosing details PubMed
- NCIC-CTG HD4: Connors JM, Klimo P, Adams G, Burns BF, Cooper I, Meyer RM, O'Reilly SE, Pater J, Quirt I, Sadura A, Shustik C, Skillings J, Sutcliffe S, Verma S, Yoshida S, Zee B. Treatment of advanced Hodgkin's disease with chemotherapy--comparison of MOPP/ABV hybrid regimen with alternating courses of MOPP and ABVD: a report from the National Cancer Institute of Canada clinical trials group. J Clin Oncol. 1997 Apr;15(4):1638-45. Erratum in: J Clin Oncol 1997 Jul;15(7):2762. link to original article dosing details in manuscript have been reviewed by our editors PubMed
- CCG-521: Hutchinson RJ, Fryer CJ, Davis PC, Nachman J, Krailo MD, O'Brien RT, Collins RD, Whalen T, Reardon D, Trigg ME, Gilchrist GS. MOPP or radiation in addition to ABVD in the treatment of pathologically staged advanced Hodgkin's disease in children: results of the Children's Cancer Group Phase III Trial. J Clin Oncol. 1998 Mar;16(3):897-906. link to original article dosing details in manuscript have been reviewed by our editors PubMed
MVPP
MVPP: Mechlorethamine, Vinblastine, Procarbazine, Prednisone
Regimen
Study | Dates of enrollment | Evidence | Comparator | Comparative Efficacy |
---|---|---|---|---|
Cooper et al. 1980 | 1972-1975 | Phase 3 (E-switch-ic) | 1. COPP | Did not meet endpoint of OS |
2. CVPP | Did not meet endpoint of OS | |||
3. MOPP | Did not meet endpoint of OS |
Chemotherapy
- Mechlorethamine (Mustargen) 6 mg/m2 IV once per day on days 1 & 8
- Vinblastine (Velban) 4 mg/m2 IV once per day on days 1 & 8
- Procarbazine (Matulane) 100 mg/m2 PO once per day on days 1 to 14
Glucocorticoid therapy
- Prednisone (Sterapred) as follows:
- Cycles 1, 3, 5: 40 mg/m2 PO once per day on days 1 to 14
28-day cycle for 6 cycles
References
- Cooper MR, Pajak TF, Nissen NI, Stutzman L, Brunner K, Cuttner J, Falkson G, Grunwald H, Bank A, Leone L, Seligman BR, Silver RT, Weiss RB, Haurani F, Blom J, Spurr CL, Glidewell OJ, Gottlieb AJ, Holland JF. A new effective four-drug combination of CCNU (1-[2-chloroethyl]-3-cyclohexyl-1-nitrosourea) (NSC-79038), vinblastine, prednisone, and procarbazine for the treatment of advanced Hodgkin's disease. Cancer. 1980 Aug 15;46(4):654-62. link to original article dosing details in manuscript have been reviewed by our editors PubMed
SCAB
SCAB: Streptozocin, CCNU (Lomustine), Adriamycin (Doxorubicin), Bleomycin
Regimen
Study | Dates of enrollment | Evidence |
---|---|---|
Diggs et al. 1981 | 1976-1978 | Non-randomized |
Chemotherapy
- Streptozocin (Zanosar) 500 mg/m2 IV once per day on days 1 to 5
- Lomustine (CCNU) 100 mg/m2 PO once on day 1
- Doxorubicin (Adriamycin) 45 mg/m2 IV once on day 1
- Bleomycin (Blenoxane) 15 mg/m2 IM once per day on days 1 to 7
1-month cycles
References
- Diggs CH, Wiernik PH, Sutherland JC. Treatment of advanced untreated Hodgkin's disease with SCAB--an alternative to MOPP. Cancer. 1981 Jan 15;47(2):224-8. link to original article dosing details in manuscript have been reviewed by our editors PubMed
- Update: Wiernik PH, Schiffer CA. Long-term follow-up of advanced Hodgkin's disease patients treated with a combination of streptozotocin, lomustine (CCNU), doxorubicin and bleomycin (SCAB). J Cancer Res Clin Oncol. 1988;114(1):105-7. link to original article PubMed
VEBEP
VEBEP: Vepesid (Etoposide), Epirubicin, Bleomycin, Endoxan (Cyclophosphamide), Prednisolone
Regimen
Study | Dates of enrollment | Evidence |
---|---|---|
Viviani et al. 1999 | 1990-09 to 1993-03 | Phase 2 |
Note: The full manuscript is not available online for review.
Chemotherapy
Glucocorticoid therapy
References
- Viviani S, Bonfante V, Santoro A, Zanini M, Devizzi L, Di Russo AD, Soncini F, Villani F, Ragni G, Valagussa P, Bonadonna G. Long-term results of an intensive regimen: VEBEP plus involved-field radiotherapy in advanced Hodgkin's disease. Cancer J Sci Am. 1999 Sep-Oct;5(5):275-82. PubMed does not contain dosing details in abstract
Maintenance after upfront therapy
BCG vaccine monotherapy
Regimen
Study | Dates of enrollment | Evidence | Comparator | Comparative Efficacy |
---|---|---|---|---|
Sokal et al. 1974 | 1965-1967 | Randomized, fewer than 20 pts in this subgroup (E-esc) | Observation | Superior PFS |
Note: this study was open to patients with "malignant lymphoma" but the majority had Hodgkin disease.
Immunotherapy
References
- Sokal JE, Aungst CW, Snyderman M. Delay in progression of malignant lymphoma after BCG vaccination. N Engl J Med. 1974 Dec 5;291(23):1226-30. link to original article PubMed
Relapsed or refractory, salvage therapy
ABDIC
ABDIC: Adriamycin (Doxorubicin), Bleomycin, DIC (Dacarbazine), CCNU (Lomustine), Prednisone
Regimen
Study | Dates of enrollment | Evidence |
---|---|---|
Rodgers et al. 1980 | 1974-1978 | Phase 2 |
Chemotherapy
- Doxorubicin (Adriamycin) 45 mg/m2 IV once on day 1
- Bleomycin (Blenoxane) 5 mg/m2 IV once per day on days 1 & 5
- Dacarbazine (DTIC) 200 mg/m2 IV once per day on days 1 to 5
- Lomustine (CCNU) 50 mg/m2 PO once on day 1
Glucocorticoid therapy
- Prednisone (Sterapred) 40 mg/m2 PO once per day on days 1 to 5
28-day cycles
References
- Rodgers RW, Gamble JF, Loh KK, Shullenberger CC. Adriamycin, bleomycin, DIC, CCNU, and prednisone (ABDIC) chemotherapy in MOPP-resistant Hodgkin's disease. Cancer. 1980 Dec 1;46(11):2349-55. link to original article dosing details in manuscript have been reviewed by our editors PubMed
- Update: Tannir N, Hagemeister F, Velasquez W, Cabanillas F. Long-term follow-up with ABDIC salvage chemotherapy of MOPP-resistant Hodgkin's disease. J Clin Oncol. 1983 Jul;1(7):432-9. link to original article PubMed
ABVD
ABVD: Adriamycin (Doxorubicin), Bleomycin, Vinblastine, Dacarbazine
Regimen
Study | Dates of enrollment | Evidence |
---|---|---|
Harker et al. 1984 | 1973-1982 | Non-randomized |
Krikorian et al. 1978 | 1975-06-19 to 1976-12-22 | Phase 2 |
Santoro & Bonadonna 1979 | Not reported | Non-randomized |
Santoro et al. 1982a | Not reported in abstract | Non-randomized |
Note: This is for historical interest only; ABVD is no longer used in the salvage setting.
Chemotherapy
- Doxorubicin (Adriamycin) 25 mg/m2 IV once on day 1
- Bleomycin (Blenoxane) 10 mg/m2 IV once on day 1
- Vinblastine (Velban) 6 mg/m2 IV once on day 1
- Dacarbazine (DTIC) 375 mg/m2 IV once on day 1
14-day cycles
References
- Krikorian JG, Portlock CS, Rosenberg SA. Treatment of advanced Hodgkin's disease with adriamycin, bleomycin, vinblastine, and imidazole carboxamide (ABVD) after failure of MOPP therapy. Cancer. 1978 Jun;41(6):2107-11. link to original article dosing details in manuscript have been reviewed by our editors PubMed
- Santoro A, Bonadonna G. Prolonged disease-free survival in MOPP-resistant Hodgkin's disease after treatment with adriamycin, bleomycin, vinblastine and dacarbazine (ABVD). Cancer Chemother Pharmacol. 1979;2(2):101-5. link to original article PubMed
- Santoro A, Bonfante V, Bonadonna G. Salvage chemotherapy with ABVD in MOPP-resistant Hodgkin's disease. Ann Intern Med. 1982 Feb;96(2):139-43. link to original article PubMed
- Harker WG, Kushlan P, Rosenberg SA. Combination chemotherapy for advanced Hodgkin's disease after failure of MOPP: ABVD and B-CAVe. Ann Intern Med. 1984 Oct;101(4):440-6. link to original article PubMed
B-CAVe
B-CAVe: Bleomycin, CCNU (Lomustine), Adriamycin (Doxorubicin), Vinblastine
Regimen
Study | Dates of enrollment | Evidence |
---|---|---|
Porzig et al. 1978 | 1973-1976 | Non-randomized |
Harker et al. 1984 | 1973-1982 | Non-randomized |
Chemotherapy
- Bleomycin (Blenoxane) 2.5 mg/m2 IV once per day on days 1, 28, 35
- Lomustine (CCNU) 100 mg/m2 PO once on day 1
- Doxorubicin (Adriamycin) 60 mg/m2 IV once on day 1
- Vinblastine (Velban) 5 mg/m2 IV once on day 1
42-day cycles
References
- Porzig KJ, Portlock CS, Robertson A, Rosenberg SA. Treatment of advanced Hodgkin's disease with B-CAVE following MOPP failure. Cancer. 1978 May;41(5):1670-5. link to original article dosing details in manuscript have been reviewed by our editors PubMed
- Harker WG, Kushlan P, Rosenberg SA. Combination chemotherapy for advanced Hodgkin's disease after failure of MOPP: ABVD and B-CAVe. Ann Intern Med. 1984 Oct;101(4):440-6. link to original article PubMed
BVCPP
BVCPP: BCNU (Carmustine), Vinblastine, Cyclophosphamide, Procarbazine, Prednisone
Regimen
Study | Dates of enrollment | Evidence |
---|---|---|
Durant et al. 1978 | 1971-1975 | Non-randomized part of RCT |
Note: It is not clear from the manuscript whether the procarbazine ramp occurred with each cycle or just with the first cycle.
Chemotherapy
- Carmustine (BCNU) 100 mg/m2 IV once on day 1
- Vinblastine (Velban) 5 mg/m2 IV once on day 1
- Cyclophosphamide (Cytoxan) 600 mg/m2 IV once on day 1
- Procarbazine (Matulane) 100 mg/m2 PO once per day on days 1 to 10, "reached by 50 mg increments"
Glucocorticoid therapy
- Prednisone (Sterapred) 60 mg/m2/day PO on days 1 to 10
28-day cycle for 6 cycles
Subsequent treatment
- Durant et al. 1978, patients who achieved CR: No additional therapy versus MOPP consolidation x 6 versus BVCPP continuation x 6 additional cycles
References
- Durant JR, Gams RA, Velez-Garcia E, Bartolucci A, Wirtschafter D, Dorfman R. BCNU, velban, cyclophosphamide, procarbazine, and prednisone (BVCPP) in advanced Hodgkin's disease. Cancer. 1978 Nov;42(5):2101-10. link to original article dosing details in manuscript have been reviewed by our editors PubMed
BVDS
BVDS: Bleomycin, Vinblastine, Doxorubicin, Streptozocin
Regimen
Study | Dates of enrollment | Evidence |
---|---|---|
Vinciguerra et al. 1977 | Not reported | Non-randomized, fewer than 20 pts |
Chemotherapy
- Bleomycin (Blenoxane) 5 mg/m2 IV once per day on days 1 & 15
- Vinblastine (Velban) 6 mg/m2 IV once per day on days 1 & 15
- Doxorubicin (Adriamycin) 30 mg/m2 IV once on day 1
- Streptozocin (Zanosar) 1500 mg/m2 IV once per day on days 1 & 15
1-month cycle for at least 12 cycles
References
- Vinciguerra V, Coleman M, Jarowski CI, Degnan TJ, Silver RT. A new combination chemotherapy for resistant Hodgkin disease. JAMA. 1977 Jan 3;237(1):33-5. link to original article dosing details in manuscript have been reviewed by our editors PubMed
CEP
CEP: CCNU (Lomustine), Etoposide, Prednimustine
References
- Santoro A, Viviani S, Valagussa P, Bonfante V, Bonadonna G. CCNU, etoposide, and prednimustine (CEP) in refractory Hodgkin's disease. Semin Oncol. 1986 Mar;13(1 Suppl 1):23-6. PubMed
CVB
CVB: CCNU (Lomustine), Vinblastine, Bleomycin
Regimen
Study | Dates of enrollment | Evidence |
---|---|---|
Goldman & Dawson 1975 | 1973-1975 | Non-randomized |
Chemotherapy
- Lomustine (CCNU) 100 mg/m2 PO once on day 1
- Vinblastine (Velban) 6 mg/m2 IV once per day on days 1 & 8
- Bleomycin (Blenoxane) 15 mg IM once per day on days 1 & 8
28-day cycles
References
- Goldman JM, Dawson AA. Combination therapy for advanced resistant Hodgkin's disease. Lancet. 1975 Dec 20;2(7947):1224-7. link to original article dosing details in manuscript have been reviewed by our editors PubMed
CVPP
CVPP: CCNU (Lomustine), Vinblastine, Procarbazine, Prednisone
Regimen
Study | Dates of enrollment | Evidence | Comparator | Comparative Efficacy |
---|---|---|---|---|
Vinciguerra et al. 1986 | 1975-1981 | Randomized (C) | 1. ABOS 2. CVPP/ABOS |
Did not meet co-primary endpoints of CR rate/DFS/OS |
Chemotherapy
- Lomustine (CCNU) 75 mg/m2 PO once on day 1
- Vinblastine (Velban) 4 mg/m2 IV once per day on days 1 & 8
- Procarbazine (Matulane) 100 mg/m2 PO once per day on days 1 to 14
Glucocorticoid therapy
- Prednisone (Sterapred) as follows:
- Cycles 1, 4, 7, 10: 40 mg/m2 PO once per day on days 1 to 14
1-month cycle for 12 cycles
References
- Vinciguerra V, Propert KJ, Coleman M, Anderson JR, Stutzman L, Pajak TF, Nissen NI, Frizzera G, Gottlieb A, Holland JF; CALGB. Alternating cycles of combination chemotherapy for patients with recurrent Hodgkin's disease following radiotherapy: a prospectively randomized study by the Cancer and Leukemia Group B. J Clin Oncol. 1986 Jun;4(6):838-46. link to original article dosing details in manuscript have been reviewed by our editors PubMed
SCAB
SCAB: Streptozocin, CCNU (Lomustine), Adriamycin (Doxorubicin), Bleomycin
Regimen
Study | Dates of enrollment | Evidence |
---|---|---|
Levi et al. 1977 | Not reported in abstract | Non-randomized, fewer than 20 pts |
Chemotherapy
- Streptozocin (Zanosar) 500 mg/m2 IV once per day on days 1 to 5
- Lomustine (CCNU) 100 mg/m2 PO once on day 1
- Doxorubicin (Adriamycin) 45 mg/m2 IV once on day 1
- Bleomycin (Blenoxane) 15 mg/m2 IM once per day on days 1 & 8
28-day cycles
References
- Levi JA, Wiernik PH, Diggs CH. Combination chemotherapy of advanced previously treated Hodgkin's disease with streptozotocin, CCNU, adriamycin and bleomycin. Med Pediatr Oncol. 1977;3(1):33-40. link to original article dosing details in abstract have been reviewed by our editors PubMed
Relapsed or refractory, further lines of therapy
Carmustine monotherapy
Regimen
Study | Dates of enrollment | Evidence |
---|---|---|
Young et al. 1971 | 1966 to not reported | Non-randomized |
Chemotherapy
References
- Young RC, DeVita VT Jr, Serpick AA, Canellos GP. Treatment of advanced Hodgkin's disease with (1,3 bis (2-chloroethyl)-1-nitrosourea) BCNU. N Engl J Med. 1971 Aug 26;285(9):475-9. link to original article PubMed
Doxorubicin & Lomustine
Regimen
Study | Dates of enrollment | Evidence |
---|---|---|
Williams & Einhorn 1977 | 1973-1975 | Non-randomized, fewer than 20 pts |
Chemotherapy
- Doxorubicin (Adriamycin) 60 mg/m2 IV once on day 1, then 45 mg/m2 IV once on day 22
- Lomustine (CCNU) 100 mg/m2 PO once on day 1
42-day cycle for up to 5 cycles (maximum doxorubicin cumulative dose of 550 mg/m2)
References
- Williams SD, Einhorn LH. Combination chemotherapy with doxorubicin and lomustine: treatment of refractory Hodgkin's disease. JAMA. 1977 Oct 10;238(15):1659-61. link to original article dosing details in manuscript have been reviewed by our editors PubMed
Panobinostat monotherapy
Regimen
Study | Dates of enrollment | Evidence | Efficacy |
---|---|---|---|
Younes et al. 2012 (CLBH589E2214) | 2008-2009 | Phase 2 | Investigator assessment: 27% Central review: 22% |
Note: Patients had progressed after auto HSCT and had a median of 4 prior systemic regimens (range 2 to 7).
References
- CLBH589E2214: Younes A, Sureda A, Ben-Yehuda D, Zinzani PL, Ong TC, Prince HM, Harrison SJ, Kirschbaum M, Johnston P, Gallagher J, Le Corre C, Shen A, Engert A. Panobinostat in patients with relapsed/refractory Hodgkin's lymphoma after autologous stem-cell transplantation: results of a phase II study. J Clin Oncol. 2012 Jun 20;30(18):2197-203. Epub 2012 Apr 30. link to original article dosing details in manuscript have been reviewed by our editors PubMed NCT00742027
Sirolimus & Vorinostat
Regimen
Study | Dates of enrollment | Evidence |
---|---|---|
Janku et al. 2020 (MDACC 2009-0729) | 2010-2015 | Non-randomized |
Note: This was a very heavily pre-treated cohort, median of 6 prior therapies; doses here are one level below MTD and are proposed as the ongoing doses to be studied.
Immunosuppressive therapy
- Sirolimus (Rapamune) 4 mg PO once per day on days 1 to 28
Targeted therapy
- Vorinostat (Zolinza) as follows:
- Cycle 1: 300 mg PO once per day on days 7 to 28
- Cycle 2 onwards: 300 mg PO once per day on days 1 to 28
28-day cycles
References
- MDACC 2009-0729: Janku F, Park H, Call SG, Madwani K, Oki Y, Subbiah V, Hong DS, Naing A, Velez-Bravo VM, Barnes TG, Hagemeister FB, Falchook GS, Karp DD, Wheler JJ, Piha-Paul SA, Garrido-Laguna I, Shpall EJ, Fayad LE, Neelapu SS, Meric-Bernstam F, Kurzrock R, Fanale MA. Safety and Efficacy of Vorinostat Plus Sirolimus or Everolimus in Patients with Relapsed Refractory Hodgkin Lymphoma. Clin Cancer Res. 2020 Nov 1;26(21):5579-5587. Epub 2020 Oct 14. link to original article PubMed NCT01087554