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No Impact of Bleomycin and Vincristine Discontinuation on Efficacy of BEACOPP in Advanced Hodgkin Lymphoma

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Key Points

  • No significant differences in progression-free or overall survival were observed for receipt of four or fewer vs more than four cycles of bleomycin in patients with advanced Hodgkin lymphoma.
  • No significant differences were observed for receipt of three or fewer vs more than three cycles of vincristine in these same patients.

In an analysis of  the German Hodgkin Study Group HD12 and HD15 trials reported in the Journal of Clinical Oncology, Haverkamp et al found that discontinuation of bleomycin and vincristine due to drug-specific adverse effects did not affect efficacy of BEACOPP (bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine [Matulane], and prednisone) in patients with advanced Hodgkin lymphoma.

No Differences in Progression-Free or Overall Survival

Among 3,309 patients, bleomycin was discontinued in 17.6%, and vincristine was stopped in 32.6%. A total of 157 patients (4.7%) received four or fewer cycles of bleomycin, and 218 (6.6%) received three or fewer cycles of vincristine.

After a median follow-up of 59 months for progression-free survival and 67 months for overall survival, there was no significant difference between receipt of four or fewer vs more than four cycles of bleomycin in progression-free survival (5-year difference = 1.7%, 95% confidence interval [CI] = −4.2% to 7.6%) or overall survival (5-year difference = 1.5%, 95% CI = −2.6% to 5.5%). There was no significant difference between receipt of three or fewer vs more than three cycles of vincristine in progression-free survival (5-year difference = −1.3%, 95% CI = −5.6% to 3.1%) or overall survival (5-year difference = −0.1%, 95% CI = −3.1% to 2.9%).

The investigators concluded: “Bleomycin and vincristine discontinuation because of drug-specific adverse effects does not affect the efficacy of treatment in this setting.”

Bastian von Tresckow, MD, of Cologne University Hospital, is the corresponding author of the Journal of Clinical Oncology article.

The study was supported by Deutsche Krebshilfe, the German Federal Ministry for Education and Research, and the University of Cologne Faculty of Medicine. For full disclosures of the study authors, visit jco.ascopubs.org.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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