title: ABVD compared with BEACOPP compared with CEC for the initial treatment of patients with advanced Hodgkin's lymphoma: results from the HD2000 Gruppo Italiano per lo Studio dei Linfomi Trial.
abstract: OBJECTIVE
  To compare doxorubicin, bleomycin, vinblastine, dacarbazine (ABVD) versus bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone (BEACOPP) versus cyclophosphamide, lomustine, vindesine, melphalan, prednisone, epidoxirubicin, vincristine, procarbazine, vinblastine, and bleomycin (COPPEBVCAD; CEC) for advanced Hodgkin's lymphoma (HL).
  
  
  METHODS
  Three hundred seven patients with advanced HL (stage IIB, III, and IV) were randomly assigned to receive six courses of ABVD, four escalated plus two standard courses of BEACOPP, or six courses of CEC, plus a limited radiation therapy program.
  
  
  RESULTS
  After a median follow-up of 41 months, BEACOPP resulted in a superior progression-free survival (PFS), with a significant reduction in risk of progression (hazard ratio [HR] = 0.50) compared with ABVD. No differences between BEACOPP and CEC, or CEC and ABVD were observed. The 5-year PFS was 68% (95% CI, 56% to 78%), 81% (95% CI, 70% to 89%), and 78% (95% CI, 68% to 86%), for ABVD, BEACOPP, and CEC, respectively (BEACOPP v ABVD, P = .038; CEC v ABVD and BEACOPP v CEC, P = not significant [NS]). The 5-year overall survival was 84% (95% CI, 69% to 92%), 92% (95% CI, 84% to 96%), and 91% (95% CI, 81% to 96%) for ABVD, BEACOPP, and CEC, respectively (P = NS). BEACOPP and CEC resulted in higher rates of grade 3-4 neutropenia than ABVD (P = .016); BEACOPP was associated with higher rates of severe infections than ABVD and CEC (P = .003).
  
  
  CONCLUSIONS
  As adopted in this study BEACOPP is associated with a significantly improved PFS compared with ABVD, with a predictable higher acute toxicity.
authors.affiliation: Dipartimento di Oncologia ed Ematologia, Centro Oncologico Modenese, Università di Modena e Reggio Emilia, Modena, Italy. federico@unimore.it
authors.forename: Massimo
authors.initials: M
authors.lastname: Federico
authors.forename: Stefano
authors.initials: S
authors.lastname: Luminari
authors.forename: Emilio
authors.initials: E
authors.lastname: Iannitto
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Polimeno
authors.forename: Luigi
authors.initials: L
authors.lastname: Marcheselli
authors.forename: Antonella
authors.initials: A
authors.lastname: Montanini
authors.forename: Antonio
authors.initials: A
authors.lastname: La Sala
authors.forename: Francesco
authors.initials: F
authors.lastname: Merli
authors.forename: Caterina
authors.initials: C
authors.lastname: Stelitano
authors.forename: Samantha
authors.initials: S
authors.lastname: Pozzi
authors.forename: Renato
authors.initials: R
authors.lastname: Scalone
authors.forename: Nicola
authors.initials: N
authors.lastname: Di Renzo
authors.forename: Pellegrino
authors.initials: P
authors.lastname: Musto
authors.forename: Luca
authors.initials: L
authors.lastname: Baldini
authors.forename: Giulia
authors.initials: G
authors.lastname: Cervetti
authors.forename: Francesco
authors.initials: F
authors.lastname: Angrilli
authors.forename: Patrizio
authors.initials: P
authors.lastname: Mazza
authors.forename: Maura
authors.initials: M
authors.lastname: Brugiatelli
authors.forename: Paolo G
authors.initials: PG
authors.lastname: Gobbi
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001761:Bleomycin / Q000627:therapeutic use; D016190:Carboplatin / Q000627:therapeutic use; D003520:Cyclophosphamide / Q000627:therapeutic use; D003606:Dacarbazine / Q000627:therapeutic use; D004317:Doxorubicin / Q000627:therapeutic use; D005047:Etoposide / Q000627:therapeutic use; D005260:Female; D006689:Hodgkin Disease / Q000188:drug therapy* / Q000401:mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D011241:Prednisone / Q000627:therapeutic use; D011344:Procarbazine / Q000627:therapeutic use; D014747:Vinblastine / Q000627:therapeutic use; D014750:Vincristine / Q000627:therapeutic use
chemical_list: D001761:Bleomycin; D011344:Procarbazine; D014750:Vincristine; D014747:Vinblastine; D005047:Etoposide; D003606:Dacarbazine; D004317:Doxorubicin; D003520:Cyclophosphamide; D016190:Carboplatin; D011241:Prednisone