Is BEACOPP better than ABVD?
The majority of patients with advanced Hodgkin's lymphoma are cured with currently available therapy, such as ABVD (Adriamycin [doxorubicin], bleomycin, vinblastine, and dacarbazine). However, almost 20% of patients fail to achieve a complete remission and almost 40% relapse with prolonged follow-up. BEACOPP (bleomycin, etoposide, Adriamycin, cyclophosphamide, vincristine, procarbazine, and prednisone) was developed by the German Hodgkin's Study Group to improve on standard therapy by intensifying treatment and substituting the active agent etoposide for vinblastine and dacarbazine. Promising results led to the HD9 trial, in which escalated BEACOPP was superior to COPP/ABVD (cyclophosphamide, vincristine, prednisone, procarbazine/ABVD). Nevertheless, escalated BEACOPP is myelosuppressive and is associated with an increased risk of secondary malignancies. Modifications of BEACOPP have been developed in an attempt to increase efficacy and reduce the adverse effects. Whether BEACOPP should be selected in preference to ABVD may be determined by clinical stage, patient age, and other risk factors. The answer to whether escalated BEACOPP is superior to ABVD will require the results of an ongoing randomized trial.
Cheson
Bruce D
BD
Georgetown University Hospital, 3800 Reservoir Road N.W., Washington, DC 20007, USA. bdc4@georgetown.edu
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001761:Bleomycin / Q000008:administration & dosage / Q000009:adverse effects; D002986:Clinical Trials as Topic / Q000706:statistics & numerical data; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000009:adverse effects; D003606:Dacarbazine / Q000008:administration & dosage / Q000009:adverse effects; D004317:Doxorubicin / Q000008:administration & dosage / Q000009:adverse effects; D005047:Etoposide / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D005544:Forecasting; D006689:Hodgkin Disease / Q000188:drug therapy* / Q000532:radiotherapy; D006801:Humans; D007246:Infertility / Q000139:chemically induced; D008297:Male; D015337:Multicenter Studies as Topic / Q000706:statistics & numerical data; D016609:Neoplasms, Second Primary / Q000139:chemically induced; D018579:Patient Selection; D011241:Prednisone / Q000008:administration & dosage / Q000009:adverse effects; D011344:Procarbazine / Q000008:administration & dosage / Q000009:adverse effects; D012074:Remission Induction; D015996:Survival Rate; D016896:Treatment Outcome; D014747:Vinblastine / Q000008:administration & dosage / Q000009:adverse effects; D014750:Vincristine / Q000008:administration & dosage / Q000009:adverse effects
D001761:Bleomycin; D011344:Procarbazine; D014750:Vincristine; D014747:Vinblastine; D005047:Etoposide; D003606:Dacarbazine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone