title: Doxorubicin, vinblastine, and gemcitabine (CALGB 50203) for stage I/II nonbulky Hodgkin lymphoma: pretreatment prognostic factors and interim PET.
abstract: To reduce doxorubicin, bleomycin, vinblastine and dacarbazine toxicity, the Cancer and Leukemia Group B conducted a phase 2 trial of doxorubicin, vinblastine, and gemcitabine for newly diagnosed, nonbulky stages I and II Hodgkin lymphoma. Ninety-nine assessable patients received 6 cycles of doxorubicin 25 mg/m(2), vinblastine 6 mg/m(2), and gemcitabine 800 mg/m(2) (1000 mg/m(2) in first 6) on days 1 and 15 every 28 days. Computed tomography (CT) and positron emission tomography (PET) were performed before and after 2 and 6 cycles. Complete remission (CR)/CR unconfirmed was achieved in 72 of 99 patients (72.7%) and partial remission in 24 of 99 patients (24.2%). The CR rate was 81% when using PET criteria. Two patients have died of Hodgkin lymphoma progression. Median follow-up for nonprogressing patients is 3.3 years. The progression-free survival (PFS) at 3 years was 77% (95% confidence interval, 68%-84%). The relapse rate was less than 10% for patients with favorable prognostic factors. The 2-year PFS for cycle 2 PET-negative and -positive patients was 88% and 54%, respectively (P = .0009), compared with 89% and 27% for cycle 6 PET-negative and -positive patients (P = .0001). Although the CR rate and PFS were lower than anticipated, patients with favorable prognostic features had a low rate of relapse. Cycle 2 PET and cycle 6 PET were predictive of PFS.
authors.affiliation: Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA. strausd@mskcc.org
authors.forename: David J
authors.initials: DJ
authors.lastname: Straus
authors.forename: Jeffrey L
authors.initials: JL
authors.lastname: Johnson
authors.forename: Ann S
authors.initials: AS
authors.lastname: LaCasce
authors.forename: Nancy L
authors.initials: NL
authors.lastname: Bartlett
authors.forename: Lale
authors.initials: L
authors.lastname: Kostakoglu
authors.forename: Eric D
authors.initials: ED
authors.lastname: Hsi
authors.forename: Heiko
authors.initials: H
authors.lastname: Schöder
authors.forename: Nathan C
authors.initials: NC
authors.lastname: Hall
authors.forename: Sin-Ho
authors.initials: SH
authors.lastname: Jung
authors.forename: George P
authors.initials: GP
authors.lastname: Canellos
authors.forename: Lawrence H
authors.initials: LH
authors.lastname: Schwartz
authors.forename: Ronald W
authors.initials: RW
authors.lastname: Takvorian
authors.forename: Malik E
authors.initials: ME
authors.lastname: Juweid
authors.forename: Bruce D
authors.initials: BD
authors.lastname: Cheson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects; D003841:Deoxycytidine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives; D018572:Disease-Free Survival; D004317:Doxorubicin / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D006689:Hodgkin Disease / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D011379:Prognosis; D012074:Remission Induction; D014747:Vinblastine / Q000008:administration & dosage / Q000009:adverse effects; D055815:Young Adult; D000093542:Gemcitabine
chemical_list: D003841:Deoxycytidine; D014747:Vinblastine; D004317:Doxorubicin; D000093542:Gemcitabine