Randomized Comparison of the Stanford V Regimen and ABVD in the Treatment of Advanced Hodgkin's Lymphoma: United Kingdom National Cancer Research Institute Lymphoma Group Study ISRCTN 64141244

• Published in: Journal of clinical oncology Vol. 27; no. 32; pp. 5390 - 5396
• Main Authors: HOSKIN, Peter J, LOWRY, Lisa, PETTITT, Andrew, CUNNINGHAM, David, PETTENGELL, Ruth, SWEETENHAM, John, LINCH, David, JOHNSON, Peter W. M, HORWICH, Alan, JACK, Andrew, MEAD, Ben, HANCOCK, Barry W, SMITH, Paul, WENDI QIAN, PATRICK, Philippa, POPOVA, Bilyana
• Format: Journal Article
• Language: English
• Published: Alexandria, VA American Society of Clinical Oncology 10.11.2009
• Subjects: Adolescent; Adult; Aged; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biological and medical sciences; Bleomycin - administration & dosage; Bleomycin - adverse effects; Dacarbazine - administration & dosage; Dacarbazine - adverse effects; Disease-Free Survival; Doxorubicin - administration & dosage; Doxorubicin - adverse effects; Female; Hematologic and hematopoietic diseases; Hodgkin Disease - drug therapy; Hodgkin Disease - pathology; Humans; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; Lung Diseases - chemically induced; Male; Medical sciences; Middle Aged; Neoplasm Staging; Prospective Studies; Treatment Outcome; Tumors; Vinblastine - administration & dosage; Vinblastine - adverse effects; Young Adult; United Kingdom; Europe; Hodgkin disease; Malignant hemopathy; Research; Lymphoid neoplasm; Lymphoma; Randomization; Cancerology; Treatment; Lymphoproliferative syndrome; Advanced stage; Therapeutic protocol; Comparative study; Cancer
• ISSN: 0732-183X; 1527-7755
• DOI: 10.1200/JCO.2009.23.3239

This multicenter, prospective, randomized controlled trial compared the efficacy and toxicity of two chemotherapy regimens in advanced Hodgkin's lymphoma (HL): the weekly alternating Stanford V and the standard, twice-weekly regimen of doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD). Patients had stage IIB, III, or IV disease or had stages I to IIA disease with bulky disease or other adverse features. Radiotherapy was administered in both arms to sites of previous bulk (> 5 cm) and to splenic deposits, although this was omitted in the latter part of the trial for patients achieving complete remission (CR) in the ABVD arm. A total of 520 patients were randomly assigned and were assessed for the primary outcome measure of progression-free survival (PFS). Five hundred patients received protocol treatment, and radiotherapy was administered to 73% in the Stanford V arm and to 53% in the ABVD arm. The overall response rates after completion of all treatment were 91% for Stanford V and 92% for ABVD. During a median follow-up of 4.3 years, there was no evidence of a difference in projected 5-year PFS and overall survival (OS) rates (76% and 90%, respectively, for ABVD; 74% and 92%, respectively, for Stanford V). More pulmonary toxicity was reported for ABVD, whereas other toxicities were more frequent with Stanford V. In a large, randomized trial, the efficacies of Stanford V and ABVD were comparable when given in combination with appropriate radiotherapy.