Optimizing First-Line Therapy for Advanced-Stage Classic Hodgkin Lymphoma

Goals of first-line therapy in classic Hodgkin lymphoma (cHL) should focus on balancing risk versus benefit to the individual while increasing efficacy and decreasing toxicity. Overall, the ABVD regimen is well tolerated but slightly less effective, with a better safety profile compared with escalated BEACOPP. BV-AVD is somewhere in between ABVD and escalated BEACOPP on the cure/morbidity scale. Interim PET is predictive, but new prognostic biomarkers are emerging that may better identify patients at high risk for treatment failure. In patients with interim PET-negative cHL, de-escalating therapy does not impact overall survival along 1) with no proven role for radiotherapy. cHL is largely a disease of young people, and the choice of treatment should always take into account the potential for both short- and long-term toxicity with the goal of optimizing survivorship.

Download Full-text

Long-term follow-up of brentuximab vedotin ± dacarbazine as first line therapy in elderly patients with Hodgkin lymphoma.

Journal of Clinical Oncology ◽

10.1200/jco.2018.36.15_suppl.7542 ◽

2018 ◽

Vol 36 (15_suppl) ◽

pp. 7542-7542 ◽

Cited By ~ 2

Author(s):

Jonathan W. Friedberg ◽

Andres Forero-Torres ◽

Beata Holkova ◽

Jerome H. Goldschmidt ◽

Ralph V. Boccia ◽

...

Keyword(s):

Elderly Patients ◽

Hodgkin Lymphoma ◽

Brentuximab Vedotin ◽

First Line ◽

First Line Therapy ◽

Line Therapy ◽

Long Term Follow Up

Download Full-text

EVALUATION OF RESPONSE TO THE FIRST‐LINE THERAPY OF PATIENTS WITH CLASSICAL HODGKIN LYMPHOMA BASED ON INTERIM PET‐CT AT A PRIVATE BRAZILIAN INSTITUTION

Hematological Oncology ◽

10.1002/hon.68_2881 ◽

2021 ◽

Vol 39 (S2) ◽

Author(s):

J. M. De Almeida ◽

A. Alves

Keyword(s):

Hodgkin Lymphoma ◽

Classical Hodgkin Lymphoma ◽

First Line ◽

Interim Pet ◽

First Line Therapy ◽

Line Therapy ◽

Pet Ct

Download Full-text

Optimizing further treatment choices in short- and long-term responders to first-line therapy for patients with advanced renal cell carcinoma

Expert Review of Anticancer Therapy ◽

10.1586/era.12.76 ◽

2012 ◽

Vol 12 (8) ◽

pp. 1089-1096 ◽

Cited By ~ 4

Author(s):

Giuseppe Procopio ◽

Roberto Sabbatini ◽

Camillo Porta ◽

Elena Verzoni ◽

Enzo Galligioni ◽

...

Keyword(s):

Renal Cell Carcinoma ◽

Cell Carcinoma ◽

Renal Cell ◽

Advanced Renal Cell Carcinoma ◽

First Line ◽

Treatment Choices ◽

First Line Therapy ◽

Line Therapy ◽

Short And Long Term

Download Full-text

Not BCL2 mutation but dominant mutation conversation contributed to acquired venetoclax resistance in acute myeloid leukemia

Biomarker Research ◽

10.1186/s40364-021-00288-7 ◽

2021 ◽

Vol 9 (1) ◽

Author(s):

Xiang Zhang ◽

Jiejing Qian ◽

Huafeng Wang ◽

Yungui Wang ◽

Yi Zhang ◽

...

Keyword(s):

Acute Myeloid Leukemia ◽

Myeloid Leukemia ◽

Underlying Mechanism ◽

Lymphocytic Leukemia ◽

First Line ◽

Dominant Mutation ◽

First Line Therapy ◽

Line Therapy ◽

Acute Myeloid

AbstractVenetoclax (VEN) plus azacitidine has become the first-line therapy for elderly patients with acute myeloid leukemia (AML), and has a complete remission (CR) plus CR with incomplete recovery of hemogram rate of ≥70%. However, the 3-year survival rate of these patients is < 40% due to relapse caused by acquired VEN resistance, and this remains the greatest obstacle for the maintenance of long-term remission in VEN-sensitive patients. The underlying mechanism of acquired VEN resistance in AML remains largely unknown. Therefore, in the current study, nine AML patients with acquired VEN resistance were retrospectively analyzed. Our results showed that the known VEN resistance-associated BCL2 mutation was not present in our cohort, indicating that, in contrast to chronic lymphocytic leukemia, this BCL2 mutation is dispensable for acquired VEN resistance in AML. Instead, we found that reconstructed existing mutations, especially dominant mutation conversion (e.g., expanded FLT3-ITD), rather than newly emerged mutations (e.g., TP53 mutation), mainly contributed to VEN resistance in AML. According to our results, the combination of precise mutational monitoring and advanced interventions with targeted therapy or chemotherapy are potential strategies to prevent and even overcome acquired VEN resistance in AML.

Download Full-text

Long‐term outcome comparing histological grades of follicular lymphoma patients treated with immunochemotherapy as first‐line therapy: A retrospective analysis from two institutions

European Journal Of Haematology ◽

10.1111/ejh.13359 ◽

2019 ◽

Vol 104 (3) ◽

pp. 198-206

Author(s):

Santiago Mercadal ◽

Juan‐Manuel Sancho ◽

Fina Climent ◽

Gustavo Tapia ◽

Helena Pomares ◽

...

Keyword(s):

Follicular Lymphoma ◽

Retrospective Analysis ◽

First Line ◽

Term Outcome ◽

Long Term Outcome ◽

First Line Therapy ◽

Line Therapy

Download Full-text

Systematic review and meta-analysis on the prognostic value of complete remission status at FDG-PET in Hodgkin lymphoma after completion of first-line therapy

Annals of Hematology ◽

10.1007/s00277-015-2529-2 ◽

2015 ◽

Vol 95 (1) ◽

pp. 1-9 ◽

Cited By ~ 23

Author(s):

Hugo J. A. Adams ◽

Rutger A. J. Nievelstein ◽

Thomas C. Kwee

Keyword(s):

Systematic Review ◽

Complete Remission ◽

Hodgkin Lymphoma ◽

Fdg Pet ◽

Prognostic Value ◽

Meta Analysis ◽

First Line ◽

First Line Therapy ◽

Remission Status ◽

Line Therapy

Download Full-text

Cost-Effectiveness of Pembrolizumab Plus Chemotherapy Versus Pembrolizumab Monotherapy in Metastatic Non-Squamous and Squamous NSCLC Patients With PD-L1 Expression ≥ 50%

Frontiers in Pharmacology ◽

10.3389/fphar.2021.803626 ◽

2022 ◽

Vol 12 ◽

Author(s):

Qiao Liu ◽

Zhen Zhou ◽

Xia Luo ◽

Lidan Yi ◽

Liubao Peng ◽

...

Keyword(s):

Cost Effectiveness ◽

Life Expectancy ◽

Cost Effective ◽

Base Case ◽

First Line ◽

Term Survival ◽

First Line Therapy ◽

Line Therapy ◽

Nsclc Patients

Objective To compare the cost-effectiveness of the combination of pembrolizumab and chemotherapy (Pembro+Chemo) versus pembrolizumab monotherapy (Pembro) as the first-line treatment for metastatic non-squamous and squamous non-small-cell lung cancer (NSCLC) with PD-L1expression ≥50%, respectively, from a US health care perspective.Material and Methods A comprehensive Makrov model were designed to compare the health costs and outcomes associated with first-line Pembro+Chemo and first-line Pembro over a 20-years time horizon. Health states consisted of three main states: progression-free survival (PFS), progressive disease (PD) and death, among which the PFS health state was divided into two substates: PFS while receiving first-line therapy and PFS with discontinued first-line therapy. Two scenario analyses were performed to explore satisfactory long-term survival modeling.Results In base case analysis, for non-squamous NSCLC patients, Pembro+Chemo was associated with a significantly longer life expectancy [3.24 vs 2.16 quality-adjusted life-years (QALYs)] and a substantially greater healthcare cost ($341,237 vs $159,055) compared with Pembro, resulting in an ICER of $169,335/QALY; for squamous NSCLC patients, Pembro+Chemo was associated with a slightly extended life expectancy of 0.22 QALYs and a marginal incremental cost of $3,449 compared with Pembro, resulting in an ICER of $15,613/QALY. Our results were particularly sensitive to parameters that determine QALYs. The first scenario analysis yielded lower ICERs than our base case results. The second scenario analysis founded Pembro+Chemo was dominated by Pembro.Conclusion For metastatic non-squamous NSCLC patients with PD-L1 expression ≥50%, first-line Pembro+Chemo was not cost-effective when compared with first-line Pembro. In contrast, for the squamous NSCLC patient population, our results supported the first-line Pembro+Chemo as a cost-effective treatment. Although there are multiple approaches that are used for extrapolating long-term survival, the optimal method has yet to be determined.

Download Full-text