EBEACOPP under the guidance of PET-2 can be used as a treatment option for advanced NLPHL

Nodular lymphocyte-based Hodgkin's lymphoma (NLPHL) is a rare malignant tumor that accounts for about 5% of all Hodgkin's lymphoma (HL)
.

The best treatment for newly diagnosed advanced NLPHL is currently uncertain
.

Therefore, Professor DA Eichenauer and others conducted a subgroup analysis of a randomized clinical trial for advanced HL (German Hodgkin’s Lymphoma Study Group HD18 Trial [GHSG HD18 Study]), and evaluated the mid-term PET/CT examination (PET -2) Under the guidance, the efficacy of eBEACOPP in the treatment of advanced NLPHL, in order to determine the best treatment method for patients with advanced NLPHL
.

1 Research methods The study included patients 18-60 years old who received eBEACOPP intensive chemotherapy under the guidance of mid-term PET/CT examination results
.

The specific medications of the eBEACOPP program are: cyclophosphamide 1250mg/m2 IV d1, doxorubicin 35mg/m2 IV d1, etoposide 200mg/m2 IV d1-3, procarbazine 100mg/m2 PO d1-7, prednisone 40mg/m2 PO d1-14, vincristine 1.
4mg/m2 (maximum 2mg) IV d8, bleomycin 10mg/m2 IV d8
.

The patients included in the study underwent PET/CT examination (PET-2) after 2 cycles of chemotherapy
.

2 Research results There are 84 patients with NLPHL confirmed by biopsy in the study.
Compared with the 1412 classic HL (cHL) patients treated in the study, the median age is higher, the proportion of male patients is higher, and clinical The probability of risk factors is low
.

After a median follow-up of 5.
2 years, the 5-year progression-free survival (PFS) rate of all NLPHL patients was 82.
4%; in contrast, the 5-year PFS rate of all cHL patients was 90.
8% (P=0.
04)
.

The 5-year PFS rates of PET-2 positive NLPHL subgroup patients (n=31) and cHL subgroup patients (n=683) were 70.
1% and 59.
4% (P=0.
04); PET-2 negative NLPHL subgroup patients ( The 5-year PFS rates of patients in the n=53) and PET-2 negative cHL subgroups (n=729) were 90.
2% and 92.
2% (P=0.
30), respectively
.

There was no significant difference in PFS between the NLPHL patients randomly assigned to the standard group and the experimental group
.

The 5-year overall survival (OS) rates of all NLPHL patients and cHL patients were 94.
8% and 96.
0%, respectively (P=0.
55)
.

A total of 10 patients in the NLPHL subgroup relapsed, of which 8 patients received high-dose chemotherapy and autologous hematopoietic stem cell transplantation (ASCT) after recurrence
.

3 Research conclusions The research results show that when disease control is the main goal of treatment, eBEACOPP therapy under the guidance of PET-2 (PET-2 positive for 6 cycles; PET-2 negative for 4 cycles) can be used as young , An option for patients with advanced NLPHL
.

References: DA Eichenauer, S Kreissl, I Bühnen et al.
PET-2-guided escalated BEACOPP for advanced nodular lymphocyte-predominant Hodgkin lymphoma: a subgroup analysis of the randomized German Hodgkin Study Group HD18 study.
Ann Oncol.
2021 Jun;32 (6):807-810.
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