Tag: Hodgkin Lymphoma

Can PET-CT Scans be used to Guide the Treatment of Advanced Hodgkin Lymphoma?

Lisa Roth, MD
Lisa Roth, MD

By Lisa Roth, MD

The New England Journal of Medicine recently published results from a study where researchers used positron-emission tomography-computed tomography (PET-CT) scans to guide treatment for patients with advanced Hodgkin lymphoma. The chemotherapy used to treat Hodgkin lymphoma can be associated with long-term health risks including toxicity in the lungs as a result of the chemotherapy agent bleomycin. Decreasing the risk of long-term toxicity is especially important in Hodgkin lymphoma where the majority of patients will be cured of their disease and their long term quality of life heavily factors into treatment decisions.

In this study patients were treated with 2 cycles of the chemotherapy regimen ABVD, which includes bleomycin. After 2 cycles of ABVD patients underwent a PET-CT scan. Patients who had a positive PET scan received more intensive therapy with the BEACOPP chemotherapy regimen. Patients who had a negative PET-CT were randomly assigned to continue treatment with ABVD or receive AVD, which does not include bleomycin. The outcomes of the ABVD and AVD groups were compared.

A total of 1,214 patients enrolled in this trial and the majority (83.7%) had a negative PET-CT after two cycles of ABVD. The statistical analysis comparing the group receiving ABVD with the group receiving AVD was designed to determine if AVD was not inferior to ABVD non-inferiority. Although the data fell just short of demonstrating non-inferiority, the difference in outcome between the AVD and ABVD groups was minimal (1.6%). Importantly, the risk of lung toxicity was higher in the group of patients who continued to receive ABVD.

This data suggests that omitting bleomycin in the treatment of patients with advanced Hodgkin lymphoma, who have a negative PET-CT after 2 cycles of ABVD, decreases the risk of lung toxicity without significantly increasing the risk of relapse.

New Clinical Trial: A Phase 1 Study to Assess Safety/Tolerability of REGN1979 & REGN2810 in Patients with B-Cell Malignancies

The Weill Cornell Medicine Lymphoma Program has recently opened a new clinical trial for men and women with B-cell non-Hodgkin lymphoma. The study sponsor is Regeneron Pharmaceuticals, Inc., and the principal investigator at Weill Cornell is Sarah Rutherford, M.D. For more information about the study, please call Rita Gazivoda, RN at 212-746-0702 or e-mail Rita at rig9021@med.cornell.edu.

Key Eligibility

  • Men and women age 18 and older with either B-cell non-Hodgkin lymphoma with active disease that is either refractory to or relapsed after most recent prior therapy for whom no standard of care options exist or documented Hodgkin lymphoma with active disease not responsive to prior therapy or relapsed after prior therapy for whom no standard of care options exist.
  • Detailed eligibility reviewed when you contact the study team.

Study Summary

This clinical trial is for men and women with lymphoma for whom no standard of care options exist. Currently available treatments for lymphoma are effective in some patients, however, other patients experience relapse or refractory disease following treatment. Therefore, there is a need to find more effective treatments when patients fail to respond to existing standard of care options. Patients will be administered REGN2810 intravenously every 2 weeks at a specified dose level. Patients will receive REGN2810 for a minimum of 12 doses (24 weeks) and up to a maximum of 24 doses (48 weeks). Upon completion of treatment, there will be a 24-week follow-up period. Patients will continue on treatment as long as they are responding to therapy and not experiencing unacceptable side effects.

Clinical Trial Participation May Improve Outcomes for Patients with Lymphoma

Picture1By Peter Martin, M.D.

Recently researchers from the Mayo Clinic presented data at the 2016 ASCO annual meeting suggesting that clinical trial participation might be associated with a survival benefit. The researchers used the Mayo Clinic Lymphoma Database to identify patients with relapsed Hodgkin lymphoma (HL), diffuse large B-cell lymphoma (DLBCL), or relapsed mantle cell lymphoma (MCL), and compared the characteristics and outcomes of those enrolled in clinical trials versus those who were eligible, but not enrolled in clinical trials. Between January 2001 and December 2014, 340 patients with DLBCL, 159 with MCL, and 115 patients with HL were identified. Over this same period 47 unique Phase 1-3 trials led to the FDA approval of 17 treatments.

94 of 340 (27%) DLBCL, 63 of 159 (41%) MCL and 66 of 115 (57%) HL patients were enrolled on a clinical trial at some point during therapy, with 38% of patients enrolled in more than 1 study. Researchers found that the median survival of patients treated in a clinical trial was roughly twice as long as patients not treated on a clinical trial in all 3 lymphoma subtypes. There are several possible sources of bias or confounding that might explain the difference, despite the researchers’ efforts to control for these variables. Clearly, more research in this areas is indicated. Nonetheless, the magnitude of benefit was striking and should be reassuring to patients considering clinical trial participation.