KEY TAKEAWAYS
- The study aimed to assess shorter prednisone treatment duration’s effect on AVN risk in eBEACOPP-treated patients with Hodgkin lymphoma.
- Researchers conclude that the shortening of the corticosteroid course in eBEACOPP for HL maintains efficacy; further investigation is ongoing.
eBEACOPP is the most effective chemotherapy regimen for younger patients with early unfavorable (EU) and advanced-stage (AS) Hodgkin lymphoma (HL), albeit with significant toxicities. The 14-day/cycle prednisone course contributes to side effects, including osteoarticular events like avascular bone necrosis (AVN). Their center has been using eBEACOPP since 2009 for AS and 2014 for EU patients. In 2016, they reduced prednisone treatment to 7-10 days to lessen AVN risk and analyzed the effects of this approach.
Ida Hude Dragičević and the team aimed to assess the impact of shortening the prednisone treatment duration to 7-10 days on AVN risk in patients receiving eBEACOPP for Hodgkin lymphoma.
They performed an inclusive analysis, retrospectively collecting data on patients who received at least two cycles of eBEACOPP for first-line (1L) treatment of Hodgkin lymphoma.
About 162 patients (33 EU, 129 AS), median age 31 (range 19-59 years), 88 males. 94 patients received full corticosteroid courses, 68 reduced. The overall response rate (ORR) was 98%. No significant effect of corticosteroid dosing on ORR, febrile neutropenia episodes, or hospital admissions. Median follow-up (mFU) 58 months. 5yPFS for the entire cohort: 98% vs. 95% for standard vs. short corticosteroids course (P = 0.37), 5yOS: 98% vs. 99% (P = 0.87).
In AS patients for six eBEACOPP cycles, 5yPFS and 5yOS: 100% vs. 97%, 100% vs. 99% (P = 0.56 and P = 0.17). In EU patients, 5yPFS: 97% (standard) vs. 95% (short) (P = 0.98), 5yOS: 100% vs. 93.3% (P = 0.87). Osteoarticular events numerically lower with shorter prednisone course but not statistically significant.
The study concluded that shortening the corticosteroid course in eBEACOPP treatment for HL does not compromise efficacy, potentially reducing toxicity. However, longer follow-ups and larger studies are needed for confirmation of these findings.
This study received no external funding.
Source: https://pubmed.ncbi.nlm.nih.gov/38541156/
Hude Dragičević I, Bašić-Kinda S, Markotić H, et al. (2024). “Reduced Corticosteroid Exposure Is Safe and Does Not Reduce Disease Control among Hodgkin Lymphoma Patients Treated with Escalated BEACOPP (eBEACOPP).” Medicina (Kaunas). 2024 Mar 2;60(3):430. doi: 10.3390/medicina60030430. PMID: 38541156; PMCID: PMC10972460.
