Previous research has suggested that patients with classical Hodgkin lymphoma who are refractory to or relapse after first-line therapy may be more likely to be cured after receiving second-line salvage chemotherapy followed by autologous stem cell transplantation (ASCT) than after receiving standard-dose chemotherapy.1,2 High complete remission rates prior to ASCT have been shown to predict better long-term outcomes for patients with the condition.3 Researchers have investigated a number of combination therapy regimens as induction regimens prior to ASCT for refractory to or relapsed lymphoma, yielding pre-ASCT CR rates ranging from 20% to 54% and overall response rates (ORRs) of 60% to 80%.4<\/p>\n
A prospective multicenter single-arm phase 2 study also indicated that the combination of bendamustine, gemcitabine, and vinorelbine (BEGEV) as second-line chemotherapy before ASCT, in 59 patients with relapsed\/refractory (R\/R) classical Hodgkin lymphoma, resulted in a CR of 73% and ORR of 83%.5<\/p>\n
Now, updated 5-year results from that same study have confirmed the benefits, showing a CR rate of 75% and ORR of 83%.6 But experts cautioned that a randomized trial would be needed to determine whether the regimen is superior to other treatments.<\/p>\n
The update[d] 5-year results ofBEGEV (bendamustine, gemcitabine, vinorelbine) followed by autologous stem celltransplantation in patients with Hodgkin disease refractory or relapsing tofirst-line therapy confirm the significant data in terms of CR rate (75%) aswell as PFS (59%) and overall survival (78%), lead study author ArmandoSantoro, MD, director of the Cancer Center at Humanitas Research Hospital,Milan, said in an email.<\/p>\n
The trial involved 27 patientswith classical Hodgkin lymphoma who were refractory to and 32 patients whorelapsed after receiving 1 line of chemotherapy. The patients received 800 mg\/mgemcitabine on days 1 and 4, 20 mg\/ m vinorelbine on day 1, and 90 mg\/mbendamustine on days 2 and 3. The patients received 100 mg prednisolone on days1 to 4. They were given 4 cycles of BEGEV every 21 days.<\/p>\n
Those patients who experiencedcomplete response or partial response after completing the 4 cycles receivedmyeloablative therapy with carmustine, etoposide, cytarabine and melphalan orfotemustine, etoposide, cytarabine and melphalan, which preceded the reinfusionof CD341 cells.<\/p>\n
The researchers evaluated diseaseresponses before and after the fourth BEGEV cycle using computed tomography and18F-fluorodeoxyglucosepositron emission tomography scans accordingto the International Working Group response criteria.<\/p>\n
The treatment prompted CR in 44patients (75%) and partial response (PR) in 5 (8%), yielding an OR of 83%. Theauthors noted that the CR rate was higher than the 54% CR rate previouslyreported for the ifosfamide, gemcitabine, vinorelbine, and prednisolone (IGEV)regimen as well as other second-line chemotherapy-based salvage regimens.<\/p>\n
Of 49 patients who responded toBEGEV and were eligible for ASCT, 43 ended up receiving transplants. After 5years following BEGEV treatment, the PFS for all series was 59% and OS was 78%.More than 90% of patients were at high risk for relapse post-ASCT. At 5 years,33 patients who received transplants experienced continuous CR, 7 relapsed, and3 died due to unrelated factors that included pneumonia, infection, andmultiorgan failure. <\/p>\n
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BEGEV Salvage Regimen Linked to High Complete Remission Rates - Cancer Therapy Advisor<\/a><\/p>\n","protected":false},"excerpt":{"rendered":" Previous research has suggested that patients with classical Hodgkin lymphoma who are refractory to or relapse after first-line therapy may be more likely to be cured after receiving second-line salvage chemotherapy followed by autologous stem cell transplantation (ASCT) than after receiving standard-dose chemotherapy.1,2 High complete remission rates prior to ASCT have been shown to predict better long-term outcomes for patients with the condition.3 Researchers have investigated a number of combination therapy regimens as induction regimens prior to ASCT for refractory to or relapsed lymphoma, yielding pre-ASCT CR rates ranging from 20% to 54% and overall response rates (ORRs) of 60% to 80%.4 A prospective multicenter single-arm phase 2 study also indicated that the combination of bendamustine, gemcitabine, and vinorelbine (BEGEV) as second-line chemotherapy before ASCT, in 59 patients with relapsed\/refractory (R\/R) classical Hodgkin lymphoma, resulted in a CR of 73% and ORR of 83%.5 Now, updated 5-year results from that same study have confirmed the benefits, showing a CR rate of 75% and ORR of 83%.6 But experts cautioned that a randomized trial would be needed to determine whether the regimen is superior to other treatments. Continue reading