Subscribe to RSS
DOI: 10.1055/s-0040-1701862
Clinical trial of Childhood, Adolescent and Young Adult Hodgkin Lymphoma in Japan
Publication History
Publication Date:
18 March 2020 (online)
Introduction Pediatric Hodgkin Lymphoma (HL) accounts for approximately 10-20% of lymphoma in pediatric patients, and the incidence of pediatric HL is lower in Japan than in Western countries. Here, we assess a multicenter, single-treatment trial (HL-14) that commenced in 2015 in Japan to determine the risk-adapted omission of radiation therapy for patients with negative fluorodeoxyglucose-positron emission tomography (FDG-PET) results, following an initial treatment response to combination chemotherapy.
Methods Patients with untreated HL aged <20 years at diagnosis are enrolled. The Japanese Pediatric Leukemia/Lymphoma Study Gropup, Japan Children’s Cancer Groupe (JPLSG, JCCG) HL-14 sudy will examine the effects of omitting radiation therapy if the FDG-PET findings after two completed cycles of combination chemotherapy are negative. Low-risk patients (stage IA, IB, and IIA) receive two cycles of OEPA (vincristine, etoposide, prednisolone, and doxorubicin) (boys) or OPPA (vincristine, procarbazine, prednisolone, and doxorubicin) (girls). Intermediate-risk patients (stage IEA, IEB, IIEA, IIB, and IIIA) receive two cycles of OEPA (boys) or OPPA (girls) and two cycles of COPDAC (cyclophosphamide, vincristine, prednisolone, and dacarbazine) (boys) or COPP (cyclophosphamide, vincristine, procarbazine, and prednisolone) (girls). High-risk patients (stage IIEB, IIIEA, IIIEB, IIIB, IVA, and IVB) receive two cycles of OEPA (boys) or OPPA (girls) and four cycles of COPDAC (boys) or COPP (girls). If the PET2 results are negative, no radiation therapy will be administered. All patients with positive PET2 results will receive involved-field, involved-site, or node radiation therapy (20–36 Gy) following the completion of chemotherapy.
Results Our trial is now ongoing.
Conclusion This trial aimed to determine, within the confines of safety, whether assessing treatment response using PET (which is highly sensitive and specific) was effective for Japanese. In our next study, we plan to assess the safety and treatment response of brentuximab vedotin, which is used to treat cases of relapse in Japan, in early induction therapy using evaluation with PET2.
#
-
References
- 1 Koga Y. et al., The effect of interim FDG-PET-guided response-adapted therapy in pediatric patients with Hodgkin’s lymphoma (HL-14): protocol for a phase II study. Acta Med Okayama 2018; 72 ( (04) : 437-440
- 2 Mauz-Korhoz C. , et al. Procarbazine-free OEPA-COPDAC chemotherapy in boys and standard OPPA-COPP in girls have comparable effectiveness in pediatric Hodgkin’s lymphoma: the GPOH-HD-2002 study,. J Clin Oncol 2010; 28 ( (23) : 3680-3686
- 3 Kurch L. , et al. Only strongly enhanced residual FDG uptake in early response PET (Deauville 5 or qPET ≥ 2) is prognostic in pediatric Hodgkin lymphoma: results of the GPOH-HD2002 trial,. Pediatr Blood Cancer 2019; 66 ( (03) : e27539
-
References
- 1 Koga Y. et al., The effect of interim FDG-PET-guided response-adapted therapy in pediatric patients with Hodgkin’s lymphoma (HL-14): protocol for a phase II study. Acta Med Okayama 2018; 72 ( (04) : 437-440
- 2 Mauz-Korhoz C. , et al. Procarbazine-free OEPA-COPDAC chemotherapy in boys and standard OPPA-COPP in girls have comparable effectiveness in pediatric Hodgkin’s lymphoma: the GPOH-HD-2002 study,. J Clin Oncol 2010; 28 ( (23) : 3680-3686
- 3 Kurch L. , et al. Only strongly enhanced residual FDG uptake in early response PET (Deauville 5 or qPET ≥ 2) is prognostic in pediatric Hodgkin lymphoma: results of the GPOH-HD2002 trial,. Pediatr Blood Cancer 2019; 66 ( (03) : e27539