News | PET Imaging | April 13, 2016

PET Scans Guiding Chemo Boost Remission for Hodgkin Patients

Treatment approach tested in first large-scale U.S. trial

PET, Hodgkin lymphoma, chemotherapy, remission, U.S. trial

April 13, 2016 — Using positron emission tomography (PET) to guide chemotherapy treatment significantly increases the number of people with advanced Hodgkin lymphoma who go into remission, according to new research. The study, conducted by SWOG and two other National Cancer Institute research groups, also found PET guidance decreases toxic side effects.

The Journal of Clinical Oncology published results of the clinical trial on April 11, along with an editorial. Oliver Press, M.D., Ph.D., a SWOG member at Fred Hutchinson Cancer Research Center and the lead author of the JCO article, said the study is exciting because it is the first large-scale U.S. trial to test this treatment approach with people with Hodgkin lymphoma, a cancer of the immune system that struck an estimated 9,050 Americans last year.

“The goal of cancer treatment is to cure as many people as possible with as little toxicity as possible,” said Press, the acting director of the Clinical Research Division and the acting senior vice president of Fred Hutch and a professor of medicine at University of Washington. “We found a promising way to do that by tailoring treatment to Hodgkin patients, an approach which could lead to a new standard of care.”

Doctors routinely use PET scans to detect cancer. In this study, they used this form of medical imaging to help treat cancer, too. Investigators tested “response-adapted therapy” with Stage III and IV Hodgkin patients — people whose cancer had spread throughout their lymphatic system and often into other parts of their body. These patients have the lowest chance for recovery.

Researchers recruited 358 Hodgkin patients to the trial and were able to evaluate 331 of them. All trial volunteers were given two rounds of ABVD, the standard, four-drug chemotherapy regimen used to treat Hodgkin patients after diagnosis. Then everyone received a PET scan to gauge response to the initial treatment. If the scan was negative, and the cancer appeared to be gone, this group received a final four cycles of ABVD.

Patients whose scan was positive, however, were given six cycles of a chemotherapy regimen called eBEACOPP, a seven-drug combination used in Europe. This treatment is both powerful and harmful. Some Europeans who’ve received eBEACOPP treatment became infertile, sustained heart or lung damage, and sometimes were put at greater risk of secondary cancers such as leukemia.

Typically, if a Hodgkin patient’s initial ABVD treatment fails and they continue taking the drug, about 15 to 30 percent are cancer-free after two years. However, 64 percent of the SWOG trial patients who received the eBEACOPP treatment after getting a negative scan were cancer-free after two years, more than double the sustained remission rate.

“What’s also important is that only 20 percent of the patients in our trial were exposed to eBEACOPP — which means they weren’t exposed to its bad effects,” said Jonathan Friedberg, M.D., a longtime SWOG member and the director of the James P. Wilmot Cancer Institute at the University of Rochester Medical Center. “That’s important because many people diagnosed with Hodgkin lymphoma are in their 20s and 30s and want to have children. This response-adapted therapy would ensure that the people who need the more toxic drugs receive them— and would spare others from infertility and serious toxicities.”

SWOG managed the trial with support from the Alliance for Clinical Trials in Oncology and ECOG-ACRIN. All three groups enrolled patients to the trial, and Alliance experts read all PET scans centrally to ensure consistency. Researchers from the NCI’s AIDS Malignancy Consortium also participated. SWOG, the Alliance, and ECOG-ACRIN are part of the NCI’s National Clinical Trials Network.

The NCI provided the majority of funding for the study. The David and Patricia Giuliani Family Foundation, the Lymphoma Foundation, the Adam Spector Fund for Hodgkin Research, and the Ernest & Jeanette Dicker Charitable Foundation provided additional support. A National Institutes of Health’s American Recovery and Reinvestment Act grant supported some of the PET imaging.

For more information: www.jco.ascopubs.org

Related Content

DOSIsoft Receives FDA 510(k) Clearance for Planet Onco Dose Software
Technology | Information Technology | June 20, 2019
DOSIsoft announced it has received 510(k) clearance from the U.S. Food and Drug Administration (FDA) to market Planet...
Bay Labs Announces New Echocardiography Guidance Software Data at ASE 2019 Scientific Sessions
News | Cardiovascular Ultrasound | June 20, 2019
Bay Labs announced that new data on the company’s first-of-its-kind deep learning investigational guidance software...
United Imaging Announces First U.S. Clinical Install of uMI 550 Digital PET/CT System
News | PET-CT | June 19, 2019
United Imaging announced the first U.S. clinical installation of the uMI 550 Digital positron emission tomography/...
LVivo EF Comparable to MRI, Contrast Echo in Assessing Ejection Fraction
News | Cardiovascular Ultrasound | June 19, 2019
DiA Imaging Analysis announced the presentation of two studies assessing the performance and accuracy of the company's...
New Data Demonstrates Safety Profile of GammaTile Therapy for Various Brain Tumors
News | Brachytherapy Systems | June 18, 2019
GT Medical Technologies Inc. announced the presentation of clinical data from a prospective study of GammaTile Therapy...
Black Men Less Likely to Adopt Active Surveillance for Low-Risk Prostate Cancer
News | Prostate Cancer | June 17, 2019
A new study reveals black men are less likely than white men to adopt an active surveillance strategy for their...
International Working Group Releases New Multiple Myeloma Imaging Guidelines

X-ray images such as the one on the left fail to indicate many cases of advanced bone destruction caused by multiple myeloma, says the author of new guidelines on imaging for patients with myeloma and related disorders. Image courtesy of Roswell Park Comprehensive Cancer Center.

News | Computed Tomography (CT) | June 17, 2019
An International Myeloma Working Group (IMWG) has developed the first set of new recommendations in 10 years for...
A high-fidelity 3-D tractography of the left ventricle heart muscle fibers of a mouse

Figure 1. A high-fidelity 3-D tractography of the left ventricle heart muscle fibers of a mouse from Amsterdam Ph.D. researcher Gustav Strijkers.

News | Magnetic Resonance Imaging (MRI) | June 07, 2019
The Amsterdam University Medical Center has won MR Solutions’ Image of the Year 2019 award for the best molecular...
BGN Technologies Introduces Novel Medical Imaging Radioisotope Production Method
News | Radiopharmaceuticals and Tracers | June 05, 2019
BGN Technologies, the technology transfer company of Ben-Gurion University (BGU), introduced a novel method for...
RefleXion Opens New Manufacturing Facility for Biology-guided Radiotherapy Platform
News | Radiation Therapy | May 31, 2019
RefleXion Medical recently announced the opening of its new manufacturing facility at its headquarters in Hayward,...