Among patients with advanced-stage classical Hodgkin lymphoma (cHL) receiving ABVD chemotherapy, PET performed after the first two treatment cycles (PET-2) has prognostic value. However, 15% of patients with a negative PET-2 will experience treatment failure. Here we prospectively evaluated serum thymus and activation-regulated chemokine (TARC) levels, to improve risk assessment in patients treated according to HD0607 PET-driven trial (#NCT00795613). In 266 patients with available serum samples, who have agreed to participate in a sub-study for assessment of the role of TARC monitoring, serum TARC levels were measured at baseline and at time of PET-2 by commercially available ELISA test kits. The primary end-point was to evaluate the association between TARC after 2 ABVD cycles and PFS. Median TARC-2 values were significantly higher in PET-2-positive patients compared to PET-2-negative patients (P = .001), and in patients with treatment failure compared to those in continuous CR (P = .01). The 4-year PFS significantly differed between patients with TARC-2 > 800 pg/mL vs ≤800 pg/mL (64% vs 86%, P = .0001). Moreover, among PET-2-negative patients, elevated TARC-2 identified those with a worse prognosis (74% vs 89%; P = .01). In multivariable analysis, TARC-2 > 800 pg/mL was a significant independent predictor of PFS in the whole study population (HR 2.39, P = .004) and among the PET-2-negative patients (HR 2.49, P = .02). In conclusion, our results indicate that TARC-2 serum levels above 800 pg/mL suggest the need for a stringent follow-up in PET-2-negative patients, and the evaluation of new drugs in PET-2-positive, who will likely fail to respond to intensification with escalated BEACOPP. This article is protected by copyright. All rights reserved.

Early Serum TARC Reduction Predicts Prognosis in Advanced-Stage Hodgkin Lymphoma Patients Treated with a PET-Adapted Strategy / S. Viviani, A. Mazzocchi, C. Pavoni, F. Taverna, A. Rossi, C. Patti, A. Romano, L. Trentin, R. Sorasio, A. Guidetti, D. Gottardi, C. Tarella, M. Cimminiello, R. Zanotti, L. Farina, A.J.M. Ferreri Ajm, M. Galbiati, P. Corradini, A.M. Gianni, A. Gallamini, A. Rambaldi. - In: HEMATOLOGICAL ONCOLOGY. - ISSN 0278-0232. - (2020). [Epub ahead of print]

Early Serum TARC Reduction Predicts Prognosis in Advanced-Stage Hodgkin Lymphoma Patients Treated with a PET-Adapted Strategy

F. Taverna;A. Guidetti;C. Tarella;P. Corradini;A. Rambaldi
Ultimo
2020

Abstract

Among patients with advanced-stage classical Hodgkin lymphoma (cHL) receiving ABVD chemotherapy, PET performed after the first two treatment cycles (PET-2) has prognostic value. However, 15% of patients with a negative PET-2 will experience treatment failure. Here we prospectively evaluated serum thymus and activation-regulated chemokine (TARC) levels, to improve risk assessment in patients treated according to HD0607 PET-driven trial (#NCT00795613). In 266 patients with available serum samples, who have agreed to participate in a sub-study for assessment of the role of TARC monitoring, serum TARC levels were measured at baseline and at time of PET-2 by commercially available ELISA test kits. The primary end-point was to evaluate the association between TARC after 2 ABVD cycles and PFS. Median TARC-2 values were significantly higher in PET-2-positive patients compared to PET-2-negative patients (P = .001), and in patients with treatment failure compared to those in continuous CR (P = .01). The 4-year PFS significantly differed between patients with TARC-2 > 800 pg/mL vs ≤800 pg/mL (64% vs 86%, P = .0001). Moreover, among PET-2-negative patients, elevated TARC-2 identified those with a worse prognosis (74% vs 89%; P = .01). In multivariable analysis, TARC-2 > 800 pg/mL was a significant independent predictor of PFS in the whole study population (HR 2.39, P = .004) and among the PET-2-negative patients (HR 2.49, P = .02). In conclusion, our results indicate that TARC-2 serum levels above 800 pg/mL suggest the need for a stringent follow-up in PET-2-negative patients, and the evaluation of new drugs in PET-2-positive, who will likely fail to respond to intensification with escalated BEACOPP. This article is protected by copyright. All rights reserved.
Advanced stage; Biomarker; Hodgkin Lymphoma; PET-2; PET-adapted strategy; TARC
Settore MED/15 - Malattie del Sangue
Settore MED/36 - Diagnostica per Immagini e Radioterapia
30-giu-2020
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2434/755188
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