Efficacies and Toxicities of Seven Chemotherapy Regimens for Advanced Hodgkin Lymphoma

Fajun Pei; Yang Yu; Bin Dong; Hui Guan; Xinzhe Dong; Fen Zhao

doi:10.3389/fphar.2021.694545

Efficacies and Toxicities of Seven Chemotherapy Regimens for Advanced Hodgkin Lymphoma

Front Pharmacol. 2021 Nov 16:12:694545. doi: 10.3389/fphar.2021.694545. eCollection 2021.

Authors

Fajun Pei¹, Yang Yu^{2

3}, Bin Dong⁴, Hui Guan⁵, Xinzhe Dong⁶, Fen Zhao^{3

7}

Affiliations

¹ Department of Urology Surgery, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China.
² School of Graduate Studies, Shandong Academy of Medical Sciences, Shandong First Medical University, Jinan, China.
³ Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China.
⁴ Department of Medical Imaging, The First People's Hospital of Pingdu, Qingdao, China.
⁵ Department of Radiation Oncology, The Fourth People's Hospital of Jinan, Jinan, China.
⁶ Department of Radiation Oncology, Qilu Hospital of Shandong University, Jinan, China.
⁷ Shandong University, Jinan, China.

Abstract

Background/Aims: Hodgkin Lymphoma (HL) has become one of the most treatable cancers, with more than 80% patients in the advanced stage being cured through improvement of therapeutic regimens. Nevertheless, some treatments were accompanied with toxicities. Methods: In the current study, a network meta-analysis (NMA) was conducted to compare the efficacies and toxicities of different chemotherapy regimens for advanced Hodgkin lymphoma (HL). We reviewed PubMed and EMBASE databases from inception to May 2018, and identified randomized controlled trials (RCTs) in which advanced HL patients received chemotherapy. Fourteen eligible RCTs published between 1992 and 2017 were enrolled in this NMA. These studies included a total of 5,964 HL patients, and assessed at least one of seven different chemotherapy regimens. Direct and indirect evidence was combined to calculate odds ratios (ORs) and 95% confidence intervals (95% CIs), and to establish a surface under the cumulative ranking (SUCRA) curve. Results: A cluster analysis was performed to evaluate efficacies and toxicities of different regimens. The COPP + ABVD (cyclophosphamide + vincristine + procarbazine + prednisone + doxorubicin + bleomycin + vinblastine + dacarbazine) regimen had the highest SUCRA partial response and overall remission rate values, while the ABVD regimen resulted in the lowest incidences of anemia, thrombocytopenia, neutropenia, and leucopenia. Conclusion: Cluster analysis revealed that COPP + ABVD had the best efficacy against advanced HL among the seven regimens, and ABVD had the lowest toxicity.

Keywords: chemotherapy; efficacy; hodgkin lymphoma; network meta-analysis; randomized controlled trial.

Publication types

Review