Contemporary clinical trials for newly diagnosed older HL patients*
| Author, year . | N . | Therapy . | Median age (years) . | Baseline GA and patient fitness . | Outcomes . | Febrile neutropenia . | Peripheral neuropathy (≥ grade 3) . | Treatment-related mortality rate . |
|---|---|---|---|---|---|---|---|---|
| Anthracycline-based chemotherapy +/− targeted therapy | ||||||||
| Evens 201819 | 48 | Brentuximab vedotin sequentially with AVD | 69 | Median CIRS-G 7 (31% ≥ 10); 14% pts loss IADL | 2-yr PFS 84% 2-yr OS 93% | 8% | 4% | 2% |
| Boll 201861 | 49 | Brentuximab vedotin + CAP (concurrent) | 66 | Limited GA; all pts CIRS-G ≤6 | 1-yr PFS 74% 1-yr OS 93% | 27% | 0% | 2% |
| Boll 201960 | 25 | Lenalidomide + AVD (concurrent) | 67 | Limited GA; all pts CIRS-G ≤7 (mean 2) | 3-yr PFS 70% 3-yr OS 84% | 4% | NR | NR |
| Salvi 201957 | 47 | MBVD | 75 | Limited GA; CIRS-G grade 3/4 in 11% | 3-yr PFS 43% 3-yr OS 70% | 6.3% | NR | 6.4% |
| Ghesquieres 202158 | 89 | PVAB | 68 | Limited GA; median CIRS-G 3 | 4-yr PFS 50% 4-year OS 69% | NR | NR | NR |
| Evens 202259 | 84 | A+AVD (concurrent) | 68 | ND | 2-yr PFS 70% 2-yr OS ~85% | 37% | 18% | 3.6% |
| 102 | ABVD | 66 | ND | 2-yr PFS 71% 2-yr OS ~85% | 17% | 3% | 5.1% | |
| Torka 202364 | 40 | N+AVD (concurrent) | 66 | Median scores: ADL 83, IADL 14, TUG 11.5 sec | 2-yr PFS 86% 2-yr OS 96% | 8% | 0% | 0% |
| Wilson 202362 | 41 | ACOPP** | 74 | Limited GA; median CIRS-G 5 | 2-yr PFS 73% 2-yr OS 94% | 15% | 0% | 2% |
| Targeted therapy +/− low-intensity chemotherapy | ||||||||
| Forero-Torres 201565 | 27 | Brentuximab vedotin | 78 | 7% loss IADL; 30% ≥ 1 fall; TUG >13.5 sec in 48% | 2-yr PFS ~25% 2-yr OS ~70% | 0% | 26% | NR |
| Friedberg 201766 | 21 | Brentuximab vedotin + DTIC | 69 | 20% loss IADL; 26% ≥ 1 fall; TUG >13.5 sec in 70% | 2-yr PFS ~45% 2-yr OS ~90% | 5% | 27% | 0% |
| Gibb 202067 | 35 | Brentuximab vedotin | 77 | Limited GA, median CIRS-G 6 | 2-yr PFS 7% 2-yr OS 42% | 0% | ~10% | 3% |
| Yasenchak 202066 | 42 | Brentuximab vedotin + nivolumab | 72 | NR | 2-yr PFS ~60% 2-yr OS ~90% | NR | 33% | 0% |
| Cheson 202068 | 46 | Brentuximab vedotin + nivolumab | 72 | ND | 2-yr PFS ~40% 2-yr OS NR | 0% | 11% | 2% |
| Lazarovici 202169 | 64 | Nivolumab +/- vinblastine | 78 | Median CIRS-G 10; median G8 score 12.5 | 2-yr PFS ~20% 2-yr OS 77% | 0% | 0% | 3% |
| Dickinson 202370 | 25 | Pembrolizumab | 77 | Limited GA; median CIRS-G 7 | 2-yr PFS ~15% 2-yr OS 83% | 0% | 0% | 0% |
| Author, year . | N . | Therapy . | Median age (years) . | Baseline GA and patient fitness . | Outcomes . | Febrile neutropenia . | Peripheral neuropathy (≥ grade 3) . | Treatment-related mortality rate . |
|---|---|---|---|---|---|---|---|---|
| Anthracycline-based chemotherapy +/− targeted therapy | ||||||||
| Evens 201819 | 48 | Brentuximab vedotin sequentially with AVD | 69 | Median CIRS-G 7 (31% ≥ 10); 14% pts loss IADL | 2-yr PFS 84% 2-yr OS 93% | 8% | 4% | 2% |
| Boll 201861 | 49 | Brentuximab vedotin + CAP (concurrent) | 66 | Limited GA; all pts CIRS-G ≤6 | 1-yr PFS 74% 1-yr OS 93% | 27% | 0% | 2% |
| Boll 201960 | 25 | Lenalidomide + AVD (concurrent) | 67 | Limited GA; all pts CIRS-G ≤7 (mean 2) | 3-yr PFS 70% 3-yr OS 84% | 4% | NR | NR |
| Salvi 201957 | 47 | MBVD | 75 | Limited GA; CIRS-G grade 3/4 in 11% | 3-yr PFS 43% 3-yr OS 70% | 6.3% | NR | 6.4% |
| Ghesquieres 202158 | 89 | PVAB | 68 | Limited GA; median CIRS-G 3 | 4-yr PFS 50% 4-year OS 69% | NR | NR | NR |
| Evens 202259 | 84 | A+AVD (concurrent) | 68 | ND | 2-yr PFS 70% 2-yr OS ~85% | 37% | 18% | 3.6% |
| 102 | ABVD | 66 | ND | 2-yr PFS 71% 2-yr OS ~85% | 17% | 3% | 5.1% | |
| Torka 202364 | 40 | N+AVD (concurrent) | 66 | Median scores: ADL 83, IADL 14, TUG 11.5 sec | 2-yr PFS 86% 2-yr OS 96% | 8% | 0% | 0% |
| Wilson 202362 | 41 | ACOPP** | 74 | Limited GA; median CIRS-G 5 | 2-yr PFS 73% 2-yr OS 94% | 15% | 0% | 2% |
| Targeted therapy +/− low-intensity chemotherapy | ||||||||
| Forero-Torres 201565 | 27 | Brentuximab vedotin | 78 | 7% loss IADL; 30% ≥ 1 fall; TUG >13.5 sec in 48% | 2-yr PFS ~25% 2-yr OS ~70% | 0% | 26% | NR |
| Friedberg 201766 | 21 | Brentuximab vedotin + DTIC | 69 | 20% loss IADL; 26% ≥ 1 fall; TUG >13.5 sec in 70% | 2-yr PFS ~45% 2-yr OS ~90% | 5% | 27% | 0% |
| Gibb 202067 | 35 | Brentuximab vedotin | 77 | Limited GA, median CIRS-G 6 | 2-yr PFS 7% 2-yr OS 42% | 0% | ~10% | 3% |
| Yasenchak 202066 | 42 | Brentuximab vedotin + nivolumab | 72 | NR | 2-yr PFS ~60% 2-yr OS ~90% | NR | 33% | 0% |
| Cheson 202068 | 46 | Brentuximab vedotin + nivolumab | 72 | ND | 2-yr PFS ~40% 2-yr OS NR | 0% | 11% | 2% |
| Lazarovici 202169 | 64 | Nivolumab +/- vinblastine | 78 | Median CIRS-G 10; median G8 score 12.5 | 2-yr PFS ~20% 2-yr OS 77% | 0% | 0% | 3% |
| Dickinson 202370 | 25 | Pembrolizumab | 77 | Limited GA; median CIRS-G 7 | 2-yr PFS ~15% 2-yr OS 83% | 0% | 0% | 0% |
Since 2018; minimum 20 patients; **retrospective.
A+AVD, brentuximab vedotin, doxorubicin, vinblastine, dacarbazine; ABVD, doxorubicin, bleomycin, vinblastine, and dacarbazine; ACOPP, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisolone; ADL, activities of daily living; AVD, doxorubicin, vinblastine, dacarbazine; CAP, cyclophosphamide, doxorubicin, prednisone; CIRS-G, cumulative illness rating score-geriatric; DTIC, dacarbazine; ECOG, Eastern Cooperative Oncology Group performance status; G8, geriatric 8 score; GA, geriatric assessment; IADL, instrumental activities of daily living; KPS, Karonfsky performance scale; MBVD, nonpegylated liposomal doxorubicin (myocet), bleomycin, vinblastine, dacarbazine; mPFS, modified progression-free survival; N+AVD, ; ND, not done; NR, not reported; OS, overall survival; PFS, progression-free survival; pts, patients; PVAB, prednisone, vinblastine, doxorubicin, bendamustine; PVAG (prednisone, vinblastine, doxorubicin, and gemcitabine); sec, seconds; TUG, timed up and go.