Will it be another 20 years before Hodgkin lymphoma patients benefit from BEACOPP therapy?

Volker Diehl and Andreas Engert

This article has no abstract so we have provided the first paragraph of the full text.

Hodgkin lymphoma (HL) has become one of the most curable malignancies in adults. Major success was achieved by vigorous improvement in radiation techniques and, more importantly, by the development of multiagent polychemotherapy. In the late 1960s, DeVita and coworkers were the first to pioneer the combination of mechlorethamine, vincristine, procarbazine and prednisone (MOPP)—one of the landmark events in modern oncology.¹ When this regimen was used in patients with advanced HL, more than 80% achieved remission, with approximately 50% alive at 5 years. In an attempt to find a non-crossresistant regimen, Bonadonna et al.² developed an approach using doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD), which had an improved antitumor efficacy and tolerability compared with MOPP. ABVD was initially regarded as 'European' in contrast to the US-developed MOPP. Surprisingly, it took nearly 20 years before ABVD finally replaced MOPP or MOPP-like regimens for the treatment of advanced HL. This was partly because the efficacy differences between these regimens were subtle, with 5-year overall survival of around 80% and 70%, and tumor-free survival of 60% and 50%, for ABVD and MOPP, respectively. ABVD produced less short-term and long-term toxicity, and is generally considered the 'gold standard' for the treatment of advanced HL.

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