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Upfront VIP‐reinforced‐ABVD (VIP‐rABVD) is not superior to CHOP/21 in newly diagnosed peripheral T cell lymphoma. Results of the randomized phase III trial GOELAMS‐LTP95
Authors:Audrey Simon  Michel Peoch  Philippe Casassus  Eric Deconinck  Philippe Colombat  Bernard Desablens  Olivier Tournilhac  Houchingue Eghbali  Charles Foussard  Jerome Jaubert  Jean Pierre Vilque  Jean François Rossi  Virginie Lucas  Vincent Delwail  Antoine Thyss  Frederic Maloisel  Noel Milpied  Steven Le Gouill  Thierry Lamy  Rémy Gressin
Affiliation:1. Centre Hospitalo‐Universitaire (CHU) Grenoble;2. CHU Saint Etienne;3. CHU Avicenne, Bobigny;4. CHU Besan?on and Inserm U645 Besan?on University;5. CHU Tours;6. CHU Amiens;7. CHU Clermont‐Ferrand;8. Institut Bergonié, Bordeaux;9. CHU Angers;10. CHU, Reims;11. CHU, Montpellier;12. CH, Orléans;13. CHU, Poitiers;14. Centre de Lutte contre le Cancer Lacassagne, Nice;15. CHU, Strasbourg;16. CHU, Bordeaux;17. CHU, Nantes and Inserm UMR 892, Nantes University;18. CHU, Rennes;19. Team 7 INSERM‐ U823, Joseph Fourier University, Institut Albert Bonniot, Grenoble, France
Abstract:Peripheral T‐Cell lymphomas (PTCL) are relatively rare diseases but appear to be highly aggressive and display worse remission and survival rates than B‐cell lymphomas. Despite unsatisfactory results with the cyclophosphamide, doxorubicin, vincristine, prednisone (CHOP) regimen, it remains the reference front‐line therapy in these diseases, but has not been challenged in phase III trials. The Groupe Ouest Est d’Etude des Leucémies et Autres Maladies du Sang (GOELAMS) devised an alternative therapeutic schedule including etoposide, ifosfamide, cisplatin alternating with doxorubicin, bleomycin, vinblastine, dacarbazine (VIP‐reinforced‐ABVD; VIP‐rABVD) and compared it to CHOP/21 as front‐line treatment in non‐cutaneous PTCL. All newly diagnosed patients were eligible. The primary objective was to improve the 2‐year event‐free survival (EFS) rate. Secondary objectives were to compare the response rate, overall survival, and toxicities as well as identify prognostic factors. Eighty‐eight patients were identified between 1996 and 2002 . Both arms were well balanced for patients’ characteristics in terms of histological and clinical presentation. No significant difference was observed between the two arms in terms of 2‐year EFS. Anaplastic large cell lymphoma type and Ann Arbor stage I–II were identified as two independent favourable prognostic factors influencing survival. VIP‐rABVD was not superior to CHOP/21 in terms of EFS as first‐line treatment of PTCL, confirming that CHOP/21 remains the reference regimen in these lymphomas.
Keywords:T‐cell lymphoma  clinical trials  cyclophosphamide  doxorubicin  vincristine  prednisone (CHOP)
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