952P - Patients with Hodgkin's lymphoma have a significantly better outcome if treated within a clinical trial

Date 28 September 2014
Event ESMO 2014
Session Poster Display session
Topics Lymphomas
Bioethics, Legal, and Economic Issues
Presenter Alden Moccia
Citation Annals of Oncology (2014) 25 (suppl_4): iv327-iv339. 10.1093/annonc/mdu339
Authors A.A. Moccia, G. Wiebke, A. Stathis, F. Cavalli, M. Ghielmini, K. Aprile von Hohenstaufen, B. Vannata, E. Zucca
  • Department Of Medical Oncology, Oncology Institute of Southern Switzerland (IOSI), 6500 - Bellinzona/CH

Abstract

Aim

Clinical trials have led to a remarkable improvement of treatment outcome for patients with Hodgkin's lymphoma (HL) over the last 3 decades. Prognosis of patients enrolled in clinical trials may even be superior than the one of patients treated in the community. Since the mid 90ies, many patients with HL treated in our Institution have been prospectively included in the German Hodgkin Lymphoma Group (GHSG) trials. However, many other patients with HL have not been included in these trials for various reasons.

Methods

We performed a retrospective population-based analysis using the electronic lymphoma database of our Institution and included all patients with HL from January 1996 to December 2012. Primary endpoint was OS which was defined according to the NCI criteria and estimated by the method of Kaplan–Meier. The Cox proportional hazards model was used for the estimation of hazard ratio and its confidence interval in a multivariate analysis.

Results

172 patients were identified. Clinical characteristics at diagnosis were: median age 38 years, 54% male, 13% stage I, 56% stage II, 15% stage III, 16% stage IV, 40% B symptoms, 10% GHSG early stage, 40% GHSG early unfavorable stage and 50% had GHSG advanced stage. With a median follow-up of 5.6 years, the 5-year overall survival of the whole studied population was 79%. The rate of enrollment in the GHSG trials in our Institution was 24%; participation of patients younger than 40 years in randomized trials was significantly higher compared with those older than 40 years. Patients entered in clinical trials had a significantly better outcome irrespectively of age (p = 0.0047). The inclusion in a clinical study maintained its prognostic value at a multivariate analysis in a Cox model controlling for age and for the GHSG risk group.

Conclusions

This analysis suggests that patients enrolled in clinical trials may have a better outcome than patients with similar clinical characteristics at diagnosis. We plan to conduct a national survey in collaboration with the Swiss Cancer registries; the proposed research project may allow a better understanding of the different parameters behind this observation and their impact on treatment modalities and prognosis.

Disclosure

All authors have declared no conflicts of interest.