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Real-World Adherence to NCCN Guidelines in Advanced Classical Hodgkin Lymphoma

 

Christopher Yasenchak, MD, Willamette Valley Cancer Institute and Research Center/US Oncology Research, Eugene, Oregon, discusses real-world adherence to National Comprehensive Cancer Network (NCCN) Guidelines regarding PET/CT usage and reported Deuville scores in advanced stage classical Hodgkin lymphoma.

This study was presented at the virtual 62nd American Society of Hematology (ASH) Annual Meeting.

Transcript

Hi, I'm Christopher Yasenchak, medical oncologist at the Willamette Valley Cancer Institute, Associate Chair for Hematology Research with US Oncology Research.

I'd like to discuss our poster on PET utilization and Deauville score reporting in stage III and IV classical Hodgkin lymphoma. PET utilization in classical Hodgkin lymphoma is important for staging, at interim response, and at the end of therapy.

This study was performed as a retrospective observational chart review within the US Oncology Network between January, 2017 and January, 2020. Specific goal was to review usage of PET utilization and Deauville score reporting in patients treated with either ABVD, A+AVD, or escalated BEACOPP in the frontline setting.

262 patients were identified in this study. 194 received ABVD, 66 A+AVD, and 2 BEACOPP. Baseline PET imaging was performed in 86% of the patients, interim PET imaging to assess for response performed in 78% of patients. That being said, 60% of those patients with interim PET did not have a formal Deauville score reported.

Why is this important? A Deauville score 1-3 would be considered negative, 4 and 5 would be considered positive. We now live in the era of response-adapted therapy, and patients with a positive PET scan after two cycles of ABVD have a progression-free survival of roughly 13%, which would indicate that adjustments in therapy are required.

I think the results of this study largely show that PET scans are being performed in the community, with an intent for response-adapted therapy. That being said, there is an opportunity to educate oncologists and radiologists on the importance of consistently reporting Deauville scores to ensure treatment modifications are optimized.


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