Evaluating GVDex chemotherapy for patients with recurrent or persistent Hodgkin’s lymphoma

This study examined if GVDex is as effective and safe as GVDoxil for treating Hodgkin's lymphoma (HL) that has come back or stopped responding to treatment. The authors found that GVDex was as effective as GVDoxil, with fewer side effects.

For most patients with HL, primary therapy is highly effective. However, for 20 – 30% of patients, the cancer comes back (relapses) or stops responding to treatment (refractory). Relapsed or refractory HL is usually treated with salvage chemotherapy, followed by a stem cell transplant. Salvage therapy is the treatment of cancer that comes back after initial treatment.

There are several salvage chemotherapy regimens for relapsed or refractory HL. One regimen is called GVDoxil (gemcitabine, vinorelbine, doxorubicin). This regimen is effective, but it is associated with side effects and is expensive. Another regimen called GVDex replaces doxorubicin with dexamethasone (Decadron). Whether GVDex is as safe and effective as GVDoxil for patients with relapsed or refractory HL is unclear.

This study examined 48 patients with HL that came back or stopped responding to treatment. All patients received salvage chemotherapy with GVDex as either a first salvage treatment (28 patients) or a second salvage treatment (20 patients). Patients were followed-up for an average of 20 months.

Overall, 64% of patients responded to treatment with GVDex. 51% of patients had no signs of cancer after treatment, and 13% had tumor shrinkage.71% of patients who had GVDex as a first salvage responded to treatment. 50% of patients who had GVDex as a second salvage responded to treatment. 

19 patients (45%) met the criteria to receive a stem cell transplant after responding well to GVDex. Of these, 11 patients received more treatment after the transplant. 59% of patients who had the transplant are still alive and disease-free.

At follow-up, 54% of all patients were still alive after finishing treatment. 2 years later, 60% of all patients were still alive. 49% of patients did not have tumor growth or spread.

31% of patients experienced no side effects from GVDex. However, some patients did experience side effects. The most common ones were low white blood cell levels (43%), low white blood cell levels with fever (21%), and poor liver function (12%).

This study concluded that GVDex was effective for patients with HL that came back or stopped responding to treatment. The authors suggest that GVDex is just as effective as GVDoxil but with fewer side effects for these patients.

This study had a small number of patients and a short follow-up time. It was also conducted only in India, which may have influenced the results. Also, GVDoxil was not given to another group of patients as a source of comparison. More studies are needed to confirm these results.

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