BEACOPP
BEACOPP is a chemotherapy regimen for treatment of Hodgkin's lymphoma developed by the German Hodgkin Study Group used for patients in Stages > II or early (IA or IB) with unfavorable risk factors.[1] Patients typically receive treatment in cycles of 21 days with no drugs given on days 15–21.[2] There also exists a more intensive regimen with cycles of 14 days. Usually a course of BEACOPP therapy consists of four, sometimes six to eight cycles, or in combination with ABVD. In some countries BEACOPP still is experimental, in others (e.g. Germany and Austria) it is a standard therapy. In the United States, ABVD (or Stanford V) is generally given instead, because BEACOPP was thought to induce more secondary neoplasias (such as leukemias), although the final results from the GHSG HD14 trial indicate that "there were no overall differences in treatment-related mortality or secondary malignancies" of BEACOPP relative to ABVD.[1]
Some consider that the BEACOPP regimen is not generally given in the US for cost reasons:
- Twice as many infusion per cycle relative to ABVD;
- Requirement for G-CSF support, which is still under patent protection as Neupogen by Amgen in the US until Dec. 12, 2013,[3] while Neupogen patent protection in the EU expired in 2008;[4]
- Higher likelihood of adverse events requiring hospitalization, such as infection or acute toxicity;
However, BEACOPP delivers approximately 7% points success relative to ABVD for early unfavorable Hodgkin's disease (as measured five-year freedom from treatment failure)[1] and 12% points greater success relative to ABVD for advanced Hodgkin's disease (Stage IIB with risk factors or stages III and IV) as measured by seven-year freedom from treatment failure.[5]
Predecessors of BEACOPP were COPP and (the earliest) MOPP.
Dosing regimen
| Drug | Base BEACOPP | Dose-Escalated BEACOPP | Method | Cycle Day |
| (B)leomycin | 10 mg/m² | 10 mg/m² | i.v. push | day 8 |
| (E)toposide | 100 mg/m² | 200 mg/m² | i.v. infusion | day 1–3 |
| (A)driamycin (doxorubicin) | 25 mg/m² | 35 mg/m² | i.v. push | day 1 |
| (C)yclophosphamide | 650 mg/m² | 1250 mg/m² | i.v. infusion | day 1 |
| (O)ncovin=Vincristine | 1.4 mg/m² (max 2 mg) | 1.4 mg/m² (max 2 mg) | i.v. infusion | day 8 |
| (P)rocarbazine | 100 mg/m² | 100 mg/m² | orally | day 1–7 |
| (P)rednisone | 40 mg/m² | 40 mg/m² | orally | day 1–14 |
References
- 1 2 3 von Tresckow, Bastian; et al. (March 20, 2012). "Dose-Intensification in Early Unfavorable Hodgkin’s Lymphoma: Final Analysis of the German Hodgkin Study Group HD14 Trial" (PDF). Journal of Clinical Oncology 30: 907–913. doi:10.1200/JCO.2011.38.5807. Retrieved 2013-01-24.
- ↑ See HD14 Redacted Trial Protocol, available at
- ↑ "Neupogen". Fierce Pharma. Retrieved 2013-01-24.
- ↑ "Amgen And Its Biosimilar Competitors". SeekingAlpha. Retrieved 2013-01-24.
- ↑ Viviani, Simonetta; et al. (July 21, 2011). "ABVD versus BEACOPP for Hodgkin’s Lymphoma When High-Dose Salvage Is Planned". New England Journal of Medicine 365 (3): 203–212. doi:10.1056/nejmoa1100340.