A decade of combination chemotherapy of advanced Hodgkin's disease

Abstract

In 1963, prompted by the early success of the use of combinations of drugs for the treatment of acute childhood leukemia, a pilot study was performed using combinations of drugs in Hodgkin's disease (vinca alkaloids, alkylating agents, prenisone, and methotrexate). The results were encouraging enough to lead to an expanded program substituting procarbazine for methotrexate. This combined drug program (MOPP) 9 years later has yielded results significantly different than those previously achieved with single agents. The results of this program and of several other studies employing combinations of effective drugs consistently show a higher rate of induction of complete remissions in patients with advanced Hodgkin's disease (80%) and prolongation of remission duration after all therapy is stopped (36 months). These results have been confirmed in several cooperative trials. With a doubling or tripling of the complete remission rate and an eight to tenfold increase in remission duration after therapy is stopped, it is no surprise that survival appears prolonged over what was obtainable in the past using single agents. Data from the NCI show that approximately 70% of the patients with Stages III and IV disease who achieved remission with combination chemotherapy, between 1964 and 1967, are alive at 5 and 6 years. Forty‐one per cent of complete responders have remained continuously free of disease with no further treatment up to 6 years. The complete remission rate alone should not be used to judge the effectiveness of new treatment programs. These therapies should also be evaluated by their ability to produce a long disease‐free interval when all therapy is stopped. Copyright © 1972 American Cancer Society