Researchers at the Rutgers Cancer Institute in New Jersey, the state’s only NCI-designated Comprehensive Cancer Center and leading cancer program with Tufts Medical Center in Boston, developed and validated the Aadvanced stageHOdgkin’s lymphomaIinternationalPrognosticationIindex (A-HIPI). A-HIPI is a state-of-the-art clinical decision model for predicting five-year progression-free survival and overall survival in adults with advanced classical Hodgkin’s lymphoma using comprehensive patient data from international clinical trials and major prospective cancer registries. To improve the use of A-HIPI, the team developed an online calculator to help clinicians and patients estimate individualized prognosis. This work was published in theJournal of Clinical Oncology (DO I: https://ascopubs.org/doi/full/10.1200/JCO.22.02473) concurrently with an oral abstract presentation at the 2022 American Society of Hematology (ASH) Annual Meeting and Exposition.
For the past 25 years, the International Prognostic Score (IPS) has been the most commonly used risk stratification tool for patients with advanced Hodgkin’s lymphoma, however, more modern tools to help inform a treatment individualized and promote personalized cancer care is needed. Significant debate remains over the optimal treatment of patients with Hodgkin lymphoma in the modern era, in part because its treatment comes at a human cost, including an increased risk of late treatment-related effects such as secondary malignant neoplasms and cardiovascular diseases, a compromised quality of life for health. life and the potential loss of young lives.
A-HIPI is the inaugural work of the HoLISTIC (International Hodgkin’s Lymphoma Study for Individual Care) project, which draws on detailed multi-source individual patient data from more than 15,000 patients with Hodgkin’s lymphoma. The development of A-HIPI was carried out on eight recent phase 3 clinical trials conducted worldwide. External validation was performed from patients treated concurrently at four “real-world” Hodgkin’s lymphoma registries in North America and Australia.
HoLISTIC is led by Andrew M. Evens, DO, MBA, MSc, Associate Director of Clinical Services at Rutgers Cancer Institute and Medical Oncology System Director and Chief Oncology Officer, RWJBarnabas Health and Susan K. Parsons, MD, MRP , Medical Director of the Adolescent and Young Adult (AYA) Program and Research Director of the Center for Health Solutions at Tufts Medical Center, who are co-principal investigators of the work.
Through continued collaboration with clinical Hodgkin lymphoma experts, policy makers, statisticians, epidemiologists and patient advocates around the world, we are one step closer to improving individualized prognosis and personalized medicine for patients with of Hodgkin’s lymphoma at all ages and at all stages of the disease. Through HoLISTIC, we will continue to develop innovative, evidence-based decision support models to guide Hodgkin lymphoma patients, their families, and healthcare providers. »
Dr. Andrew M. Evens, DO, MBA, MSc, Associate Director of Clinical Services, Rutgers Cancer Institute
“The A-HIPI model is an exciting first step for the HoLISTIC consortium,” notes Dr. Parsons, who is also a professor of medicine and pediatrics at Tufts University School of Medicine. “The next phase of the project will be important as we extend the rigorous clinical modeling methodology to early-stage Hodgkin lymphoma and relapsed/refractory disease. We will also explore the impact of treatment selection and integrate PET imaging findings and important biological factors. in the model.” The researchers plan to synthesize all of this information into a comprehensive and robust clinical decision model that estimates the probability of cure, life expectancy, post-acute and late effects, and adjusted life expectancy. quality function for individual patients across various treatment options.
Dynamic and interactive decision support models generated by the HoLISTIC Consortium will guide patients and clinicians through the first diagnosis, relapse and survival, in addition to serving as a solid foundation for future analyzes of health outcomes, including patient preferences and cost of care. The authors note that limitations of the study include a lack of data in adults over 65 who were treated in the clinical trials used for model development. Efforts are underway to identify other sources of information about the elderly, as well as about younger patients (adolescents and young adults), who are also often underrepresented in adult clinical trials.