A novel clinical prediction model appears to be effective at determining patient prognosis in advanced-stage classical Hodgkin lymphoma (cHL), according to research published in the Journal of Clinical Oncology.
The International Prognostic Score (IPS), which was originally developed by the German Hodgkin Study Group, uses a 7-point scoring system (IPS7) among patients with newly diagnosed advanced disease. This scoring system was designed to be prognostic for 5-year overall survival (OS).
The authors of the present paper noted that this test has been effective at determining 5-year prognosis over the past 25 years, though, the authors claim, revisions are necessary. This is for several reasons, including improved cHL therapeutic options and management, and improved technological sophistication for determining disease prognosis.
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The Hodgkin Lymphoma International Study for Individual Care (HoLISTIC) consortium was formed in 2018 to evaluate how individual patient data from phase 3 cHL clinical trials may be used to create an updated prognostic model in this patient population. For this study, researchers evaluated whether, building upon the IPS, the Advanced-stage cHL International Prognostication Index (A-HIPI) would be effective at predicting 5-year OS and progression-free survival (PFS) in the newly diagnosed, advanced-stage cHL setting.
Overall, data from 4022 and 1431 patients were included in the study’s development and validation phases, respectively. In the development and validation phases, the median ages were 33 and 32 years, respectively, 45.5% and 43.5% of patients were female sex, and 33.5% and 32.7% of patients had stage IV disease. The most common overall histology was nodular sclerosis.
Analysis showed that the 5-year Kaplan-Meier estimates for PFS and OS were 0.77 and 0.92, respectively. Variables that appeared to predict for PFS and OS included age, sex, disease stage and bulk, absolute lymphocyte count, hemoglobin, and albumin. The relationship between age and absolute lymphocyte and clinical outcomes was nonlinear, however.
Further analysis of the validation cohort showed good discrimination and calibration, both in the internal and external settings. The novel model also appeared to better predict PFS and OS than did the IPS.
“Collectively, the multisource modeling approach herein may also inform the development of similar methods, treatment models, and analytic algorithms for other cancers and diseases,” the authors wrote in their report.
Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, or device companies. Please see the original reference for a full list of authors’ disclosures.
Reference
Rodday AM, Parsons SK, Upshaw JN, et al. The Advanced-Stage Hodgkin Lymphoma International Prognostic Index: development and validation of a clinical prediction model from the HoLISTIC consortium. J Clin Oncol. Published online December 10, 2022. doi:10.1200/JCO.22.02473
