For patients with classical Hodgkin lymphoma (cHL), what is the comparative effectiveness of standard chemotherapy versus inhibitors of activated signaling pathways (such as Jak-STAT)?

Briefly describe a specific question, or set of related questions, about a health care test or treatment that this program should consider.: For patients with classical Hodgkin lymphoma (cHL), what is the comparative effectiveness of standard chemotherapy versus inhibitors of activated signaling pathways (such as Jak-STAT)?
Does your question include a comparison of different health care approaches? (If no, your topic will still be considered.): yes
If yes, explain the specific technologies, devices, drugs, or interventions you would like to see compared:: ABVD (Doxorubicin, Bleomycin, Vinblastine, Dacarbazine) and IRT (involved field radiation) Vs Curcumin and IRT
What patients or group(s) of patients does your question apply to? (Please include specific details such as age range, gender, coexisting diagnoses, and indications for therapy.): Age: 10-80y Gender: Male or female Coexisting Diagnoses: any Indications: classical Hodgkin lymphoma
Are there subgroups of patients that your question might apply to? (For example, an ethnic group, stage or severity of a disease.): Classical Hodgkin lymphoma, Nodular sclerosis (NS) subtype
Describe the health-related benefits you are interested in. (For example, improvements in patient symptoms or problems from treatment or diagnosis.): Reduction of tumor burden and improvements in patient's B symptoms
Describe any health-related risks, side effects, or harms that you are concerned about.

Does your question include a health care drug, intervention, device, or technology available (or likely to be available) in the U.S.?

yes

Which priority area(s) and population(s) does this topic apply to? (check all that apply)

EHC Priority Conditions (updated in 2008)

AHRQ Priority Populations

Federal Health Care Program

Describe why this topic is important.: The standard chemotherapeutic regimen in cHL is associated with secondary malignancies and chemorefractoriness.
What specifically motivated you to ask this question? (For example, you are developing a clinical guideline, working with a policy with large uncertainty about the appropriate approach, costly intervention, new research you have read, items in the media you may have seen, a clinical practice dilemma you know of, etc.): I would like to develop a clinical guideline that incorporates cell signaling pathway inhibitor as part of the therapeutic intervention. Our data shows that Hodgkin lymphoma cells upregulated the Jak-STAT pathway. This is supported by the a recent study (reported in International Journal of Cancer 2008, 123, 56-65) which shows curcumin triggers cell death in Hodgkin lymphoma cells.
Does your question represent uncertainty for clinicians and/or policy-makers? (For example, variations in clinical care, controversy in what constitutes appropriate clinical care, or a policy decision.): yes
If yes, please explain:: The current clinical care employs a combination therapeutic regimen which is supported by a good therapeutic outcome in a majority of cases. However, a subset of patients do not respond. The responders face the risk of secondary malignancies later in life. Thus there is a need for development of new therapeutic strategies.

How will an answer to your research question be used or help inform decisions for you or your group?: A possible new therapeutic approach for treatment of Hodgkin lymphoma can be developed. The patients will have a choice of a less toxic treatment regimen.
Describe the timeframe in which an answer to your question is needed.: 2 years
Describe any health disparities, inequities, or impact on vulnerable populations your question applies to.

Other Information About You: (optional)

Please choose a description that best describes your role or perspective: (you may select more than one category if appropriate): A possible new therapeutic approach for treatment of Hodgkin lymphoma can be developed. The patients will have a choice of a less toxic treatment regimen.

Are you making a suggestion as an individual or on behalf of an organization?: Organization

Effective Health Care Program