What is Stanford V Chemotherapy?
The Stanford V is an experimental chemotherapy regimen currently in a Phase II Clinical Trial at Stanford Medical Center. It is a multiple drug treatment comprised of seven different chemotherapy drugs that are administered over a shorter period of time, but more frequently, than standard chemotherapy regimens such as MOPP or ABVD. It is believed that this regimen will prove to be at least as effective as ABVD, while being better tolerated and having fewer long term side effects. It is administered every week for 8 weeks with Stage I and II Hodgkin's disease, and for 12 weeks with Stages III or IV.
Drug/Week	1	2	3	4	5	6	7	8	9	10	11	12
Mechlorethamine (Nitrogen Mustard) by vein	X	-	-	-	X	-	-	-	X	-	-	-
Doxorubicin (Adriamycin) by vein	X	-	X	-	X	-	X	-	X	-	X	-
Vinblastine (Velban) by vein	X	-	X	-	X	-	X	-	X	-	X	-
Vincristine (Oncovin) by vein	-	X	-	X	-	X	-	X	-	X	-	X
Bleomycin by vein	-	X	-	X	-	X	-	X	-	X	-	X
Etoposide (VP-16) by vein 2 days in a row	-	-	XX	-	-	-	XX	-	-	-	XX	-
Prednisone by mouth every other day	X	X	X	X	X	X	X	X	X	X	X	X
Additional Medications
Acyclovir (Zovirax) : 200mg tablets/3 times per day - Prevents Herpes infection in mouth.
Ativan (Lorazepam) : 1mg tablets/1 or 2 tablets every 4 hours - As needed for nausea or vomiting.
Colace (Docusate Sodium) : 100mg tablets/2 times per day - Stool softener.
Compazine (Prochlorperazine) : 10mg tablets/every 4 hours - As needed for nausea or vomiting.
Ketoconazole (Nizoral) : 200mg tablets/Once per day - Prevents fungal infection in mouth.
Septra DS (Bactrim, TMP-SMZ) : 800-160m tablets/2 times per day - Prevents pneumonia.
Zantac (Ranitidine) : 150mg tablets/2 times per day - Prevents high acid in stomach.
Potential Additional Medications
Ambien : 5mg tablets/1 or 2 tablets - As needed for insomnia.
Duphalac : 30cc/Every 2 hours - To relieve constipation.
Neupogen (Granulocyte-Colony Stimulating Factor) : Subcutaneous injection - As needed to prevent white blood count from dropping too low.
Prilosec : 20mg tablets/Once per day - Prevents high acid in stomach, replaces Zantac.
Thorazine (Chlorpromazine) : 25mg tablets/Every 6 hours - As needed for hiccups.
Results of the trial as of 1995
May 1989 - August 1995, 94 previously untreated patients with Hodgkin's disease stage II bulky (n=28), and stage III or IV (n=66) received Stanford V chemotherapy for 12 weeks +/- radiotherapy. With a median follow-up of 3 years, the actuarial 6-year survival is 93% and the freedom from progression is 89%. There have been no relapses or deaths among the 28 patients with stage II bulky mediastinal disease. Eight relapses and three deaths have occurred in the group of 66 patients with stage III-IV disease. Lower cumulative exposure to alkylating agents, doxorubicin, bleomycin and limited use of radiation is expected to improved the prospects for fertility and decrease the risks for second neoplasms and late cardiopulmonary toxicity.
Disclaimer:
Because the total duration and dosage of individual drugs in the Stanford V is reduced, it may be revealed by this study that the standard treatment is superior in efficacy. This is not a guarantee for a cure, and Hodgkin's disease can recur even if the treatment appears to be successful. STANFORD CANNOT AND DOES NOT GUARANTEE OR PROMISE THAT ANY BENEFITS WILL BE RECEIVED BY THE PATIENTS IN THIS STUDY.