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Follow-up of the GHSG HD16 trial of PET-guided treatment in early-stage favorable Hodgkin lymphoma

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Item Type:Article
Title:Follow-up of the GHSG HD16 trial of PET-guided treatment in early-stage favorable Hodgkin lymphoma
Creators Name:Fuchs, M. and Jacob, A.S. and Kaul, H. and Kobe, C. and Kuhnert, G. and Pabst, T. and Greil, R. and Bröckelmann, P.J. and Topp, M.S. and Just, M. and Hertenstein, B. and Soekler, M. and Vogelhuber, M. and Zijlstra, J.M. and Keller, U.B. and Krause, S.W. and Dührsen, U. and Meissner, J. and Viardot, A. and Eich, H.T. and Baues, C. and Diehl, V. and Rosenwald, A. and Buehnen, I. and von Tresckow, B. and Dietlein, M. and Borchmann, P. and Engert, A. and Eichenauer, D.A.
Abstract:The primary analysis of the GHSG HD16 trial indicated a significant loss of tumor control with PET-guided omission of radiotherapy (RT) in patients with early-stage favorable Hodgkin lymphoma (HL). This analysis reports long-term outcomes. Overall, 1150 patients aged 18-75 years with newly diagnosed early-stage favorable HL were randomized between standard combined-modality treatment (CMT) (2x ABVD followed by PET/CT [PET-2] and 20 Gy involved-field RT) and PET-2-guided treatment omitting RT in case of PET-2 negativity (Deauville score [DS] < 3). The study aimed at excluding inferiority of PET-2-guided treatment and assessing the prognostic impact of PET-2 in patients receiving CMT. At a median follow-up of 64 months, PET-2-negative patients had a 5-year progression-free survival (PFS) of 94.2% after CMT (n = 328) and 86.7% after ABVD alone (n = 300; HR = 2.05 [1.20-3.51]; p = 0.0072). 5-year OS was 98.3% and 98.8%, respectively (p = 0.14); 4/12 documented deaths were caused by second primary malignancies and only one by HL. Among patients assigned to CMT, 5-year PFS was better in PET-2-negative (n = 353; 94.0%) than in PET-2-positive patients (n = 340; 90.3%; p = 0.012). The difference was more pronounced when using DS4 as cut-off (DS 1-3: n = 571; 94.0% vs. DS ≥ 4: n = 122; 83.6%; p < 0.0001). Taken together, CMT should be considered standard treatment for early-stage favorable HL irrespective of the PET-2-result.
Keywords:Antineoplastic Combined Chemotherapy Protocols, Bleomycin, Dacarbazine, Doxorubicin, Follow-Up Studies, Hodgkin Disease, Neoplasm Staging, Positron Emission Tomography Computed Tomography, Vinblastine
Publisher:Nature Publishing Group
Page Range:160-167
Date:January 2024
Official Publication:https://doi.org/10.1038/s41375-023-02064-y
PubMed:View item in PubMed

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