Follow-up of the GHSG HD16 trial of PET-guided treatment in early-stage favorable Hodgkin lymphoma
Author:
Fuchs Michael, Jacob Anne Sophie, Kaul Helen, Kobe CarstenORCID, Kuhnert Georg, Pabst ThomasORCID, Greil Richard, Bröckelmann Paul J.ORCID, Topp Max S., Just Marianne, Hertenstein Bernd, Soekler Martin, Vogelhuber Martin, Zijlstra Josée M., Keller Ulrich BerndORCID, Krause Stefan W.ORCID, Dührsen Ulrich, Meissner JuliaORCID, Viardot Andreas, Eich Hans-Theodor, Baues Christian, Diehl Volker, Rosenwald Andreas, Buehnen Ina, von Tresckow BastianORCID, Dietlein Markus, Borchmann Peter, Engert Andreas, Eichenauer Dennis A.ORCID
Abstract
AbstractThe 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.
Funder
Sanofi-Genzyme, Takeda Employment/leadership position (University Hospital of Cologne, Head of the GHSG Trial Coordination Centre), honorarium Takeda Medical Research Foundation Bristol-Myers Squibb Company | Bristol-Myers Squibb Canada BeiGene, MSD Stemline Gilead Sciences Miltenyi Biotec Novartis Roche Amgen Pfizer Merck & Co., Inc. | Merck Sharp and Dohme AbbVie AstraZeneca allogene, Cerus, incyte, IQVIA, Noscendo, Pentixapharm,
Publisher
Springer Science and Business Media LLC
Subject
Oncology,Cancer Research,Hematology
Reference26 articles.
1. Yahalom J. Don’t throw out the baby with the bathwater: on optimizing cure and reducing toxicity in Hodgkin’s lymphoma. J Clin Oncol. 2006;24:544–8. 2. Girinsky T, van der Maazen R, Specht L, Aleman B, Poortmans P, Lievens Y, et al. Involved-node radiotherapy (INRT) in patients with early Hodgkin lymphoma: concepts and guidelines. Radiother Oncol. 2006;79:270–7. 3. Koontz BF, Kirkpatrick JP, Clough RW, Prosnitz R, Gockerman J, Moore J, et al. Combined-modality therapy versus radiotherapy alone for treatment of early-stage Hodgkin’s disease: cure balanced against complications. J Clin Oncol. 2006;24:605–11. 4. Behringer K, Goergen H, Hitz F, Zijlstra J, Greil R, Markova J, et al. Omission of dacarbazine or bleomycin, or both, from the ABVD regimen in treatment of early-stage favorable Hodgkin’s lymphoma (GHSG HD13): an open-label, randomized, non-inferiority trial. Lancet. 2015;385:1418–27. 5. Sasse S, Brockelmann PJ, Goergen H, Pluetschow A, Mueller H, Kreissl S, et al. Long-term follow-up of contemporary treatment in early-stage Hodgkin lymphoma: updated analyses of the German Hodgkin Study Group HD7, HD8, HD10, and HD11 trials. J Clin Oncol. 2017;35:1999–2007.
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