“Hodgkin lymphoma has become one of the most curable malignancies in adults,” was stated by Dr Andreas Engert, Professor of Haematology at the University Hospital of Cologne in Germany.

Results of the German Hodgkin Study Group (GHSG) HD 15 trial were presented at the 17th Congress of the European Haematology Association in Amsterdam.

Using the multi-agent chemotherapy regimen BEACOPP the GHSG demonstrated significantly better tumour control and overall survival compared to previously used regimens.

In addition, the need for radiotherapy in patients with advanced stage Hodgkin lymphoma has been unclear. We thus conducted a prospectively randomised clinical trial comparing the standard of care (8 x BEACOPPescalated) with two reduced-intensity chemotherapy variants.

Chemotherapy was followed by positron emission tomography (PET) guided radiotherapy. In total, 2182 patients with newly diagnosed advanced stage Hodgkin lymphoma were randomised.

Treatment with 6 cycles of BEACOPPescalated was not only better tolerated than 8 cycles but resulted in improved tumour control (89.3% versus 84.4%) and overall survival (94.5% versus 91.9%).

This was in part due to a lower mortality with 6 cycles as compared to 8 in terms of treatment related events (0.8% versus 2.1%) and secondary malignancies (0.7% versus 1.8%). In addition, the PET-guided radiotherapy resulted in a substantially reduced number of patients radiated in the present HD15 trial (11%).

The outcome in HD15 was comparable to the prior HD9 study in which 70% had received additional radiotherapy.

Thus, we suggested that 6 cycles of BEACOPPescalated is the treatment of choice for advanced stage Hodgkin lymphoma; PET performed after chemotherapy can guide the need of additional radiotherapy in this setting.

Source: EHA