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

Media type: E-Article

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

Contributor: Fuchs, Michael [Author]; Jacob, Anne Sophie [Author]; Kaul, Helen [Author]; Kobe, Carsten Andreas [Author]; Kuhnert, Georg Eckhard [Author]; Pabst, Thomas [Author]; Greil, Richard [Author]; Bröckelmann, Paul Jan [Author]; Topp, Max S. [Author]; Just, Marianne [Author]; Hertenstein, Bernd [Author]; Soekler, Martin [Author]; Vogelhuber, Martin [Author]; Zijlstra, Josée M. [Author]; Keller, Ulrich [Author]; Krause, Stefan W. [Author]; Dührsen, Ulrich [Author]; Meißner, Julia [Author]; Viardot, Andreas [Author]; Eich, Hans Theodor [Author]; Baues, Christian Manfred [Author]; Diehl, Volker [Author]; Rosenwald, Andreas [Author]; Buehnen, Ina [Author]; Tresckow, Bastian von [Author]; Dietlein, Markus [Author]; Borchmann, Peter [Author]; Engert, Andreas [Author]; Eichenauer, Dennis Alexander [Author]

Published: 16 October 2023

Language: English

DOI: 10.1038/s41375-023-02064-y

Identifier:

Keywords: Chemotherapy ; Radiotherapy

Origination:

Footnote: Im Web of Science ist der DOI fälschlich als 10.1038/s41375-023-02064 angegeben

Description: 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.

Access State: Open Access

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