The HD8 trial, an early-stage, unfavorable HL trial, enrolled 1064 patients with a median follow-up of 153 months. Follow-up from this trial supported non-inferiority of IF-RT to extended-field RT on PFS (HR, 1.0; 95% CI, 0.8-1.2).
HD11 enrolled 1395 patients with a median follow-up of 106 months. Results from long-term follow-up did not suggest any superiority of bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone at baseline (BEACOPPbaseline) over ABVD.
Twenty Gy IF-RT were non-inferior to 30 Gy IF-RT after BEACOPPbaseline; 10-year PFS was 84% for both arms.
In the arm that originally underwent ABVD, PFS was inferior on 20 Gy IF-RT compared with 30 GY IF-RT. The 10-year PFS in post-ABVD patients on 20 Gy IF-RT was 76% vs 84% in post-ABVD patients who underwent 30 Gy IF-RT.
No differences in OS or SNs occurred in HD8 or HD11.
Dr Engert commented that the biggest unmet need in HL is “[t]o identify those patients who really need additional radiotherapy. So far, PET was unable to identify those patients at high risk for relapse.”
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“New drugs such as PD1 inhibitors might help to further reduce toxicity,” he said.
- Sasse S, Bröckelmann PJ, Goergen H, 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 Apr 18. doi: 10.1200/JCO.2016.70.9410 [Epub ahead of print]