Hodgkin Lymphoma: Risk-adapted Therapy Recommended
Long-term follow-up data from randomized trials on Hodgkin lymphoma support current risk-adapted therapeutic approaches for early-stage disease.
The long-term follow-up data from 4 randomized trials on Hodgkin lymphoma (HL) support current risk-adapted therapeutic approaches for early-stage disease. Continuous follow-up to evaluate safety is, however, needed.1
Researchers assessed follow-up data from 4276 patients treated in the German Hodgkin Study Group. Between 1993 and 2003, patients with early-stage, favorable HL were enrolled in HD7 and HD10; patients with early-stage, unfavorable HL were enrolled in HD8 and HD11.
HD7 enrolled 627 patients with a median follow-up of 120 months. Combined-modality treatment resulted in improved outcomes over extended-field radiotherapy (RT). The 15-year progression-free survival (PFS) was 73% in the combined-modality arm vs 52% in the RT arm (hazard ratio [HR], 0.5; 95% CI, 0.3-0.6; P < .001).
There was no difference in overall survival (OS) between the 2 arms.
The other early-stage favorable HL trial, HD10, enrolled 1190 patients with a median follow-up of 98 months. This trial compared intensity of treatment — with 1 arm undergoing 2 cycles of doxorubicin, bleomycin, vinblastine, dacarbazine (ABVD) plus 20 Gy involved-field (IF)-RT — with more intensive 4 cycles of ABVD plus 30 Gy IF-RT.
Results from long-term follow-up of HD10 confirmed non-inferiority of the less intensive treatment, with a 10-year PFS of 87% in both arms and a 10-year OS of 94% in both arms.
Neither HD7 nor HD10 revealed any differences in second neoplasia (SN).
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“The risk of SN is being addressed by reducing both radiotherapy field size and dose,” explained senior author Andreas Engert, MD, chairman of the German Hodgkin Study Group and professor of internal medicine in hematology and oncology at the University Hospital of Cologne in Germany, in an interview with Cancer Therapy Advisor.