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European Hematology Association: Early Metabolic Response Determination by FDG-PET Allows Substantial Reduction of Chemotherapy and its Toxicity in Patients with Advanced Stage Hodgkin Lymphoma: the GHSG HD18 Study

Saturday, June 24, 2017 General News
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MADRID, June 24, 2017 /PRNewswire/ --
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Hodgkin lymphoma is the most common malignancy of young adults. Intensive chemotherapy with eight or six cycles of eBEACOPP is very effective in patients with advanced-stage Hodgkin's lymphoma (HL), albeit at the expense of severe toxicities. Aiming at better tolerability, we investigated whether metabolic response determined by positron emission tomography after two cycles (PET-2) would allow us to select patients, who could be treated with reduced intensity (four cycles) without loss of efficacy.
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The GHSG HD18 trial was conducted in five European countries (Germany, Switzerland (SAKK), Austria (AGMT), Czech Republic, the Netherlands). Between 05/2008 and 07/2014, 2101 patients aged 18-60 years with newly diagnosed, advanced-stage HL were recruited, of whom 1005 were PET-2 negative.

Reduced therapy with four cycles of eBEACOPP was non-inferior to 6/8 cycles in terms of five-year progression-free survival (92·2% versus 90·8%, difference +1·4%, 95% CI -2·7-5·4). We observed no treatment related mortality in the experimental group, fewer infections, less organ toxicities and a very low incidence of second acute myeloid leukemia. Overall, this resulted in a significantly superior five-year overall survival (97·7% versus 95·4%, log-rank p=0·004) for the patient cohort with reduced treatment.

In conclusion, treatment with four cycles of eBEACOPP in patients with negative PET-2 is extremely effective, very safe, short (12 weeks), and affordable. Results for efficacy and safety compare favorably with any other published treatment strategy.

We therefore recommend PET-2-guided eBEACOPP for patients with advanced-stage HL.

Presenter:  Dr Peter Borchmann

Affiliation:  Uniklinik Koeln, Cologne, Germany

Topic:  TREATMENT REDUCTION IN PATIENTS WITH ADVANCED-STAGE HODGKIN LYMPHOMA AND NEGATIVE INTERIM PET: FINAL RESULTS OF THE INTERNATIONAL, RANDOMIZED PHASE 3 TRIAL HD18 BY THE GERMAN HODGKIN STUDY GROUP

Abstract S150 will be presented by Peter Borchmann on Friday, June 23 15:45 - 17:00 in Hall A.

About the EHA Annual Congress

Hematology is a specialty that covers everything to do with blood: its origin in the bone marrow, diseases of blood and their treatments. The latest data on research and developments will be presented. The topics range from stem cell physiology and development, to leukemia, lymphoma, myeloma - diagnosis and treatment; red blood cells, white blood cells- and platelet disorders; thrombosis and bleeding disorders.

SOURCE European Hematology Association

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