Interim analysis of the German HD14 RCT for limited stage HL

1. Interim analysis of the German HD14 RCT for limited stage HL Summary Author: Dr. C. Tom Kouroukis, MD MSc FRCPC Date posted: January 30, 2009

2. GHSG HD14 Trial • Treatment for limited stage Hodgkin’s Lymphoma (HL) • Standard therapy for LS HL is 4 cycles of chemo and IF-RT based on the previous German HD8 trial • HD8 OS/FFTF 91%/83% at 5 years • Wanted to test BEACOPP as the chemo instead of ABVD as a way of increasing dose intensity • 1216 patients with limited stage unfavourable HL • Extranodal, large mediastinal mass, elevated ESR, at least 3 sites • Clinical stage I, II A or IIB Borchmann et al., ASH 2008: #367

3. GHSG HD14 Schema R ABVD x 4 escBEACOPP x 2 ABVD x 2 IF RT 30 Gy Borchmann et al., ASH 2008: #367

4. GHSG HD14 • 1216 patients • 1010 patients evaluable • 4 cycles of ABVD versus 2 cycles of BEACOPP and 2 cycles ABVD • All patients received involved field RT, 30 Gy • Third interim analysis • Balanced baseline characteristics Borchmann et al., ASH 2008: #367

5. GHSG HD14 - results Borchmann et al., ASH 2008: #367

6. GHSG HD14 - conclusions • Superior FFTF for the BEACOPP/ABVD arm • Not sure about overall survival yet • No increased toxicity with BEACOPP/ABVD arm Borchmann et al., ASH 2008: #367

7. GHSG HD14 - Canadian context • Currently ABVD x 3 cycles and IF RT are standards in Canada • In some institutions, ABVD alone might be given to patients with excellent early responses • In this study, unfavourable limited stage patients were included, in some cases, large mediastinal masses or patients with IIB disease may be treated with full course chemotherapy (ie ABVD x 6) plus irradiation