Increased risk of relapse omitting RT in early PET scan negative Hodgkin lymphoma

Increased risk of relapse omitting RT in early PET scan negative Hodgkin lymphoma

Interim analysis of the intergroup EORTC-LYSA-FIL 20051 H10 trial published in the Journal of Clinical Oncology indicates an increased risk of early relapse when omitting radiotherapy in early PET scan negative patients with stage I/II Hodgkin's lymphoma. Early outcome, however, was excellent in both arms, and the final analysis should reveal whether these initial findings are maintained over time.

Dr. J.M.M. Raemaekers of the Radboud university medical center Nijmegen, The Netherlands, and central coordinator of the study says, "The standard for patients with clinical stage I/II Hodgkin's Lymphoma is ABVD (adriamycin, bleomycin, vinblastin and dacarbazin) chemotherapy followed by . Striking the right balance between initial cure through combined modality treatment and accepting a higher risk of late complications, and a higher recurrence rate after omitting radiotherapy in subsets of patients who will subsequently need intensive salvage treatment, is a matter of unsettled debate."

The main objective of the H10 trial was to evaluate whether involved-node radiotherapy could be omitted without loss of efficacy in terms of progression-free survival in patients with stage I/II Hodgkin's Lymphoma who had a negative earlyPET scan after two cycles of ABVD chemotherapy. This interim trial analysis included a total of 1137 patients with untreated clinical stage I/II Hodgkin's Lymphoma. Of these, 444 patients had favorable and 693 unfavorable prognoses. Patients in each prognostic group were randomized between standard and experimental treatment and first received two cycles of ABVD chemotherapy. Patients in the experimental arm who attained a negative earlyPET scan after the two cycles of ABVD chemotherapy were spared involved-node radiotherapy.

For patients with a favorable prognosis and a negative earlyPET scan, one progression occurred in the standard arm and nine progressions occurred in the experimental arm. For patients with unfavorable prognosis and a negative earlyPET scan, seven events occurred in the standard arm and 16 events occurred in the experimental arm. Even though there were few events and the median follow-up time short, the Independent Data Monitoring Committee concluded it was unlikely that the final results would show non-inferiority for the experimental treatment. They, therefore, advised that randomization should be stopped for earlyPET negative .

More information: dx.doi.org/10.1200/JCO.2013.51.9298

Related Stories

HIV status doesn't influence Hodgkin's lymphoma outcome

date Oct 11, 2012

(HealthDay)—Despite more extensive disease and more adverse prognostic factors, HIV-positive patients with Hodgkin's lymphoma (HL) do not have worse outcomes when treated with doxorubicin, bleomycin, vinblastine, ...

Recommended for you

DNA blood test detects lung cancer mutations

date 14 hours ago

Cancer DNA circulating in the bloodstream of lung cancer patients can provide doctors with vital mutation information that can help optimise treatment when tumour tissue is not available, an international group of researchers ...

Tumors prefer the easy way out

date 17 hours ago

Tumor cells become lethal when they spread. Blocking this process can be a powerful way to stop cancer. Historically, scientists thought that tumor cells migrated by brute force, actively pushing through whatever ...

Brain tumors may be new targets of Ebola-like virus

date 17 hours ago

Brain tumors are notoriously difficult for most drugs to reach, but Yale researchers have found a promising but unlikely new ally against brain cancers—portions of a deadly virus similar to Ebola.

User comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.