PET-adapted therapeutic trials in early-stage HL
| Study (median follow-up) . | Patient population (N) . | Risk factors at enrollment . | PET negative . | Treatment arms . | PFS or FFTF . | OS . |
|---|---|---|---|---|---|---|
| UK RAPID6 (5.0 years) | Stage IA or IIA (n = 602) | Nonbulky | Deauville 1-2 | PET neg: ABVD × 3 PET neg: ABVD × 3 + 30 Gy IFRT PET pos: ABVD × 4 + 30 Gy IFRT | 3-year 90.8% 3-year 94.6% 3-year 83% | 3-year 99.0% 3-year 97.1% |
| CALGB 506048 (3.8 years) | Stage I or II (n = 164) | Nonbulky | Deauville 1-3 | PET neg: ABVD × 4 PET pos: ABVD × 2, eBEACOPP × 2, 30 Gy IFRT | 3-year PFS 91% 3-year PFS 66% | |
| EORTC9 (4.5-5.1 years) | Stage I or II (n = 1950) | Favorable (no risk factors) Unfavorable (any of the following) 1. Age ≥50 2. Bulk 3. >3 nodal sites 4. ESR ≥50 (or 30 if B-symptoms) | Deauville 1-2 | (F) PET neg: ABVD × 3 + 30 Gy INRT (F) PET neg: ABVD × 4 | 5-year PFS 99% 5-year PFS 87.1% | 5-year OS 100% 5-year OS 99.6% |
| (U) PET neg: ABVD × 4 + 30 Gy INRT (U) PET neg: ABVD × 6 | 5-year PFS 92.1% 5-year 89.6% | 5-year OS 96.7% 5-year OS 98.3% | ||||
| (F/U) PET pos: ABVD × 4 + 30 Gy INRT (F/U) PET pos: ABVD × 2, eBEACOPP × 2, 30 Gy INRT | 5-year PFS 77.4% 5-year PFS 90.6% | 5 year OS 89.3% 5 year OS 96.0% | ||||
| GHSG HD1610 (45 months) | Stage I or II (N = 1150) | Favorable (none of the following risk factors): 1. Bulk 2. Extranodal sites 3. >2 nodal areas 4. ESR ≥50 (or 30 if B-symptoms) | Deauville 1-2 | PET neg: ABVD × 2 + 20 Gy IFRT PET neg: ABVD × 2 PET pos: ABVD × 2 + 20 Gy IFRT | 5-year PFS 93.4% 5-year PFS 86.1% 5-year PFS 88.4% | 5-year OS 98.1% 5-year OS 98.4% 5-year OS 97.9% |
| GHSG HD1711 (46.2 months) | Stage I or II (N = 1100) | Unfavorable (with one of the following risk factors): 1. Bulk 2. Extranodal sites 3. >2 nodal areas 4. ESR ≥50 (or 30 if B-symptoms) | Deauville 1-2 | PET negative: eBEACOPP/ABVD × 4 + 30 Gy IFRT PET neg: eBEACOPP/ABVD × 4 PET pos: eBEACOPP/ABVD × 4 + 30 Gy IFRT | 5-year PFS 97.7% 5-year PFS 95.9% 5-year PFS 94.2% | 5-year OS 98.7% 5-year OS 98.8% 5-year OS 99.2% |
| Study (median follow-up) . | Patient population (N) . | Risk factors at enrollment . | PET negative . | Treatment arms . | PFS or FFTF . | OS . |
|---|---|---|---|---|---|---|
| UK RAPID6 (5.0 years) | Stage IA or IIA (n = 602) | Nonbulky | Deauville 1-2 | PET neg: ABVD × 3 PET neg: ABVD × 3 + 30 Gy IFRT PET pos: ABVD × 4 + 30 Gy IFRT | 3-year 90.8% 3-year 94.6% 3-year 83% | 3-year 99.0% 3-year 97.1% |
| CALGB 506048 (3.8 years) | Stage I or II (n = 164) | Nonbulky | Deauville 1-3 | PET neg: ABVD × 4 PET pos: ABVD × 2, eBEACOPP × 2, 30 Gy IFRT | 3-year PFS 91% 3-year PFS 66% | |
| EORTC9 (4.5-5.1 years) | Stage I or II (n = 1950) | Favorable (no risk factors) Unfavorable (any of the following) 1. Age ≥50 2. Bulk 3. >3 nodal sites 4. ESR ≥50 (or 30 if B-symptoms) | Deauville 1-2 | (F) PET neg: ABVD × 3 + 30 Gy INRT (F) PET neg: ABVD × 4 | 5-year PFS 99% 5-year PFS 87.1% | 5-year OS 100% 5-year OS 99.6% |
| (U) PET neg: ABVD × 4 + 30 Gy INRT (U) PET neg: ABVD × 6 | 5-year PFS 92.1% 5-year 89.6% | 5-year OS 96.7% 5-year OS 98.3% | ||||
| (F/U) PET pos: ABVD × 4 + 30 Gy INRT (F/U) PET pos: ABVD × 2, eBEACOPP × 2, 30 Gy INRT | 5-year PFS 77.4% 5-year PFS 90.6% | 5 year OS 89.3% 5 year OS 96.0% | ||||
| GHSG HD1610 (45 months) | Stage I or II (N = 1150) | Favorable (none of the following risk factors): 1. Bulk 2. Extranodal sites 3. >2 nodal areas 4. ESR ≥50 (or 30 if B-symptoms) | Deauville 1-2 | PET neg: ABVD × 2 + 20 Gy IFRT PET neg: ABVD × 2 PET pos: ABVD × 2 + 20 Gy IFRT | 5-year PFS 93.4% 5-year PFS 86.1% 5-year PFS 88.4% | 5-year OS 98.1% 5-year OS 98.4% 5-year OS 97.9% |
| GHSG HD1711 (46.2 months) | Stage I or II (N = 1100) | Unfavorable (with one of the following risk factors): 1. Bulk 2. Extranodal sites 3. >2 nodal areas 4. ESR ≥50 (or 30 if B-symptoms) | Deauville 1-2 | PET negative: eBEACOPP/ABVD × 4 + 30 Gy IFRT PET neg: eBEACOPP/ABVD × 4 PET pos: eBEACOPP/ABVD × 4 + 30 Gy IFRT | 5-year PFS 97.7% 5-year PFS 95.9% 5-year PFS 94.2% | 5-year OS 98.7% 5-year OS 98.8% 5-year OS 99.2% |
eBEACOPP, escalated bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine and prednisone; EN, XXX; F, favorable; FFTF, freedom from treatment failure; neg, negative; pos, positive; U, unfavorable.