Selected therapeutic trials in early-stage HL
| Trial . | Trial design . | PET negative definition . | Disease stage/ characteristics . | N . | Median follow-up . | PFS . | OS . |
|---|---|---|---|---|---|---|---|
| RAPID25 | ABVD × 3 - > PET neg: no further treatment or 30 Gy IFRT PET pos: ABVD × 1 plus 30 Gy IFRT | DS 1-2 | Stage IA or IIA Nonbulky | 602 | 5 yrs | 3-yr 90.8% 3-yr 94.6% 3-yr 83% | 3-yr 99.0% 3-yr 97.1% 3-yr 87.6% |
| EORTC H1019 | Favorable ABVD × 2- > ABVD × 1 plus INRT Or ABVD × 2 - > PET PET neg: ABVD × 2 PET pos: escBEACOPP × 2 plus INRT Unfavorable ABVD × 2- > ABVD × 2 plus INRT Or ABVD × 2- > PET PET neg: ABVD × 4 PET pos: escBEACOPP × 2 plus INRT | DS 1-2 | Stage I or II Favorable or unfavorable | 1950 | 4.5 yrs | (F) PET neg control = 5-yr 99% (F) PET neg trial = 5-yr 87.1% (U) PET neg control = 5-yr 92% (U) PET neg trial = 5-yr 89.6% (F/U) PET pos control = 5-yr 77.4% (F/U) PET pos trial = 5-yr 90.6% | 5-yr 100% 5-yr 99.6% 5-yr 96.7% 5-yr 98.3% 5-yr 89.3% 5-yr 96.0% |
| CALGB 5060427 | ABVD × 2 - > PET PET neg: ABVD × 2 PET pos: escBEACOPP × 2 plus IFRT | DS 1-3 | Stage I or II Nonbulky | 164 | 3.8 yrs | 3-yr 91% 3-yr 66% | |
| GHSG HD16 26 | CMT arm: ABVD × 2 plus 20 Gy IFRT ABVD × 2 - > PET neg: no further treatment PET pos: 20 Gy IFRT | DS 1-2 | Stage I or II – Favorable Nonbulky | 1150 | 3.8 yrs | 5-yr 93.4% 5-yr 86.1% 5-yr 88.4% | 5-yr 98.1% 5-yr 98.4% 5-yr 97.9% |
| GHSG HD1728 | CMT arm: escBEACOPP/ABVD × 4 plus 30 Gy IFRT PET-4 neg: no further treatment PET-4 pos: 30 Gy IFRT | DS 1-2 | Stage I or II – Unfavorable Bulky | 1100 | 3.9 yrs | 5-yr 97.7% 5-yr 95.9% 5-yr 94% | 5-yr 98.7% 5-yr 98.8% 5-yr 99.2% |
| CALGB 5080139 | ABVD × 2 - > PET PET neg: ABVD × 4 PET pos: escBEACOPP × 4 plus 30 Gy ISRT | DS 1-3 | Stage IA-IIB Bulky only | 94 | 5.5 yrs | 3-yr 89.7% 3-yr 92% | 3-yr 94.4% 3-yr 97.7% |
| RATHL29 | ABVD × 2 - > PET PET neg: ABVD × 4 or AVD × 4 PET pos: BEACOPP × 4 | DS 1-3 | Stage IIB-IV or IIA with adverse features | 1203 | 3.4 yrs | 3-yr 85.7%, ABVD 3-yr 84.4%, ABVD- > AVD 3-yr 67.5% | 3-yr 97.2% 3-yr 97.6% 3-yr 87.8% |
| HD1040 | ABVD × 4 plus 30 Gy IFRT ABVD × 4 plus 20 Gy IFRT ABVD × 2 plus 30 Gy IFRT ABVD × 2 plus 20 Gy IFRT | Not PET adapted | Stage I or II Favorable | 1370 | 7.5 yrs | 8-yr 88.4% 8-yr 90.0% 8-yr 85.4% 8-yr 86.5% | 8-yr 94.4% 8-yr 94.7% 8-yr 93.6% 8-yr 95.1% |
| Trial . | Trial design . | PET negative definition . | Disease stage/ characteristics . | N . | Median follow-up . | PFS . | OS . |
|---|---|---|---|---|---|---|---|
| RAPID25 | ABVD × 3 - > PET neg: no further treatment or 30 Gy IFRT PET pos: ABVD × 1 plus 30 Gy IFRT | DS 1-2 | Stage IA or IIA Nonbulky | 602 | 5 yrs | 3-yr 90.8% 3-yr 94.6% 3-yr 83% | 3-yr 99.0% 3-yr 97.1% 3-yr 87.6% |
| EORTC H1019 | Favorable ABVD × 2- > ABVD × 1 plus INRT Or ABVD × 2 - > PET PET neg: ABVD × 2 PET pos: escBEACOPP × 2 plus INRT Unfavorable ABVD × 2- > ABVD × 2 plus INRT Or ABVD × 2- > PET PET neg: ABVD × 4 PET pos: escBEACOPP × 2 plus INRT | DS 1-2 | Stage I or II Favorable or unfavorable | 1950 | 4.5 yrs | (F) PET neg control = 5-yr 99% (F) PET neg trial = 5-yr 87.1% (U) PET neg control = 5-yr 92% (U) PET neg trial = 5-yr 89.6% (F/U) PET pos control = 5-yr 77.4% (F/U) PET pos trial = 5-yr 90.6% | 5-yr 100% 5-yr 99.6% 5-yr 96.7% 5-yr 98.3% 5-yr 89.3% 5-yr 96.0% |
| CALGB 5060427 | ABVD × 2 - > PET PET neg: ABVD × 2 PET pos: escBEACOPP × 2 plus IFRT | DS 1-3 | Stage I or II Nonbulky | 164 | 3.8 yrs | 3-yr 91% 3-yr 66% | |
| GHSG HD16 26 | CMT arm: ABVD × 2 plus 20 Gy IFRT ABVD × 2 - > PET neg: no further treatment PET pos: 20 Gy IFRT | DS 1-2 | Stage I or II – Favorable Nonbulky | 1150 | 3.8 yrs | 5-yr 93.4% 5-yr 86.1% 5-yr 88.4% | 5-yr 98.1% 5-yr 98.4% 5-yr 97.9% |
| GHSG HD1728 | CMT arm: escBEACOPP/ABVD × 4 plus 30 Gy IFRT PET-4 neg: no further treatment PET-4 pos: 30 Gy IFRT | DS 1-2 | Stage I or II – Unfavorable Bulky | 1100 | 3.9 yrs | 5-yr 97.7% 5-yr 95.9% 5-yr 94% | 5-yr 98.7% 5-yr 98.8% 5-yr 99.2% |
| CALGB 5080139 | ABVD × 2 - > PET PET neg: ABVD × 4 PET pos: escBEACOPP × 4 plus 30 Gy ISRT | DS 1-3 | Stage IA-IIB Bulky only | 94 | 5.5 yrs | 3-yr 89.7% 3-yr 92% | 3-yr 94.4% 3-yr 97.7% |
| RATHL29 | ABVD × 2 - > PET PET neg: ABVD × 4 or AVD × 4 PET pos: BEACOPP × 4 | DS 1-3 | Stage IIB-IV or IIA with adverse features | 1203 | 3.4 yrs | 3-yr 85.7%, ABVD 3-yr 84.4%, ABVD- > AVD 3-yr 67.5% | 3-yr 97.2% 3-yr 97.6% 3-yr 87.8% |
| HD1040 | ABVD × 4 plus 30 Gy IFRT ABVD × 4 plus 20 Gy IFRT ABVD × 2 plus 30 Gy IFRT ABVD × 2 plus 20 Gy IFRT | Not PET adapted | Stage I or II Favorable | 1370 | 7.5 yrs | 8-yr 88.4% 8-yr 90.0% 8-yr 85.4% 8-yr 86.5% | 8-yr 94.4% 8-yr 94.7% 8-yr 93.6% 8-yr 95.1% |
ABVD, doxorubicin, bleomycin, vinblastine, and dacarbazine; BEACOPP, bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone; CMT, combined modality treatment; DS, Deauville score; escBEACOPP, escalated BEACOPP; F, favorable; IFRT, involved-field radiotherapy; INRT, involved nodal radiotherapy; ISRT, involved site radiotherapy; neg, negative; OS, overall survival; PFS, progression-free survival; pos, positive; U, unfavorable; − >, followed by.