Final results of the HD14 trial
Von Tresckow and colleagues recently reported the final results of the HD14 trial in early unfavorable hodgkin disease patients. In this prospective randomized (1:1) trial it was compared whether a combination of 2x BEACOPP-escalated plus 2x ABVD (arm B) was superior to the old standard 4x ABVD (arm A), both regimens followed by 30 Gy involved-field RT. Altogether 1655 patients were recruited whereas 1528 were eligible for evaluation. Acute toxicity was significantly higher in arm B with 87.1% acute toxicity (G3+4) compared to 50.7% in arm A. Four pts died in arm B because of acute toxicities whereas no one died in arm A, but no significant difference could be derived concerning treatment-related mortality or secondary malignancies. 5-y freedom-from-treatment failure rate was siginificantly better in arm B (94.8% vs. 87.7%, p < 0,001), a significant difference was also observed in PFS but not in OS (due to effective salvage therapies). These results underscore that 2 + 2 plus 30 Gy IFRT is the new GHSG standard for patients with early unfavorable HD age 60 years or younger. Link: http://www.ncbi.nlm.nih.gov/pubmed/22271480 Further reading on early unfavorable ("intermediate") stages: HD17 (ongoing): http://www.ncbi.nlm.nih.gov/pubmed/18956517 (principles of IN RT) HD11: http://www.ncbi.nlm.nih.gov/pubmed/20713848 HD8: http://www.ncbi.nlm.nih.gov/pubmed/12913100 HD5: http://www.ncbi.nlm.nih.gov/pubmed/11786577 HD1-3: http://www.ncbi.nlm.nih.gov/pubmed/2438613 by MNiy
