Multinational phase 3 trial of first-line PET-guided BrECADD versus eBEACOPP in advanced classical Hodgkin lymphoma

The phase 3 HD21 trial, at 233 centers across nine countries, compared efficacy and tolerability of two regimens as first-line treatment for advanced classical Hodgkin lymphoma (cHL): the novel regimen of PET-2 guided BrECADD (brentuximab vedotin, etoposide, cyclophosphamide, doxorubicin, dacarbazine, and dexamethason) versus the standard regimen eBEACOPP (etoposide, doxorubicin, cyclophosphamide, bleomycin, vincristine, procarbazine, en prednisone).Treatment-related morbidity was significantly lower with BrECADD (42% of patients) than with eBEACOPP (59%; RR 0.72; p<0.0001). At a median follow-up of 48 months, BrECADD improved progression-free survival compared with eBEACOPP (HR 0.66; p=0.035). The overall survival rates were not significantly different between the two groups. The authors conclude that BrECADD guided by PET after two cycles was better tolerated and more effective that eBEACOPP in first-line treatment of adult patients with advanced-stage, classical Hodgkin Lymphoma.