Table 1. Treatment of patients with... | American Society of Hematology

Table 1.

Treatment of patients with high-risk HL

Trial	Group	Age, y	Treatment	Anthracycline, mg/m²	Radiation, Gy
High-risk clinical trials
AHOD1331²¹	COG	<19	Bv-AVEPC vs ABVE-PC	250	21 + 9 boost if incomplete metabolic response at end of therapy
AHOD1331²¹	COG	<19	Bv-AVEPC vs ABVE-PC	250
HLHR13²⁴	SJ–Stanford–Dana-Farber Consortium	<19	AEPA/CAPDac	160	25.5 ISRT to individual sites with an inadequate response at ERA
HOD99³⁹	SJ–Stanford–Dana-Farber Consortium	≤21	Stanford V	150	25.5 IFRT (15 if in CR at ERA)
C2¹⁹	EuroNet-PHL	<18 or <25 in France, Italy, and UK	OEPA/COPDAC vs OEPA/DECOPDAC	160	19.8 + 10 boost to LRA PET⁺ lesions 30 only to PET⁺ lesions at LRA
C2¹⁹	EuroNet-PHL	<18 or <25 in France, Italy, and UK	OEPA/COPDAC vs OEPA/DECOPDAC	260
NYMC 568⁴⁰	New York Medical Center	<30	BV-AVD-R (+2 cycles ifosfamide/vinorelbine) for slow early responders	300	RT only foreseen for patients that do not achieve a CR at the EOT
HD21⁴¹	German Hodgkin Study Group	≥18	Escalated BEACOPP × 4 or 6 vs BrECADD × 4 or 6	140 or 210	30 Gy to residual PET⁺ lesions at EOT
HD21⁴¹	German Hodgkin Study Group	≥18	Escalated BEACOPP × 4 or 6 vs BrECADD × 4 or 6	140 or 210	30 Gy to residual PET⁺ lesions at EOT
Checkmate 205	Bristol-Myers Squibb	≥18	N + N-AVD	300	No RT
ECHELON-1²⁵	Seattle Genetics	≥18	A-AVD × 6 vs ABVD × 6	300	No RT (on this phase of trial)
ECHELON-1²⁵	Seattle Genetics	≥18	A-AVD × 6 vs ABVD × 6	300	No RT (on this phase of trial)
EORTC-20012⁴²	EORTC	≥16	ABVD × 8 vs Escalated BEACOPP × 4 then BEACOPP × 4	400	No RT
EORTC-20012⁴²	EORTC	≥16	ABVD × 8 vs Escalated BEACOPP × 4 then BEACOPP × 4	240	No RT
CA209-447⁴³	Memorial Sloan Kettering	≥18	ABVD × 6 + nivolumab × 8 doses	300	No RT
Standards of care–NCCN guidelines
n/a	n/a	≥18	ABVD × 6	300	30-36 36-45 for sites of partial response
n/a	n/a	≥18	ABVD × 6	300
n/a	n/a	≥18	ABVD × 2 + 4 escalated BEACOPP	240	To initially bulky sites or PET + sites
n/a	n/a	≥18	Escalated BEACOPP × 6	210	30-36 36-45 for sites of partial response
n/a	n/a	≥18	Escalated BEACOPP × 6	210
n/a	n/a	≥18	Stanford V	150	30-36 to initial sites >5 cm

Trial	Group	Age, y	Treatment	Anthracycline, mg/m²	Radiation, Gy
High-risk clinical trials
AHOD1331²¹	COG	<19	Bv-AVEPC vs ABVE-PC	250	21 + 9 boost if incomplete metabolic response at end of therapy
AHOD1331²¹	COG	<19	Bv-AVEPC vs ABVE-PC	250
HLHR13²⁴	SJ–Stanford–Dana-Farber Consortium	<19	AEPA/CAPDac	160	25.5 ISRT to individual sites with an inadequate response at ERA
HOD99³⁹	SJ–Stanford–Dana-Farber Consortium	≤21	Stanford V	150	25.5 IFRT (15 if in CR at ERA)
C2¹⁹	EuroNet-PHL	<18 or <25 in France, Italy, and UK	OEPA/COPDAC vs OEPA/DECOPDAC	160	19.8 + 10 boost to LRA PET⁺ lesions 30 only to PET⁺ lesions at LRA
C2¹⁹	EuroNet-PHL	<18 or <25 in France, Italy, and UK	OEPA/COPDAC vs OEPA/DECOPDAC	260
NYMC 568⁴⁰	New York Medical Center	<30	BV-AVD-R (+2 cycles ifosfamide/vinorelbine) for slow early responders	300	RT only foreseen for patients that do not achieve a CR at the EOT
HD21⁴¹	German Hodgkin Study Group	≥18	Escalated BEACOPP × 4 or 6 vs BrECADD × 4 or 6	140 or 210	30 Gy to residual PET⁺ lesions at EOT
HD21⁴¹	German Hodgkin Study Group	≥18	Escalated BEACOPP × 4 or 6 vs BrECADD × 4 or 6	140 or 210	30 Gy to residual PET⁺ lesions at EOT
Checkmate 205	Bristol-Myers Squibb	≥18	N + N-AVD	300	No RT
ECHELON-1²⁵	Seattle Genetics	≥18	A-AVD × 6 vs ABVD × 6	300	No RT (on this phase of trial)
ECHELON-1²⁵	Seattle Genetics	≥18	A-AVD × 6 vs ABVD × 6	300	No RT (on this phase of trial)
EORTC-20012⁴²	EORTC	≥16	ABVD × 8 vs Escalated BEACOPP × 4 then BEACOPP × 4	400	No RT
EORTC-20012⁴²	EORTC	≥16	ABVD × 8 vs Escalated BEACOPP × 4 then BEACOPP × 4	240	No RT
CA209-447⁴³	Memorial Sloan Kettering	≥18	ABVD × 6 + nivolumab × 8 doses	300	No RT
Standards of care–NCCN guidelines
n/a	n/a	≥18	ABVD × 6	300	30-36 36-45 for sites of partial response
n/a	n/a	≥18	ABVD × 6	300
n/a	n/a	≥18	ABVD × 2 + 4 escalated BEACOPP	240	To initially bulky sites or PET + sites
n/a	n/a	≥18	Escalated BEACOPP × 6	210	30-36 36-45 for sites of partial response
n/a	n/a	≥18	Escalated BEACOPP × 6	210
n/a	n/a	≥18	Stanford V	150	30-36 to initial sites >5 cm

Treatment of patients with high-risk HL.^{19,21,24,26,39-43}

A-AVD, brentuximab vedotin, doxorubicin, vinblastine, dacarbazine; ABVD, Adriamycin (doxorubicin), bleomycin, vinblastine, dacarbazine; ABVE-PC, Adriamycin, bleomycin, vincristine, etoposide, prednisone, cyclophosphamide; AEPA/CAPDac; brentuximab vedotin, etoposide, prednisone and doxorubicin/ cyclophosphamide, brentuximab vedotin, prednisone and dacarbazine; BrECADD, brentuximab vedotin, etoposide, cyclophosphamide, doxorubicin, dacarbazine, dexamethasone; BV-AVD-R, brentuximab vedotin, doxorubicin, vinblastine, dacarbazine, rituximab; Bv-AVEPC, brentuximab vedotin, Adriamycin, vincristine, etoposide, prednisone, cyclophosphamide; COG, Children’s Oncology Group; CR, complete response; EORTC, European Organization for Research and Treatment of Cancer; EOT, end of therapy; ERA, early response assessment; Escalated BEACOPP, bleomycin, etoposide, Adriamycin, cyclophosphamide, Oncovin (vincristine), procarbazine, prednisone; EuroNet-PHL, European Network Group on Pediatric Hodgkin Lymphoma; HOD, studies by the St. Jude–Stanford–Dana-Farber Pediatric Hodgkin Consortium; IFRT, involved field radiation therapy; ISRT, involved site radiation therapy; LRA, late response assessment; N + N-AVD, nivolumab + nivolumab, doxorubicin, vinblastine, dacarbazine; n/a, not applicable; NCCN, National Comprehensive Cancer Network; OEPA/COPDAC, vincristine, etoposide, prednisone and doxorubicin/ cyclophosphamide, vincristine, prednisone and dacarbazine; OEPA/DECOPDAC, vincristine, etoposide, prednisone and doxorubicin/doxorubicin, etoposide, cyclophosphamide, vincristine, prednisone and dacarbazine; PET, positron emission tomography; RT, radiation therapy; SJ, St. Jude Children’s Research Hospital; Stanford V, doxorubicin, vinblastine, mechlorethamine, vincristine, bleomycin, etoposide, prednisone; UK, United Kingdom.

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