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. 2018 Jun 12;132(4):376–384. doi: 10.1182/blood-2018-01-778548

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
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
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
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)
300
 EORTC-2001242 EORTC ≥16 ABVD × 8 vs Escalated BEACOPP × 4 then BEACOPP × 4 400 No RT
240
 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 × 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 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.