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. 2020 Jan 13;2020(1):CD012643. doi: 10.1002/14651858.CD012643.pub3

Andre 2017.

Study characteristics
Methods Secondary citation(s)
  • Raemarkers 2014, Cottereau 2018


Language of publication
  • English


Study design
  • Prospective, multi‐centre, phase III randomised trial


Study centre(s)
  • Various


Countries
  • Belgium, Croatia, Denmark, France, Italy, the Netherlands, Slovakia, Switzerland


Median follow‐up time (range)
  • 55 months

Participants Number of included participants
  • Total: 1925

  • Randomised to standard treatment without change in protocol because of interim PET: 954


Inclusion criteria
  • Previously untreated

  • Classic supradiaphragmic stage I and II HL

  • Age 15 to 70 years


Exclusion criteria
  • Previous laparotomy

  • Concomitant or previous cancer other than basal‐cell carcinoma of the skin or in situ carcinoma of the cervix

  • Concomitant severe illness that would reduce life expectancy

  • Social circumstances not allowing for proper treatment and follow‐up

  • Positivity for the human immunodeficiency virus


(exclusion criteria reported in Fermé 20071)
Consent
  • Yes; written informed consent


Recruitment period
  • November 2006 to June 2011


Age (range, in years)
  • Favourable, standard treatment group median: 31 (15‐49)

  • Unfavourable, standard treatment group median: 32 (15‐70)


Ethnic group(s)
  • Not reported


Stages of disease
  • Early stages (I and II)


Comorbidities
  • Not reported, except for the exclusion criteria


Therapy regimen
  • ABVD and radiotherapy depending on treatment arm, favourable/unfavourable disease, and early PET (ePET) positivity

Prognostic factor(s) Prognostic factor(s)
  • Early PET (ePET)


Definition of prognostic factor(s)
  • Not reported


Timing of prognostic factor measurement
  • After 2 ABVD cycles


Method for measurement (use of specific scale and cut‐off)
  • International Harmonization Project criteria. According to these criteria: PET‐negative corresponds to Deauville score 1 (no uptake) and score 2 (uptake ≤ mediastinum)

  • Central review performed online (up to 6 experts, and one local expert)


Was the same definition and method for measurement used in all participants?
  • Central review started later for 2 centres in Italy due to technical difficulties, only 75% of ePET were centrally reviewed


Were prognostic factor(s) assessed blinded for outcome(s), and for each other (if relevant)?
  • Not reported

Outcome(s) Primary outcome(s) and definition(s)
  • Progression‐free survival (PFS), defined as time from random assignment to date of progression (as experiencing relapse after previous complete remission, progressive disease, or death from any cause)


Secondary outcome(s) and definition(s)
  • Overall survival (OS), not defined


Timing of outcome measurement
  • At 5 years


Was the same definition and method for measurement used in all participants?
  • Yes


Was/were outcome(s) assessed blinded for prognostic factor(s), and for each other (if relevant)?
  • Not reported

Missing data Participants with any missing value?
  • No


If yes, how were missing data handled?
  • Not applicable

Analysis Univariable analysis: Yes
Total number of participants included inunivariateanalysis for each outcome
  • PFS: all

  • OS: all


Statistical method
  • Kaplan‐Meier method

  • HR (95% CI)

  • Randomised arms were compared using the log‐rank test stratified by Ann Arbor stage and availability of a baseline FDG‐PET scan


How was the prognostic factor treated?
  • Binary


Multivariable analysis: No
Risk of bias (QUIPS) Study participation
  • Low risk

  • Clear description of participants and study characteristics.


Study attrition
  • Low risk

  • Length of follow‐up reported. Exclusion of participants due to safety amendment during the study.


Prognostic factor measurement
  • Moderate risk

  • Adequate measurement and description. Central review only for 75% of scans and delayed in the case of 2 centres due to technical difficulties.


Outcome: Overall survival
Not reported
Outcome: Progression‐free survival
Outcome measurement
  • Low risk

  • No definition of outcome. Outcome measured the same way for all participants.


'Other prognostic factors (covariates)'
  • Low risk


Statistical analysis and reporting
  • Low risk

  • Statistical method appropriate for the data.


Outcome: Adverse events
Not reported
Notes Conflict of interest
  • Casasnovas O: honoraria received from Genentech, Takeda, Gilead Sciences, Sanofi; consulting or advisory role at Genentech, Takeda, Gilead Sciences; research funding received from Genentech; travel, accomodation, expenses received from Genentech, Takeda, Gilead Sciences

  • Brice P: research funding received from Merck Sharp & Dohme Oncology, Takeda; travel, accomodation, expenses received from Takeda

  • Specht L: consulting or advisory role at Takeda; research funding received from Varian Medical Systems; travel, accomodation, expenses received from Takeda

  • Delarue R: honoraria received from Servier, Gilead Sciences, Roche, Celgene, Takeda; consulting or advisory role at Gilead Sciences, Roche; Speakers' Bureau at Karyopharm Therapeutics; travel, accomodation, expenses received from Roche, Takeda, Celgene

  • Hutchings M: consulting or advisory role at Takeda, Genentech, Celgene, Bayer; research funding received from Takeda, Janssen‐Cilag, Genentech, Celgene; travel, accomodation, expenses received from Takeda, Bristol‐Myers, Squibb, Janssen‐Cilag


Funding
  • Supported by European Organisation for Research and Treatment of Cancer (Belgium), LYmphoma Study Association (France), Fondazione Italiana Limfomi (Italy), Fondation Belge Contre le Cancer (Belgium), Dutch Cancer Society (the Netherlands), Institut National du Cancer (France), Assistance Publique des Hopitaux de Paris (France), Societe Française de Medecine Nucleaire et Imagerie Moleculaire (France), Associazone Angela Serra (Italy), van Vlissingen Lymfoom Fonds (the Netherlands), and Chugai Pharmaceutical (Japan).


[1] Fermé C, Eghbali H, Meerwaldt JH, Rieux C, Bosq J, Berger F, et al. Chemotherapy plus involved‐field radiation in early‐stage Hodgkin’s disease. New England Journal of Medicine 2007;357:1916‐1927