Miguel Bronchud, Veteran Cancer Clinician, Researcher, Co-Founder and ex Advisory Board at Regenerative Medicine Solutions, shared on LinkedIn:
” Hodgkin’s Lymphoma: …on the benefits of early PET-CT controls following first chemotherapy to de escalate treatments intensity – But the field is undergoing major changes….
HD0607 is a phase-2 multicenter prospective clinical trial enrolling stage IIB-IV patients with untreated classic Hodgkin’s Lymphoma.
In advanced-stage classic Hodgkin lymphoma (cHL), risk-adapted therapeutic strategies have proven to be safe and effective, although long term efficacy data are lacking.
Furthermore, some concern persists about the risk of late occurrence of second primary malignancies (SPM) or cardiovascular events (CVE) in survivors.
HD0607 is a phase-2 multicenter prospective clinical trial enrolling stage IIB-IV patients with untreated cHL. All subjects started treatment with 2 ABVD cycles and subsequently underwent an interim PET (PET-2).
PET-2 positive patients [Deauville score (DS) 4–5] switched to BEACOPP escalated/baseline (4 + 4 cycles), while PET-2 negative patients (DS ≤ 3) were treated with 4 more ABVD cycles.
Patients with a large nodal mass (LNM, defined as ≥5 cm in diameter) at baseline and both PET-2 and end-of-chemotherapy (EoT) PET negative scans were randomly allocated to receive consolidation radiotherapy (cRT) or no further therapy (NFT).
Out of 782 enrolled subjects, 630 (81%) had a negative while 150 (19%) a positive PET-2. After a median follow-up of 11 years (IQR 7–13 years), 102/630 patients with a negative PET-2 (16.2%) and 57/150 (38.0%) with a positive PET-2 progressed or relapsed.
The 10-years PFS and OS were 83% and 96% vs. 58% and 85% (p < 0.0001) for PET-2 negative and PET-2 positive patients, respectively. Patients randomized to NFT did not have an increased risk of relapse or death (PFS HR 0.67, 95%CI 0.31–1.43; OS HR 0.49, 95% CI 0.09–2.68).
During the follow-up 28 (3.6%) and 16 (2.1%) patients developed a SPM and CVE, respectively.
After more than a decade of follow-up the HD0607 trial confirmed: i) the long-term predictive value of PET-2; ii) the persistent and sustained remission rate of PET-2 negative patients; iii) no PFS benefit consolidation RT over a non-FDG avid LNM; iv) the cumulative low incidence of SPM and CVE in the enrolled patients.
But: Frontline treatment for classical Hodgkin lymphoma – following decades of good survival outcomes with ABVD and various types of radiotherapy, at the expense of often significant acute and chronic toxicities- is over the past few years undergoing one of the most significant transformations in modern hematology. Following the SWOG S1826 trial and FDA approval of nivolumab-based frontline therapy in 2026, clinicians are rapidly adopting immunotherapy-forward regimens that improve disease control while reducing long-term toxicity.
The brentuximab vedotin plus nivolumab-containing regimen has emerged as the new frontline standard for advanced-stage classical Hodgkin lymphoma, supported by SWOG S1826 trial.”
Other articles about Hodgkin’s Lymphoma on OncoDaily.