I will present only a summary of the study and I can invite you to go to the session this morning at 11.30 Room A2 for more extensive results.
The AHL2011 study was dedicated to advanced Hodgkin lymphoma.
The purpose of the study was to evaluate the strategy of de-escalated treatment in patients with advanced Hodgkin lymphoma who reached metabolic response after two cycles of escalated BEACOPP to allow to obtain disease control similar to six cycles of escalated BEACOPP with a lower toxicity.
The study randomised 823 patients who were randomised between the experimental arm testing the de-escalated strategy for patients with negative PET2.
After two escalated BEACOPP patients received four cycles of ABVD and the dose intensity was maintained only for patients with positive PET2 who received two escalated BEACOPP.
This experimental arm was compared to a standard arm with six escalated BEACOPP that is the standard of treatment within the German Hodgkin Study Group and the treatment which allows us to obtain the better disease control published so far.
In the experimental arm 84% of patients reached negative PET2 and received de-escalated therapy.
The disease control was similar in both arms and progression free survival was quite satisfactory with a five year progression free survival higher than 85% in both arms – 85.7% in the experimental arm.
The overall survival was also similar in both arms.
The toxicity in the experimental arm including serious adverse events was significantly reduced.
We reduced by about 40% the risk of serious adverse events.
So, PET performed after two cycles of de-escalated BEACOPP can be safely used to guide subsequent treatment and support a response adapted strategy delivering four cycles of ABVD for patients with negative PET2.
We can reduce the treatment in most patients, 84% of patients, without impairing the disease control.
This approach allows us to significantly reduce the treatment related toxicity in most patients and the reduction of serious adverse events is about 40% and provides similar patient outcomes compared to standard escalated BEACOPP treatment.
We can consider that this approach is probably a new standard of treatment in this disease.
