Evidence map›Paper›PMID 27332902›Full record

Trial reportThe New England journal of medicine2016

Adapted Treatment Guided by Interim PET-CT Scan in Advanced Hodgkin's Lymphoma.

Peter Johnson, Massimo Federico, Amy Kirkwood, Alexander Fosså, Leanne Berkahn, Angelo Carella, Francesco d'Amore, Gunilla Enblad, Antonella Franceschetto, Michael Fulham and 11 more

2 registry-linked trialsOpen access · bronzeAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in The New England journal of medicine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 341 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
341citing papers in PubMed, 6 pooled it
65.9field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00678327 phase3completednot on this map

A Randomized Phase III Trial to Assess Response Adapted Therapy Using FDG-PET Imaging in Patients With Newly Diagnosed, Advanced Hodgkin Lymphoma

TypeinterventionalSponsorUniversity College, LondonRan2008 to 2024Enrolled1,202ConditionsLymphomaArmsbleomycin sulfate, filgrastim, pegfilgrastim, cyclophosphamide, dacarbazine
NCT03500133 phase4recruitingnot on this mapstarted 2017, after this paper: background citation

Non Randomized, Multicenter, Prospective Pediatric Hodgkin Lymphoma Treatment Trial Stratified According to Initial Risk Factors and Response to Chemotherapy, Reduced Cumulative Doses of Antineoplastic Agents and Radiotherapy.

TypeinterventionalSponsorHospital JP GarrahanRan2017 to 2032Enrolled500ConditionsPediatric Hodgkin's DiseaseArmsNo radiotherapy if CR at the end of chemotherapy., Low risk with complete early response after two cycles of ABVD chemotherapy schedule. Only one more ABVD course is delivered., Low risk with partial remisssion after 4 cycles of ABVD chemotherapy schedule. Two ESHAP courses are delivered., IN 30Gy RT in case of PR at the end of chemotherapy, Intermediate risk with complete early response after two cycles of ABVD chemotherapy schedule. Three more ABVD courses are delivered.
3 · Its place in the literature

Who cites it

341 citing papers in PubMed, 6 syntheses or guidelines pooled it, 779 citations in OpenAlex.

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  10. Phase II Trial of Nivolumab Plus Doxorubicin, Vinblastine, Dacarbazine as Frontline Therapy in Older Adults With Hodgkin Lymphoma.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2025
    Trial
  11. Hypoxia-Directed Treatment of Human Papillomavirus-Related Oropharyngeal Carcinoma.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2024
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  18. Cancer-related cognitive impairment in patients with newly diagnosed aggressive lymphoma undergoing standard chemotherapy: a longitudinal feasibility study.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2022
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281 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

21 authors at 1 institution in 1 country.

Peter JohnsonFrom the Cancer Research UK Centre, University of Southampton, Southampton (P.J.), Cancer Research UK and University College London Cancer Trials Centre (A.K., P.P., T.R., L.S., P.S.) and the PET Imaging Centre, King's College London, King's Health Partners, St. Thomas' Hospital (M.O., Z.V., S.B.), London, the Department of Haematology, Lincoln County Hospital, Lincoln (G.S.), and the Department of Medical Oncology, Christie Hospital, Manchester (J.R.) - all in the United Kingdom; the Department of Diagnostic, Clinical, and Public Health Medicine, University of Modena and Reggio Emilia, Modena (M. Federico, A. Franceschetto, S.L.), the Department of Hematology, San Martino University Hospital, Genoa (A.C.), and Arcispedale Santa Maria Nuova-Istituti di Ricovero e Cura a Carattere Scientifico, Reggio Emilia (S.L.) - all in Italy; the Department of Medical Oncology, Oslo University Hospital, Oslo (A. Fosså); the Department of Haematology, Auckland City Hospital, Auckland, New Zealand (L.B.); the Department of Hematology, Aarhus University Hospital, Aarhus, Denmark (F.A.); the Department of Immunology, Genetics, and Pathology, Uppsala University, Uppsala, Sweden (G.E.); and the Department of Molecular Imaging, Royal Prince Alfred Hospital (M. Fulham), and Concord Repatriation General Hospital, University of Sydney (J.T.), Sydney.
Massimo FedericoFrom the Cancer Research UK Centre, University of Southampton, Southampton (P.J.), Cancer Research UK and University College London Cancer Trials Centre (A.K., P.P., T.R., L.S., P.S.) and the PET Imaging Centre, King's College London, King's Health Partners, St. Thomas' Hospital (M.O., Z.V., S.B.), London, the Department of Haematology, Lincoln County Hospital, Lincoln (G.S.), and the Department of Medical Oncology, Christie Hospital, Manchester (J.R.) - all in the United Kingdom; the Department of Diagnostic, Clinical, and Public Health Medicine, University of Modena and Reggio Emilia, Modena (M. Federico, A. Franceschetto, S.L.), the Department of Hematology, San Martino University Hospital, Genoa (A.C.), and Arcispedale Santa Maria Nuova-Istituti di Ricovero e Cura a Carattere Scientifico, Reggio Emilia (S.L.) - all in Italy; the Department of Medical Oncology, Oslo University Hospital, Oslo (A. Fosså); the Department of Haematology, Auckland City Hospital, Auckland, New Zealand (L.B.); the Department of Hematology, Aarhus University Hospital, Aarhus, Denmark (F.A.); the Department of Immunology, Genetics, and Pathology, Uppsala University, Uppsala, Sweden (G.E.); and the Department of Molecular Imaging, Royal Prince Alfred Hospital (M. Fulham), and Concord Repatriation General Hospital, University of Sydney (J.T.), Sydney.
Amy KirkwoodFrom the Cancer Research UK Centre, University of Southampton, Southampton (P.J.), Cancer Research UK and University College London Cancer Trials Centre (A.K., P.P., T.R., L.S., P.S.) and the PET Imaging Centre, King's College London, King's Health Partners, St. Thomas' Hospital (M.O., Z.V., S.B.), London, the Department of Haematology, Lincoln County Hospital, Lincoln (G.S.), and the Department of Medical Oncology, Christie Hospital, Manchester (J.R.) - all in the United Kingdom; the Department of Diagnostic, Clinical, and Public Health Medicine, University of Modena and Reggio Emilia, Modena (M. Federico, A. Franceschetto, S.L.), the Department of Hematology, San Martino University Hospital, Genoa (A.C.), and Arcispedale Santa Maria Nuova-Istituti di Ricovero e Cura a Carattere Scientifico, Reggio Emilia (S.L.) - all in Italy; the Department of Medical Oncology, Oslo University Hospital, Oslo (A. Fosså); the Department of Haematology, Auckland City Hospital, Auckland, New Zealand (L.B.); the Department of Hematology, Aarhus University Hospital, Aarhus, Denmark (F.A.); the Department of Immunology, Genetics, and Pathology, Uppsala University, Uppsala, Sweden (G.E.); and the Department of Molecular Imaging, Royal Prince Alfred Hospital (M. Fulham), and Concord Repatriation General Hospital, University of Sydney (J.T.), Sydney.
Alexander FossåFrom the Cancer Research UK Centre, University of Southampton, Southampton (P.J.), Cancer Research UK and University College London Cancer Trials Centre (A.K., P.P., T.R., L.S., P.S.) and the PET Imaging Centre, King's College London, King's Health Partners, St. Thomas' Hospital (M.O., Z.V., S.B.), London, the Department of Haematology, Lincoln County Hospital, Lincoln (G.S.), and the Department of Medical Oncology, Christie Hospital, Manchester (J.R.) - all in the United Kingdom; the Department of Diagnostic, Clinical, and Public Health Medicine, University of Modena and Reggio Emilia, Modena (M. Federico, A. Franceschetto, S.L.), the Department of Hematology, San Martino University Hospital, Genoa (A.C.), and Arcispedale Santa Maria Nuova-Istituti di Ricovero e Cura a Carattere Scientifico, Reggio Emilia (S.L.) - all in Italy; the Department of Medical Oncology, Oslo University Hospital, Oslo (A. Fosså); the Department of Haematology, Auckland City Hospital, Auckland, New Zealand (L.B.); the Department of Hematology, Aarhus University Hospital, Aarhus, Denmark (F.A.); the Department of Immunology, Genetics, and Pathology, Uppsala University, Uppsala, Sweden (G.E.); and the Department of Molecular Imaging, Royal Prince Alfred Hospital (M. Fulham), and Concord Repatriation General Hospital, University of Sydney (J.T.), Sydney.
Leanne BerkahnFrom the Cancer Research UK Centre, University of Southampton, Southampton (P.J.), Cancer Research UK and University College London Cancer Trials Centre (A.K., P.P., T.R., L.S., P.S.) and the PET Imaging Centre, King's College London, King's Health Partners, St. Thomas' Hospital (M.O., Z.V., S.B.), London, the Department of Haematology, Lincoln County Hospital, Lincoln (G.S.), and the Department of Medical Oncology, Christie Hospital, Manchester (J.R.) - all in the United Kingdom; the Department of Diagnostic, Clinical, and Public Health Medicine, University of Modena and Reggio Emilia, Modena (M. Federico, A. Franceschetto, S.L.), the Department of Hematology, San Martino University Hospital, Genoa (A.C.), and Arcispedale Santa Maria Nuova-Istituti di Ricovero e Cura a Carattere Scientifico, Reggio Emilia (S.L.) - all in Italy; the Department of Medical Oncology, Oslo University Hospital, Oslo (A. Fosså); the Department of Haematology, Auckland City Hospital, Auckland, New Zealand (L.B.); the Department of Hematology, Aarhus University Hospital, Aarhus, Denmark (F.A.); the Department of Immunology, Genetics, and Pathology, Uppsala University, Uppsala, Sweden (G.E.); and the Department of Molecular Imaging, Royal Prince Alfred Hospital (M. Fulham), and Concord Repatriation General Hospital, University of Sydney (J.T.), Sydney.
Angelo CarellaFrom the Cancer Research UK Centre, University of Southampton, Southampton (P.J.), Cancer Research UK and University College London Cancer Trials Centre (A.K., P.P., T.R., L.S., P.S.) and the PET Imaging Centre, King's College London, King's Health Partners, St. Thomas' Hospital (M.O., Z.V., S.B.), London, the Department of Haematology, Lincoln County Hospital, Lincoln (G.S.), and the Department of Medical Oncology, Christie Hospital, Manchester (J.R.) - all in the United Kingdom; the Department of Diagnostic, Clinical, and Public Health Medicine, University of Modena and Reggio Emilia, Modena (M. Federico, A. Franceschetto, S.L.), the Department of Hematology, San Martino University Hospital, Genoa (A.C.), and Arcispedale Santa Maria Nuova-Istituti di Ricovero e Cura a Carattere Scientifico, Reggio Emilia (S.L.) - all in Italy; the Department of Medical Oncology, Oslo University Hospital, Oslo (A. Fosså); the Department of Haematology, Auckland City Hospital, Auckland, New Zealand (L.B.); the Department of Hematology, Aarhus University Hospital, Aarhus, Denmark (F.A.); the Department of Immunology, Genetics, and Pathology, Uppsala University, Uppsala, Sweden (G.E.); and the Department of Molecular Imaging, Royal Prince Alfred Hospital (M. Fulham), and Concord Repatriation General Hospital, University of Sydney (J.T.), Sydney.
Francesco d'AmoreFrom the Cancer Research UK Centre, University of Southampton, Southampton (P.J.), Cancer Research UK and University College London Cancer Trials Centre (A.K., P.P., T.R., L.S., P.S.) and the PET Imaging Centre, King's College London, King's Health Partners, St. Thomas' Hospital (M.O., Z.V., S.B.), London, the Department of Haematology, Lincoln County Hospital, Lincoln (G.S.), and the Department of Medical Oncology, Christie Hospital, Manchester (J.R.) - all in the United Kingdom; the Department of Diagnostic, Clinical, and Public Health Medicine, University of Modena and Reggio Emilia, Modena (M. Federico, A. Franceschetto, S.L.), the Department of Hematology, San Martino University Hospital, Genoa (A.C.), and Arcispedale Santa Maria Nuova-Istituti di Ricovero e Cura a Carattere Scientifico, Reggio Emilia (S.L.) - all in Italy; the Department of Medical Oncology, Oslo University Hospital, Oslo (A. Fosså); the Department of Haematology, Auckland City Hospital, Auckland, New Zealand (L.B.); the Department of Hematology, Aarhus University Hospital, Aarhus, Denmark (F.A.); the Department of Immunology, Genetics, and Pathology, Uppsala University, Uppsala, Sweden (G.E.); and the Department of Molecular Imaging, Royal Prince Alfred Hospital (M. Fulham), and Concord Repatriation General Hospital, University of Sydney (J.T.), Sydney.
Gunilla EnbladFrom the Cancer Research UK Centre, University of Southampton, Southampton (P.J.), Cancer Research UK and University College London Cancer Trials Centre (A.K., P.P., T.R., L.S., P.S.) and the PET Imaging Centre, King's College London, King's Health Partners, St. Thomas' Hospital (M.O., Z.V., S.B.), London, the Department of Haematology, Lincoln County Hospital, Lincoln (G.S.), and the Department of Medical Oncology, Christie Hospital, Manchester (J.R.) - all in the United Kingdom; the Department of Diagnostic, Clinical, and Public Health Medicine, University of Modena and Reggio Emilia, Modena (M. Federico, A. Franceschetto, S.L.), the Department of Hematology, San Martino University Hospital, Genoa (A.C.), and Arcispedale Santa Maria Nuova-Istituti di Ricovero e Cura a Carattere Scientifico, Reggio Emilia (S.L.) - all in Italy; the Department of Medical Oncology, Oslo University Hospital, Oslo (A. Fosså); the Department of Haematology, Auckland City Hospital, Auckland, New Zealand (L.B.); the Department of Hematology, Aarhus University Hospital, Aarhus, Denmark (F.A.); the Department of Immunology, Genetics, and Pathology, Uppsala University, Uppsala, Sweden (G.E.); and the Department of Molecular Imaging, Royal Prince Alfred Hospital (M. Fulham), and Concord Repatriation General Hospital, University of Sydney (J.T.), Sydney.
Antonella FranceschettoFrom the Cancer Research UK Centre, University of Southampton, Southampton (P.J.), Cancer Research UK and University College London Cancer Trials Centre (A.K., P.P., T.R., L.S., P.S.) and the PET Imaging Centre, King's College London, King's Health Partners, St. Thomas' Hospital (M.O., Z.V., S.B.), London, the Department of Haematology, Lincoln County Hospital, Lincoln (G.S.), and the Department of Medical Oncology, Christie Hospital, Manchester (J.R.) - all in the United Kingdom; the Department of Diagnostic, Clinical, and Public Health Medicine, University of Modena and Reggio Emilia, Modena (M. Federico, A. Franceschetto, S.L.), the Department of Hematology, San Martino University Hospital, Genoa (A.C.), and Arcispedale Santa Maria Nuova-Istituti di Ricovero e Cura a Carattere Scientifico, Reggio Emilia (S.L.) - all in Italy; the Department of Medical Oncology, Oslo University Hospital, Oslo (A. Fosså); the Department of Haematology, Auckland City Hospital, Auckland, New Zealand (L.B.); the Department of Hematology, Aarhus University Hospital, Aarhus, Denmark (F.A.); the Department of Immunology, Genetics, and Pathology, Uppsala University, Uppsala, Sweden (G.E.); and the Department of Molecular Imaging, Royal Prince Alfred Hospital (M. Fulham), and Concord Repatriation General Hospital, University of Sydney (J.T.), Sydney.
Michael FulhamFrom the Cancer Research UK Centre, University of Southampton, Southampton (P.J.), Cancer Research UK and University College London Cancer Trials Centre (A.K., P.P., T.R., L.S., P.S.) and the PET Imaging Centre, King's College London, King's Health Partners, St. Thomas' Hospital (M.O., Z.V., S.B.), London, the Department of Haematology, Lincoln County Hospital, Lincoln (G.S.), and the Department of Medical Oncology, Christie Hospital, Manchester (J.R.) - all in the United Kingdom; the Department of Diagnostic, Clinical, and Public Health Medicine, University of Modena and Reggio Emilia, Modena (M. Federico, A. Franceschetto, S.L.), the Department of Hematology, San Martino University Hospital, Genoa (A.C.), and Arcispedale Santa Maria Nuova-Istituti di Ricovero e Cura a Carattere Scientifico, Reggio Emilia (S.L.) - all in Italy; the Department of Medical Oncology, Oslo University Hospital, Oslo (A. Fosså); the Department of Haematology, Auckland City Hospital, Auckland, New Zealand (L.B.); the Department of Hematology, Aarhus University Hospital, Aarhus, Denmark (F.A.); the Department of Immunology, Genetics, and Pathology, Uppsala University, Uppsala, Sweden (G.E.); and the Department of Molecular Imaging, Royal Prince Alfred Hospital (M. Fulham), and Concord Repatriation General Hospital, University of Sydney (J.T.), Sydney.
Stefano LuminariFrom the Cancer Research UK Centre, University of Southampton, Southampton (P.J.), Cancer Research UK and University College London Cancer Trials Centre (A.K., P.P., T.R., L.S., P.S.) and the PET Imaging Centre, King's College London, King's Health Partners, St. Thomas' Hospital (M.O., Z.V., S.B.), London, the Department of Haematology, Lincoln County Hospital, Lincoln (G.S.), and the Department of Medical Oncology, Christie Hospital, Manchester (J.R.) - all in the United Kingdom; the Department of Diagnostic, Clinical, and Public Health Medicine, University of Modena and Reggio Emilia, Modena (M. Federico, A. Franceschetto, S.L.), the Department of Hematology, San Martino University Hospital, Genoa (A.C.), and Arcispedale Santa Maria Nuova-Istituti di Ricovero e Cura a Carattere Scientifico, Reggio Emilia (S.L.) - all in Italy; the Department of Medical Oncology, Oslo University Hospital, Oslo (A. Fosså); the Department of Haematology, Auckland City Hospital, Auckland, New Zealand (L.B.); the Department of Hematology, Aarhus University Hospital, Aarhus, Denmark (F.A.); the Department of Immunology, Genetics, and Pathology, Uppsala University, Uppsala, Sweden (G.E.); and the Department of Molecular Imaging, Royal Prince Alfred Hospital (M. Fulham), and Concord Repatriation General Hospital, University of Sydney (J.T.), Sydney.
Michael O'DohertyFrom the Cancer Research UK Centre, University of Southampton, Southampton (P.J.), Cancer Research UK and University College London Cancer Trials Centre (A.K., P.P., T.R., L.S., P.S.) and the PET Imaging Centre, King's College London, King's Health Partners, St. Thomas' Hospital (M.O., Z.V., S.B.), London, the Department of Haematology, Lincoln County Hospital, Lincoln (G.S.), and the Department of Medical Oncology, Christie Hospital, Manchester (J.R.) - all in the United Kingdom; the Department of Diagnostic, Clinical, and Public Health Medicine, University of Modena and Reggio Emilia, Modena (M. Federico, A. Franceschetto, S.L.), the Department of Hematology, San Martino University Hospital, Genoa (A.C.), and Arcispedale Santa Maria Nuova-Istituti di Ricovero e Cura a Carattere Scientifico, Reggio Emilia (S.L.) - all in Italy; the Department of Medical Oncology, Oslo University Hospital, Oslo (A. Fosså); the Department of Haematology, Auckland City Hospital, Auckland, New Zealand (L.B.); the Department of Hematology, Aarhus University Hospital, Aarhus, Denmark (F.A.); the Department of Immunology, Genetics, and Pathology, Uppsala University, Uppsala, Sweden (G.E.); and the Department of Molecular Imaging, Royal Prince Alfred Hospital (M. Fulham), and Concord Repatriation General Hospital, University of Sydney (J.T.), Sydney.
Pip PatrickFrom the Cancer Research UK Centre, University of Southampton, Southampton (P.J.), Cancer Research UK and University College London Cancer Trials Centre (A.K., P.P., T.R., L.S., P.S.) and the PET Imaging Centre, King's College London, King's Health Partners, St. Thomas' Hospital (M.O., Z.V., S.B.), London, the Department of Haematology, Lincoln County Hospital, Lincoln (G.S.), and the Department of Medical Oncology, Christie Hospital, Manchester (J.R.) - all in the United Kingdom; the Department of Diagnostic, Clinical, and Public Health Medicine, University of Modena and Reggio Emilia, Modena (M. Federico, A. Franceschetto, S.L.), the Department of Hematology, San Martino University Hospital, Genoa (A.C.), and Arcispedale Santa Maria Nuova-Istituti di Ricovero e Cura a Carattere Scientifico, Reggio Emilia (S.L.) - all in Italy; the Department of Medical Oncology, Oslo University Hospital, Oslo (A. Fosså); the Department of Haematology, Auckland City Hospital, Auckland, New Zealand (L.B.); the Department of Hematology, Aarhus University Hospital, Aarhus, Denmark (F.A.); the Department of Immunology, Genetics, and Pathology, Uppsala University, Uppsala, Sweden (G.E.); and the Department of Molecular Imaging, Royal Prince Alfred Hospital (M. Fulham), and Concord Repatriation General Hospital, University of Sydney (J.T.), Sydney.
Thomas RobertsFrom the Cancer Research UK Centre, University of Southampton, Southampton (P.J.), Cancer Research UK and University College London Cancer Trials Centre (A.K., P.P., T.R., L.S., P.S.) and the PET Imaging Centre, King's College London, King's Health Partners, St. Thomas' Hospital (M.O., Z.V., S.B.), London, the Department of Haematology, Lincoln County Hospital, Lincoln (G.S.), and the Department of Medical Oncology, Christie Hospital, Manchester (J.R.) - all in the United Kingdom; the Department of Diagnostic, Clinical, and Public Health Medicine, University of Modena and Reggio Emilia, Modena (M. Federico, A. Franceschetto, S.L.), the Department of Hematology, San Martino University Hospital, Genoa (A.C.), and Arcispedale Santa Maria Nuova-Istituti di Ricovero e Cura a Carattere Scientifico, Reggio Emilia (S.L.) - all in Italy; the Department of Medical Oncology, Oslo University Hospital, Oslo (A. Fosså); the Department of Haematology, Auckland City Hospital, Auckland, New Zealand (L.B.); the Department of Hematology, Aarhus University Hospital, Aarhus, Denmark (F.A.); the Department of Immunology, Genetics, and Pathology, Uppsala University, Uppsala, Sweden (G.E.); and the Department of Molecular Imaging, Royal Prince Alfred Hospital (M. Fulham), and Concord Repatriation General Hospital, University of Sydney (J.T.), Sydney.
Gamal SidraFrom the Cancer Research UK Centre, University of Southampton, Southampton (P.J.), Cancer Research UK and University College London Cancer Trials Centre (A.K., P.P., T.R., L.S., P.S.) and the PET Imaging Centre, King's College London, King's Health Partners, St. Thomas' Hospital (M.O., Z.V., S.B.), London, the Department of Haematology, Lincoln County Hospital, Lincoln (G.S.), and the Department of Medical Oncology, Christie Hospital, Manchester (J.R.) - all in the United Kingdom; the Department of Diagnostic, Clinical, and Public Health Medicine, University of Modena and Reggio Emilia, Modena (M. Federico, A. Franceschetto, S.L.), the Department of Hematology, San Martino University Hospital, Genoa (A.C.), and Arcispedale Santa Maria Nuova-Istituti di Ricovero e Cura a Carattere Scientifico, Reggio Emilia (S.L.) - all in Italy; the Department of Medical Oncology, Oslo University Hospital, Oslo (A. Fosså); the Department of Haematology, Auckland City Hospital, Auckland, New Zealand (L.B.); the Department of Hematology, Aarhus University Hospital, Aarhus, Denmark (F.A.); the Department of Immunology, Genetics, and Pathology, Uppsala University, Uppsala, Sweden (G.E.); and the Department of Molecular Imaging, Royal Prince Alfred Hospital (M. Fulham), and Concord Repatriation General Hospital, University of Sydney (J.T.), Sydney.
Lindsey StevensFrom the Cancer Research UK Centre, University of Southampton, Southampton (P.J.), Cancer Research UK and University College London Cancer Trials Centre (A.K., P.P., T.R., L.S., P.S.) and the PET Imaging Centre, King's College London, King's Health Partners, St. Thomas' Hospital (M.O., Z.V., S.B.), London, the Department of Haematology, Lincoln County Hospital, Lincoln (G.S.), and the Department of Medical Oncology, Christie Hospital, Manchester (J.R.) - all in the United Kingdom; the Department of Diagnostic, Clinical, and Public Health Medicine, University of Modena and Reggio Emilia, Modena (M. Federico, A. Franceschetto, S.L.), the Department of Hematology, San Martino University Hospital, Genoa (A.C.), and Arcispedale Santa Maria Nuova-Istituti di Ricovero e Cura a Carattere Scientifico, Reggio Emilia (S.L.) - all in Italy; the Department of Medical Oncology, Oslo University Hospital, Oslo (A. Fosså); the Department of Haematology, Auckland City Hospital, Auckland, New Zealand (L.B.); the Department of Hematology, Aarhus University Hospital, Aarhus, Denmark (F.A.); the Department of Immunology, Genetics, and Pathology, Uppsala University, Uppsala, Sweden (G.E.); and the Department of Molecular Imaging, Royal Prince Alfred Hospital (M. Fulham), and Concord Repatriation General Hospital, University of Sydney (J.T.), Sydney.
Paul SmithFrom the Cancer Research UK Centre, University of Southampton, Southampton (P.J.), Cancer Research UK and University College London Cancer Trials Centre (A.K., P.P., T.R., L.S., P.S.) and the PET Imaging Centre, King's College London, King's Health Partners, St. Thomas' Hospital (M.O., Z.V., S.B.), London, the Department of Haematology, Lincoln County Hospital, Lincoln (G.S.), and the Department of Medical Oncology, Christie Hospital, Manchester (J.R.) - all in the United Kingdom; the Department of Diagnostic, Clinical, and Public Health Medicine, University of Modena and Reggio Emilia, Modena (M. Federico, A. Franceschetto, S.L.), the Department of Hematology, San Martino University Hospital, Genoa (A.C.), and Arcispedale Santa Maria Nuova-Istituti di Ricovero e Cura a Carattere Scientifico, Reggio Emilia (S.L.) - all in Italy; the Department of Medical Oncology, Oslo University Hospital, Oslo (A. Fosså); the Department of Haematology, Auckland City Hospital, Auckland, New Zealand (L.B.); the Department of Hematology, Aarhus University Hospital, Aarhus, Denmark (F.A.); the Department of Immunology, Genetics, and Pathology, Uppsala University, Uppsala, Sweden (G.E.); and the Department of Molecular Imaging, Royal Prince Alfred Hospital (M. Fulham), and Concord Repatriation General Hospital, University of Sydney (J.T.), Sydney.
Judith TrotmanFrom the Cancer Research UK Centre, University of Southampton, Southampton (P.J.), Cancer Research UK and University College London Cancer Trials Centre (A.K., P.P., T.R., L.S., P.S.) and the PET Imaging Centre, King's College London, King's Health Partners, St. Thomas' Hospital (M.O., Z.V., S.B.), London, the Department of Haematology, Lincoln County Hospital, Lincoln (G.S.), and the Department of Medical Oncology, Christie Hospital, Manchester (J.R.) - all in the United Kingdom; the Department of Diagnostic, Clinical, and Public Health Medicine, University of Modena and Reggio Emilia, Modena (M. Federico, A. Franceschetto, S.L.), the Department of Hematology, San Martino University Hospital, Genoa (A.C.), and Arcispedale Santa Maria Nuova-Istituti di Ricovero e Cura a Carattere Scientifico, Reggio Emilia (S.L.) - all in Italy; the Department of Medical Oncology, Oslo University Hospital, Oslo (A. Fosså); the Department of Haematology, Auckland City Hospital, Auckland, New Zealand (L.B.); the Department of Hematology, Aarhus University Hospital, Aarhus, Denmark (F.A.); the Department of Immunology, Genetics, and Pathology, Uppsala University, Uppsala, Sweden (G.E.); and the Department of Molecular Imaging, Royal Prince Alfred Hospital (M. Fulham), and Concord Repatriation General Hospital, University of Sydney (J.T.), Sydney.
Zaid VineyFrom the Cancer Research UK Centre, University of Southampton, Southampton (P.J.), Cancer Research UK and University College London Cancer Trials Centre (A.K., P.P., T.R., L.S., P.S.) and the PET Imaging Centre, King's College London, King's Health Partners, St. Thomas' Hospital (M.O., Z.V., S.B.), London, the Department of Haematology, Lincoln County Hospital, Lincoln (G.S.), and the Department of Medical Oncology, Christie Hospital, Manchester (J.R.) - all in the United Kingdom; the Department of Diagnostic, Clinical, and Public Health Medicine, University of Modena and Reggio Emilia, Modena (M. Federico, A. Franceschetto, S.L.), the Department of Hematology, San Martino University Hospital, Genoa (A.C.), and Arcispedale Santa Maria Nuova-Istituti di Ricovero e Cura a Carattere Scientifico, Reggio Emilia (S.L.) - all in Italy; the Department of Medical Oncology, Oslo University Hospital, Oslo (A. Fosså); the Department of Haematology, Auckland City Hospital, Auckland, New Zealand (L.B.); the Department of Hematology, Aarhus University Hospital, Aarhus, Denmark (F.A.); the Department of Immunology, Genetics, and Pathology, Uppsala University, Uppsala, Sweden (G.E.); and the Department of Molecular Imaging, Royal Prince Alfred Hospital (M. Fulham), and Concord Repatriation General Hospital, University of Sydney (J.T.), Sydney.
John RadfordFrom the Cancer Research UK Centre, University of Southampton, Southampton (P.J.), Cancer Research UK and University College London Cancer Trials Centre (A.K., P.P., T.R., L.S., P.S.) and the PET Imaging Centre, King's College London, King's Health Partners, St. Thomas' Hospital (M.O., Z.V., S.B.), London, the Department of Haematology, Lincoln County Hospital, Lincoln (G.S.), and the Department of Medical Oncology, Christie Hospital, Manchester (J.R.) - all in the United Kingdom; the Department of Diagnostic, Clinical, and Public Health Medicine, University of Modena and Reggio Emilia, Modena (M. Federico, A. Franceschetto, S.L.), the Department of Hematology, San Martino University Hospital, Genoa (A.C.), and Arcispedale Santa Maria Nuova-Istituti di Ricovero e Cura a Carattere Scientifico, Reggio Emilia (S.L.) - all in Italy; the Department of Medical Oncology, Oslo University Hospital, Oslo (A. Fosså); the Department of Haematology, Auckland City Hospital, Auckland, New Zealand (L.B.); the Department of Hematology, Aarhus University Hospital, Aarhus, Denmark (F.A.); the Department of Immunology, Genetics, and Pathology, Uppsala University, Uppsala, Sweden (G.E.); and the Department of Molecular Imaging, Royal Prince Alfred Hospital (M. Fulham), and Concord Repatriation General Hospital, University of Sydney (J.T.), Sydney.
Sally BarringtonFrom the Cancer Research UK Centre, University of Southampton, Southampton (P.J.), Cancer Research UK and University College London Cancer Trials Centre (A.K., P.P., T.R., L.S., P.S.) and the PET Imaging Centre, King's College London, King's Health Partners, St. Thomas' Hospital (M.O., Z.V., S.B.), London, the Department of Haematology, Lincoln County Hospital, Lincoln (G.S.), and the Department of Medical Oncology, Christie Hospital, Manchester (J.R.) - all in the United Kingdom; the Department of Diagnostic, Clinical, and Public Health Medicine, University of Modena and Reggio Emilia, Modena (M. Federico, A. Franceschetto, S.L.), the Department of Hematology, San Martino University Hospital, Genoa (A.C.), and Arcispedale Santa Maria Nuova-Istituti di Ricovero e Cura a Carattere Scientifico, Reggio Emilia (S.L.) - all in Italy; the Department of Medical Oncology, Oslo University Hospital, Oslo (A. Fosså); the Department of Haematology, Auckland City Hospital, Auckland, New Zealand (L.B.); the Department of Hematology, Aarhus University Hospital, Aarhus, Denmark (F.A.); the Department of Immunology, Genetics, and Pathology, Uppsala University, Uppsala, Sweden (G.E.); and the Department of Molecular Imaging, Royal Prince Alfred Hospital (M. Fulham), and Concord Repatriation General Hospital, University of Sydney (J.T.), Sydney.
Cancer Research UK · GB

Funding

Cancer Research UK 16463Cancer Research UK 9619Cancer Research UK A9619Cancer Research UK CRUK/07/033
6 · The paper itself

Abstract

backgroundWe tested interim positron-emission tomography-computed tomography (PET-CT) as a measure of early response to chemotherapy in order to guide treatment for patients with advanced Hodgkin's lymphoma.

methodsPatients with newly diagnosed advanced classic Hodgkin's lymphoma underwent a baseline PET-CT scan, received two cycles of ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine) chemotherapy, and then underwent an interim PET-CT scan. Images were centrally reviewed with the use of a 5-point scale for PET findings. Patients with negative PET findings after two cycles were randomly assigned to continue ABVD (ABVD group) or omit bleomycin (AVD group) in cycles 3 through 6. Those with positive PET findings after two cycles received BEACOPP (bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone). Radiotherapy was not recommended for patients with negative findings on interim scans. The primary outcome was the difference in the 3-year progression-free survival rate between randomized groups, a noninferiority comparison to exclude a difference of 5 or more percentage points.

resultsA total of 1214 patients were registered; 937 of the 1119 patients (83.7%) who underwent an interim PET-CT scan according to protocol had negative findings. With a median follow-up of 41 months, the 3-year progression-free survival rate and overall survival rate in the ABVD group were 85.7% (95% confidence interval [CI], 82.1 to 88.6) and 97.2% (95% CI, 95.1 to 98.4), respectively; the corresponding rates in the AVD group were 84.4% (95% CI, 80.7 to 87.5) and 97.6% (95% CI, 95.6 to 98.7). The absolute difference in the 3-year progression-free survival rate (ABVD minus AVD) was 1.6 percentage points (95% CI, -3.2 to 5.3). Respiratory adverse events were more severe in the ABVD group than in the AVD group. BEACOPP was given to the 172 patients with positive findings on the interim scan, and 74.4% had negative findings on a third PET-CT scan; the 3-year progression-free survival rate was 67.5% and the overall survival rate 87.8%. A total of 62 patients died during the trial (24 from Hodgkin's lymphoma), for a 3-year progression-free survival rate of 82.6% and an overall survival rate of 95.8%.

conclusionsAlthough the results fall just short of the specified noninferiority margin, the omission of bleomycin from the ABVD regimen after negative findings on interim PET resulted in a lower incidence of pulmonary toxic effects than with continued ABVD but not significantly lower efficacy. (Funded by Cancer Research UK and Others; ClinicalTrials.gov number, NCT00678327.).

Indexed as

Positron-Emission TomographyTomography, X-Ray ComputedAdolescentAdultAntineoplastic Combined Chemotherapy ProtocolsBleomycinDacarbazineDisease-Free SurvivalDoxorubicinFemaleHodgkin DiseaseHumansMaleMiddle AgedProspective StudiesSurvival RateBleomycinDacarbazineDoxorubicinVinblastine

Identifiers

PMID27332902
PMCPMC4961236
OpenAlexW2469052042

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.