Potential impact of consolidation radiation therapy for advanced Hodgkin lymphoma: a secondary analysis of SWOG S0816

Abstract

The role of radiotherapy (RT) in the management of advanced Hodgkin Lymphoma (HL) is inadequately defined in this era of functional imaging with PET scan. SWOG-S0816 treated advanced stage Hodgkin lymphoma patients with ABVD+/- escBEACOPP and no RT. We queried whether RT might have benefited patients in S0816 who would have met the GHSG-HD15 criteria for RT by simulating RT use as per HD15 criteria of PET + residual disease ≥2.5 cm. Receiver-operating-characteristics analyses were performed by varying disease-control rates within radiation fields and size cutoffs for residual disease. Among the 49 PET3+ S0816 patients, RT would have raised the 2-year PFS from 30.6% to 50.2–58.1% using three residual disease cutoffs (1.5, 2.0 and 2.5 cm) and assuming 80 and 90% in-field control rates . Although there may be improvement in PFS as size cutoff point is lowered, consequential toxicities from RT require further definition to assess relative benefits.

Keywords:

• Hodgkin lymphoma
• radiotherapy
• PET (positron emission tomography)

Acknowledgsments

This study is presented in memory of Oliver W. Press, M.D., Ph.D., Principal Investigator of S0816, mentor, scientist, colleague and friend.

Disclosure statement

DMS has received research funding from Acerta, Gilead, Karyopharm and honoraria from Genentech. HS has served as a consultant for Allero Therapeutics. DJS has received research funding and serves as a consultant for Seattle Genetics. LMR holds a patent through NanoString. NLB has received research funding from Gilead, Kite, Seattle Genetics, Affimed, Bristol-Meyers Squibb, Celgene, Forty Seven, Genentech, Immune Design, Janssen, Merck, Millennium, and Pharmacyclics. She serves as a consultant for Pfizer and Acerta. AME serves as a consultant and has received honoraria from Seattle Genetics, Bayer, Verastem, and Pharmacyclics. ASL serves as a consultant for Seattle Genetics and Bristol Myers Squib. PRB serves as a consultant for Abbvie. EDH serves as a consultant for Celgene, Seattle Genetics, and Jazz and has received research funding from Abbvie and Eli Lilly. JPL serves as a consultant for Celgene, Juno, Bristol Meyers Squibb, Sutro, Gilead, Genentech, Pfizer, Bayer, Biotest, United Therapeutics, Karyopharm, ADC Therapeutics, MEI Pharma, AstraZeneca, and Novartis. BSK serves as a consultant for Genentech, Celgene, Acerta, AstraZeneca, Juno, CTI, ADC Therapeutics, Abbvie, Gilead, and Seattle Genetics. SMS serves as a consultant for Bristol Meyers Squibb, Humanigen, and Seattle Genetics and has received research funding from Forty Seven and Sanofi. JWF has received honoraria from Bayer. No potential conflict of interest was reported by the author(s).

Clinical trial information

Secondary analysis for SWOG S0816.

Additional information

Funding

This investigation was supported in part by National Institutes of Health/National Cancer Institute/National Clinical Trials Network grants CA180888, CA180819, CA180821, CA180820, UG1CA233339, CA180833, CA180818, CA11083, and CA04919. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.