{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T02:51:53Z","timestamp":1764557513045},"reference-count":54,"publisher":"American Society of Hematology","issue":"1","content-domain":{"domain":["ashpublications.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2019,12,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Classic Hodgkin lymphoma (cHL) stands out as success story in the field of medical oncology, with multiagent chemotherapy with or without radiation leading to durable remission for most patients. Large-scale clinical trials during the past 40 years have sought to minimize toxicities while maintaining strong efficacy, including efforts to reduce the size of radiation fields, minimize alkylator chemotherapy, reduce the number of chemotherapy cycles, and omit radiation in select populations. The last decade has also ushered in novel therapies, including brentuximab vedotin (BV), that have improved clinical outcomes for patients with cHL resistant to standard cytotoxic therapies. More recently, a large randomized trial compared BV plus chemotherapy with chemotherapy alone for first-line treatment of advanced stage cHL. With \u223c24 months of available follow-up, the BV containing regimen was found to be associated with a reduction in the risk of progression, death, or incomplete response to first-line treatment (modified progression-free survival). Whether this early signal of improved efficacy is worth the additional acute toxicities and added drug-related expenses associated with incorporating BV into first-line treatment remains controversial. This chapter provides historical background; reviews the cost-effectiveness of available cHL therapies; and summarizes potential ways to balance innovation, affordability, and patient access to novel therapeutics.<\/jats:p>","DOI":"10.1182\/hematology.2019000030","type":"journal-article","created":{"date-parts":[[2019,12,6]],"date-time":"2019-12-06T15:12:14Z","timestamp":1575645134000},"page":"252-259","update-policy":"http:\/\/dx.doi.org\/10.1182\/blood.2019cm0000","source":"Crossref","is-referenced-by-count":2,"title":["Cure at what (systemic) financial cost? Integrating novel therapies into first-line Hodgkin lymphoma treatment"],"prefix":"10.1182","volume":"2019","author":[{"given":"Scott F.","family":"Huntington","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Section of Hematology, Yale University, New Haven, CT"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"234","reference":[{"issue":"21","key":"2019120610095956600_B1","doi-asserted-by":"crossref","first-page":"8643","DOI":"10.1158\/0008-5472.CAN-07-6611","article-title":"A history of cancer chemotherapy","volume":"68","author":"DeVita","year":"2008","journal-title":"Cancer Res"},{"issue":"21","key":"2019120610095956600_B2","doi-asserted-by":"crossref","first-page":"1478","DOI":"10.1056\/NEJM199211193272102","article-title":"Chemotherapy of advanced Hodgkin\u2019s disease with MOPP, ABVD, or MOPP alternating with ABVD","volume":"327","author":"Canellos","year":"1992","journal-title":"N Engl J Med"},{"issue":"24","key":"2019120610095956600_B3","doi-asserted-by":"crossref","first-page":"2386","DOI":"10.1056\/NEJMoa022473","article-title":"Standard and increased-dose BEACOPP chemotherapy compared with COPP-ABVD for advanced Hodgkin\u2019s disease [published erratum appears in N Engl J Med. 2005;353(7):744]","volume":"348","author":"Diehl","year":"2003","journal-title":"N Engl J Med"},{"issue":"26","key":"2019120610095956600_B4","doi-asserted-by":"crossref","first-page":"2499","DOI":"10.1056\/NEJMoa1505949","article-title":"Second cancer risk up to 40 years after treatment for Hodgkin\u2019s lymphoma","volume":"373","author":"Schaapveld","year":"2015","journal-title":"N Engl J Med"},{"issue":"7","key":"2019120610095956600_B5","doi-asserted-by":"crossref","first-page":"640","DOI":"10.1056\/NEJMoa1000067","article-title":"Reduced treatment intensity in patients with early-stage Hodgkin\u2019s lymphoma","volume":"363","author":"Engert","year":"2010","journal-title":"N Engl J Med"},{"issue":"25","key":"2019120610095956600_B6","doi-asserted-by":"crossref","first-page":"2419","DOI":"10.1056\/NEJMoa1510093","article-title":"Adapted treatment guided by interim PET-CT scan in advanced Hodgkin\u2019s lymphoma","volume":"374","author":"Johnson","year":"2016","journal-title":"N Engl J Med"},{"issue":"17","key":"2019120610095956600_B7","doi-asserted-by":"crossref","first-page":"1598","DOI":"10.1056\/NEJMoa1408648","article-title":"Results of a trial of PET-directed therapy for early-stage Hodgkin\u2019s lymphoma","volume":"372","author":"Radford","year":"2015","journal-title":"N Engl J Med"},{"issue":"16","key":"2019120610095956600_B8","doi-asserted-by":"crossref","first-page":"1786","DOI":"10.1200\/JCO.2016.68.6394","article-title":"Early positron emission tomography response-adapted treatment in stage I and II Hodgkin lymphoma: final results of the randomized EORTC\/LYSA\/FIL H10 Trial","volume":"35","author":"Andr\u00e9","year":"2017","journal-title":"J Clin Oncol"},{"issue":"suppl 1","key":"2019120610095956600_B9","doi-asserted-by":"crossref","first-page":"925","DOI":"10.1182\/blood-2018-99-114519","article-title":"PET-guided treatment of early-stage favorable Hodgkin lymphoma: final results of the international, randomized phase 3 trial HD16 by the German Hodgkin Study Group [abstract]","volume":"132","author":"Fuchs","year":"2018","journal-title":"Blood"},{"issue":"3","key":"2019120610095956600_B10","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1056\/NEJMoa1100340","article-title":"ABVD versus BEACOPP for Hodgkin\u2019s lymphoma when high-dose salvage is planned","volume":"365","author":"Viviani","year":"2011","journal-title":"N Engl J Med"},{"issue":"5","key":"2019120610095956600_B11","doi-asserted-by":"crossref","first-page":"608","DOI":"10.6004\/jnccn.2017.0064","article-title":"Hodgkin Lymphoma Version 1.2017, NCCN Clinical Practice Guidelines in Oncology","volume":"15","author":"Hoppe","year":"2017","journal-title":"J Natl Compr Canc Netw"},{"issue":"suppl 4","key":"2019120610095956600_B12","doi-asserted-by":"crossref","first-page":"iv19","DOI":"10.1093\/annonc\/mdy080","article-title":"ESMO Guidelines Committee. 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