{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T01:50:10Z","timestamp":1790733010453,"version":"4.1.0"},"reference-count":24,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"27","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO"],"published-print":{"date-parts":[[2025,9,20]]},"abstract":"<jats:sec>\n            <jats:title>PURPOSE<\/jats:title>\n            <jats:p>Positron emission tomography (PET)-guided therapy with 4-6 cycles of brentuximab vedotin, etoposide, cyclophosphamide, doxorubicin, dacarbazine, and dexamethasone (BrECADD) is highly effective in younger patients with advanced-stage classic Hodgkin lymphoma (AS-cHL). We report feasibility and efficacy of PET-guided BrECADD as first-line treatment in older patients with AS-cHL.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>PATIENTS AND METHODS<\/jats:title>\n            <jats:p>\n              Patients with AS-cHL aged 61-75 years were enrolled in a phase II single-arm cohort of the HD21 trial (ClinicalTrials.gov identifier:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\/ct2\/show\/NCT02661503\">NCT02661503<\/jats:ext-link>\n              ). Patients with negative PET\/computed tomography after 2\u00d7BrECADD (PET2) received a total of 4\u00d7BrECADD, while PET2-positive patients received 6\u00d7BrECADD. The primary end point was the centrally reviewed complete remission (CR) rate after the end of chemotherapy (EOC). Secondary end points included feasibility, adverse events, treatment-related morbidity (TRMB), progression-free survival (PFS), overall survival (OS), and health-related quality of life (HRQoL).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS<\/jats:title>\n            <jats:p>Between June 2020 and April 2023, 85 patients were enrolled, of whom 83 with a median age of 67 years (range, 61-75) were analyzed in the intention-to-treat cohort. Most prevalent \u2265grade 3 toxicities included leukopenia (n = 80 [96%]), thrombocytopenia (n = 71 [86%]), anemia (n = 57 [69%]), and febrile neutropenia (n = 46 [55%]). Forty-eight (60%) of 80 patients with centrally reviewed PET2 were scheduled for 4\u00d7BrECADD and 32 (40%) for 6\u00d7BrECADD. Of these, 71 patients (89%) received the target number of cycles. Sixty-eight patients (82%; 95% CI, 72 to 90) achieved CR at EOC. PFS and OS estimates at 2 years were 91.5% (95% CI, 85 to 98) and 90.8% (95% CI, 84 to 98), respectively. No death was attributed to study treatment. Initially, impaired HRQoL scores improved during follow up and on average reached population reference values.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSION<\/jats:title>\n            <jats:p>PET-guided BrECADD in older patients is feasible and effective. With a PFS rate on par with that of younger patients, short duration, and limited anthracycline exposure, BrECADD is a valuable treatment option also for older patients with AS-cHL.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1200\/jco-25-00439","type":"journal-article","created":{"date-parts":[[2025,7,17]],"date-time":"2025-07-17T19:59:28Z","timestamp":1752782368000},"page":"2974-2985","update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":16,"title":["Positron Emission Tomography\u2013Guided Brentuximab Vedotin, Etoposide, Cyclophosphamide, Doxorubicin, Dacarbazine, and Dexamethasone in Older Patients With Advanced-Stage Classic Hodgkin Lymphoma: A Prospective, Multicenter, Single-Arm, Phase II Cohort of the German Hodgkin Study Group HD21 Trial"],"prefix":"10.1200","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3481-7997","authenticated-orcid":true,"given":"Justin","family":"Ferdinandus","sequence":"first","affiliation":[{"name":"Department I of Internal Medicine, Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), German Hodgkin Study Group (GHSG), University of Cologne, Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helen","family":"Kaul","sequence":"additional","affiliation":[{"name":"Department I of Internal Medicine, Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), German Hodgkin Study Group (GHSG), University of Cologne, Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Foss\u00e5","sequence":"additional","affiliation":[{"name":"Department of Oncology, Oslo University Hospital, Oslo, Norway"},{"name":"Nordic Lymphoma Group, Arhus, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2230-3873","authenticated-orcid":true,"given":"Andreas","family":"H\u00fcttmann","sequence":"additional","affiliation":[{"name":"Department of Hematology, and Stem Cell Transplantation, West German Cancer Center and German Cancer Consortium (DKTK partner site Essen), University Hospital Essen, University of Duisburg-Essen, Essen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felix","family":"Keil","sequence":"additional","affiliation":[{"name":"Department of Hematology, Hanusch Krankenhaus, Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yon-Dschun","family":"Ko","sequence":"additional","affiliation":[{"name":"Oncological Center, Johanniter Hospital, Bonn, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-1741-5819","authenticated-orcid":true,"given":"Felicitas","family":"Hitz","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology\/Hematology, Kantonsspital St.Gallen, St.Gallen, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michaela","family":"Schwarz","sequence":"additional","affiliation":[{"name":"Department of Hematology, Oncology and Tumor Immunology, Charit\u00e9-Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin, Campus Virchow Clinic, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corinna","family":"Trenker","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Hematology, Oncology and Immunology, Philipps University Marburg and University Hospital Giessen and Marburg, Campus Marburg, Marburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6904-2821","authenticated-orcid":false,"given":"Andrea","family":"Kerkhoff","sequence":"additional","affiliation":[{"name":"Department for Medicine A, Hematology, Oncology, Hemostaseology and Pneumology, University Hospital Muenster, Muenster, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Staib","sequence":"additional","affiliation":[{"name":"Department of Hematology and Oncology, St Antonius Hospital Eschweiler, Eschweiler, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kai","family":"Wille","sequence":"additional","affiliation":[{"name":"University Clinic for Hematology, Oncology, Hemostaseology and Palliative Care, Johannes Wesling Medical Center Minden, University of Bochum, Bochum, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irmgard","family":"Dresel","sequence":"additional","affiliation":[{"name":"Ortenau Klinikum, Offenburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dennis","family":"Hahn","sequence":"additional","affiliation":[{"name":"Department of Hematology, Oncology, Stem-Cell Transplantation and Palliative Care, Klinikum Stuttgart, Stuttgart, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernd","family":"Hertenstein","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I, Klinikum Bremen Mitte, Bremen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Moosmann","sequence":"additional","affiliation":[{"name":"Cantonal Hospital Aarau, Aarau, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrich","family":"Mey","sequence":"additional","affiliation":[{"name":"Oncology and Hematology, Kantonsspital Graubuenden, Chur, Switzerland"},{"name":"Swiss Group for Clinical Cancer Research, Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Balabanov","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology and Hematology, University Hospital of Zurich, Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tasman","family":"Armytage","sequence":"additional","affiliation":[{"name":"Department of Haematology Gosford Hospital, Gosford, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-9955-5928","authenticated-orcid":true,"given":"Fernando","family":"Roncolato","sequence":"additional","affiliation":[{"name":"St George Hospital, Kogarah, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8409-3037","authenticated-orcid":true,"given":"Johannes C.","family":"Hellmuth","sequence":"additional","affiliation":[{"name":"Department of Medicine III, University Hospital, Ludwig-Maximilians-Universit\u00e4t M\u00fcnchen (LMU), Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Hertzberg","sequence":"additional","affiliation":[{"name":"Department of Haematology, Prince of Wales Hospital, and UNSW, Sydney, Australia"},{"name":"Australasian Leukaemia &amp; Lymphoma Group (ALLG), Melbourne, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2909-0826","authenticated-orcid":true,"given":"Carsten","family":"Kobe","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, University Hospital of Cologne, Center for Integrated Oncology Aachen Bonn Cologne D\u00fcsseldorf (CIO ABCD), German Hodgkin Study Group (GHSG), Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wolfram","family":"Klapper","sequence":"additional","affiliation":[{"name":"Department of Pathology, Hematopathology Section, University of Schleswig-Holstein, Campus Kiel, Kiel, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1733-6064","authenticated-orcid":true,"given":"Christian","family":"Baues","sequence":"additional","affiliation":[{"name":"Dept. of Radiation Oncology, University Hospital of Ruhr-Universit\u00e4t Bochum, Marien Hospital Herne, Herne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans-Theodor","family":"Eich","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy, University Hospital of Muenster, Muenster, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefanie","family":"Kreissl","sequence":"additional","affiliation":[{"name":"Ordensklinikum Linz Elisabethinen, Linz, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3289-3272","authenticated-orcid":true,"given":"Michael","family":"Fuchs","sequence":"additional","affiliation":[{"name":"Department I of Internal Medicine, Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), German Hodgkin Study Group (GHSG), University of Cologne, Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-2811-4762","authenticated-orcid":true,"given":"Janina","family":"Jablonski","sequence":"additional","affiliation":[{"name":"Department I of Internal Medicine, Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), German Hodgkin Study Group (GHSG), University of Cologne, Cologne, 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Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1927-3514","authenticated-orcid":true,"given":"Dennis A.","family":"Eichenauer","sequence":"additional","affiliation":[{"name":"Department I of Internal Medicine, Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), German Hodgkin Study Group (GHSG), University of Cologne, Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1410-4487","authenticated-orcid":true,"given":"Bastian","family":"von Tresckow","sequence":"additional","affiliation":[{"name":"Department I of Internal Medicine, Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), German Hodgkin Study Group (GHSG), University of Cologne, Cologne, Germany"},{"name":"Department of Hematology, and Stem Cell Transplantation, 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