ESMO 2014 Report: Patients with Hodgkin’s lymphoma have a significantly better outcome if treated within a clinical trial

by Denys Wheatley: ESMO  Madrid September 2014: Session on Sunday 28 September (poster).  Dr Moccia and his group in Bellinzona (Switzerland) report on the marked improvement over 30 years in the treatment of Hodgkin’s lymphoma. This was particularly noticeable in patients from The Oncology Institute of Southern Switzerland who had been prospectively included in the large German Hodgkin Lymphoma Group trials.  They followed a cohort of 172 patients recruited in this way from 1996 to 2012, representing about one quarter of all their cases, of which about 50% were male, with more <40 compared with >40 years of age. A retrospective analysis was made of overall survival (OS) on NCI criteria. At diagnosis the breakdown was 13, 56, 15 and 16% of cases in stages I, II, II and IV, respectively. On the German trial criteria, there were 10% in the early stage, 40% early but with a poor prognosis, and 50% in advanced stage. The 5-year OS was 70% where the median follow-up had been 5.6 years. This finding proved significantly better than patients who had not been enrolled in the GHSG trials (p = 0.0047). This indicates that being on a trial seems to lead to a better prognosis than those not entering a trial, as concluded from a multivariate Cox analysis controlling for age and other risk factors.  However, at this time, there seems to be little indication as to the main factors that contribute to this better outcome, which will require more detailed inspection of many more parameters.