Clinical Trial Shows “Best Results Ever Seen” In Younger Patients With Advanced-stage Hodgkin Lymphoma

Patient outcomes of an international clinical trial for Advanced-stage Hodgkin lymphoma, published recently in The Lancet show “the best results we have ever seen in younger patients from 18 to 60 years” according to the trial’s Australian lead researcher, Professor Mark Hertzberg AM from the Australasian Leukaemia and Lymphoma (ALLG). New Zealand’s Auckland Hospital was one of the clinical trial’s sites.

Advanced-stage Hodgkin lymphoma, or Hodgkin Disease (HD), often shortens life expectancy and involves very intensive toxic therapies that can incur major side-effects, including infertility. The GHSG HD21 / ALLG HD10 trial outcomes set a new benchmark for the primary cure rate in this disease.

With superior survival results, minimal side-effects and no known impact on fertility, the clinical trial identified effective first-line treatments for the disease and prevented toxic side effects but maintained the effect in eliminating cancer cells. The trial demonstrated that individualised treatment with PET2-guided BrECADD is now the most effective therapy currently available for Advanced-stage Hodgkin lymphoma.

Professor Hertzberg, a haematologist at Prince of Wales Hospital and veteran leader of blood cancer clinical trials group the ALLG, was a co-author on The Lancet publication and served as Chief Investigator for the ALLG HD10; the Australian and New Zealand arm of this global trial initiated by the German Hodgkin Study Group (GHSG) HD21. It is through such ALLG international blood cancer trial collaborations that Australian and New Zealand patients can participate in innovative global trials for better treatments.

“Analysis of this study confirmed that, at four years, 94.3% of BrECADD-treated patients remain free of disease recurrence,” Prof Hertzberg explained. “For patients who are PET-negative after 2 cycles [no demonstrable disease can be seen] this rises to 96.8% of patients who remain free of progression. “The superior outcomes of the GHSG HD21 / ALLG HD10 clinical trial will change how Hodgkin lymphoma is treated in many countries around the world.

The results are particularly important for the trial’s participants like Emma Priest from Melbourne. Emma was only 38 years old when diagnosed in May 2019 with an aggressive Hodgkin lymphoma that had grown an 11 centimetre mass [tumour] wrapped around her aorta and oesophagus. She was a nurse at St Vincent’s Hospital Melbourne and had generally been healthy with no past medical issues other than an occasional cold. She never suspected having blood cancer despite some body aches, night sweats, a cough and fever.

“I thought it must be a flu or virus,” Emma explained. “I went into denial when they first told me I had a fast-growing Hodgkin lymphoma, as I thought ‘I'm a healthy person this doesn't make sense, I don't feel sick. I'm a nurse. I stand on the other side of the bed’.”

Emma started on the ALLG HD10 trial in June 2019 at St Vincent’s Hospital, Melbourne, and finished in August 2019. “Being on the trial gave me an opportunity to receive treatment that offered the same success rate as standard treatment but with less side effects.”

“I had a dedicated care team, was reviewed more frequently and more in depth, and I had a point of contact available for any questions or concerns,” Emma said. “I also believe that research is so important to continue to improve treatments for diseases and conditions so that we can either eradicate them or manage them effectively for improved quality of life,” Emma explained.

“I had two cycles of very aggressive chemo that included seven agents. I only got nauseous once. I slept well, I ate well. I got some neuropathy, with tingling in the tips of fingers, but by the third week of recovery I was back to baseline. I was then re-scanned to see how I was going. The haematologist came in with my results after the PET scan and said, ‘you are in complete metabolic remission’. I said, ‘show me the scan!’ Nothing lit up on the scan, which was great news. I did a happy little dance.

“I needed just two last cycles of chemo to mop up any little cells that may have been left over.” Emma was able to go back to work a couple months after finishing treatment, in November 2019 and back to her passion of dancing with a trip to Bali in February 2020. “Lucky I did, as the world went into Covid lock-down after that!”

Delaine Smith, ALLG CEO, said, “ALLG collaborates extensively with leading international blood cancer research groups to ensure the latest treatments can reach patients across Australia and New Zealand.”

“The HD10 trial is a fantastic example of the benefits for local patients, providing access to a superior treatment regimen with shorter duration and less side effects, that otherwise would have been unavailable.”

Professor Mark Hertzberg AM is a haematologist and Australian lymphoma clinician researcher, an investigator on a number of trials, and leads several international trial collaborations. He led the Australian and New Zealand arm (ALLG HD10) of this international trial. He is a current ALLG Board Director, and a former Chair of the ALLG Scientific Advisory Committee that guides the group’s research direction. Prof Hertzberg had also chaired the ALLG High Grade Lymphoma Disease Group Committee.

Emma Priest, ALLG HD10 clinical trial participant / patient, was diagnosed in May 2019 at age 38 and commenced treatment on the trial in June 2019 and finished in August 2019. She went back to work as a clinical research nurse at St Vincent’s Hospital Melbourne, Neurosurgery, in November 2019 and was back to her passion of dancing in February 2020. Emma is now also an ALLG Consumer Representative.

Ms Delaine Smith, CEO, Australasian and Leukaemia Group (ALLG) is a key contributor to Australia’s National Blood Cancer Taskforce and a member of the Steering Committee and leader of the Enabling Access Working Group. Delaine has also held a range of advisory appointments in key government and industry sector.

About the ALLG:

The Australasian Leukaemia and Lymphoma Group (ALLG) is Australia’s and New Zealand’s only not-for-profit clinical trial organisation that sponsors local investigator-initiated clinical trials. Established 50 years ago in 1973, the ALLG’s membership of over 1,000 blood cancer health professionals includes Haematologists - clinician researchers -, scientists and nurses treating Leukaemia and Lymphoma across Australia and New Zealand. The ALLG plans, designs, conducts, monitors and publishes investigator initiated clinical trials. A registered charity, with no guaranteed funding; 100 per cent of donations go to the ALLG clinical trial program. For more information on the ALLG, visit www.allg.org.au.

About the clinical trial: The GHSG HD21 / ALLG HD10 trial was an open-label, prospective, multicenter trial with two parallel groups and central stratified randomisation (minimisation method).

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