Young patients with advanced Hodgkin's lymphoma now have significantly better prospects for starting families after cancer treatment, according to groundbreaking results from an international study led by the German Hodgkin Study Group (GHSG) at University Hospital Cologne. The research demonstrates that the new BrECADD chemotherapy regimen preserves fertility substantially better than the previous standard eBEACOPP treatment while maintaining equivalent cure rates.
Superior Fertility Preservation Outcomes
The HD21 trial revealed striking differences in fertility preservation between the two treatment approaches. Three years after treatment completion, 95% of women and 86% of men in the BrECADD group had recovered normal hormone levels, compared to only 73% of women and 40% of men in the eBEACOPP group. The study also documented more pregnancies and births following BrECADD treatment, with men experiencing particularly significant improvements in their chances of biological paternity.
"BrECADD gives young adults with Hodgkin's lymphoma a better chance of starting a family later in life – with an equally good or even slightly better cure rate," explains Dr. Justin Ferdinandus, Study Physician in the German Hodgkin Study Group and first author of the publication.
Clinical Trial Design and Methodology
The HD21 study represents a robust randomized phase III clinical trial involving over 1,500 participants up to age 60 across 233 centers in nine countries. Patients with advanced classical Hodgkin's lymphoma were randomly assigned to receive either the experimental BrECADD therapy or the standard eBEACOPP treatment. Researchers monitored fertility recovery by measuring blood serum levels of follicle-stimulating hormone and tracking pregnancies and births following treatment completion.
Practice-Changing Implications
The study's findings are already transforming clinical practice guidelines. "The HD21 study is fundamentally changing practice. Our data clearly show that BrECADD is the preferred first-line treatment for patients who wish to have children – at University Hospital Cologne and in the current Onkopedia guideline, this is already the new standard," states Dr. Karolin Behringer, Study Physician at the GHSG and last author of the study.
The research, published in The Lancet Oncology under the title "Fertility in patients with advanced-stage classic Hodgkin lymphoma treated with BrECADD versus eBEACOPP: a secondary analysis of the multicentre, randomised, parallel, open-label, phase 3 HD21 Trial," was supported by Takeda Oncology. This advancement offers hope to young cancer patients who previously faced difficult choices between effective treatment and future fertility.
