# GHSG HD21

Source: https://onco.cc/trials/hd21/  
OnCo record `hd21` (Trial). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

A new brentuximab-based intensive regimen matched Europe's most effective (and most toxic) chemotherapy with far fewer side effects.

## Summary

GHSG HD21, trial NCT02661503 sponsored by the German Hodgkin Study Group and published in the Lancet in 2024, showed that a new brentuximab-based intensive regimen, BrECADD, matched and then beat escalated BEACOPP, Europe's most effective and most toxic chemotherapy for advanced Hodgkin lymphoma, with far fewer side effects. It randomised about 1,500 patients aged 18 to 60 to PET-guided BrECADD or escalated BEACOPP for four to six cycles, met non-inferiority and then superiority on progression-free survival at four and five years, and reduced treatment-related morbidity while preserving fertility markers. OnCo links it to Hodgkin lymphoma, PET-adapted therapy, brentuximab vedotin, Peter Borchmann, the German Hodgkin Study Group and the ECHELON-1 and S1826 papers. Whether an intensive regimen is still needed when nivolumab-AVD has performed so well is the open question.

## Fields

- Kind: Trial
- Status: positive
- Last checked: 2026-09-07
- Registry id: NCT02661503
- Phase: 3
- Setting: Untreated advanced-stage classical Hodgkin lymphoma, age 18-60: PET-guided BrECADD vs escalated BEACOPP
- Sponsor: German Hodgkin Study Group
- Enrolled: 1500
- Result: 4-year PFS 94.3% vs 90.9%, HR 0.66; less toxicity.
- Outcomes: Progression-free survival at 4 years: BrECADD 94.3% vs eBEACOPP 90.9%, HR 0.66; Treatment-related morbidity: BrECADD 42% vs eBEACOPP 59%

## Sources

- ClinicalTrials.gov NCT02661503: https://clinicaltrials.gov/study/NCT02661503

## Connected records

- roadmaps: [Lymphoma roadmap: from a jaw tumour in Uganda and the first human cancer virus to gene-expression subtypes, PET-adapted chemotherapy, CAR-T cells, bispecific antibodies and the genetics-directed trials now recruiting](https://onco.cc/roadmaps/lymphoma-roadmap/)
- trials: [AHL2011](https://onco.cc/trials/ahl2011/), [ECHELON-1](https://onco.cc/trials/echelon-1/), [GHSG HD10](https://onco.cc/trials/hd10/), [GHSG HD18](https://onco.cc/trials/hd18/)
- cancers: [Advanced-stage classical Hodgkin lymphoma (stage III to IV)](https://onco.cc/cancers/advanced-stage-classical-hodgkin-lymphoma/), [Hodgkin lymphoma](https://onco.cc/cancers/hodgkin-lymphoma/), [Non-Hodgkin lymphoma (all types)](https://onco.cc/cancers/non-hodgkin-lymphoma/)
- technologies: [PET-adapted (response-adapted) therapy](https://onco.cc/technologies/pet-adapted-therapy/)
- drugs: [Brentuximab vedotin](https://onco.cc/drugs/brentuximab-vedotin/), [Doxorubicin](https://onco.cc/drugs/doxorubicin/)
- companies: [German Breast Group (GBG)](https://onco.cc/companies/gbg/), [German Hodgkin Study Group](https://onco.cc/companies/ghsg/)
- people: [Peter Borchmann](https://onco.cc/people/peter-borchmann/)
- terms: [British and American lymphoma practice: where they differ, and why](https://onco.cc/terms/lymphoma-tx-uk-versus-us/), [Escalated chemotherapy or ABVD in advanced Hodgkin lymphoma: more cures, more late harm, and what the interim scan changed](https://onco.cc/terms/lymphoma-decision-beacopp-or-abvd/), [Fertility before lymphoma treatment: what to ask for, and when](https://onco.cc/terms/lymphoma-tx-fertility-preservation/), [Late effects of Hodgkin lymphoma treatment, and the follow-up that answers them](https://onco.cc/terms/lymphoma-tx-hodgkin-late-effects/)
- key papers: [ECHELON-1: brentuximab vedotin replacing bleomycin in first-line chemotherapy for advanced Hodgkin lymphoma](https://onco.cc/key-papers/paper-echelon-1-brentuximab-avd-nejm-2018/), [GHSG HD21: PET-guided BrECADD versus escalated BEACOPP in advanced-stage classical Hodgkin lymphoma](https://onco.cc/key-papers/paper-ghsg-hd21-brecadd-vs-ebeacopp-advanced-hodgkin-lancet-2024/), [PET-guided treatment in patients with advanced-stage Hodgkin's lymphoma (HD18): final results of an open-label, international, randomised phase 3 trial by the German Hodgkin Study Group](https://onco.cc/key-papers/paper-ghsg-hd18-pet-guided-escalated-beacopp-lancet-2017/), [SWOG S1826: nivolumab plus AVD chemotherapy versus brentuximab-AVD for advanced Hodgkin lymphoma in adolescents and adults](https://onco.cc/key-papers/paper-swog-s1826-nivolumab-avd-nejm-2024/)
- targets: [SSX2](https://onco.cc/targets/ssx2/)

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