# GHSG HD21: PET-guided BrECADD versus escalated BEACOPP in advanced-stage classical Hodgkin lymphoma

Source: https://onco.cc/key-papers/paper-ghsg-hd21-brecadd-vs-ebeacopp-advanced-hodgkin-lancet-2024/  
OnCo record `paper-ghsg-hd21-brecadd-vs-ebeacopp-advanced-hodgkin-lancet-2024` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

A new regimen built around brentuximab vedotin cured more patients with advanced Hodgkin lymphoma than the intensive BEACOPP standard, and did so with less toxicity, including less damage to fertility.

## Summary

International randomised phase 3 trial of 1,500 patients with newly diagnosed advanced-stage classical Hodgkin lymphoma comparing PET-guided BrECADD (brentuximab vedotin, etoposide, cyclophosphamide, doxorubicin, dacarbazine and dexamethasone) with PET-guided escalated BEACOPP, four or six cycles depending on interim PET.

Four-year progression-free survival was 94.3 percent with BrECADD against 90.9 percent with escalated BEACOPP, and treatment-related morbidity was lower (about 42 versus 59 percent), with faster recovery of gonadal function. BrECADD is now the GHSG standard for advanced disease.

## Fields

- Kind: Key paper
- Last checked: 2026-09-18
- Journal: The Lancet
- Year: 2024
- DOI: 10.1016/S0140-6736(24)01315-1
- Authors: Borchmann P, Ferdinandus J, Schneider G, et al.
- Findings: Four-year progression-free survival 94.3 percent with BrECADD versus 90.9 percent with escalated BEACOPP.; Treatment-related morbidity about 42 versus 59 percent, with better recovery of gonadal function.
- What it means: For fit younger patients treated in the intensive German tradition, BrECADD replaces escalated BEACOPP; how it compares with nivolumab-AVD from S1826 is the open question.
- Caveats: Patients were mostly under 60 and fit enough for intensive therapy.; Follow-up for late effects such as second cancers is still short.

## Sources

- Lancet 2024: https://doi.org/10.1016/S0140-6736(24)01315-1
- PubMed: https://pubmed.ncbi.nlm.nih.gov/38971175/

## Connected records

- cancers: [Advanced-stage classical Hodgkin lymphoma (stage III to IV)](https://onco.cc/cancers/advanced-stage-classical-hodgkin-lymphoma/)
- drugs: [Brentuximab vedotin](https://onco.cc/drugs/brentuximab-vedotin/), [Cyclophosphamide](https://onco.cc/drugs/cyclophosphamide/), [Dacarbazine](https://onco.cc/drugs/dacarbazine/), [Doxorubicin](https://onco.cc/drugs/doxorubicin/), [Etoposide](https://onco.cc/drugs/etoposide/)
- trials: [GHSG HD21](https://onco.cc/trials/hd21/)
- journals: [The Lancet](https://onco.cc/journals/lancet/)

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