LymphomaPhase 3NCT00005584
Combination Chemotherapy With or Without Radiation Therapy in Treating Patients With Hodgkin's Lymphoma
A Phase 3 study testing bleomycin sulfate, ABVD regimen and BEACOPP regimen in people with Lymphoma, run by European Organisation for Research and Treatment of Cancer - EORTC at 121 sites in 10 countries.
Trial summary
RATIONALE: Drugs used in chemotherapy use different ways to stop cancer cells from dividing so they stop growing or die. Radiation therapy uses high-energy x-rays to damage cancer cells. Combining chemotherapy with radiation therapy may kill more cancer cells. Read more about this study
- Who is it for?
- Ages 15 to 70 years
- Conditions the study is for
- Lymphoma
- What is being tested?
- bleomycin sulfate, ABVD regimen and BEACOPP regimen
- Type of treatment
- Surgery or procedure
- How many people
- 1,649 participants
- Where
- 121 sitesin 10 countries
- Study dates
- Oct 1998to May 2004
- Phase
- Phase 3
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 15 to 70 years
- All sexes
- No healthy volunteers
- Child, Adult, Older adult
DISEASE CHARACTERISTICS:
- Randomized groups: Histologically proven previously untreated stage I or II supradiaphragmatic Hodgkin's lymphoma
- No prior staging laparotomy
- Favorable (closed to accrual as of 4/28/04) or unfavorable (closed to accrual as of 9/2002) prognosis
- Nonrandomized group: Histologically proven lymphocyte-predominant Hodgkin's lymphoma, nodular subtype (nodular paragranuloma)
- Stage I with complete or incomplete resection OR
- Stage II
PATIENT CHARACTERISTICS:
Age:
- 15 to 70
Performance status:
- WHO 0-2
Life expectancy:
- Not specified
Hematopoietic:
- Not specified
Hepatic:
- Not specified
Renal:
- Not specified
Cardiovascular:
- No severe cardiac disease that would interfere with normal life expectancy or study treatment
Pulmonary:
- No severe pulmonary disease that would interfere with normal life expectancy or study treatment
Other:
- No other prior or concurrent malignancy except basal cell skin cancer or carcinoma in situ of the cervix
- No severe neurologic or metabolic disease that would interfere with normal life expectancy or study treatment
- No psychologic, familial, socioeconomic, or geographic circumstances that would preclude proper staging or compliance
- HIV negative
- Not pregnant
- Fertile patients must use effective contraception
PRIOR CONCURRENT THERAPY:
Biologic therapy
- No prior biologic therapy for this malignancy
Chemotherapy
- No prior chemotherapy for this malignancy
Endocrine therapy
- No prior endocrine therapy for this malignancy
Radiotherapy
- No prior radiotherapy for this malignancy
Surgery
- No prior surgery for this malignancy
Trial locations and contacts
121 sites in 10 countries.
121 sites in 10 countries
France77 sites
Centre Hospitalier Annemasse Bonneville
Ambilly, 74100
Centre Hospitalier d'Annecy
Annecy, 74011 Cedex
Centre Hospital General Robert Ballanger
Aulnay-sous-Bois, 93602
Hopital Duffaut
Avignon, 84902
Centre Hospitalier de la Cote Basque
Bayonne, 64109
CHR de Besancon - Hopital Jean Minjoz
Besançon, 25030
Hopital de Beziers
Béziers, 34500
Hopital Saint Andre
Bordeaux, 33075
Institut Bergonie
Bordeaux, 33076
C.H. Bourg En Bresse
Bourg-en-Bresse, 01012
CMC Bligny
Briis-sous-Forges, 91640
CHU de Caen
Caen, 14033
Centre Regional Francois Baclesse
Caen, 14076
Centre Hospitalier Regional de Chambery
Chambéry, 73011
Hopital Fontenoy
Chartres, 28018
Centre d'Oncologie et de Radiotherapie de Chaumont le Bois
Chaumont, 52000
Hopital d'Instruction des Armees Percy
Clamart, 92140
Hopital Antoine Beclere
Clamart, 92141
Hopital Beaujon
Clichy, 92110
Hopital Louis Pasteur
Colmar, 68024
Centre Hospitalier Compiegne
Compiègne, 60321
Centre Hospitalier Sud Francilien - Site Corbeil
Corbeil, 91100
Centre Hospitalier Universitaire Henri Mondor
Créteil, 94010
Hopital Du Bocage
Dijon, 21034
Centre de Lutte Contre le Cancer, Georges-Francois Leclerc
Dijon, 21079
Institut Prive de Cancerologie
Grenoble, 38100
Centre Hospitalier
Juvisy-sur-Orge, 91260
Hopital Andre Mignot
Le Chesnay, 78157
C.H.G. Du Havre - Hopital J. Monod
Le Havre, 76083
Centre Hospitalier Universitaire de Bicetre
Le Kremlin-Bicêtre, 94275
Clinique Victor Hugo
Le Mans, F-72000
Centre Hospitalier Lens
Lens, Cedex 62307
Centre Hospital Universitaire Hop Huriez
Lille, 59037
Centre Hospitalier Regional et Universitaire de Lille
Lille, 59037
Centre Hospital Regional Universitaire de Limoges
Limoges, 87042
Centre Hospitalier General
Lons-le-Saunier, 39000
Clinique Saint Jean
Lyon, 69008
Centre Leon Berard
Lyon, 69373
Hopital Edouard Herriot
Lyon, 69437
Institut J. Paoli and I. Calmettes
Marseille, 13273
Centre Hospitalier de Meaux
Meaux, 77104
Hopital Notre-Dame de Bon Secours
Metz, 55038
Intercommunal Hospital
Montfermeil, 93370
Clinique Gui de Chauliac
Montpellier, 34295
Centre Regional de Lutte Contre le Cancer - Centre Val d'Aurelle
Montpellier, 34298
Centre Hospitalier de Mulhouse
Mulhouse, 68051
Hopital Pasteur
Nice, 06002
Centre Antoine Lacassagne
Nice, 06189
C.H.U. de Nimes - Groupe Hospitals-Universitaire Caremeau
Nîmes, 30000
Hopital Saint Antoine
Paris, 75012
Hopital de la Croix Rouge Francaise des Peupliers
Paris, 75013
Hotel Dieu de Paris
Paris, 75181
Institut Curie - Section Medicale
Paris, 75248
Hopital Lariboisiere
Paris, 75475
Hopital Saint-Louis
Paris, 75475
CHU Pitie-Salpetriere
Paris, 75651
Hopital Cochin
Paris, 75674
Hopital Necker
Paris, 75743
C.H.G. De Pau
Pau, 64046 Universite Cedex
Hopital Haut Leveque
Pessac, 33604
Centre Hospitalier Lyon Sud
Pierre-Bénite, 69310
Centre Hospitalier Intercommunal de Poissy
Poissy, 78498
Hopital Rene Dubos
Pontoise, 95300
Polyclinique De Courlancy
Reims, F-51100
CHG Roanne
Roanne, F-42300
Centre Henri Becquerel
Rouen, 76038
Centre Rene Huguenin
Saint-Cloud, 92211
C.H.U. Saint Etienne Hospital Nord
Saint-Etienne, 42055
Hopital de Saint Germain-en-Laye
Saint-Germain-en-Laye, 78104
Centre Medico-Chirurgical Foch
Suresnes, 92151
Centre Hospitalier Regional de Purpan
Toulouse, 31059
Centre Hospitalier Valence
Valence, 26000
Centre Hospitalier de Valenciennes
Valenciennes, 59300
Centre Alexis Vautrin
Vandœuvre-lès-Nancy, 54511
CHU de Nancy - Hopitaux de Brabois
Vandœuvre-lès-Nancy, 54511
Hopital Paul Brousse
Villejuif, 94804
Institut Gustave Roussy
Villejuif, F-94805
Netherlands24 sites
Groot Ziekengasthuis 's-Hertogenbosch
's-Hertogenbosch, 5211 NL
Medisch Centrum Alkmaar
Alkmaar, 1815 JD
Meander Medisch Centrum
Amersfoort, 3816 CP
Comprehensive Cancer Center Amsterdam
Amsterdam, 1006 CX
Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital
Amsterdam, 1066 CX
Onze Lieve Vrouwe Gasthuis
Amsterdam, 1091 HA
Academisch Medisch Centrum
Amsterdam, 1105 AZ
Streekziekenhuizen Gooi-Noord
Blaricum, 1261 AN
Amphia Ziekenhuis - locatie Molengracht
Breda, 4818 CK
Atrium Medisch Centrum - Brunssum
Brunssum, 6442 BE
Reinier de Graaf Group
Delft, NL 2600 GA
Catharina Ziekenhuis
Eindhoven, 5602 ZA
Medisch Spectrum Twente
Enschede, 7500 KA
Academisch Ziekenhuis Groningen
Groningen, 9713 EZ
Atrium Medical Centre
Heerlen, 6419 PC
Radiotherapeutisch Instituut
Leeuwarden, 8934 AD
Diaconessenhuis Leiden
Leiden, 2300 RD
Academisch Ziekenhuis Maastricht
Maastricht, 6202 AZ
Sint Antonius Ziekenhuis
Nieuwegein, 3435 CM
University Medical Center Nijmegen
Nijmegen, NL-6500 HB
Daniel Den Hoed Cancer Center at Erasmus Medical Center
Rotterdam, 3008 AE
Maasland Hospital
Sittard, 6131 BK
Leyenburg Ziekenhuis
The Hague, 2545 CH
Academisch Ziekenhuis Utrecht
Utrecht, 3584 CX
Belgium10 sites
Sint Augustinus Ziekenhuis
Antwerp, 2610
A.Z. St. Jan
Bruges, 8000
C.H.U. Saint-Pierre
Brussels, 1000
Institut Jules Bordet
Brussels, 1000
Cliniques Universitaires Saint-Luc
Brussels, 1200
Centre Hospitalier Universitaire Brugmann
Brussels, B 1020
Universitair Ziekenhuis Antwerpen
Edegem, B-2650
U.Z. Gasthuisberg
Leuven, B-3000
Clinique Universitaire De Mont-Godinne
Mont-Godinne Yvoir, 5530
Clinique Saint-Pierre
Ottignies, B-1340
Italy3 sites
Centro di Riferimento Oncologico - Aviano
Aviano, 33081
Ospedale Sta. Maria Delle Croci
Ravenna, 48100
Ospedale S. Giovanni A.S. Dipartimente di Oncologia di Turin
Turin, 10123
Switzerland2 sites
Hopital Cantonal Universitaire de Geneve
Geneva, CH-1211
Centre Hospitalier Universitaire Vaudois
Lausanne, CH-1011
Poland1 site
Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology
Warsaw, 02-781
Portugal1 site
Instituto Portugues de Oncologia Centro do Porto, SA
Porto, 4200
About this study
Official title: Prospective Controlled Trial in Clinical Stages I-II Supradiaphragmatic Hodgkin's Disease: Evaluation of Treatment Efficacy, (Long Term) Toxicity and Quality of Life in Two Different Prognostic Subgroups
RATIONALE: Drugs used in chemotherapy use different ways to stop cancer cells from dividing so they stop growing or die. Radiation therapy uses high-energy x-rays to damage cancer cells. Combining chemotherapy with radiation therapy may kill more cancer cells. It is not yet known which combination chemotherapy regimen is most effective in treating Hodgkin's lymphoma.
PURPOSE: Randomized phase III trial to compare the effectiveness of different regimens of combination chemotherapy with or without radiation therapy in treating patients who have Hodgkin's lymphoma.
Read the detailed description
OBJECTIVES:
- Compare the late toxicity of 6 courses of epirubicin, bleomycin, vinblastine, and prednisone (EBVP) followed by involved-field radiotherapy (IF-RT) (36 Gy) vs IF-RT (20 Gy), vs no IF-RT (closed to accrual as of 6/2002) in patients with supradiaphragmatic Hodgkin's lymphoma, favorable prognosis, and complete remission (CR) or CR unconfirmed after completion of chemotherapy. (Favorable prognosis group [group 1] closed to accrual as of 4/28/04.)
- Compare 6 courses of doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) vs 4 courses of ABVD vs 4 courses of cyclophosphamide, doxorubicin, vincristine, bleomycin, etoposide, procarbazine, and prednisone (BEACOPP) followed by IF-RT, with respect to overall survival and late treatment-related toxicity, in patients with supradiaphragmatic Hodgkin's lymphoma and unfavorable prognosis. (Unfavorable prognosis group [group 2] closed to accrual as of 9/2002.) (Favorable prognosis group [group 1] closed to accrual as of 4/28/04.)
- Maintain the failure-free survival and relapse-free survival rates that were reached in the previous EORTC studies (H5 to H8), with a reduction in acute and delayed side effects of the treatment, in particular that of severe late radiotherapy and chemotherapy-related toxicity.
- Compare the quality of life, overall survival, treatment quality control, and duration of treatment in patients with favorable (closed to accrual as of 4/28/04) or unfavorable (closed to accrual as of 9/2002) prognoses treated with these regimens.
- Determine the efficacy of conservative therapy comprised of observation until disease progression (DP) and administration of IF-RT at the time of DP in patients with lymphocyte-predominant Hodgkin's lymphoma, nodular subtype (nodular paragranuloma).
OUTLINE: This is a randomized, multicenter study.
Patients with classical Hodgkin's lymphoma are assigned to 1 of 2 randomized groups. (Group 2 [unfavorable prognosis] closed to accrual as of 9/2002.) (Group 1 [favorable prognosis] closed to accrual as of 4/28/04.) Patients with lymphocyte-predominant Hodgkin's lymphoma are assigned to the nonrandomized group.
Randomized groups
- Patients are stratified by prognosis (favorable vs unfavorable). Patients are assigned to 1 of 2 treatment groups based on prognosis. (Group 2 [unfavorable prognosis] closed to accrual as of 9/2002.) (Group 1 [favorable prognosis] closed to accrual as of 4/28/04.)
- Group 1 (favorable prognosis) (closed to accrual as of 4/28/04): Patients receive epirubicin IV over 5 minutes, bleomycin intramuscularly (IM) (or IV if necessary), and vinblastine IV on day 1 and oral prednisone on days 1-5. Treatment repeats every 3 weeks for 6 courses. Patients are then assigned to 1 of 3 involved-field radiotherapy (IF-RT) groups based on response to chemotherapy:
- Group A (complete remission (CR) or CR unconfirmed [CRu]) Patients are randomized to 1 of 3 radiotherapy arms. (Arm III closed to accrual as of 6/2002.)
- Arm I (36 Gy): Patients undergo IF-RT 5 days a week for 3.5 weeks.
- Arm II (20 Gy): Patients undergo IF-RT 5 days a week for 2 weeks.
- Arm III (closed to accrual as of 6/2002): Patients undergo no IF-RT.
- Group B (partial remission [PR]): Patients undergo IF-RT 5 days a week for 3.5 weeks and boost radiotherapy.
- Group C (stable disease or disease progression [DP]): Patients receive no IF-RT and are taken off study.
- Group 2 (unfavorable prognosis) (closed to accrual as of 9/2002): Patients are randomized to 1 of 3 treatment arms.
- Arm I: Patients receive doxorubicin IV over 5 minutes, bleomycin IM (or IV if necessary), vinblastine IV, and dacarbazine IV over 5-10 minutes on days 1 and 15. Treatment repeats every 4 weeks for 6 courses.
- Arm II: Patients receive chemotherapy as in arm I. Treatment repeats every 4 weeks for 4 courses.
- Arm III: Patients receive cyclophosphamide IV and doxorubicin IV over 5 minutes on day 1, vincristine IV and bleomycin IM (or IV if necessary) on day 8, etoposide IV over a minimum of 30 minutes on days 1-3, oral procarbazine on days 1-7, and oral prednisone on days 1-14. Treatment repeats every 3 weeks for 4 courses.
Patients on all arms who achieve CR or CRu undergo IF-RT 5 days a week for 3 weeks. Patients who achieve PR undergo IF-RT 5 days a week for 3.5 weeks and boost radiotherapy.
- Groups 1 and 2 (group 2 closed to accrual as of 9/2002) (group 1 closed to accrual as of 4/28/04): IF-RT begins within 3-4 weeks after completion of the last course of chemotherapy.
Nonrandomized group
- Patients with completely resected stage I disease undergo observation until DP and undergo IF-RT after documentation of DP. Patients with stage II or incompletely resected stage I disease undergo IF-RT immediately.
Quality of life is assessed before starting study therapy, immediately after completion of study, and then annually for 10 years.
Patients are followed at 2, 4, 6, 9, and 12 months; every 4 months for 1 year; every 6 months for 3 years; and then annually thereafter.
PROJECTED ACCRUAL: A total of 903 patients (group 1) will be accrued for this study within 7.7 years. A total of 723 patients (group 2) will be accrued for this study within 3.8 years. (Group 2 [unfavorable prognosis] closed to accrual as of 9/2002.) (Group 1 [favorable prognosis] closed to accrual as of 4/28/04.)
- Conditions
- Lymphoma
- Being tested
- bleomycin sulfate, ABVD regimen, BEACOPP regimen, epirubicin hydrochloride, prednisone
- Keywords
- stage I adult Hodgkin lymphoma, stage II adult Hodgkin lymphoma, adult lymphocyte predominant Hodgkin lymphoma
- Medical subject headings
- Lymphoma, Hodgkin Disease
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
bleomycin sulfateBiological
ABVD regimenDrug
BEACOPP regimenDrug
epirubicin hydrochlorideDrug
prednisoneDrug
vinblastine sulfateDrug
radiation therapyRadiation
What is being measured
The primary outcome is the main question the study is designed to answer.
Relapse-free rate
with events defined as lack of CR/CRu at the end of treatment or relapse
Measured: 5 years
Secondary outcomes (3)
Overall Survival
Measured: Till withdrawal criteria met
Failure Free Survival
Measured: Till withdrawal criteria met
Relapse Free Survival
Measured: Till withdrawal criteria met
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted27 Jan 2003 (estimated)
- Study startOct 1998
- Primary completionMay 2004
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (11)Papers the sponsor has linked to this study.
- Other trials for LymphomaStudies of the same condition, open and under way.
- More trials run by European Organisation for Research and Treatment of Cancer - EORTCThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 3
- Primary purpose
- Treatment
- Allocation
- Randomised
- Masking
- None (open label)
- Enrolment
- 1,649 participants (actual)
Sponsor and investigators
- Sponsor type
- Research network
- Collaborators
- Lymphoma Study Association, UNICANCER
- Responsible party
- Sponsor
- Investigators
- Jose Thomas, MD, Study chair, University Hospital, GasthuisbergH. Eghbali, MD, Study chair, Institut BergoniéE.M. Noordijk, MD, Study chair, Leiden University Medical CenterChristophe Ferme, Study chair, Centre Medical de BlignyChristian Gisselbrecht, MD, Study chair, Hopital Saint-LouisThierry O. Philip, MD, Study chair, Centre Leon Berard
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT00005584
- Sponsor's protocol ID
- EORTC-20982
- Other IDs
- FRE-FNCLCC-98014, GELA-H9
- Status last verified
- Aug 2025
- First submitted
- 2 May 2000
- Last updated
- 5 Aug 2025
- Results posted
- No
Publications
van der Kaaij MA, Heutte N, van Echten-Arends J, Raemaekers JM, Carde P, Noordijk EM, Ferme C, Thomas J, Eghbali H, Brice P, Bonmati C, Henry-Amar M, Kluin-Nelemans HC. Sperm quality before treatment in patients with early stage Hodgkin's lymphoma enrolled in EORTC-GELA Lymphoma Group trials. Haematologica. 2009 Dec;94(12):1691-7. doi: 10.3324/haematol.2009.009696. Epub 2009 Oct 22.
PubMed 19850901van der Kaaij MA, Heutte N, Le Stang N, Raemaekers JM, Simons AH, Carde P, Noordijk EM, Ferme C, Thomas J, Eghbali H, Kluin-Nelemans HC, Henry-Amar M; European Organisation for Research and Treatment of Cancer: EORTC Lymphoma Group; Groupe d'Etude des Lymphomes de l'Adulte. Gonadal function in males after chemotherapy for early-stage Hodgkin's lymphoma treated in four subsequent trials by the European Organisation for Research and Treatment of Cancer: EORTC Lymphoma Group and the Groupe d'Etude des Lymphomes de l'Adulte. J Clin Oncol. 2007 Jul 1;25(19):2825-32. doi: 10.1200/JCO.2006.10.2020. Epub 2007 May 21.
PubMed 17515571Eghbali H, Brice P, Creemers GY, et al.: Comparison of three radiation dose levels after EBVP regimen in favorable supradiaphragmatic clinical stages (CS) I-II Hodgkin's lymphoma (HL): preliminary results of the EORTC-GELA H9-F trial. [Abstract] Blood 106 (11): A-814, 2005.
Ferme C, Diviné M, Vranovsky A, et al.: Four ABVD and involved-field radiotherapy in unfavorable supradiaphragmatic clinical stages (CS) I-II Hodgkin's lymphoma (HL): preliminary results of the EORTC-GELA H9-U trial. [Abstract] Blood 106 (11): A-813, 2005.
Girinsky T, Gargi T, Carrie C, et al.: Quality assurance program in the EORTC-GELA H9 randomized study results on 282 patients. [Abstract] Int J Radiat Oncol Biol Phys 63 (2 Suppl 1): A77, S47, 2005.
Noordijk EM, Thomas J, Fermé C, et al.: First results of the EORTC-GELA H9 randomized trials: the H9-F trial (comparing 3 radiation dose levels) and H9-U trial (comparing 3 chemotherapy schemes) in patients with favorable or unfavorable early stage Hodgkin's lymphoma (HL) . [Abstract] J Clin Oncol 23 (Suppl 16): A-6505, 561s, 2005.
Thomas J, Ferme C, Noordijk EM, et al.: Six cycles of EBVP followed by 36 Gy involved-field irradiation vs. no irradiation in favourable supradiaphragmatic clinical stages I-II Hodgkin's lymphoma: the EORTC-GELA strategy in 771 patients (H9-F trial-20982). [Abstract] Eur J Haematol 75 (Suppl 65): A-E11a, 40, 2004.
Thomas J, Ferme C, Noordijk EM, et al.: Six cycles of ABVD + IF-RT vs. four cycles of ABVD + IF-RT vs. four cycles of BEACOPP + IF-RT in unfavourable supradiaphragmatic clinical stages I-II Hodgkin's lymphoma: the EORTC-GELA H9-U randomized clinical trial (20982) in 808 patients. [Abstract] Eur J Haematol 73 (Supp 65): A-E12, 40, 2004.
Martinez Alcala R, Visser L, Fortpied C, Ferme C, Henry-Amar M, Aleman B, Arens A, Juul S, Hayat A, Hude Dragicevic I, Hutchings M, Meijnders P, Mutsaers P, Paszkiewicz-Kozik E, Rossetti S, Sureda A, Syrykh C, Tonino S, Plattel W, Diepstra A. Immunohistochemistry for c-MET, HLA class II, and CD68 does not show prognostic value in early-stage classic Hodgkin lymphoma patients in the EORTC-GELA H9 intergroup randomised trial. PLoS One. 2026 Oct 8;21(10):e0360080. doi: 10.1371/journal.pone.0360080. eCollection 2026.
PubMed 42848781Thomas J, Ferme C, Noordijk EM, Morschhauser F, Girinsky T, Gaillard I, Lugtenburg PJ, Andre M, Lybeert MLM, Stamatoullas A, Beijert M, Helias P, Eghbali H, Gabarre J, van der Maazen RWM, Jaubert J, Bouabdallah K, Boulat O, Roesink JM, Christian B, Ong F, Bordessoule D, Tertian G, Gonzalez H, Vranovsky A, Quittet P, Tirelli U, de Jong D, Audouin J, Aleman BMP, Henry-Amar M. Comparison of 36 Gy, 20 Gy, or No Radiation Therapy After 6 Cycles of EBVP Chemotherapy and Complete Remission in Early-Stage Hodgkin Lymphoma Without Risk Factors: Results of the EORT-GELA H9-F Intergroup Randomized Trial. Int J Radiat Oncol Biol Phys. 2018 Apr 1;100(5):1133-1145. doi: 10.1016/j.ijrobp.2017.10.015. Epub 2017 Oct 27.
PubMed 29229324Ferme C, Thomas J, Brice P, Casasnovas O, Vranovsky A, Bologna S, Lugtenburg PJ, Bouabdallah R, Carde P, Sebban C, Eghbali H, Salles G, van Imhoff GW, Thyss A, Noordijk EM, Reman O, Lybeert MLM, Janvier M, Spina M, Audhuy B, Raemaekers JMM, Delarue R, Anglaret B, de Weerdt O, Marjanovic Z, Tersteeg RJHA, de Jong D, Briere J, Henry-Amar M; European Organisation for Research and Treatment of Cancer Lymphoma Group, and; Groupe d'Etude des Lymphomes de l'Adulte. ABVD or BEACOPPbaseline along with involved-field radiotherapy in early-stage Hodgkin Lymphoma with risk factors: Results of the European Organisation for Research and Treatment of Cancer (EORTC)-Groupe d'Etude des Lymphomes de l'Adulte (GELA) H9-U intergroup randomised trial. Eur J Cancer. 2017 Aug;81:45-55. doi: 10.1016/j.ejca.2017.05.005. Epub 2017 Jun 8.
PubMed 28601705
Study at a glance
From the registry record, last updated by the sponsor on 5 Aug 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Prospective Controlled Trial in Clinical Stages I-II Supradiaphragmatic Hodgkin's Disease: Evaluation of Treatment Efficacy, (Long Term) Toxicity and Quality of Life in Two Different Prognostic Subgroups
- ClinicalTrials.gov ID
- NCT00005584
- Acronym / sponsor ID
- EORTC-20982
- Conditions
- Lymphoma
- Keywords
- stage I adult Hodgkin lymphoma, stage II adult Hodgkin lymphoma, adult lymphocyte predominant Hodgkin lymphoma
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Active, not recruiting
- Enrolment
- 1,649 participants (actual)
- Lead sponsor
- European Organisation for Research and Treatment of Cancer - EORTCResearch network
- Collaborators
- Lymphoma Study Association, UNICANCER
- Study start
- Oct 1998 (actual)
- Primary completion
- May 2004 (actual)
- First posted
- 27 Jan 2003 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
RATIONALE: Drugs used in chemotherapy use different ways to stop cancer cells from dividing so they stop growing or die. Radiation therapy uses high-energy x-rays to damage cancer cells. Combining chemotherapy with radiation therapy may kill more cancer cells. It is not yet known which combination chemotherapy regimen is most effective in treating Hodgkin's lymphoma.
PURPOSE: Randomized phase III trial to compare the effectiveness of different regimens of combination chemotherapy with or without radiation therapy in treating patients who have Hodgkin's lymphoma.
Detailed description
OBJECTIVES:
- Compare the late toxicity of 6 courses of epirubicin, bleomycin, vinblastine, and prednisone (EBVP) followed by involved-field radiotherapy (IF-RT) (36 Gy) vs IF-RT (20 Gy), vs no IF-RT (closed to accrual as of 6/2002) in patients with supradiaphragmatic Hodgkin's lymphoma, favorable prognosis, and complete remission (CR) or CR unconfirmed after completion of chemotherapy. (Favorable prognosis group [group 1] closed to accrual as of 4/28/04.)
- Compare 6 courses of doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) vs 4 courses of ABVD vs 4 courses of cyclophosphamide, doxorubicin, vincristine, bleomycin, etoposide, procarbazine, and prednisone (BEACOPP) followed by IF-RT, with respect to overall survival and late treatment-related toxicity, in patients with supradiaphragmatic Hodgkin's lymphoma and unfavorable prognosis. (Unfavorable prognosis group [group 2] closed to accrual as of 9/2002.) (Favorable prognosis group [group 1] closed to accrual as of 4/28/04.)
- Maintain the failure-free survival and relapse-free survival rates that were reached in the previous EORTC studies (H5 to H8), with a reduction in acute and delayed side effects of the treatment, in particular that of severe late radiotherapy and chemotherapy-related toxicity.
- Compare the quality of life, overall survival, treatment quality control, and duration of treatment in patients with favorable (closed to accrual as of 4/28/04) or unfavorable (closed to accrual as of 9/2002) prognoses treated with these regimens.
- Determine the efficacy of conservative therapy comprised of observation until disease progression (DP) and administration of IF-RT at the time of DP in patients with lymphocyte-predominant Hodgkin's lymphoma, nodular subtype (nodular paragranuloma).
OUTLINE: This is a randomized, multicenter study.
Patients with classical Hodgkin's lymphoma are assigned to 1 of 2 randomized groups. (Group 2 [unfavorable prognosis] closed to accrual as of 9/2002.) (Group 1 [favorable prognosis] closed to accrual as of 4/28/04.) Patients with lymphocyte-predominant Hodgkin's lymphoma are assigned to the nonrandomized group.
Randomized groups
- Patients are stratified by prognosis (favorable vs unfavorable). Patients are assigned to 1 of 2 treatment groups based on prognosis. (Group 2 [unfavorable prognosis] closed to accrual as of 9/2002.) (Group 1 [favorable prognosis] closed to accrual as of 4/28/04.)
- Group 1 (favorable prognosis) (closed to accrual as of 4/28/04): Patients receive epirubicin IV over 5 minutes, bleomycin intramuscularly (IM) (or IV if necessary), and vinblastine IV on day 1 and oral prednisone on days 1-5. Treatment repeats every 3 weeks for 6 courses. Patients are then assigned to 1 of 3 involved-field radiotherapy (IF-RT) groups based on response to chemotherapy:
- Group A (complete remission (CR) or CR unconfirmed [CRu]) Patients are randomized to 1 of 3 radiotherapy arms. (Arm III closed to accrual as of 6/2002.)
- Arm I (36 Gy): Patients undergo IF-RT 5 days a week for 3.5 weeks.
- Arm II (20 Gy): Patients undergo IF-RT 5 days a week for 2 weeks.
- Arm III (closed to accrual as of 6/2002): Patients undergo no IF-RT.
- Group B (partial remission [PR]): Patients undergo IF-RT 5 days a week for 3.5 weeks and boost radiotherapy.
- Group C (stable disease or disease progression [DP]): Patients receive no IF-RT and are taken off study.
- Group 2 (unfavorable prognosis) (closed to accrual as of 9/2002): Patients are randomized to 1 of 3 treatment arms.
- Arm I: Patients receive doxorubicin IV over 5 minutes, bleomycin IM (or IV if necessary), vinblastine IV, and dacarbazine IV over 5-10 minutes on days 1 and 15. Treatment repeats every 4 weeks for 6 courses.
- Arm II: Patients receive chemotherapy as in arm I. Treatment repeats every 4 weeks for 4 courses.
- Arm III: Patients receive cyclophosphamide IV and doxorubicin IV over 5 minutes on day 1, vincristine IV and bleomycin IM (or IV if necessary) on day 8, etoposide IV over a minimum of 30 minutes on days 1-3, oral procarbazine on days 1-7, and oral prednisone on days 1-14. Treatment repeats every 3 weeks for 4 courses.
Patients on all arms who achieve CR or CRu undergo IF-RT 5 days a week for 3 weeks. Patients who achieve PR undergo IF-RT 5 days a week for 3.5 weeks and boost radiotherapy.
- Groups 1 and 2 (group 2 closed to accrual as of 9/2002) (group 1 closed to accrual as of 4/28/04): IF-RT begins within 3-4 weeks after completion of the last course of chemotherapy.
Nonrandomized group
- Patients with completely resected stage I disease undergo observation until DP and undergo IF-RT after documentation of DP. Patients with stage II or incompletely resected stage I disease undergo IF-RT immediately.
Quality of life is assessed before starting study therapy, immediately after completion of study, and then annually for 10 years.
Patients are followed at 2, 4, 6, 9, and 12 months; every 4 months for 1 year; every 6 months for 3 years; and then annually thereafter.
PROJECTED ACCRUAL: A total of 903 patients (group 1) will be accrued for this study within 7.7 years. A total of 723 patients (group 2) will be accrued for this study within 3.8 years. (Group 2 [unfavorable prognosis] closed to accrual as of 9/2002.) (Group 1 [favorable prognosis] closed to accrual as of 4/28/04.)
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Masking
- None (open label)
Who may qualify
- Ages
- 15 to 70 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Child, Adult, Older adult
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| bleomycin sulfate | Biological | – |
| ABVD regimen | Drug | – |
| BEACOPP regimen | Drug | – |
| epirubicin hydrochloride | Drug | – |
| prednisone | Drug | – |
| vinblastine sulfate | Drug | – |
| radiation therapy | Radiation | – |
Primary outcome
Relapse-free rate
Time frame: 5 years
with events defined as lack of CR/CRu at the end of treatment or relapse
3 secondary outcomes
Overall Survival
Time frame: Till withdrawal criteria met
Failure Free Survival
Time frame: Till withdrawal criteria met
Relapse Free Survival
Time frame: Till withdrawal criteria met
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 5 Aug 2025.
- Background: PubMed 19850901van der Kaaij MA, Heutte N, van Echten-Arends J, Raemaekers JM, Carde P, Noordijk EM, Ferme C, Thomas J, Eghbali H, Brice P, Bonmati C, Henry-Amar M, Kluin-Nelemans HC. Sperm quality before treatment in patients with early stage Hodgkin's lymphoma enrolled in EORTC-GELA Lymphoma Group trials. Haematologica. 2009 Dec;94(12):1691-7. doi: 10.3324/haematol.2009.009696. Epub 2009 Oct 22.
- Background: PubMed 17515571van der Kaaij MA, Heutte N, Le Stang N, Raemaekers JM, Simons AH, Carde P, Noordijk EM, Ferme C, Thomas J, Eghbali H, Kluin-Nelemans HC, Henry-Amar M; European Organisation for Research and Treatment of Cancer: EORTC Lymphoma Group; Groupe d'Etude des Lymphomes de l'Adulte. Gonadal function in males after chemotherapy for early-stage Hodgkin's lymphoma treated in four subsequent trials by the European Organisation for Research and Treatment of Cancer: EORTC Lymphoma Group and the Groupe d'Etude des Lymphomes de l'Adulte. J Clin Oncol. 2007 Jul 1;25(19):2825-32. doi: 10.1200/JCO.2006.10.2020. Epub 2007 May 21.
- Results publicationEghbali H, Brice P, Creemers GY, et al.: Comparison of three radiation dose levels after EBVP regimen in favorable supradiaphragmatic clinical stages (CS) I-II Hodgkin's lymphoma (HL): preliminary results of the EORTC-GELA H9-F trial. [Abstract] Blood 106 (11): A-814, 2005.
- Results publicationFerme C, Diviné M, Vranovsky A, et al.: Four ABVD and involved-field radiotherapy in unfavorable supradiaphragmatic clinical stages (CS) I-II Hodgkin's lymphoma (HL): preliminary results of the EORTC-GELA H9-U trial. [Abstract] Blood 106 (11): A-813, 2005.
- Results publicationGirinsky T, Gargi T, Carrie C, et al.: Quality assurance program in the EORTC-GELA H9 randomized study results on 282 patients. [Abstract] Int J Radiat Oncol Biol Phys 63 (2 Suppl 1): A77, S47, 2005.
- Results publicationNoordijk EM, Thomas J, Fermé C, et al.: First results of the EORTC-GELA H9 randomized trials: the H9-F trial (comparing 3 radiation dose levels) and H9-U trial (comparing 3 chemotherapy schemes) in patients with favorable or unfavorable early stage Hodgkin's lymphoma (HL) . [Abstract] J Clin Oncol 23 (Suppl 16): A-6505, 561s, 2005.
- Results publicationThomas J, Ferme C, Noordijk EM, et al.: Six cycles of EBVP followed by 36 Gy involved-field irradiation vs. no irradiation in favourable supradiaphragmatic clinical stages I-II Hodgkin's lymphoma: the EORTC-GELA strategy in 771 patients (H9-F trial-20982). [Abstract] Eur J Haematol 75 (Suppl 65): A-E11a, 40, 2004.
- Results publicationThomas J, Ferme C, Noordijk EM, et al.: Six cycles of ABVD + IF-RT vs. four cycles of ABVD + IF-RT vs. four cycles of BEACOPP + IF-RT in unfavourable supradiaphragmatic clinical stages I-II Hodgkin's lymphoma: the EORTC-GELA H9-U randomized clinical trial (20982) in 808 patients. [Abstract] Eur J Haematol 73 (Supp 65): A-E12, 40, 2004.
- Derived from this study: PubMed 42848781Martinez Alcala R, Visser L, Fortpied C, Ferme C, Henry-Amar M, Aleman B, Arens A, Juul S, Hayat A, Hude Dragicevic I, Hutchings M, Meijnders P, Mutsaers P, Paszkiewicz-Kozik E, Rossetti S, Sureda A, Syrykh C, Tonino S, Plattel W, Diepstra A. Immunohistochemistry for c-MET, HLA class II, and CD68 does not show prognostic value in early-stage classic Hodgkin lymphoma patients in the EORTC-GELA H9 intergroup randomised trial. PLoS One. 2026 Oct 8;21(10):e0360080. doi: 10.1371/journal.pone.0360080. eCollection 2026.
- Derived from this study: PubMed 29229324Thomas J, Ferme C, Noordijk EM, Morschhauser F, Girinsky T, Gaillard I, Lugtenburg PJ, Andre M, Lybeert MLM, Stamatoullas A, Beijert M, Helias P, Eghbali H, Gabarre J, van der Maazen RWM, Jaubert J, Bouabdallah K, Boulat O, Roesink JM, Christian B, Ong F, Bordessoule D, Tertian G, Gonzalez H, Vranovsky A, Quittet P, Tirelli U, de Jong D, Audouin J, Aleman BMP, Henry-Amar M. Comparison of 36 Gy, 20 Gy, or No Radiation Therapy After 6 Cycles of EBVP Chemotherapy and Complete Remission in Early-Stage Hodgkin Lymphoma Without Risk Factors: Results of the EORT-GELA H9-F Intergroup Randomized Trial. Int J Radiat Oncol Biol Phys. 2018 Apr 1;100(5):1133-1145. doi: 10.1016/j.ijrobp.2017.10.015. Epub 2017 Oct 27.
- Derived from this study: PubMed 28601705Ferme C, Thomas J, Brice P, Casasnovas O, Vranovsky A, Bologna S, Lugtenburg PJ, Bouabdallah R, Carde P, Sebban C, Eghbali H, Salles G, van Imhoff GW, Thyss A, Noordijk EM, Reman O, Lybeert MLM, Janvier M, Spina M, Audhuy B, Raemaekers JMM, Delarue R, Anglaret B, de Weerdt O, Marjanovic Z, Tersteeg RJHA, de Jong D, Briere J, Henry-Amar M; European Organisation for Research and Treatment of Cancer Lymphoma Group, and; Groupe d'Etude des Lymphomes de l'Adulte. ABVD or BEACOPPbaseline along with involved-field radiotherapy in early-stage Hodgkin Lymphoma with risk factors: Results of the European Organisation for Research and Treatment of Cancer (EORTC)-Groupe d'Etude des Lymphomes de l'Adulte (GELA) H9-U intergroup randomised trial. Eur J Cancer. 2017 Aug;81:45-55. doi: 10.1016/j.ejca.2017.05.005. Epub 2017 Jun 8.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Jose Thomas, MD study chair
University Hospital, Gasthuisberg
H. Eghbali, MD study chair
Institut Bergonié
E.M. Noordijk, MD study chair
Leiden University Medical Center
121 sites in 10 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing bleomycin sulfate, ABVD regimen and BEACOPP regimen in people with Lymphoma, run by European Organisation for Research and Treatment of Cancer - EORTC at 121 sites in 10 countries.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: under way, not looking for participants, as of the sponsor's last update on 5 Aug 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 121 sites in France, Netherlands, Belgium, Italy, Switzerland and 5 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Relapse-free rate (time frame: 5 years). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT00005584, which also lists 11 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 5 Aug 2025.