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.
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“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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