# Advanced-stage classical Hodgkin lymphoma (stage III to IV)

Source: https://onco.cc/cancers/advanced-stage-classical-hodgkin-lymphoma/  
OnCo record `advanced-stage-classical-hodgkin-lymphoma` (Cancer). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Advanced-stage classical Hodgkin lymphoma is Hodgkin lymphoma involving nodes on both sides of the diaphragm or organs such as the liver, lungs or bone marrow. It is treated with six cycles of combination chemotherapy, and two trials changed the standard: replacing bleomycin with brentuximab vedotin (ECHELON-1) and then with nivolumab (SWOG S1826), which cured more patients with less toxicity.

## Summary

Advanced classical Hodgkin lymphoma was the first disseminated cancer cured by chemotherapy, with MOPP in the 1960s and then ABVD from 1975, and for forty years the argument was between ABVD and the more intensive escalated BEACOPP of the German Hodgkin Study Group, which cures more patients up front at the cost of infertility, leukaemia and toxicity. PET-adapted therapy eased the trade-off: the RATHL trial (New England Journal of Medicine 2016) showed bleomycin can be dropped after two cycles in PET-negative patients without loss of efficacy, and HD18 showed escalated BEACOPP can be shortened to four cycles in PET-negative patients. The International Prognostic Score, the Deauville score on interim PET and baseline metabolic tumour volume stratify risk.

Two trials then rebuilt the regimen. ECHELON-1 (New England Journal of Medicine 2018) randomised 1,334 patients to ABVD or to brentuximab vedotin with AVD (A+AVD), replacing bleomycin with the CD30 antibody-drug conjugate; modified progression-free survival improved and, in the six-year update (New England Journal of Medicine 2022), overall survival was higher with A+AVD (93.9 against 89.4 percent), the first survival gain in advanced Hodgkin lymphoma in a generation. SWOG S1826 (New England Journal of Medicine 2024) then randomised 994 patients aged 12 and over to A+AVD or to nivolumab with AVD (N+AVD): one-year progression-free survival was 94 against 86 percent with fewer peripheral neuropathy and infection problems and almost no radiotherapy, making N+AVD the preferred regimen in the NCCN guideline for adults and adolescents. In Europe, GHSG HD21 (Lancet 2024) showed that BrECADD, a brentuximab-containing variant of escalated BEACOPP, was less toxic and at least as effective as escalated BEACOPP with four-year progression-free survival of 94.3 against 90.9 percent, giving a second intensive PET-guided option. Paediatric groups are testing brentuximab vedotin and PD-1 antibodies in children with advanced disease, older patients receive AVD-based or brentuximab-sequenced regimens because bleomycin and BEACOPP are too toxic, and consolidation radiotherapy is now limited to residual PET-positive bulky disease.

## Fields

- Kind: Cancer
- Last checked: 2026-09-18
- Also known as: Stage III to IV classical Hodgkin lymphoma; Advanced Hodgkin lymphoma; Disseminated Hodgkin lymphoma; High-risk Hodgkin lymphoma (IPS 4 or more)
- Tags: subtype-page; haematologic
- Group: haematologic
- Burden: About half of classical Hodgkin lymphoma at diagnosis; most patients are cured, but a fifth to a quarter relapse after ABVD, and older patients fare worse.
- Subtypes: Stage III classical Hodgkin lymphoma (nodes on both sides of the diaphragm); Stage IV classical Hodgkin lymphoma (extranodal spread to liver, lung, bone or marrow); Advanced classical Hodgkin lymphoma with a high International Prognostic Score (4 or more); Advanced classical Hodgkin lymphoma in adolescents and young adults (S1826 population); Advanced classical Hodgkin lymphoma in older adults (over 60; bleomycin-free regimens); Interim PET-positive advanced classical Hodgkin lymphoma (escalation or consolidation)
- Biomarkers: International Prognostic Score (IPS 0 to 7); Interim FDG-PET after cycle two (Deauville score, RATHL and HD18 escalation or de-escalation); Baseline metabolic tumour volume; CD30 expression (universal; brentuximab target); 9p24.1 amplification and PD-L1 expression (PD-1 responsiveness); Circulating tumour DNA (research)

## Sections of this record

The page is a hub with ten sections in reading order; large sections have their own page. The same plan as JSON: https://onco.cc/api/v1/cancers/advanced-stage-classical-hodgkin-lymphoma/sections.json

- Overview (on the hub): The TL;DR, the family this cancer belongs to, the organ, who gets it and what the state of the art is. https://onco.cc/cancers/advanced-stage-classical-hodgkin-lymphoma/#overview [3 state-of-the-art points]
- Types and stages (on the hub): Anatomy, the subtypes and how they differ, how it is staged, and where advanced disease spreads. https://onco.cc/cancers/advanced-stage-classical-hodgkin-lymphoma/#what-it-is [6 subtypes]
- Symptoms and diagnosis (on the hub): How this cancer shows itself, how the diagnosis is confirmed, and the biomarkers clinicians test for. https://onco.cc/cancers/advanced-stage-classical-hodgkin-lymphoma/#finding-it [6 biomarkers]
- Treatment (on the hub): The standard of care by setting, the medicines, surgery and radiotherapy named in it, and the regimens behind them. https://onco.cc/cancers/advanced-stage-classical-hodgkin-lymphoma/#treating-it [9 settings, 9 decisions with options]
- Trials and papers (on the hub): Trials recruiting now, the landmark trials, the trials held by this cancer's subtypes, the key papers and what they mean, the latest literature, and the milestones year by year. https://onco.cc/cancers/advanced-stage-classical-hodgkin-lymphoma/#evidence [8 trials, 9 key papers, 7 milestones]
- Biology and targets (on the hub): The molecular landscape: the targets and how often each appears, the pathways, the mechanics stages and the preclinical models. https://onco.cc/cancers/advanced-stage-classical-hodgkin-lymphoma/#science [4 targets]
- Countries and centres (own page): Cases by country, the UK and NHS pathway and other country lenses, the expert centres with trials on record, and the centres named on this cancer's subtypes. https://onco.cc/cancers/advanced-stage-classical-hodgkin-lymphoma/where-you-are/ [25 UK centres]
- Decisions and support (on the hub): The decisions you may face, the aids that walk through them, the warnings on record, the first sixty days and the questions to ask. https://onco.cc/cancers/advanced-stage-classical-hodgkin-lymphoma/#living-with-it [18 questions, 6 red cards]
- Pipeline and open problems (own page): Everything in development, the medicines held by this cancer's subtypes, the open problems and what is being done about them, the roadmaps, and what changed on this record. https://onco.cc/cancers/advanced-stage-classical-hodgkin-lymphoma/coming/ [12 medicines, 8 trials, 2 ideas, 4 open problems]
- Data (own page): Every connected record, the notes, the JSON, Markdown and RDF twins, and where the record came from and when it was checked. https://onco.cc/cancers/advanced-stage-classical-hodgkin-lymphoma/data/ [101 connected records, 1 note]

## Standard of care

- Staging and risk: FDG-PET/CT with Lugano staging, International Prognostic Score, fertility counselling and cardiac and pulmonary baselines. ([FDG PET](https://onco.cc/technologies/fdg-pet/), [Lugano classification / Ann Arbor staging](https://onco.cc/terms/lugano-classification/), [Oncofertility and fertility preservation](https://onco.cc/technologies/fertility-preservation/), [Cardio-oncology](https://onco.cc/technologies/cardio-oncology/))
- First line, adults and adolescents 12 and over: Nivolumab with AVD for six cycles (SWOG S1826, preferred); brentuximab vedotin with AVD (ECHELON-1) as an alternative; PET-adapted ABVD with bleomycin omission after two cycles (RATHL) where antibodies are unavailable. ([Nivolumab](https://onco.cc/drugs/nivolumab/), [SWOG S1826](https://onco.cc/trials/swog-s1826/), [Brentuximab vedotin](https://onco.cc/drugs/brentuximab-vedotin/), [ECHELON-1](https://onco.cc/trials/echelon-1/), [Doxorubicin](https://onco.cc/drugs/doxorubicin/), [Vinblastine](https://onco.cc/drugs/vinblastine/), [Dacarbazine](https://onco.cc/drugs/dacarbazine/), [RATHL](https://onco.cc/trials/rathl/), [PD-1 blockade + AVD chemotherapy](https://onco.cc/pairings/pd1-plus-avd-hodgkin/), [Caution: bleomycin lung toxicity, especially with brentuximab or G-CSF](https://onco.cc/pairings/bleomycin-omission-caution/))
- First line, intensive European option: BrECADD for four to six cycles guided by interim PET (GHSG HD21), replacing escalated BEACOPP. ([GHSG HD21](https://onco.cc/trials/hd21/), [Brentuximab vedotin](https://onco.cc/drugs/brentuximab-vedotin/), [ABVD, BEACOPP and BrECADD (Hodgkin lymphoma regimens)](https://onco.cc/terms/abvd-beacopp/), [PET-adapted (response-adapted) therapy](https://onco.cc/technologies/pet-adapted-therapy/))
- Children: Response-adapted Children's Oncology Group or EuroNet regimens; brentuximab vedotin with AVD in advanced paediatric disease; radiotherapy for slow responders only. ([A Study of Brentuximab Vedotin + Adriamycin, Vinblastine, and Dacarbazine in Pediatric Participants With Advanced Stage Newly Diagnosed Hodgkin Lymphoma](https://onco.cc/trials/nct02979522/), [Brentuximab vedotin](https://onco.cc/drugs/brentuximab-vedotin/), [Children's Oncology Group (COG)](https://onco.cc/companies/childrens-oncology-group/), [PET-adapted (response-adapted) therapy](https://onco.cc/technologies/pet-adapted-therapy/))
- Older or frail patients: AVD with brentuximab vedotin sequenced before and after, or nivolumab-AVD; avoid bleomycin and BEACOPP. ([Brentuximab vedotin](https://onco.cc/drugs/brentuximab-vedotin/), [Nivolumab](https://onco.cc/drugs/nivolumab/), [Doxorubicin](https://onco.cc/drugs/doxorubicin/), [Cardio-oncology](https://onco.cc/technologies/cardio-oncology/))
- End of treatment: PET-directed consolidation radiotherapy only for residual PET-positive bulky disease; long-term survivorship follow-up. ([FDG PET](https://onco.cc/technologies/fdg-pet/), [IMRT / IGRT (modern external beam)](https://onco.cc/technologies/imrt-igrt/), [Deauville five-point scale](https://onco.cc/terms/deauville-score/), [Late effects and survivorship toxicity](https://onco.cc/terms/late-effects/))
- Advanced Hodgkin lymphoma in the United States: nivolumab with AVD: SWOG S1826 randomised 994 patients aged 12 and over with untreated stage III or IV classical Hodgkin lymphoma to nivolumab with AVD or to brentuximab vedotin with AVD, the regimen that had itself displaced ABVD. Two-year progression-free survival was 92 against 83 per cent (hazard ratio 0.45), and any-grade peripheral neuropathy was 28.1 against 54.2 per cent. It is the first trial in this disease to include adolescents and adults in a single protocol, and the FDA approved nivolumab with doxorubicin, vinblastine and dacarbazine for previously untreated stage III or IV classical Hodgkin lymphoma in adults and children of 12 and over on 20 March 2026, converting the two earlier relapsed-disease accelerated approvals to traditional approval at the same time.

It is a genuinely gentler regimen as well as a more effective one: less neuropathy, less growth-factor requirement, and no bleomycin. The subset analysis of the 99 eligible patients aged 60 and over reported two-year progression-free survival of 89 per cent with nivolumab-AVD against 64 per cent with brentuximab-AVD (hazard ratio 0.24) and two-year overall survival of 96 against 85 per cent (hazard ratio 0.16), with non-relapse mortality of 6 against 16 per cent, 55 per cent discontinuing brentuximab vedotin against 14 per cent discontinuing nivolumab, and six cycles delivered without dose reduction in 69 against 26 per cent. That matters, because older patients tolerate brentuximab-AVD badly and are the group in which first-line treatment most often fails.

What is not yet known: overall survival has not separated, follow-up is short for a disease measured in decades, and the long-term consequences of PD-1 blockade in a 20-year-old who will live another 60 years are unknown. That last point is the honest counter-argument to adopting it everywhere. ([SWOG S1826](https://onco.cc/trials/swog-s1826/), [Nivolumab](https://onco.cc/drugs/nivolumab/), [Brentuximab vedotin](https://onco.cc/drugs/brentuximab-vedotin/), [Doxorubicin](https://onco.cc/drugs/doxorubicin/), [Vinblastine](https://onco.cc/drugs/vinblastine/), [Dacarbazine](https://onco.cc/drugs/dacarbazine/), [ABVD, BEACOPP and BrECADD (Hodgkin lymphoma regimens)](https://onco.cc/terms/abvd-beacopp/), [British and American lymphoma practice: where they differ, and why](https://onco.cc/terms/lymphoma-tx-uk-versus-us/), [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/))
- Advanced Hodgkin lymphoma in Germany and much of Europe: PET-guided BrECADD: GHSG HD21 randomised about 1,500 patients aged 18 to 60 with untreated advanced-stage classical Hodgkin lymphoma to PET-guided BrECADD or PET-guided escalated BEACOPP. Four-year progression-free survival was 94.3 against 90.9 per cent (hazard ratio 0.66) and treatment-related morbidity, a composite of organ toxicity, infection and haematological toxicity, was 42 against 59 per cent. BrECADD replaces the bleomycin, vincristine and procarbazine of escalated BEACOPP with brentuximab vedotin and dacarbazine, which removes the lung toxicity, most of the neuropathy and much of the infertility risk, and PET guidance means most patients receive four cycles rather than six.

This is the highest progression-free survival reported in advanced Hodgkin lymphoma. It is also intensive treatment that requires an experienced unit, hospital admission for febrile neutropenia in a substantial minority, and growth-factor support throughout.

The earlier PET-guided BEACOPP trials, HD18 and AHL2011, established the principle: HD18 reduced treatment from eight cycles to four in PET-negative patients, and AHL2011 switched PET-negative patients from escalated BEACOPP to ABVD, in both cases without losing disease control. ([GHSG HD21](https://onco.cc/trials/hd21/), [Brentuximab vedotin](https://onco.cc/drugs/brentuximab-vedotin/), [Etoposide](https://onco.cc/drugs/etoposide/), [Cyclophosphamide](https://onco.cc/drugs/cyclophosphamide/), [Doxorubicin](https://onco.cc/drugs/doxorubicin/), [Dacarbazine](https://onco.cc/drugs/dacarbazine/), [Dexamethasone](https://onco.cc/drugs/dexamethasone/), [Procarbazine](https://onco.cc/drugs/procarbazine/), [Bleomycin](https://onco.cc/drugs/bleomycin/), [Vincristine](https://onco.cc/drugs/vincristine/), [ABVD, BEACOPP and BrECADD (Hodgkin lymphoma regimens)](https://onco.cc/terms/abvd-beacopp/), [FDG PET](https://onco.cc/technologies/fdg-pet/), [PET-adapted (response-adapted) therapy](https://onco.cc/technologies/pet-adapted-therapy/), [Fertility before lymphoma treatment: what to ask for, and when](https://onco.cc/terms/lymphoma-tx-fertility-preservation/), [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/))
- Advanced Hodgkin lymphoma with ABVD and brentuximab: what the earlier standards showed: The two regimens that the current standards displaced are still used, and still reasonable where the newer ones are not available.

ABVD with PET adaptation. RATHL enrolled 1,214 patients and showed that in those whose PET after two cycles was negative, bleomycin could be omitted from cycles 3 to 6 without loss of control: three-year progression-free survival 85.7 per cent for continued ABVD against 84.4 per cent for AVD, with less lung toxicity. This remains common British practice and is a perfectly defensible treatment.

Brentuximab vedotin with AVD. ECHELON-1 randomised 1,334 patients with untreated stage III or IV disease to A+AVD or ABVD: two-year modified progression-free survival was 82.1 against 77.2 per cent (hazard ratio 0.77) and, at six years, overall survival was 93.9 against 89.4 per cent (hazard ratio 0.59). It is the only first-line trial in advanced Hodgkin lymphoma to show an overall survival advantage. The cost is peripheral neuropathy, which is commoner and more severe than with ABVD; in SWOG S1826 any-grade peripheral neuropathy was 54.2 per cent with brentuximab-AVD against 28.1 per cent with nivolumab-AVD. Growth-factor support is mandatory. In England, NICE TA1059 recommends brentuximab vedotin with doxorubicin, dacarbazine and vinblastine for untreated stage 3 or 4 CD30-positive Hodgkin lymphoma in adults, so this is the regimen that is funded first line; there is no NICE appraisal of nivolumab with AVD.

Older and frail patients tolerate none of these well. Options are ABVD with bleomycin omitted, sequential brentuximab vedotin before and after AVD, or a reduced-intensity regimen, and the choice is made on comorbidity rather than on chronological age. ([RATHL](https://onco.cc/trials/rathl/), [ECHELON-1](https://onco.cc/trials/echelon-1/), [Brentuximab vedotin](https://onco.cc/drugs/brentuximab-vedotin/), [Doxorubicin](https://onco.cc/drugs/doxorubicin/), [Bleomycin](https://onco.cc/drugs/bleomycin/), [Vinblastine](https://onco.cc/drugs/vinblastine/), [Dacarbazine](https://onco.cc/drugs/dacarbazine/), [Growth factors: G-CSF and febrile neutropenia prevention](https://onco.cc/technologies/g-csf-growth-factors/), [ABVD, BEACOPP and BrECADD (Hodgkin lymphoma regimens)](https://onco.cc/terms/abvd-beacopp/), [RATHL: adapted treatment guided by interim PET-CT in advanced Hodgkin lymphoma](https://onco.cc/key-papers/paper-rathl-interim-pet-adapted-abvd-advanced-hodgkin-nejm-2016/), [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/))

## State of the art

- Nivolumab-AVD is the new standard, curing more patients with less toxicity than brentuximab-AVD.
- ECHELON-1 delivered the first overall survival gain in advanced disease in decades.
- PET-guided BrECADD gives Europe a less toxic intensive alternative.

## Open problems

- Long-term outcomes of nivolumab-AVD beyond a few years are not yet known.
- Nivolumab-AVD and BrECADD have never been compared.
- Older patients still have worse survival and more toxicity.
- Whether chemotherapy can be reduced further with PD-1 antibodies is the next trial question.

## Notes

- Advanced Hodgkin lymphoma, what the escalation decision costs and what it buys: This is orientation from public patient pages, guidelines and the trials themselves, not advice for your case: your own team's instructions and the 24-hour number they gave you come first, and no figure here is a prediction about you. The decision records, the question sets, the first 60 days checklist and the red cards on this page were written from the NHS, Lymphoma Action, Macmillan and Cancer Research UK patient pages, from NICE NG52, NG47, CG151 and NG234, from the NHS Breast Screening Programme protocols and the Green Book, and from the trial reports named beside each figure, all read on 1 October 2026.

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Hodgkin_lymphoma
- SWOG S1826 (NEJM 2024): https://doi.org/10.1056/NEJMoa2405888
- ECHELON-1 (NEJM 2018): https://doi.org/10.1056/NEJMoa1708984
- HD21 (Lancet 2024): https://doi.org/10.1016/S0140-6736(24)01315-1
- Wikipedia: https://en.wikipedia.org/wiki/Hodgkin_lymphoma
- Lymphoma Action: helpline services: https://lymphoma-action.org.uk/information-and-support/support-you/helpline-services
- Lymphoma Action: questions to ask your medical team about lymphoma: https://lymphoma-action.org.uk/information-and-support/tests-scans-and-lymphoma-staging/questions-ask-your-medical-team-about-lymphoma
- Lymphoma Action: follow-up after lymphoma treatment: https://lymphoma-action.org.uk/information-and-support/living-and-beyond-lymphoma/follow-after-lymphoma-treatment
- Lymphoma Action: infections, risk and prevention: https://lymphoma-action.org.uk/information-and-support/side-effects-lymphoma-and-treatment/infections-risk-and-prevention
- Lymphoma Action: neutropenia (low neutrophils): https://lymphoma-action.org.uk/information-and-support/side-effects-lymphoma-and-treatment/neutropenia-low-neutrophils
- Lymphoma Action: cancer-related fatigue: https://lymphoma-action.org.uk/information-and-support/side-effects-lymphoma-and-treatment/cancer-related-fatigue
- Lymphoma Action: lymphoma, work and you: https://lymphoma-action.org.uk/information-and-support/living-and-beyond-lymphoma/day-day-living/lymphoma-work-and-you
- Maggie's: support and information: https://www.maggies.org/support-and-information/
- Lymphoma Action: classical Hodgkin lymphoma: https://lymphoma-action.org.uk/information-and-support/types-lymphoma/hodgkin-lymphoma/classical-hodgkin-lymphoma
- Lymphoma Action: late effects of lymphoma treatment: https://lymphoma-action.org.uk/information-and-support/side-effects-lymphoma-and-treatment/late-effects-lymphoma-treatment
- Johnson et al., adapted treatment guided by interim PET-CT scan in advanced Hodgkin's lymphoma (RATHL), New England Journal of Medicine 2016: https://doi.org/10.1056/NEJMoa1510093
- Borchmann et al., PET-guided BrECADD versus escalated BEACOPP in advanced-stage classical Hodgkin lymphoma (HD21), Lancet 2024: https://doi.org/10.1016/S0140-6736(24)01315-1
- Behringer et al., gonadal function and fertility in survivors after Hodgkin lymphoma treatment within the German Hodgkin Study Group HD13 to HD15 trials, Journal of Clinical Oncology 2013 (1,323 survivors): https://doi.org/10.1200/JCO.2012.44.3721
- NHS: Hodgkin lymphoma, treatment: https://www.nhs.uk/conditions/hodgkin-lymphoma/treatment/

## Connected records

- cancers: [Diffuse large B-cell lymphoma](https://onco.cc/cancers/dlbcl/), [Early-stage classical Hodgkin lymphoma (stage I to II)](https://onco.cc/cancers/early-stage-classical-hodgkin-lymphoma/), [Hodgkin lymphoma](https://onco.cc/cancers/hodgkin-lymphoma/), [Nodular lymphocyte-predominant Hodgkin lymphoma (nodular lymphocyte-predominant B-cell lymphoma)](https://onco.cc/cancers/nodular-lymphocyte-predominant-hodgkin-lymphoma/), [Relapsed and refractory classical Hodgkin lymphoma](https://onco.cc/cancers/relapsed-refractory-hodgkin-lymphoma/)
- 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/)
- technologies: [Antibody-drug conjugate (ADC)](https://onco.cc/technologies/adc/), [Cardio-oncology](https://onco.cc/technologies/cardio-oncology/), [Cognitive behavioural therapy for fatigue and distress](https://onco.cc/technologies/cbt-fatigue-distress/), [ctDNA monitoring in lymphoma (PhasED-seq, clonoSEQ)](https://onco.cc/technologies/ctdna-lymphoma-monitoring/), [Cytotoxic chemotherapy](https://onco.cc/technologies/cytotoxic-chemotherapy/), [Early integrated palliative care](https://onco.cc/technologies/palliative-care/), [Exercise during chemotherapy and radiotherapy](https://onco.cc/technologies/exercise-during-chemotherapy/), [FDG PET](https://onco.cc/technologies/fdg-pet/), [Financial toxicity and financial navigation](https://onco.cc/technologies/financial-navigation/), [Growth factors: G-CSF and febrile neutropenia prevention](https://onco.cc/technologies/g-csf-growth-factors/), [Immune checkpoint inhibitors](https://onco.cc/technologies/checkpoint-inhibitor/), [IMRT / IGRT (modern external beam)](https://onco.cc/technologies/imrt-igrt/), [Multidisciplinary tumour boards](https://onco.cc/technologies/multidisciplinary-tumour-board/), [Nutrition support and cachexia management](https://onco.cc/technologies/oncology-nutrition/), [Oncofertility and fertility preservation](https://onco.cc/technologies/fertility-preservation/), [Peer support and support groups](https://onco.cc/technologies/peer-support-groups/), [PET-adapted (response-adapted) therapy](https://onco.cc/technologies/pet-adapted-therapy/), [PET/CT](https://onco.cc/technologies/pet-ct/), [Prehabilitation before cancer surgery](https://onco.cc/technologies/prehabilitation/), [Psycho-oncology and distress screening](https://onco.cc/technologies/psycho-oncology/), [Survivorship care and late-effects surveillance](https://onco.cc/technologies/survivorship-care-plan/)
- targets: [CD30](https://onco.cc/targets/cd30/), [PD-1](https://onco.cc/targets/pd1/), [PD-L1](https://onco.cc/targets/pdl1/)
- drugs: [Bleomycin](https://onco.cc/drugs/bleomycin/), [Brentuximab vedotin](https://onco.cc/drugs/brentuximab-vedotin/), [Cyclophosphamide](https://onco.cc/drugs/cyclophosphamide/), [Dacarbazine](https://onco.cc/drugs/dacarbazine/), [Dexamethasone](https://onco.cc/drugs/dexamethasone/), [Doxorubicin](https://onco.cc/drugs/doxorubicin/), [Etoposide](https://onco.cc/drugs/etoposide/), [Nivolumab](https://onco.cc/drugs/nivolumab/), [Pembrolizumab](https://onco.cc/drugs/pembrolizumab/), [Procarbazine](https://onco.cc/drugs/procarbazine/), [Vinblastine](https://onco.cc/drugs/vinblastine/), [Vincristine](https://onco.cc/drugs/vincristine/)
- terms: [A clinical trial or standard treatment in lymphoma](https://onco.cc/terms/lymphoma-decision-trial/), [ABVD, BEACOPP and BrECADD (Hodgkin lymphoma regimens)](https://onco.cc/terms/abvd-beacopp/), [After Hodgkin lymphoma: the late effects, and the screening that follows them](https://onco.cc/terms/lymphoma-living-hodgkin-survivorship-screening/), [British and American lymphoma practice: where they differ, and why](https://onco.cc/terms/lymphoma-tx-uk-versus-us/), [Cancer-related fatigue (tiredness)](https://onco.cc/terms/cancer-related-fatigue/), [Cardiotoxicity (LVEF decline, cardiomyopathy)](https://onco.cc/terms/cardiotoxicity/), [Central venous access (port, PICC line)](https://onco.cc/terms/central-venous-access/), [Deauville five-point scale](https://onco.cc/terms/deauville-score/), [Deauville score and PET-adapted therapy](https://onco.cc/terms/deauville/), [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/), [Fatigue after lymphoma treatment, and why it is a symptom to report](https://onco.cc/terms/lymphoma-living-fatigue/), [Febrile neutropenia](https://onco.cc/terms/febrile-neutropenia/), [Fertility before lymphoma treatment: what to ask for, and when](https://onco.cc/terms/lymphoma-tx-fertility-preservation/), [Fertility preservation before lymphoma treatment: a decision with a deadline in days](https://onco.cc/terms/lymphoma-decision-fertility-timing/), [Financial toxicity](https://onco.cc/terms/financial-toxicity/), [Hypogammaglobulinaemia and infection risk after B-cell therapies](https://onco.cc/terms/hypogammaglobulinaemia/), [Late effects and survivorship toxicity](https://onco.cc/terms/late-effects/), [Late effects of Hodgkin lymphoma treatment, and the follow-up that answers them](https://onco.cc/terms/lymphoma-tx-hodgkin-late-effects/), [Lugano classification / Ann Arbor staging](https://onco.cc/terms/lugano-classification/), [Neutropenia](https://onco.cc/terms/neutropenia/), [Performance status (ECOG, Karnofsky)](https://onco.cc/terms/performance-status/), [Quality of life](https://onco.cc/terms/quality-of-life/), [Radiotherapy in lymphoma: involved-site fields, 24 Gy, 4 Gy and total skin electron therapy](https://onco.cc/terms/lymphoma-tx-radiotherapy/), [Reed-Sternberg cell](https://onco.cc/terms/reed-sternberg-cell/), [Secondary malignancy (therapy-related cancer)](https://onco.cc/terms/secondary-malignancy/), [Stem cell transplant in lymphoma: what it is still for](https://onco.cc/terms/lymphoma-tx-transplant-role/), [The lymphoma regimen alphabet: R-CHOP, pola-R-CHP, DA-EPOCH-R, ABVD, BEACOPP and the rest](https://onco.cc/terms/lymphoma-tx-regimen-alphabet/), [What the NHS in England funds for lymphoma, appraisal by appraisal](https://onco.cc/terms/lymphoma-tx-uk-access/)
- trials: [A Study of Brentuximab Vedotin + Adriamycin, Vinblastine, and Dacarbazine in Pediatric Participants With Advanced Stage Newly Diagnosed Hodgkin Lymphoma](https://onco.cc/trials/nct02979522/), [AHL2011](https://onco.cc/trials/ahl2011/), [AHOD1331](https://onco.cc/trials/ahod1331/), [ECHELON-1](https://onco.cc/trials/echelon-1/), [GHSG HD18](https://onco.cc/trials/hd18/), [GHSG HD21](https://onco.cc/trials/hd21/), [RATHL](https://onco.cc/trials/rathl/), [SWOG S1826](https://onco.cc/trials/swog-s1826/)
- key papers: [AHOD1331: brentuximab vedotin with chemotherapy in paediatric high-risk Hodgkin lymphoma](https://onco.cc/key-papers/paper-ahod1331-brentuximab-vedotin-paediatric-hodgkin-castellino-nejm-2022/), [Cardiovascular disease after Hodgkin lymphoma treatment: 40-year disease risk](https://onco.cc/key-papers/paper-van-nimwegen-cardiovascular-disease-after-hodgkin-jama-intern-med-2015/), [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-adapted treatment for newly diagnosed advanced Hodgkin lymphoma (AHL2011): a randomised, multicentre, non-inferiority, phase 3 study](https://onco.cc/key-papers/paper-ahl2011-pet-adapted-treatment-advanced-hodgkin-lancet-oncol-2019/), [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/), [RATHL: adapted treatment guided by interim PET-CT in advanced Hodgkin lymphoma](https://onco.cc/key-papers/paper-rathl-interim-pet-adapted-abvd-advanced-hodgkin-nejm-2016/), [Second cancer risk up to 40 years after treatment for Hodgkin's lymphoma](https://onco.cc/key-papers/paper-schaapveld-second-cancer-risk-40-years-hodgkin-nejm-2015/), [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/)
- companies: [Children's Oncology Group (COG)](https://onco.cc/companies/childrens-oncology-group/), [German Breast Group (GBG)](https://onco.cc/companies/gbg/)
- pairings: [Caution: bleomycin lung toxicity, especially with brentuximab or G-CSF](https://onco.cc/pairings/bleomycin-omission-caution/), [PD-1 blockade + AVD chemotherapy](https://onco.cc/pairings/pd1-plus-avd-hodgkin/)
- ideas: [Chemotherapy-free Hodgkin lymphoma: brentuximab + PD-1 in early stage](https://onco.cc/ideas/idea-chemo-free-hodgkin/), [Measure the late effects of the treatments being given now, not the ones given in 1975](https://onco.cc/ideas/lymphoma-ev-late-effects-of-the-treatments-given-now/)

---
JSON: https://onco.cc/api/v1/entities/advanced-stage-classical-hodgkin-lymphoma.json