Major progress in fertility preservation after treatment for cancer of the lymphatic system: Study

Young patients with advanced Hodgkin's lymphoma, a cancer of the lymphatic system, now have a better chance of having their own children after treatment. An international study led by the German Hodgkin Study Group (GHSG) at University Hospital Cologne and the University’s Faculty of Medicine has shown: The new BrECADD chemotherapy regimen preserves fertility significantly better than the previous standard eBEACOPP – without worsening the chances of recovery. The results were published under the title “Fertility in patients with advanced-stage classic Hodgkin lymphoma treated withBrECADD versus eBEACOPP: a secondary analysis of the multicentre, randomised, parallel, open-label, phase 3 HD21 Trial“ in the journal The Lancet Oncology.

In the HD21 trial, patients with advanced classical Hodgkin’s lymphoma received one of two therapies: either the experimental therapy with BrECADD or the previous standard of care eBEACOPP. Three years after treatment was concluded, there were major differences: In the BrECADD group, 95 per cent of women and 86 per cent of men had normal hormone levels again – compared to 73  per cent and 40 per cent respectively in the eBEACOPP group. More pregnancies and births were documented after the BrECADD regimen was applied. For men in particular, this means a significantly higher chance of biological paternity after treatment.

”BrECADD gives young adults with Hodgkin’s lymphoma a better chance of starting a family later in life – with an equally good or even slightly better cure rate,” explains Dr Justin Ferdinandus, Study Physician in the German Hodgkin Study Group (GHSG) and first author of the publication. “The HD21 study is fundamentally changing practice. Our data clearly show that BrECADD is the preferred first-line treatment for patients who wish to have children – at University Hospital Cologne and in the current Onkopedia guideline, this is already the new standard,” adds Dr Karolin Behringer, Study Physician at the GHSG and last author of the study.

The HD21 study is a randomized phase III clinical trial involving over 1,500 participants up to the age of 60 at 233 centres in nine countries. Among other things, the recovery of hormone levels (measured via blood serum levels of follicle-stimulating hormone) were examined along with pregnancies and births after therapy was concluded.

Reference:

Ferdinandus, J., et al. (2025). Fertility in patients with advanced-stage classic Hodgkin lymphoma treated with BrECADD versus eBEACOPP: a secondary analysis of the multicentre, randomised, parallel, open-label, phase 3 HD21 trial. The Lancet Oncology. doi.org/10.1016/S1470-2045(25)00262-1.