Hodgkin lymphoma is one of the most common cancers in young adults and is mostly diagnosed at an advanced stage. Despite high cure rates, the intensive chemotherapy regimens used in first-line treatment are associated with substantial and sometimes long-lasting side effects. So far, no factors are available that predict the individually required treatment intensity before therapy starts. Treatment is currently adapted based on early response on PET/CT, which is assessed visually using the Deauville scale and is subject to considerable inter-observer variability.

The aim of this project is to establish PET/CT-based imaging biomarkers, such as metabolic tumor volume, that allow more objective and precise guidance of treatment intensity before and during therapy, thereby optimizing the benefit-risk balance for each patient. To this end, PET/CT scans from the German Hodgkin Study Group Phase III trials HD18 (1945 patients) and HD21 (1482 patients), acquired before treatment, after two cycles, and at the end of chemotherapy, will be analyzed. All scans were centrally reviewed at the reference nuclear medicine center in Cologne. The results will provide the basis for a prospective clinical trial of biomarker-guided treatment.