# RATHL

Source: https://nuclide.cc/trials/rathl/  
Nuclide record `rathl` (Trial). Data CC BY-NC 4.0, attribute "Data from Nuclide (nuclide.cc)"; commercial use needs a licence.

## TL;DR

Showed that patients whose PET scan is clear after two cycles can safely drop bleomycin and its lung toxicity.

## Summary

RATHL, trial NCT00678327 sponsored by the UK NCRI and Cancer Research UK and published in the New England Journal of Medicine in 2016, showed that patients with advanced Hodgkin lymphoma whose PET scan is clear after two cycles can safely drop bleomycin and its lung toxicity. It enrolled 1,214 patients, randomised those with a negative interim PET to continue ABVD or switch to AVD, met its non-inferiority endpoint on progression-free survival with fewer pulmonary events, and escalated PET-positive patients to BEACOPP. Nuclide links it to Hodgkin lymphoma, PET-adapted therapy, FDG PET, the Deauville scale term, Cancer Research UK, Peter Johnson and the bleomycin caution pairing, and it is concordant with GHSG HD18. It established interim PET as a treatment-steering tool, and whether PET can guide even deeper de-escalation is the open question.

## Fields

- Kind: Trial
- Status: positive
- Last checked: 2026-09-07
- Registry id: NCT00678327
- Phase: 3
- Setting: Advanced Hodgkin lymphoma: interim-PET-guided omission of bleomycin (AVD) vs continued ABVD
- Sponsor: UK NCRI / Cancer Research UK
- Enrolled: 1214
- Result: 3-year PFS 85.7% (ABVD) vs 84.4% (AVD); bleomycin safely omitted.
- Outcomes: Progression-free survival at 3 years (PET2-negative): ABVD 85.7% vs AVD 84.4%
- Replication: Concordant with GHSG HD18 (shortened BEACOPP after negative PET2).

## Sources

- ClinicalTrials.gov NCT00678327: https://clinicaltrials.gov/study/NCT00678327

## Connected records

- technologies: [FDG PET](https://nuclide.cc/technologies/fdg-pet/), [PET-adapted (response-adapted) therapy](https://nuclide.cc/technologies/pet-adapted-therapy/)
- key papers: [RATHL: adapted treatment guided by interim PET-CT in advanced Hodgkin lymphoma](https://nuclide.cc/key-papers/paper-rathl-interim-pet-adapted-abvd-advanced-hodgkin-nejm-2016/)
- pairings: [FDG PET then response-adapted chemotherapy](https://nuclide.cc/pairings/fdg-pet-response-adapted-therapy/)
- people: [Heiko Schöder](https://nuclide.cc/people/heiko-schoder/)
- terms: [Deauville five-point scale for PET](https://nuclide.cc/terms/deauville-for-pet/)

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