Fuchs M, Goergen H, Kobe C, et al. - Given that for patients with early-stage favorable Hodgkin lymphoma (HL), combined-modality treatment (CMT) with 2× ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine) and small-field radiotherapy is standard of care, researchers examined if positron emission tomography (PET) after 2× ABVD (PET-2) may assist in predicting individual outcomes and guide treatment. In this international randomized phase 3 trial, 1,150 patients (age 18 to 75 years) were recruited. They assigned patients to standard CMT of 2× ABVD and 20-Gy involved-field radiotherapy or PET-guided treatment, omitting involved-field radiotherapy after negative PET-2 (Deauville score < 3). Outcomes suggest that a positive PET after two cycles ABVD symbolizes a high risk for treatment failure in early-stage favorable HL. This was particularly observed when a Deauville score of 4 is used as a cutoff for positivity. In PET-2–negative patients, no omission of radiotherapy from CMT could be done without clinically relevant loss of tumor control.