What question did this study set out to answer?

To establish whether radiotherapy can be safely omitted in early-stage classic Hodgkin lymphoma using baseline metabolic tumor volume and interim PET response to guide risk-adapted therapy.

August 22, 2026BiomedicinesOpen Access

Radiation-Free Therapy for the Initial Treatment of Good Prognosis Early Non-Bulky Hodgkin Lymphoma, Defined by a Low Metabolic Tumor Volume and a Negative Interim PET After 2 Chemotherapy Cycles: The RAFTING Trial Protocol

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Authors

KFK. FilonenkoGdańsk Medical University MPMarco PicardiFederico II University Hospital SCStéphane ChauvieCarle Foundation Hospital

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Implication

Randomized noninferiority trial outlines risk-adapted omission of radiotherapy in early Hodgkin lymphoma, suggesting a pathway to spare radiation in low-risk patients.

Key Points

To establish whether radiotherapy can be safely omitted in early-stage classic Hodgkin lymphoma using baseline metabolic tumor volume and interim PET response to guide risk-adapted therapy.
International, prospective, phase 2 non-inferiority study (NCT04866654; EudraCT 2020-002382-33) in patients aged 18–70 years with stage I–IIA early classic Hodgkin lymphoma without bulky disease, B symptoms, or extranodal involvement.
Low-risk patients (total metabolic tumor volume <84 mL and negative PET-2) receive 2 or 4 cycles of ABVD alone without radiotherapy and undergo circulating cell-free DNA (cfDNA) monitoring.
High-risk patients (total metabolic tumor volume ≥84 mL or positive PET-2) receive triple therapy comprising 4 ABVD cycles, involved-node radiotherapy (20/30 Gy), and nivolumab.
Standard combined-modality treatment achieves 94% to 95% long-term disease control, while chemotherapy alone cures approximately 70% of patients and approximately 5% fail standard combined therapy.
Protocol stratifies early-stage disease using a total metabolic tumor volume threshold of 84 mL alongside interim PET-2 to eliminate radiation exposure in low-risk subsets.
Limited relapses in low-risk cohorts are managed with involved-node radiotherapy (36 Gy) and nivolumab to prevent exposure to high-dose chemotherapy and autologous stem cell transplantation.

Cite This Study

Filonenko et al. (2026) studied this question.

synapsesocial.com/papers/6a895f0dca7ade938187d622 https://doi.org/10.3390/biomedicines14081861

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Implication

Randomized noninferiority trial outlines risk-adapted omission of radiotherapy in early Hodgkin lymphoma, suggesting a pathway to spare radiation in low-risk patients.

Radiation-Free Therapy for the Initial Treatment of Good Prognosis Early Non-Bulky Hodgkin Lymphoma, Defined by a Low Metabolic Tumor Volume and a Negative Interim PET After 2 Chemotherapy Cycles: The RAFTING Trial Protocol

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Implication

Key Points

Cite This Study

Radiation-Free Therapy for the Initial Treatment of Good Prognosis Early Non-Bulky Hodgkin Lymphoma, Defined by a Low Metabolic Tumor Volume and a Negative Interim PET After 2 Chemotherapy Cycles: The RAFTING Trial Protocol

Discussion

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Implication

Key Points

Cite This Study

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