Dacarbazine

For fit younger patients treated in the intensive German tradition, BrECADD replaces escalated BEACOPP; how it compares with nivolumab-AVD from S1826 is the open question.

Nodular lymphocyte-predominant Hodgkin lymphoma is rarely fatal when treated with standard Hodgkin lymphoma protocols, so the goal for most patients is to give less treatment, not more; the minority with advanced or variant disease still need better options.

Confirmation, by a different route from HD18, that the interim scan can safely direct de-escalation in advanced Hodgkin lymphoma, and that most of the toxicity of escalated BEACOPP can be avoided in the 84 per cent of patients who respond early.

Radiotherapy cannot be omitted in early-stage favourable Hodgkin lymphoma on the basis of a negative interim scan without a clinically relevant loss of tumour control. The scan is better at identifying who needs more than at identifying who needs less.

The interim scan should be used to intensify treatment in early Hodgkin lymphoma, not to withhold radiotherapy. The 99.0 per cent five-year progression-free survival in the scan-negative favourable group with combined-modality treatment is the number any radiotherapy-sparing strategy has to match.

Eribulin is an approved later-line treatment for liposarcoma, one of the few sarcoma drugs with a demonstrated survival benefit.

An interim PET scan after two cycles guides treatment of advanced Hodgkin lymphoma: drop bleomycin if negative, intensify if positive.

Trabectedin is a standard later-line option for liposarcoma and leiomyosarcoma and is especially active in myxoid liposarcoma.