{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T23:19:44Z","timestamp":1793834384663,"version":"4.6.1"},"reference-count":32,"publisher":"American Medical Association (AMA)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Oncol"],"published-print":{"date-parts":[[2023,5,1]]},"abstract":"Importance<\/jats:title>To our knowledge, this is the first clinical trial designed to investigate concurrent treatment with a checkpoint inhibitor and conventional chemotherapy in relapsed or refractory classic Hodgkin lymphoma in patients destined for an autologous stem cell transplant.<\/jats:p><\/jats:sec>Objective<\/jats:title>To evaluate the complete response rate as assessed by 18<\/jats:sup>F-fluorodeoxyglucose\u2013positron emission tomography with computed tomography (FDG-PET\/CT) after salvage therapy for patients with relapsed or refractory classic Hodgkin lymphoma.<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>A single-group, phase 2, multi-institutional nonrandomized clinical trial to evaluate the addition of pembrolizumab to ifosfamide, carboplatin, and etoposide (ICE) chemotherapy was conducted from April 20, 2017, to October 29, 2020, at 5 US sites. The 42 patients were aged 18 years or older, with an Eastern Cooperative Oncology Group Performance Status Scale score of 0 or 1 and biopsy-proven relapsed or refractory classic Hodgkin lymphoma after 1 or 2 prior lines of chemotherapy. Patients were required to be appropriate candidates for transplant, with measurable lesions detected by FDG-PET\/CT.<\/jats:p><\/jats:sec>Interventions<\/jats:title>Two cycles of pembrolizumab (200 mg intravenously on day 1) with ICE chemotherapy every 21 days, followed by stem cell mobilization and collection, and then 1 cycle of pembrolizumab monotherapy followed by FDG-PET\/CT response assessment.<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>The primary end point was complete response rate detected by FDG-PET\/CT, defined as a Deauville score of 3 or lower. Patients with a complete response proceeded to an autologous stem cell transplant. Secondary end points included progression-free survival, overall survival, stem cell mobilization, and neutrophil and platelet engraftment. Adverse events were monitored to assess safety.<\/jats:p><\/jats:sec>Results<\/jats:title>Forty-two patients were enrolled, with 37 evaluable for the primary end point. The median age was 34 years (range, 19-70 years), 25 patients were female (68%), 6 were African American (16%), and 26 were White (70%). The complete response rate for the 37 patients assessed by FDG-PET\/CT imaging was 86.5% (95% CI, 71.2%-95.5%); the overall response rate was 97.3% (36 patients), with 10.8% partial responses (4 patients). New areas of FDG-PET positivity in 2 patients were biopsied, showing noncaseating granuloma in 1 case and a reactive lymph node in a second. Progression-free survival and overall survival 2-year estimates were 87.2% (32 patients; 95% CI, 77.3%-98.3%) and 95.1% (95% CI, 88.8%-100%), respectively. The addition of pembrolizumab to ICE chemotherapy did not negatively affect stem cell mobilization or collection or engraftment, similar to prior experience in this patient population and setting.<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>Results suggest that the addition of pembrolizumab to ICE chemotherapy was well tolerated and highly effective in comparison with prior reports of chemotherapy-only regimens, supporting further investigation in patients with relapsed or refractory classic Hodgkin lymphoma eligible for an autologous stem cell transplant.<\/jats:p><\/jats:sec>Trial Registration<\/jats:title>ClinicalTrials.gov Identifier: NCT03077828<\/jats:ext-link><\/jats:p><\/jats:sec>","DOI":"10.1001\/jamaoncol.2022.7975","type":"journal-article","created":{"date-parts":[[2023,3,16]],"date-time":"2023-03-16T15:01:15Z","timestamp":1678978875000},"page":"683","source":"Crossref","is-referenced-by-count":67,"title":["Pembrolizumab Added to Ifosfamide, Carboplatin, and Etoposide Chemotherapy for Relapsed or Refractory Classic Hodgkin Lymphoma"],"prefix":"10.1001","volume":"9","author":[{"given":"Locke J.","family":"Bryan","sequence":"first","affiliation":[{"name":"Division of Hematology and Oncology, Georgia Cancer Center at Augusta University, Augusta"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carla","family":"Casulo","sequence":"additional","affiliation":[{"name":"Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pamela B.","family":"Allen","sequence":"additional","affiliation":[{"name":"Division of Hematology and Oncology, Emory University, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott E.","family":"Smith","sequence":"additional","affiliation":[{"name":"Division of Hematology and Oncology, Loyola University Medical Center, Maywood, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hatice","family":"Savas","sequence":"additional","affiliation":[{"name":"Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary L.","family":"Dillehay","sequence":"additional","affiliation":[{"name":"Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reem","family":"Karmali","sequence":"additional","affiliation":[{"name":"Robert H. 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