Decitabine plus camrelizumab shows activity against relapsed, refractory cHL

Treatment with the combination of decitabine plus camrelizumab yields high response rates and long-term benefits in patients with relapsed/refractory classical Hodgkin lymphoma (cHL) who failed programmed death-1 (PD-1) inhibitors, as shown in a study.

The study included 51 patients (test cohort: n=25, expansion cohort: n=26) who relapsed or progressed with prior anti-PD-1 monotherapy. They received decitabine (10 mg/day, days 1–5) plus the anti-PD-1 camrelizumab (200 mg, day 8) every 3 weeks.

Median age of the overall population was 28 years, with 55 percent having primary refractory cHL and 59 percent having extranodal disease at enrolment. They received their first dose in this study a median of 2.6 years after initial diagnosis. The median number of lines of prior therapy was five.

The objective response rate was 52 percent (complete response [CR], 36 percent) in the test cohort and 68 percent (CR, 24 percent) in the expansion cohort. Median progression-free survival was 20.0 and 21.6 months, respectively, and this was much longer than that achieved with prior anti-PD-1 monotherapy.

About 78 percent of patients who achieved CR overall exhibited durable response at 24 months. The ratio increase of circulating peripheral central memory T cells showed a direct correlation with both clinical response and progression-free survival following treatment with decitabine plus camrelizumab.

Given that durable remission occurred only in a subset of patients, a phase II study is being conducted to evaluate the combination of anti-PD-1 and other epigenetic modifying agents in patients with relapsed/refractory cHL with anti-PD-1 resistance.