Addition of Decitabine to Camrelizumab in Relapsed or Refractory Classical Hodgkin Lymphoma


Key Points

  • Among anti–PD-1 inhibitor–naive patients, complete response was more common with combination therapy.
  • Durable responses were observed with combination therapy.

In a single-center phase II trial reported in the Journal of Clinical Oncology, Nie et al found a higher complete response rate with the addition of low-dose decitabine to the programmed cell death protein 1 (PD-1) inhibitor camrelizumab in anti–PD-1 treatment–naive patients with relapsed or refractory classical Hodgkin lymphoma.

The study included 86 patients who had received at least 2 lines of previous therapy. Among these, 61 patients with no prior anti–PD-1 treatment were randomly assigned 1:2 to camrelizumab at 200-mg monotherapy every 3 weeks (n = 19) or decitabine at 10 mg/d on days 1 to 5 plus camrelizumab at 200 mg on day 8 every 3 weeks (n = 42). The 25 patients with prior anti–PD-1 treatment received combination therapy.

The primary endpoint was complete response rate and safety.


Median follow-up was 14.9 months. Among the anti-PD-1–naive patients, the complete response rate was 32% (6 of 19 patients) with camrelizumab monotherapy vs 71% (30 of 42 patients) with combination therapy (P = .003).

At the time of analysis, responses had persisted for 6 months in 76% of responders in the monotherapy group and 100% of responders in the combination group. Among patients who had previously received anti–PD-1 therapy, 28% achieved complete response and 24% achieved partial response with combination treatment; 81% of responders were estimated to have a response at more than 1 year.

Adverse Events

The most common treatment-related adverse events of any grade were cherry hemangiomas—which occurred in 84% of the monotherapy group and 87% all patients receiving combination therapy—and leukocytopenia, which occurred in 32% and 76%, respectively. Grade 3 to 4 leukocytopenia occurred in 39% of the combination group.

The investigators concluded, “Complete [response] rate in patients with relapsed [or] refractory [classical Hodgkin lymphoma] who were clinically naive to PD-1 blockade was significantly higher with decitabine plus camrelizumab than with camrelizumab alone. Decitabine plus camrelizumab may reverse resistance to PD-1 inhibitors in patients with relapsed [or] refractory [classical Hodgkin lymphoma].”

Weidong Han, MD, of the Chinese People’s Liberation Army General Hospital, Beijing, is the corresponding author for the Journal of Clinical Oncology article.

Disclosure: The study was funded by the National Key Research and Development Program of China and the National Natural Science Foundation of China. For full disclosures of the study authors, visit

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