PD-1-based combinations before autologous transplant are associated with improved outcomes in classical Hodgkin lymphoma Available to Purchase

• PD-1 blockade given pre-ASCT is associated with superior post-ASCT outcomes in relapsed/refractory classical Hodgkin lymphoma.

Combination therapy incorporating PD-1 blockade results in unprecedented response rates in both frontline and relapsed/refractory (R/R) classical Hodgkin lymphoma (cHL). Prior retrospective studies have suggested benefit for PD-1 blockade pre-ASCT but included few patients receiving PD-1 blockade with cytotoxic chemotherapy. To explore the impact of anti-PD-1 based salvage on outcomes for patients with R/R cHL, we retrospectively reviewed 1280 patients with R/R cHL who underwent ASCT from 2010-2022 at 6 transplant centers, none of whom received PD-1 blockade as part of frontline therapy. 25% received a PD-1 inhibitor at any point prior to ASCT (10% in conjunction with chemotherapy), 28% received salvage BV without PD-1 blockade, and the rest received salvage chemotherapy alone. Patients who received PD-1 inhibitors at any point before ASCT had a significantly higher 2-year PFS compared to patients who received BV without PD-1 inhibitors or patients receiving chemotherapy alone (88.2%, 70.2%, 67.4%, p < 0.0001). When restricted to patients in complete response (CR) pre-ASCT, the benefit of PD-1 blockade remained significant. PD-1 blockade pre-ASCT is independently associated with superior post-ASCT outcomes and patients proceeding to ASCT should be treated with PD-1-based salvage.