# KEYNOTE-204: pembrolizumab versus brentuximab vedotin in relapsed or refractory classical Hodgkin lymphoma

Source: https://onco.cc/key-papers/paper-keynote-204-pembrolizumab-vs-brentuximab-rr-hodgkin-lancet-oncol-2021/  
OnCo record `paper-keynote-204-pembrolizumab-vs-brentuximab-rr-hodgkin-lancet-oncol-2021` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

In a head-to-head trial, the PD-1 antibody pembrolizumab kept relapsed Hodgkin lymphoma at bay for longer than brentuximab vedotin, making immunotherapy the preferred choice after transplant failure or for patients who cannot have a transplant.

## Summary

International randomised open-label phase 3 trial of 304 patients with relapsed or refractory classical Hodgkin lymphoma after autologous transplant or ineligible for it, assigned to pembrolizumab or brentuximab vedotin.

At the interim analysis median progression-free survival was 13.2 months with pembrolizumab against 8.3 months with brentuximab vedotin (hazard ratio 0.65), with benefit across subgroups including those with primary refractory disease; pneumonitis was more frequent with pembrolizumab and neuropathy with brentuximab vedotin.

## Fields

- Kind: Key paper
- Last checked: 2026-09-18
- Journal: The Lancet Oncology
- Year: 2021
- DOI: 10.1016/S1470-2045(21)00005-X
- Authors: Kuruvilla J, Ramchandren R, Santoro A, et al.
- Findings: Median progression-free survival 13.2 months with pembrolizumab versus 8.3 months with brentuximab vedotin; hazard ratio 0.65.; Grade 3 to 5 treatment-related adverse events in a similar proportion, with different profiles (pneumonitis versus neuropathy).
- What it means: PD-1 blockade is the standard for classical Hodgkin lymphoma that has relapsed after or is unsuitable for autologous transplant, ahead of brentuximab vedotin in most patients.
- Caveats: Open-label interim analysis; overall survival data were immature.; Most patients had not received either drug before, which is now uncommon as both move into first-line therapy.

## Sources

- Lancet Oncol 2021: https://doi.org/10.1016/S1470-2045(21)00005-X
- PubMed: https://pubmed.ncbi.nlm.nih.gov/33721562/

## Connected records

- cancers: [Relapsed and refractory classical Hodgkin lymphoma](https://onco.cc/cancers/relapsed-refractory-hodgkin-lymphoma/)
- drugs: [Brentuximab vedotin](https://onco.cc/drugs/brentuximab-vedotin/), [Pembrolizumab](https://onco.cc/drugs/pembrolizumab/)
- trials: [KEYNOTE-204](https://onco.cc/trials/keynote-204/)
- journals: [The Lancet Oncology](https://onco.cc/journals/lancet-oncology/)

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