Upon joining the study, you will undergo an initial assessment to confirm eligibility. This includes a review of your medical history, a physical examination, and necessary tests to ensure you meet the study criteria.

You will be required to provide written informed consent, confirming your understanding and agreement to participate in the trial.

The treatment phase begins with the administration of pembrolizumab through an intravenous infusion. This is a type of medication that helps your immune system fight cancer cells.

Following the initial dose of pembrolizumab, you will receive a combination of chemotherapy drugs, which may include ifosfamide, cisplatin, carboplatin, etoposide phosphate, and cytarabine. These are also given through intravenous infusion.

You will undergo four cycles of combination therapy. This involves receiving pembrolizumab along with chemotherapy drugs. The specific regimen may vary, with options including 4 cycles of P-ICE (pembrolizumab, ifosfamide, carboplatin, etoposide) or 2 cycles of P-ICE followed by 2 cycles of P-DHAP (pembrolizumab, dexamethasone, cytarabine, cisplatin).

Each cycle will be followed by a period of rest to allow your body to recover before the next cycle begins.

After completing the treatment cycles, you will undergo restaging to evaluate the response to the therapy. This involves imaging tests to assess the size and activity of the cancer.

The goal is to achieve a complete metabolic response, which means the cancer shows no signs of activity on the scans.

Depending on the response to the initial treatment, you may receive additional therapy, such as high-dose chemotherapy and autologous stem cell transplantation, to further improve outcomes.

Regular follow-up visits will be scheduled to monitor your health, manage any side effects, and assess long-term outcomes such as progression-free survival and overall survival.