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Brentuximab Vedotin and Bendamustine for the Treatment of Hodgkin Lymphoma and Anaplastic Large Cell Lymphoma (ALCL) (SGN+Benda)

Primary Purpose

Hodgkin Lymphoma, Anaplastic Large Cell Lymphoma

Status
Completed
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
Brentuximab Vedotin
Bendamustine
Neulasta
Sponsored by
Columbia University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Hodgkin Lymphoma focused on measuring Hodgkin Lymphoma, Hodgkin Disease, Hodgkin's Disease, Anaplastic Large Cell Lymphoma, ALCL, SGN+Benda, Bendamustine, Brentuximab Vedotin

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Histologically confirmed relapsed or refractory HL or ALCL.
  • Documented CD30+ expression from either original diagnosis or a tumor biopsy in the relapsed setting.
  • For patients with HL, subjects are eligible after failure or having declined autologous stem cell transplant or at least two prior multi-agent chemotherapy regimens if they are not autologous stem cell transplant candidates. For patients with ALCL, subjects are eligible after failure of at least one prior multi-agent chemotherapy regimen and if they are not eligible for or have declined autologous stem cell transplant.
  • Must have received first line chemotherapy. No upper limit for the number of prior therapies.
  • Patients with prior autologous or allogeneic stem cell transplant are eligible as long as they meet all other criteria.
  • Measurable or evaluable disease, as defined in 2008 Revised Response Criteria for Malignant Lymphoma(33)
  • Age > or = 18 years
  • ECOG performance status 0,1 or 2
  • Patient's must have adequate organ and marrow function as defined below

    • Absolute neutrophil count > or = 1,000 (1.0 x 109/L)
    • Platelets > or = 50,000 (50 x 109/L)
    • Total Bilirubin < or = 1.5 x institutional limits unless documented Gilbert's syndrome (then < 2.5 x institutional upper limit)
    • AST (SGOT)/ALT (SGPT) < or = 2.0 x institutional upper limit of normal (unless known hepatic involvement then < 3.5 x institutional upper limit)
    • Creatinine within normal institutional limits OR creatinine clearance > or = 50mL/min for patients with creatinine levels above institutional normal
  • If female of childbearing age, negative serum pregnancy test within 7 days prior to the first dose of brentuximab vedotin in this study
  • Must be willing to use contraception during the study, and for 30 days following the last dose of study drug.
  • Able to understand and to sign a written consent document

Exclusion Criteria:

  • Prior treatment with brentuximab vedotin and bendamustine in combination. May have received prior therapy with brentuximab vedotin or bendamustine separately.
  • Received either brentuximab vedotin or bendamustine within 3 months of receiving their first dose of protocol based therapy.
  • If brentuximab vedotin or bendamustine was previously received, had disease progression during the first 3 cycles of either brentuximab vedotin or bendamustine.
  • Systemic steroids that have not been stabilized to the equivalent of < 10 mg/day of prednisone 7 days prior to the initiation of the trial.
  • ANY concurrent investigational agents.
  • Exposure to chemotherapy, radiotherapy, biologics or investigational agents within 3 weeks prior enrollment in the study.
  • Known cerebral or meningeal disease.
  • Active concurrent malignancy (except non-melanoma skin cancer or carcinoma in situ of the cervix). If there is a history of prior malignancy the patients must be disease free and off treatment for > or = 3 years.
  • Uncontrolled intercurrent illness including but not limited to: ongoing or active infection, systemic congestive heart failure Class III or IV by NYHA criteria, unstable angina pectoris, or cardiac arrhythmia, or in patients status post allogeneic transplantation with uncontrolled graft versus host disease (GVHD).
  • Pre-existing neuropathy grade III or greater.
  • Pregnant or nursing.
  • Known hypersensitivity to brentuximab vedotin, bendamustine, or mannitol.
  • Known Human Immunodeficiency Virus (HIV) positive, or hepatitis A, hepatitis B or hepatitis C; if hepatitis Bsurface antigen positive or Bcore antibody positive must have normal liver function tests and be willing and able to take anti-hepatitis medication such as lamivudine or equivalent.

Sites / Locations

  • Center for Lymphoid Malignancies at CUMC
  • British Columbia Cancer Agency
  • Princess Margaret Hospital

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Brentuximab Vedotin / Bendamustine

Arm Description

Subjects with relapsed or refractory Hodgkin Lymphoma or Anaplastic Large Cell Lymphoma will receive Brentuximab Vedotin in combination with Bendamustine, and prophylactic Neulasta

Outcomes

Primary Outcome Measures

Maximum tolerated dose (MTD) of brentuximab vedotin and bendamustine (phase 1)
The highest dose that does not cause unacceptable side effects.
Dose limiting toxicities (DLT) of brentuximab vedotin and bendamustine (phase 1)
A toxicity that prevents further administration of the agent at that dose level.
Overall Response Rate for the combination of brentuximab vedotin and bendamustine (phase 2)
The percentage of subjects whose cancer shrinks or disappears after study treatment - Complete Response and Partial Response.

Secondary Outcome Measures

Duration of Response (DoR) (phase 1)
Time from documentation of tumor response to disease progression.
Progression free survival (PFS) (phase 1)
The length of time during and after the study treatment that a subject lives with the disease but it does not get worse.
Overall Survival (OS) (phase 2)
The length of time from either the date of diagnosis or the start of study treatment that subjects diagnosed with the disease are still alive.

Full Information

First Posted
August 2, 2012
Last Updated
July 15, 2020
Sponsor
Columbia University
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1. Study Identification

Unique Protocol Identification Number
NCT01657331
Brief Title
Brentuximab Vedotin and Bendamustine for the Treatment of Hodgkin Lymphoma and Anaplastic Large Cell Lymphoma (ALCL)
Acronym
SGN+Benda
Official Title
A Phase I/II Clinical Trial of the Combination of Brentuximab Vedotin and Bendamustine in Patients With Relapsed or Refractory Hodgkin Lymphoma or Anaplastic Large Cell Lymphoma
Study Type
Interventional

2. Study Status

Record Verification Date
July 2020
Overall Recruitment Status
Completed
Study Start Date
July 2012 (Actual)
Primary Completion Date
April 2020 (Actual)
Study Completion Date
April 2020 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Columbia University

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This is a phase 1/2 multicenter study to assess the safety and effectiveness of brentuximab vedotin and bendamustine, when given together, in patients with Hodgkin Lymphoma or Anaplastic Large Cell Lymphoma (ALCL) that has either returned or did not respond to initial treatment(s). Patients will be accrued at Columbia University Medical Center (CUMC) and at two subsites in Canada.
Detailed Description
Brentuximab vedotin will be administered as an outpatient IV infusion on day 1 of each 21-day cycle. Bendamustine will be given as an outpatient infusion on days 1 and 2 of a 21-day cycle. Patients may receive prophylactic pegfilgrastim on day 3 of each cycle, or filgrastim for 5 to 10 days, per investigator's discretion. Patients can receive a maximum of 6 cycles of therapy.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hodgkin Lymphoma, Anaplastic Large Cell Lymphoma
Keywords
Hodgkin Lymphoma, Hodgkin Disease, Hodgkin's Disease, Anaplastic Large Cell Lymphoma, ALCL, SGN+Benda, Bendamustine, Brentuximab Vedotin

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
71 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Brentuximab Vedotin / Bendamustine
Arm Type
Experimental
Arm Description
Subjects with relapsed or refractory Hodgkin Lymphoma or Anaplastic Large Cell Lymphoma will receive Brentuximab Vedotin in combination with Bendamustine, and prophylactic Neulasta
Intervention Type
Drug
Intervention Name(s)
Brentuximab Vedotin
Other Intervention Name(s)
Adcetris, SGN35
Intervention Description
Dose escalation in phase I of the study from 1.2-1.8 mg/kg, IV infusions over 30 minutes on day 1 of each 21-day cycle.
Intervention Type
Drug
Intervention Name(s)
Bendamustine
Other Intervention Name(s)
Treanda, Bendamustine HCl
Intervention Description
Dose escalation in phase I of the study from 60-100 mg/m2, IV infusion on days 1 and 2 of each 21-day cycle.
Intervention Type
Drug
Intervention Name(s)
Neulasta
Other Intervention Name(s)
pegfilgrastim
Intervention Description
(Non-experimental) Standard procedure prophylactic pegfilgrastim on day 3 of any subsequent cycle after cycle 1, or filgrastim for 5 to 10 days, per investigator's discretion.
Primary Outcome Measure Information:
Title
Maximum tolerated dose (MTD) of brentuximab vedotin and bendamustine (phase 1)
Description
The highest dose that does not cause unacceptable side effects.
Time Frame
Up to 1.5 years
Title
Dose limiting toxicities (DLT) of brentuximab vedotin and bendamustine (phase 1)
Description
A toxicity that prevents further administration of the agent at that dose level.
Time Frame
Up to 1.5 years
Title
Overall Response Rate for the combination of brentuximab vedotin and bendamustine (phase 2)
Description
The percentage of subjects whose cancer shrinks or disappears after study treatment - Complete Response and Partial Response.
Time Frame
Up to 3 years
Secondary Outcome Measure Information:
Title
Duration of Response (DoR) (phase 1)
Description
Time from documentation of tumor response to disease progression.
Time Frame
Up to 3 years
Title
Progression free survival (PFS) (phase 1)
Description
The length of time during and after the study treatment that a subject lives with the disease but it does not get worse.
Time Frame
Up to 3 years
Title
Overall Survival (OS) (phase 2)
Description
The length of time from either the date of diagnosis or the start of study treatment that subjects diagnosed with the disease are still alive.
Time Frame
Up to 3 years
Other Pre-specified Outcome Measures:
Title
Serum Tarc levels
Description
This is designed to measure the response to study treatment if the level declines.
Time Frame
Up to 3 years
Title
Level of peripheral blood lymphocyte expression of programmed death-1 (PD-1)
Description
The level will be evaluated as a function of response to therapy with brentuximab vedotin and bendamsutine.
Time Frame
Up to 3 years
Title
Decline in serum levels of IL-10 and IL-6
Description
The decline will be evaluated as a function of response to therapy with brentuximab vedotin and bendamsutine.
Time Frame
Up to 3 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Histologically confirmed relapsed or refractory HL or ALCL. Documented CD30+ expression from either original diagnosis or a tumor biopsy in the relapsed setting. For patients with HL, subjects are eligible after failure or having declined autologous stem cell transplant or at least two prior multi-agent chemotherapy regimens if they are not autologous stem cell transplant candidates. For patients with ALCL, subjects are eligible after failure of at least one prior multi-agent chemotherapy regimen and if they are not eligible for or have declined autologous stem cell transplant. Must have received first line chemotherapy. No upper limit for the number of prior therapies. Patients with prior autologous or allogeneic stem cell transplant are eligible as long as they meet all other criteria. Measurable or evaluable disease, as defined in 2008 Revised Response Criteria for Malignant Lymphoma(33) Age > or = 18 years ECOG performance status 0,1 or 2 Patient's must have adequate organ and marrow function as defined below Absolute neutrophil count > or = 1,000 (1.0 x 109/L) Platelets > or = 50,000 (50 x 109/L) Total Bilirubin < or = 1.5 x institutional limits unless documented Gilbert's syndrome (then < 2.5 x institutional upper limit) AST (SGOT)/ALT (SGPT) < or = 2.0 x institutional upper limit of normal (unless known hepatic involvement then < 3.5 x institutional upper limit) Creatinine within normal institutional limits OR creatinine clearance > or = 50mL/min for patients with creatinine levels above institutional normal If female of childbearing age, negative serum pregnancy test within 7 days prior to the first dose of brentuximab vedotin in this study Must be willing to use contraception during the study, and for 30 days following the last dose of study drug. Able to understand and to sign a written consent document Exclusion Criteria: Prior treatment with brentuximab vedotin and bendamustine in combination. May have received prior therapy with brentuximab vedotin or bendamustine separately. Received either brentuximab vedotin or bendamustine within 3 months of receiving their first dose of protocol based therapy. If brentuximab vedotin or bendamustine was previously received, had disease progression during the first 3 cycles of either brentuximab vedotin or bendamustine. Systemic steroids that have not been stabilized to the equivalent of < 10 mg/day of prednisone 7 days prior to the initiation of the trial. ANY concurrent investigational agents. Exposure to chemotherapy, radiotherapy, biologics or investigational agents within 3 weeks prior enrollment in the study. Known cerebral or meningeal disease. Active concurrent malignancy (except non-melanoma skin cancer or carcinoma in situ of the cervix). If there is a history of prior malignancy the patients must be disease free and off treatment for > or = 3 years. Uncontrolled intercurrent illness including but not limited to: ongoing or active infection, systemic congestive heart failure Class III or IV by NYHA criteria, unstable angina pectoris, or cardiac arrhythmia, or in patients status post allogeneic transplantation with uncontrolled graft versus host disease (GVHD). Pre-existing neuropathy grade III or greater. Pregnant or nursing. Known hypersensitivity to brentuximab vedotin, bendamustine, or mannitol. Known Human Immunodeficiency Virus (HIV) positive, or hepatitis A, hepatitis B or hepatitis C; if hepatitis Bsurface antigen positive or Bcore antibody positive must have normal liver function tests and be willing and able to take anti-hepatitis medication such as lamivudine or equivalent.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Owen A O'Connor, MD, Ph.D.
Organizational Affiliation
Columbia University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Center for Lymphoid Malignancies at CUMC
City
New York
State/Province
New York
ZIP/Postal Code
10010
Country
United States
Facility Name
British Columbia Cancer Agency
City
Vancouver
State/Province
British Columbia
ZIP/Postal Code
V5z 4E6
Country
Canada
Facility Name
Princess Margaret Hospital
City
Toronto
State/Province
Ontario
Country
Canada

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
29276022
Citation
O'Connor OA, Lue JK, Sawas A, Amengual JE, Deng C, Kalac M, Falchi L, Marchi E, Turenne I, Lichtenstein R, Rojas C, Francescone M, Schwartz L, Cheng B, Savage KJ, Villa D, Crump M, Prica A, Kukreti V, Cremers S, Connors JM, Kuruvilla J. Brentuximab vedotin plus bendamustine in relapsed or refractory Hodgkin's lymphoma: an international, multicentre, single-arm, phase 1-2 trial. Lancet Oncol. 2018 Feb;19(2):257-266. doi: 10.1016/S1470-2045(17)30912-9. Epub 2017 Dec 21. Erratum In: Lancet Oncol. 2018 Mar;19(3):e137.
Results Reference
derived

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Brentuximab Vedotin and Bendamustine for the Treatment of Hodgkin Lymphoma and Anaplastic Large Cell Lymphoma (ALCL)

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