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BRENTUXIMAB VEDOTIN as Pre-ASCT Induction Therapy in R/R HL Patients Non Responding to IGEV

Primary Purpose

Relapsed/Refractory Hodgkin's Lymphoma

Status
Completed
Phase
Phase 2
Locations
Italy
Study Type
Interventional
Intervention
BRENTUXIMAB VEDOTIN
Sponsored by
Fondazione Italiana Linfomi - ETS
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Relapsed/Refractory Hodgkin's Lymphoma focused on measuring HD, Hodgkin's Lymphoma, RELAPSED-REFRACTORY

Eligibility Criteria

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

Inclusion Criteria:

  1. Classical Hodgkin Lymphoma according to the WHO classification
  2. Histologically confirmed CD30+ HL at diagnosis
  3. Patients at the first line salvage therapy
  4. FDG-PET positivity after two cycles of IGEV treatment
  5. PBPCs should have been collected after the first or the second IGEV cycle
  6. Age≥ 18 years
  7. ECOG PS of 0-2
  8. Life expectancy > 6 months.
  9. Written informed consent
  10. Patients available for periodic blood sampling, study-related assessments and management of toxicity
  11. Females of childbearing potential must have a negative β-HCG pregnancy test result (pregnancy test should be performed at screening an on day 1 of cycle 1 prior to brentuximab vedotin treatment).
  12. Female patient is either post-menopausal for at least 1 year before the screening visit or surgically sterile or if of childbearing potential, agree to practice 2 effective methods of contraception, at the same time, from the time of signing the informed consent through 6 months after the last dose of study drug, or agrees to completely abstain from heterosexual intercourse.
  13. Male patients, even if surgically sterilized, (i.e., status post vasectomy) agree to practice effective barrier contraception during the entire study period and through 6 months after the last dose of study drug, or agrees to completely abstain from heterosexual intercourse.
  14. Required baseline laboratory data: Absolute neutrophil count ≥ 1500/µl, Platelet count ≥ 75.000/ µl, Haemoglobin must be ≥ 8 g/dL, Serum bilirubin ≤ 1.5 times ULN, Serum creatinine < 2.0 mg/dL and/or creatinine clearance or calculated creatinine clearance > 40 mL/minute, Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤ 2.5 times ULN

Exclusion Criteria:

  1. Peripheral neuropathy > Grade 1
  2. Histologic diagnosis different from Hodgkin Lymphoma
  3. First line treatment with BEACOPP
  4. Compressive symptoms caused by the presence of Lymphoma
  5. Patients treated previously with any anti-CD30 antibody.
  6. Known hypersensitivity to any recombinant proteins, murine proteins, or excipients contained in the brentuximab vedotin formulation.
  7. Known human immunodeficiency virus (HIV) positive
  8. Known hepatitis B surface antigen-positive, or known or suspected active hepatitis C infection
  9. Diagnosed or treated for another malignancy within 3 years before the first dose or previously diagnosed with another malignancy and have evidence of residual disease. Patients with nonmelanoma skin cancer or carcinoma in situ of any type are not excluded if they have undergone complete resection.
  10. Patients with known history of any of the following cardiovascular conditions:Myocardial infarction within 2 years of randomization, New York Heart Association (NYHA) Class III or IV heart failure, Evidence of current uncontrolled cardiovascular conditions, including cardiac arrhythmias, congestive heart failure (CHF), angina, or electrocardiographic evidence of acute ischemia or active conduction system abnormalities, Recent evidence (within 6 months before first dose of study drug) of a left-ventricular ejection fraction <50%
  11. Patients with known active viral, bacterial, or fungal infection requiring treatment with antimicrobial therapy within 2 weeks prior to the first dose of brentuximab vedotin.
  12. Patients with known active Grade 3 or higher viral, bacterial, or fungal infection within 2 weeks prior to the first dose of brentuximab vedotin.
  13. Patients with known cerebral/meningeal disease (HL or any other etiology), including signs or symptoms of Progressive Multifocal Leukoencephalopathy
  14. Any serious medical or psychiatric illness that could, in the investigator's opinion, potentially interfere with the completion of treatment according to protocol.
  15. Symptomatic neurologic disease compromising normal activities of daily living or requiring medications.
  16. Patients who are pregnant, or lactating and breastfeeding.
  17. Patients that have not completed any prior treatment chemotherapy and/or other investigational agents within at least 5 half-lives of last dose of that prior treatment.

Sites / Locations

  • Istituto di Ematologia "L. & A. Seragnoli" , Policlinico S. Orsola Malpighi
  • Ematologia, IRCCS AOU San Martino-IST
  • Ematologia Ospedale Vito Fazzi
  • Ematologia e Unità BMT IRCCS Istituto Nazionale dei Tumori
  • Università degli Studi di Modena e Reggio Emilia, D.A.I di Medicina diagnostica clinica e sanità pubblica, AOU Policlinico
  • Dipartimento di Oncologia Medica ed Ematologia, Istituto Humanitas
  • SC Ematologia - Azienda Ospedaliera AO Città della Salute e della Scienza

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

BRENTUXIMAB VEDOTIN

Arm Description

1 arm for all patients

Outcomes

Primary Outcome Measures

Complete response (CR rate)
Complete response will be defined according to recently updated international criteria (Cheson 2007), assuming that a negative PET is defined by DEAUVILLE scores 1 and 2.

Secondary Outcome Measures

PFS
Additional study endpoint is final response to Brentuximab vedotin followed by autologous stem cell transplantation (ASCT), in terms of progression free survival (PFS).
Neurotoxicity rate
Neurotoxicity of any grade defined as National Cancer Institute Common Terminology Criteria for Adverse Events , version 4.03 (NCI CTCEA, 2010)
Duration of remission (DR)
Additional study endpoint is final response to Brentuximab vedotin followed by autologous stem cell transplantation (ASCT), in terms of duration of remission (DR).

Full Information

First Posted
September 10, 2014
Last Updated
February 8, 2018
Sponsor
Fondazione Italiana Linfomi - ETS
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1. Study Identification

Unique Protocol Identification Number
NCT02244021
Brief Title
BRENTUXIMAB VEDOTIN as Pre-ASCT Induction Therapy in R/R HL Patients Non Responding to IGEV
Official Title
A Pilot Phase II Study With BRENTUXIMAB VEDOTIN as Pre-ASCT Induction Therapy in Relapsed/Refractory Hodgkin's Lymphoma Patients Non Responding to IGEV Salvage Treatment
Study Type
Interventional

2. Study Status

Record Verification Date
February 2018
Overall Recruitment Status
Completed
Study Start Date
December 2014 (Actual)
Primary Completion Date
July 2016 (Actual)
Study Completion Date
October 2017 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Fondazione Italiana Linfomi - ETS

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
A pilot phase II study with brentuximab vedotin as pre-ASCT induction therapy in relapsed/refractory Hodgkin's lymphoma patients non-responding to IGEV salvage treatment.
Detailed Description
Brentuximab vedotin emerged as active single-agent in the treatment of relapsed or refractory HL. Some patients don't reach a complete response after salvage treatment with IGEV (ifosfamide, gemcitabine, vinorelbine) and remain PET positive so the idea is to treat this subset of patients with brentuximab vedotin with the aim of achieving a complete remission before transplant.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Relapsed/Refractory Hodgkin's Lymphoma
Keywords
HD, Hodgkin's Lymphoma, RELAPSED-REFRACTORY

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
BRENTUXIMAB VEDOTIN
Arm Type
Experimental
Arm Description
1 arm for all patients
Intervention Type
Drug
Intervention Name(s)
BRENTUXIMAB VEDOTIN
Other Intervention Name(s)
SGN-35
Intervention Description
Patients with FDG-PET positive after IGEV will be treated with brentuximab vedotin as followed: 1.8 mg/kg every 3 weeks as a 30-minute outpatient IV infusion for a total of 4 cycles of treatment Growth factors may be used at the discretion of investigators but are not routinely advised. Patients with FDG-PET negative after brentuximab vedotin treatment will be addressed to high dose chemotherapy followed by ASCT.
Primary Outcome Measure Information:
Title
Complete response (CR rate)
Description
Complete response will be defined according to recently updated international criteria (Cheson 2007), assuming that a negative PET is defined by DEAUVILLE scores 1 and 2.
Time Frame
1 year and half from the beginning of the study
Secondary Outcome Measure Information:
Title
PFS
Description
Additional study endpoint is final response to Brentuximab vedotin followed by autologous stem cell transplantation (ASCT), in terms of progression free survival (PFS).
Time Frame
2 years and half from the beginning of the study
Title
Neurotoxicity rate
Description
Neurotoxicity of any grade defined as National Cancer Institute Common Terminology Criteria for Adverse Events , version 4.03 (NCI CTCEA, 2010)
Time Frame
1 year half from the beginning of the study
Title
Duration of remission (DR)
Description
Additional study endpoint is final response to Brentuximab vedotin followed by autologous stem cell transplantation (ASCT), in terms of duration of remission (DR).
Time Frame
2 years and half from the beginning of the study

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Classical Hodgkin Lymphoma according to the WHO classification Histologically confirmed CD30+ HL at diagnosis Patients at the first line salvage therapy FDG-PET positivity after two cycles of IGEV treatment PBPCs should have been collected after the first or the second IGEV cycle Age≥ 18 years ECOG PS of 0-2 Life expectancy > 6 months. Written informed consent Patients available for periodic blood sampling, study-related assessments and management of toxicity Females of childbearing potential must have a negative β-HCG pregnancy test result (pregnancy test should be performed at screening an on day 1 of cycle 1 prior to brentuximab vedotin treatment). Female patient is either post-menopausal for at least 1 year before the screening visit or surgically sterile or if of childbearing potential, agree to practice 2 effective methods of contraception, at the same time, from the time of signing the informed consent through 6 months after the last dose of study drug, or agrees to completely abstain from heterosexual intercourse. Male patients, even if surgically sterilized, (i.e., status post vasectomy) agree to practice effective barrier contraception during the entire study period and through 6 months after the last dose of study drug, or agrees to completely abstain from heterosexual intercourse. Required baseline laboratory data: Absolute neutrophil count ≥ 1500/µl, Platelet count ≥ 75.000/ µl, Haemoglobin must be ≥ 8 g/dL, Serum bilirubin ≤ 1.5 times ULN, Serum creatinine < 2.0 mg/dL and/or creatinine clearance or calculated creatinine clearance > 40 mL/minute, Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤ 2.5 times ULN Exclusion Criteria: Peripheral neuropathy > Grade 1 Histologic diagnosis different from Hodgkin Lymphoma First line treatment with BEACOPP Compressive symptoms caused by the presence of Lymphoma Patients treated previously with any anti-CD30 antibody. Known hypersensitivity to any recombinant proteins, murine proteins, or excipients contained in the brentuximab vedotin formulation. Known human immunodeficiency virus (HIV) positive Known hepatitis B surface antigen-positive, or known or suspected active hepatitis C infection Diagnosed or treated for another malignancy within 3 years before the first dose or previously diagnosed with another malignancy and have evidence of residual disease. Patients with nonmelanoma skin cancer or carcinoma in situ of any type are not excluded if they have undergone complete resection. Patients with known history of any of the following cardiovascular conditions:Myocardial infarction within 2 years of randomization, New York Heart Association (NYHA) Class III or IV heart failure, Evidence of current uncontrolled cardiovascular conditions, including cardiac arrhythmias, congestive heart failure (CHF), angina, or electrocardiographic evidence of acute ischemia or active conduction system abnormalities, Recent evidence (within 6 months before first dose of study drug) of a left-ventricular ejection fraction <50% Patients with known active viral, bacterial, or fungal infection requiring treatment with antimicrobial therapy within 2 weeks prior to the first dose of brentuximab vedotin. Patients with known active Grade 3 or higher viral, bacterial, or fungal infection within 2 weeks prior to the first dose of brentuximab vedotin. Patients with known cerebral/meningeal disease (HL or any other etiology), including signs or symptoms of Progressive Multifocal Leukoencephalopathy Any serious medical or psychiatric illness that could, in the investigator's opinion, potentially interfere with the completion of treatment according to protocol. Symptomatic neurologic disease compromising normal activities of daily living or requiring medications. Patients who are pregnant, or lactating and breastfeeding. Patients that have not completed any prior treatment chemotherapy and/or other investigational agents within at least 5 half-lives of last dose of that prior treatment.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Angelo Michele Carella, Prof.
Organizational Affiliation
Hematology Division, IRCCS AOU San Martino, Genova, Italy
Official's Role
Principal Investigator
Facility Information:
Facility Name
Istituto di Ematologia "L. & A. Seragnoli" , Policlinico S. Orsola Malpighi
City
Bologna
Country
Italy
Facility Name
Ematologia, IRCCS AOU San Martino-IST
City
Genova
Country
Italy
Facility Name
Ematologia Ospedale Vito Fazzi
City
Lecce
Country
Italy
Facility Name
Ematologia e Unità BMT IRCCS Istituto Nazionale dei Tumori
City
Milano
Country
Italy
Facility Name
Università degli Studi di Modena e Reggio Emilia, D.A.I di Medicina diagnostica clinica e sanità pubblica, AOU Policlinico
City
Modena
Country
Italy
Facility Name
Dipartimento di Oncologia Medica ed Ematologia, Istituto Humanitas
City
Rozzano
Country
Italy
Facility Name
SC Ematologia - Azienda Ospedaliera AO Città della Salute e della Scienza
City
Torino
Country
Italy

12. IPD Sharing Statement

Learn more about this trial

BRENTUXIMAB VEDOTIN as Pre-ASCT Induction Therapy in R/R HL Patients Non Responding to IGEV

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