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Bendamustine Study in Classical Hodgkin Lymphoma Patients Over 60 Treated by Prednisone, Vinblastine and Doxorubicin (PVAB)

Primary Purpose

Classical Hodgkin Lymphoma

Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
Bendamustine
Prednisone
Vinblastine
Doxorubicin
Sponsored by
The Lymphoma Academic Research Organisation
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Classical Hodgkin Lymphoma

Eligibility Criteria

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

Inclusion Criteria:

  • Patient with a first diagnosis of classical Hodgkin lymphoma according to the World Health Organization (WHO) criteria excluding nodular lymphocyte predominant subtype
  • Age of 61 years or older
  • No previous treatment for Hodgkin lymphoma
  • Ann Arbor stages:

    • II with mediastinum/thorax ≥0.33 or extranodal localization and with B symptoms
    • Or III
    • Or IV
  • Baseline 18-FluoroDeoxyGlucose (FDG) PET scan (PET0) performed before any treatment with at least one hypermetabolic lesion
  • Eastern Cooperative Oncology Group (ECOG) performance status 0-2
  • Adequate cardio-pulmonary function with Left Ventricular Ejection Fraction (LVEF) ≥ 50%
  • Adequate renal function with creatinine clearance ≥ 40 mL/mn (MDRD formula)
  • For patients aged 70 years old and more, a Mini Nutritional Assessment (MNA) ≥ 17
  • A minimum life expectancy of 3 months
  • Negative Human Immunodeficiency Virus, Hepatitis B (HB) Virus (anti-HB c negativity) and Hepatitis C Virus serologies tests ≤ 30 days before inclusion (except after vaccination)
  • Having previously signed a written informed consent
  • The patient must be covered by a social security system, if applicable
  • Men patient must agree to use an adequate method of contraception during the study treatment and until 6 months after the end of the study treatment.

Exclusion Criteria:

  • Any other type of lymphoma including nodular lymphocyte predominant subtype
  • Any history of treated Hodgkin lymphoma
  • Contra-indication to any drug contained in the chemotherapy regimens
  • Any serious active disease (according to the investigator's decision)
  • Poor hepatic function (total bilirubin level > 30 μmol/L or transaminases > 2.5 maximum normal level) unless these abnormalities are related to the lymphoma
  • Poor bone marrow reserve as defined by leukocytes < 2 G/L or platelets < 100 G/L, unless related to bone marrow infiltration
  • Any history of cancer during the last 3 years with the exception of non-melanoma skin tumors or stage 0 (in situ) cervical carcinoma. Patients previously diagnosed with prostate cancer are eligible if they fulfil all the followings:

    1. their disease was T1-T2a, N0, M0, with a Gleason score ≤ 7, and a prostate specific antigen (PSA) ≤ 10 ng/mL prior to initial therapy,
    2. they had definitive curative therapy (i.e. prostatectomy or radiotherapy) ≥ 2 years before Day 1 of Cycle 1,
    3. at a minimum 2 years following therapy, they had no clinical evidence of prostate cancer and their PSA was undetectable if they underwent prostatectomy or < 1 ng/mL if they did not undergo prostatectomy
  • Severe metabolic disease interfering with normal application of protocol treatment as uncontrolled diabetes mellitus leading to impossibility to perform PET scan
  • Treatment with any investigational drug within 30 days before planned first cycle of chemotherapy and during the study
  • Adult under tutelage

Sites / Locations

  • A. Z. Sint-Jan
  • Clinique Universitaire St Luc
  • CHU de Liège
  • UCL Mont Godinne
  • CHU d'Amiens - Groupe Hospitalier Sud
  • Hôpital Jean Minjoz
  • Polyclinique Bordeaux Nord Aquitaine
  • CHRU de Brest - Hôpital Morvan
  • CHU de Caen
  • Médipôle de Savoie
  • CH Sud Francilien
  • Hôpital Henri Mondor
  • CHU Dijon - Hôpital d'Enfants
  • CHU de Grenoble - Hôpital Albert Michallon
  • CH Départemental Vendée
  • CH de Versailles
  • CH du Mans
  • CHRU de Lille
  • CHU de Limoges
  • Centre Léon Bérard
  • CHR de Metz-Thionville - Hôpital de Mercy
  • Hôpital Lapeyronie
  • CH de Mulhouse
  • CHU de Nantes - Hôtel Dieu
  • CHRU de Nîmes
  • Hôpital de la Pitié-Salpêtrière
  • Hôpital Saint Louis
  • Hôpital Necker
  • CHU de Bordeaux - Hôpital Haut Lévêque - Centre François Magendie
  • CHU Lyon Sud
  • CHU Poitiers
  • CH Rene Dubos
  • Centre Hospitalier Annecy-Genevois - Site d'Annecy
  • CHU de Reims
  • Hôpital Pontchaillou
  • Centre Henri Becquerel
  • CHU de Strasbourg
  • CHU de Tours - Hôpital Bretonneau
  • CH de Valenciennes
  • CHU Brabois

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

PVAB regimen

Arm Description

Prednisone 40 mg/m2 (PO) Days 1-5 ; Vinblastine 6 mg/m2 (IV) Day 1 ; Doxorubicin 40 mg/m2 (IV) Day 1 ; Bendamustine 120 mg/m2 (IV) Day 1

Outcomes

Primary Outcome Measures

Complete Metabolic Response rate at the end of study treatment (after 6 cycles of study treatment or at premature treatment discontinuation) defined according to Lugano Classification
Complete Metabolic Response rate at the end of study treatment (after 6 cycles of study treatment or at premature treatment discontinuation) defined according to Lugano Classification

Secondary Outcome Measures

Feasibility of the protocol, with adequate protocol adherence (adequate dose without excessive delay)
Feasibility of the protocol, with adequate protocol adherence (adequate dose without excessive delay)
Safety profile including immediate toxicities and non-tumor events
Safety profile including immediate toxicities and non-tumor events
Progression-free survival
Progression-free survival
Disease-free survival
Disease-free survival
Overall survival
Overall survival
Geriatric assessment program
7 Quality of Life Questionnaires (QLQ)

Full Information

First Posted
March 30, 2015
Last Updated
February 18, 2021
Sponsor
The Lymphoma Academic Research Organisation
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1. Study Identification

Unique Protocol Identification Number
NCT02414568
Brief Title
Bendamustine Study in Classical Hodgkin Lymphoma Patients Over 60 Treated by Prednisone, Vinblastine and Doxorubicin
Acronym
PVAB
Official Title
A Prospective Phase II Study of Bendamustine in Patients Aged Over 60 Years With Classical Hodgkin Lymphoma Treated by Prednisone, Vinblastine and Doxorubicin
Study Type
Interventional

2. Study Status

Record Verification Date
February 2021
Overall Recruitment Status
Completed
Study Start Date
July 17, 2015 (Actual)
Primary Completion Date
December 14, 2018 (Actual)
Study Completion Date
November 10, 2020 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
The Lymphoma Academic Research Organisation

4. Oversight

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

5. Study Description

Brief Summary
This study evaluates bendamustine in patients aged over 60 years with classical Hodgkin Lymphoma treated by prednisone, vinblastine and doxorubicin. 90 patients will be enrolled in this study.
Detailed Description
The usual treatment for Hodgkin lymphoma is chemotherapy Adriamycin (also known as doxorubicin) + Bleomycin + Vinblastine + Dacarbazine (ABVD). Studies have shown that patients aged over 60 years have a lower tolerance and efficiency during this treatment than younger patients. There are particular pulmonary toxicities with bleomycin included in the ABVD treatment. Alternative treatment strategies have been proposed removing bleomycin in the Prednisone + Vinblastine + Adriamycin/Doxorubicin +Gemcitabine (PVAG) protocol evaluated in more than 60 patients. Compared to ABVD treatment, PVAG treatment presented a more favorable toxicity profile. The quality of response between the two treatments is substantially equal. Bendamustine was evaluated in four studies in patients with Hodgkin lymphoma in relapse and showed higher efficacy than gemcitabine with an acceptable toxicity profile. In this study, the Sponsor and the coordinating investigator propose to replace dacarbazine in the standard ABVD protocol by bendamustine and to stop using bleomycin. The main objective of this study is to evaluate the safety and efficacy of bendamustine in patients treated with prednisone, vinblastine and doxorubicin. This is the PVAB treatment with which LYSARC and the coordinating investigator expect better tolerability and quality response.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Classical Hodgkin Lymphoma

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
PVAB regimen
Arm Type
Experimental
Arm Description
Prednisone 40 mg/m2 (PO) Days 1-5 ; Vinblastine 6 mg/m2 (IV) Day 1 ; Doxorubicin 40 mg/m2 (IV) Day 1 ; Bendamustine 120 mg/m2 (IV) Day 1
Intervention Type
Drug
Intervention Name(s)
Bendamustine
Other Intervention Name(s)
LEVACT
Intervention Description
Bendamustine 120 mg/m2 (IV) Day 1
Intervention Type
Drug
Intervention Name(s)
Prednisone
Other Intervention Name(s)
CORTANCYL
Intervention Description
Prednisone 40 mg/m² PO
Intervention Type
Drug
Intervention Name(s)
Vinblastine
Other Intervention Name(s)
VELBE
Intervention Description
Vinblastine 6 mg/m² IV
Intervention Type
Drug
Intervention Name(s)
Doxorubicin
Other Intervention Name(s)
ADRIBLASTINE
Intervention Description
Doxorubicin 40 mg/m² IV
Primary Outcome Measure Information:
Title
Complete Metabolic Response rate at the end of study treatment (after 6 cycles of study treatment or at premature treatment discontinuation) defined according to Lugano Classification
Description
Complete Metabolic Response rate at the end of study treatment (after 6 cycles of study treatment or at premature treatment discontinuation) defined according to Lugano Classification
Time Frame
3 years
Secondary Outcome Measure Information:
Title
Feasibility of the protocol, with adequate protocol adherence (adequate dose without excessive delay)
Description
Feasibility of the protocol, with adequate protocol adherence (adequate dose without excessive delay)
Time Frame
5 years
Title
Safety profile including immediate toxicities and non-tumor events
Description
Safety profile including immediate toxicities and non-tumor events
Time Frame
5 years
Title
Progression-free survival
Description
Progression-free survival
Time Frame
5 years
Title
Disease-free survival
Description
Disease-free survival
Time Frame
5 years
Title
Overall survival
Description
Overall survival
Time Frame
5 years
Title
Geriatric assessment program
Description
7 Quality of Life Questionnaires (QLQ)
Time Frame
5 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
61 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patient with a first diagnosis of classical Hodgkin lymphoma according to the World Health Organization (WHO) criteria excluding nodular lymphocyte predominant subtype Age of 61 years or older No previous treatment for Hodgkin lymphoma Ann Arbor stages: II with mediastinum/thorax ≥0.33 or extranodal localization and with B symptoms Or III Or IV Baseline 18-FluoroDeoxyGlucose (FDG) PET scan (PET0) performed before any treatment with at least one hypermetabolic lesion Eastern Cooperative Oncology Group (ECOG) performance status 0-2 Adequate cardio-pulmonary function with Left Ventricular Ejection Fraction (LVEF) ≥ 50% Adequate renal function with creatinine clearance ≥ 40 mL/mn (MDRD formula) For patients aged 70 years old and more, a Mini Nutritional Assessment (MNA) ≥ 17 A minimum life expectancy of 3 months Negative Human Immunodeficiency Virus, Hepatitis B (HB) Virus (anti-HB c negativity) and Hepatitis C Virus serologies tests ≤ 30 days before inclusion (except after vaccination) Having previously signed a written informed consent The patient must be covered by a social security system, if applicable Men patient must agree to use an adequate method of contraception during the study treatment and until 6 months after the end of the study treatment. Exclusion Criteria: Any other type of lymphoma including nodular lymphocyte predominant subtype Any history of treated Hodgkin lymphoma Contra-indication to any drug contained in the chemotherapy regimens Any serious active disease (according to the investigator's decision) Poor hepatic function (total bilirubin level > 30 μmol/L or transaminases > 2.5 maximum normal level) unless these abnormalities are related to the lymphoma Poor bone marrow reserve as defined by leukocytes < 2 G/L or platelets < 100 G/L, unless related to bone marrow infiltration Any history of cancer during the last 3 years with the exception of non-melanoma skin tumors or stage 0 (in situ) cervical carcinoma. Patients previously diagnosed with prostate cancer are eligible if they fulfil all the followings: their disease was T1-T2a, N0, M0, with a Gleason score ≤ 7, and a prostate specific antigen (PSA) ≤ 10 ng/mL prior to initial therapy, they had definitive curative therapy (i.e. prostatectomy or radiotherapy) ≥ 2 years before Day 1 of Cycle 1, at a minimum 2 years following therapy, they had no clinical evidence of prostate cancer and their PSA was undetectable if they underwent prostatectomy or < 1 ng/mL if they did not undergo prostatectomy Severe metabolic disease interfering with normal application of protocol treatment as uncontrolled diabetes mellitus leading to impossibility to perform PET scan Treatment with any investigational drug within 30 days before planned first cycle of chemotherapy and during the study Adult under tutelage
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Hervé Ghesquières, MD
Organizational Affiliation
The Lymphoma Academic Research Organisation
Official's Role
Principal Investigator
Facility Information:
Facility Name
A. Z. Sint-Jan
City
Bruges
ZIP/Postal Code
8000
Country
Belgium
Facility Name
Clinique Universitaire St Luc
City
Bruxelles
ZIP/Postal Code
1200
Country
Belgium
Facility Name
CHU de Liège
City
Liège
ZIP/Postal Code
4000
Country
Belgium
Facility Name
UCL Mont Godinne
City
Yvoir
ZIP/Postal Code
5530
Country
Belgium
Facility Name
CHU d'Amiens - Groupe Hospitalier Sud
City
Amiens
ZIP/Postal Code
80054
Country
France
Facility Name
Hôpital Jean Minjoz
City
Besancon
ZIP/Postal Code
25030
Country
France
Facility Name
Polyclinique Bordeaux Nord Aquitaine
City
Bordeaux
ZIP/Postal Code
33300
Country
France
Facility Name
CHRU de Brest - Hôpital Morvan
City
Brest
ZIP/Postal Code
29609
Country
France
Facility Name
CHU de Caen
City
Caen
ZIP/Postal Code
14000
Country
France
Facility Name
Médipôle de Savoie
City
Challes les eaux
ZIP/Postal Code
73190
Country
France
Facility Name
CH Sud Francilien
City
Corbeil Essonnes
ZIP/Postal Code
91106
Country
France
Facility Name
Hôpital Henri Mondor
City
Créteil
ZIP/Postal Code
94010
Country
France
Facility Name
CHU Dijon - Hôpital d'Enfants
City
Dijon
ZIP/Postal Code
21000
Country
France
Facility Name
CHU de Grenoble - Hôpital Albert Michallon
City
Grenoble
ZIP/Postal Code
38043
Country
France
Facility Name
CH Départemental Vendée
City
La Roche sur Yon
ZIP/Postal Code
85925
Country
France
Facility Name
CH de Versailles
City
Le Chesnay
ZIP/Postal Code
78157
Country
France
Facility Name
CH du Mans
City
Le Mans
ZIP/Postal Code
72000
Country
France
Facility Name
CHRU de Lille
City
Lille
ZIP/Postal Code
59037
Country
France
Facility Name
CHU de Limoges
City
Limoges
ZIP/Postal Code
87042
Country
France
Facility Name
Centre Léon Bérard
City
Lyon
ZIP/Postal Code
69373
Country
France
Facility Name
CHR de Metz-Thionville - Hôpital de Mercy
City
Metz
ZIP/Postal Code
57085
Country
France
Facility Name
Hôpital Lapeyronie
City
Montpellier
ZIP/Postal Code
34295
Country
France
Facility Name
CH de Mulhouse
City
Mulhouse
ZIP/Postal Code
68070
Country
France
Facility Name
CHU de Nantes - Hôtel Dieu
City
Nantes
ZIP/Postal Code
44093
Country
France
Facility Name
CHRU de Nîmes
City
Nîmes
ZIP/Postal Code
30029
Country
France
Facility Name
Hôpital de la Pitié-Salpêtrière
City
Paris
ZIP/Postal Code
75013
Country
France
Facility Name
Hôpital Saint Louis
City
Paris
ZIP/Postal Code
75475
Country
France
Facility Name
Hôpital Necker
City
Paris
ZIP/Postal Code
75743
Country
France
Facility Name
CHU de Bordeaux - Hôpital Haut Lévêque - Centre François Magendie
City
Pessac
ZIP/Postal Code
33604
Country
France
Facility Name
CHU Lyon Sud
City
Pierre-Bénite
ZIP/Postal Code
69310
Country
France
Facility Name
CHU Poitiers
City
Poitiers
ZIP/Postal Code
86000
Country
France
Facility Name
CH Rene Dubos
City
Pontoise
ZIP/Postal Code
95303
Country
France
Facility Name
Centre Hospitalier Annecy-Genevois - Site d'Annecy
City
Pringy
ZIP/Postal Code
74374
Country
France
Facility Name
CHU de Reims
City
Reims
ZIP/Postal Code
51092
Country
France
Facility Name
Hôpital Pontchaillou
City
Rennes
ZIP/Postal Code
35033
Country
France
Facility Name
Centre Henri Becquerel
City
Rouen
ZIP/Postal Code
76038
Country
France
Facility Name
CHU de Strasbourg
City
Strasbourg
ZIP/Postal Code
67098
Country
France
Facility Name
CHU de Tours - Hôpital Bretonneau
City
Tours
ZIP/Postal Code
37044
Country
France
Facility Name
CH de Valenciennes
City
Valenciennes
ZIP/Postal Code
59322
Country
France
Facility Name
CHU Brabois
City
Vandoeuvre les Nancy
ZIP/Postal Code
54511
Country
France

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Bendamustine Study in Classical Hodgkin Lymphoma Patients Over 60 Treated by Prednisone, Vinblastine and Doxorubicin

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