Brentuximab Vedotin in Pre-transplant Induction and Consolidation for Relapsed or Refractory Hodgkin Lymphoma
CLASSICAL HODGKIN LYMPHOMA
About this trial
This is an interventional treatment trial for CLASSICAL HODGKIN LYMPHOMA focused on measuring CLASSICAL HODGKIN LYMPHOMA, HODGKIN LYMPHOMA, LYMPHOMA, HL
Eligibility Criteria
Inclusion Criteria:
Patients must have fully recovered from the acute toxic effects of all prior chemotherapy, immunotherapy, or radiotherapy prior to entering this study
- Histologically confirmed relapsed or refractory classical HL after first line chemotherapy. CD30 has to be positive
- Age 18 to 65 years. Patient >65 years old with ECOG ≤1 and absence of comorbidities will be included in the study
- ECOG ≤2
- Karnofsky performance status ≥ 60
- No major organ dysfunction
- Biopsy at HL relapse or when refractoriness disease is diagnosed must be done prior to BV-ESHAP. If biopsy cannot be performed, tumor biopsy at initial diagnosis of HL must be available to be revised
- Absence of prior history of other malignant diseases, except:
Basal cell carcinoma of the skin or uterine "in situ" carcinoma adequately treated Any curable neoplasia adequately treated that has achieved complete response and has remained in such status longer than 3 years
- 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 30 days after the last dose of study drug, or agrees to completely abstain from heterosexual intercourse
- Male patients, even if surgically sterilized, 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
- Life-expectancy >3 months
- Platelet count ≥75•109/L (or 20 if due to Bone Marrow [BM] infiltration) absolute neutrophil count ≥1.5•109/L (or 0.5 if due to BM infiltration), and hemoglobin ≥ 8g/dL
- Total Bilirubin: <1.5 x UNL, unless clearly related to the disease (Gilbert disease will be ruled out from this point)
- AST and ALT: <3 xUNL except liver infiltration
- Serum creatinine: < 2.0 mg/dL and/or creatinine clearance or calculated creatinine clearance > 40 mL/minute
- Serum sodium >130 mmol/L
- Voluntary written informed consent
Exclusion Criteria:
- Current active hepatic or biliary disease (with exception of patients with Gilbert's syndrome, asymptomatic gallstones, liver metastases or stable chronic liver disease per investigator assessment)
- Serious medical or psychiatric illness likely to interfere with participation in this clinical study
- Patients that have been treated previously with anti-CD30 monoclonal antibodies
- Myocardial infarction within 6 months prior to enrollment. Heart failure NYHA Class III-IV, severe uncontrolled ventricular arrhythmias, or electrocardiographic evidence of acute ischemia or active conduction system abnormalities. Recent evidence (within 6 months) of a left-ventricular ejection fraction <50%
- Peripheral neuropathy or neuropathic pain grade ≥ 2
- Known cerebral or meningeal disease, including signs or symptoms of PML
- Symptomatic neurologic disease compromising normal activities of daily living or requiring medication
- Known hypersensitivity to recombinant proteins, murine proteins, or to any excipient contained in brentuximab vedotin
- Pregnant women or in breast-feeding period, or adults in childbearing period not using an effective contraception method
- Treatment with any known non-marketed drug substance or experimental therapy within the longer of 5 terminal half-lives or 4 weeks prior to enrollment or currently participating in any other interventional clinical study
- Chronic or current infectious disease requiring systemic antibiotics, antifungal, or antiviral treatment within two weeks prior to first study drug dose
- History of significant cerebrovascular disease in the past 6 months or ongoing event with active symptoms or sequelae
- HIV positive
- Significant concurrent, uncontrolled medical condition which may represent a risk for the patient
- Positive serology for HBV
- Positive serology for HCV
Sites / Locations
- Hospital Universitario Central de Asturias
- Institut Català d'Oncologia, Hospital Germans Trias i Pujol
- Institut Català d'Oncologia, Hospital Duran i Reynals
- Hospital Son Espases
- Hospital del Mar
- Hospital Clinic i Provincial de Barcelona
- Hospital General Universitario Gregorio Marañon
- Hospital Universitario Ramón y Cajal
- Hospital Universitario 12 de Octubre
- Hospital Universitario La Paz
- Hospital Universitario de Salamanca
- Hospital Universitario de Canarias
- Hospital Universitario Virgen del Rocío
- Hospital Clínico de Valencia
Arms of the Study
Arm 1
Experimental
BV-ESHAP
- 3 cycles every 21 days: Brentuximab Vedotin, on day 1 (BV will be administered at three different doses 0.9mg/kg, 1.2mg/kg, 1.8mg/kg) Etoposide 40 mg/m2/day, on days 1 to 4 Soludomerin (methylprednisolone) 250 mg/day, on days 1 to 4 Cisplatin 25 mg/m2/day, on days 1 to 4 Ara C (cytarabine) 2 g/m2, on day 5 - A fourth dose of BV will be given 21 days after the third BV dose during the evaluation of response before the transplant. - Autologous peripheral blood stem cell transplant - A fifth dose of BV (1.8mg/kg) will be given on between day 28 and 35 post-transplant, followed by two additional doses (1.8mg/kg) every 3 weeks, to complete a total of 7 BV infusions.