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PD-1 Inhibitor Combined With Decitabine Followed by ASCT as Second-line Therapy for Relapsed or Refractory Classic Hodgkin's Lymphoma

Primary Purpose

Hodgkin Lymphoma, Adult, Relapse, Refractory Hodgkin Lymphoma

Status
Recruiting
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
PD-1 inhibitor
Sponsored by
Institute of Hematology & Blood Diseases Hospital, China
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Hodgkin Lymphoma, Adult focused on measuring Hodgkin lymphoma, relapse, refractory, autologous stem cell transplantation, PD-1 inhibitor, decitabine

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Subjects must have histological confirmation of relapsed or refractory classic Hodgkin lymphoma (HL).
  2. 18 to 65 years of age.
  3. Subjects with lymphoma must have at least one measureable lesion >1 cm as defined by lymphoma response criteria.
  4. Proper functioning of the major organs: 1) The absolute value of neutrophils (≥1×10^9/L); 2) platelet count (≥75×10^9/L); 3) Serum creatinine <1.5 times Upper Limit Normal (ULN) ; 4) Serum total bilirubin < 1.5 times ULN; 5) Aspartate Aminotransferase (AST), Alanine Aminotransferase (ALT) ≤3 times ULN; 6) Serum creatinine (Cr) ≤2 ULN, or glomerular filtration rate ≥40ml/min; 7) Thyrotropin (TSH) or free thyroxine (FT4) or free triiodothyronine (FT3) were all within the normal range (±10%).
  5. Eastern Cooperative Oncology Group (ECOG) Performance status 0-2.
  6. LVEF value measured by echocardiography ≥50%.
  7. Life expectancy > 3 months.

Exclusion Criteria:

  1. Patients with central nervous system involvement by lymphoma.
  2. Patients with active autoimmune diseases requiring systematic treatment in the past two years (hormone replacement therapy is not considered systematic treatment, such as type I diabetes mellitus, hypothyroidism requiring only thyroxine replacement therapy, adrenocortical dysfunction or pituitary dysfunction requiring only physiological doses of glucocorticoid replacement therapy); Patients with autoimmune diseases who do not require systematic treatment within two years can be enrolled.
  3. Known systemic vasculitides, primary or secondary immunodeficiency(such as HIV infection or severe inflammatory disease).
  4. Pregnant or breastfeeding women.
  5. Major surgery within 4 weeks before enrollment.
  6. Impaired cardiac function:Ejection fraction <50% on MUGA scan. QTc interval > 450msecs on baseline ECG. Myocardial infarction within 6 months prior to starting study; other clinically significant heart disease (e.g. unstable angina, congestive heart failure or uncontrolled hypertension, uncontrolled arrhythmias).
  7. Other concurrent severe and/or uncontrolled medical conditions: Patients with another primary malignant disease, except those that do not currently require treatment; acute or chronic liver, pancreatic or severe renal disease; another severe and/or life-threatening medical disease.

Sites / Locations

  • Institute of Hematology & Blood Diseases HospitalRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

PD-1 inhibitor combined with decitabine followed by ASCT

Arm Description

Patients will receive salvage treatment of PD-1 inhibitor Tislelizumab combined with decitabine for four cycles, If PR or CR was obtained after salvage treatment, patients will receive GBM (gemcitabine, bulsufan and melphalan) conditioning regimen followed by ASCT. High-risk patients will receive PD-1 inhibitor for 1 year after ASCT as maintenance therapy.

Outcomes

Primary Outcome Measures

Progression-free survival
PFS

Secondary Outcome Measures

Objective response rate
ORR
Complete response rate
CRR
Duration of response
DOR
Overall survival rate
OS
Severity of the adverse events

Full Information

First Posted
November 16, 2021
Last Updated
December 14, 2021
Sponsor
Institute of Hematology & Blood Diseases Hospital, China
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1. Study Identification

Unique Protocol Identification Number
NCT05137886
Brief Title
PD-1 Inhibitor Combined With Decitabine Followed by ASCT as Second-line Therapy for Relapsed or Refractory Classic Hodgkin's Lymphoma
Official Title
PD-1 Inhibitor Combined With Decitabine Followed by ASCT as Second-line Therapy for Relapsed or Refractory Classic Hodgkin's Lymphoma
Study Type
Interventional

2. Study Status

Record Verification Date
December 2021
Overall Recruitment Status
Recruiting
Study Start Date
January 2022 (Anticipated)
Primary Completion Date
January 2024 (Anticipated)
Study Completion Date
January 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Institute of Hematology & Blood Diseases Hospital, China

4. Oversight

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

5. Study Description

Brief Summary
Young patients with relapsed or refractory classic Hodgkin's lymphoma will be treated with PD-1 inhibitor combined with decitabine as second-line salvage treatment for four cycles. If PR or CR was obtained after salvage treatment, patients will receive GBM conditioning regimen followed by ASCT as consolidation therapy. High-risk R/R cHL patients will be treated with PD-1 inhibitor after ASCT for 1 year. The purpose of current study is to determine the clinical efficacy and safety of PD-1 inhibitor combined with decitabine followed by ASCT as second-line treatment in patients with relapsed or refractory classic Hodgkin's lymphoma.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hodgkin Lymphoma, Adult, Relapse, Refractory Hodgkin Lymphoma
Keywords
Hodgkin lymphoma, relapse, refractory, autologous stem cell transplantation, PD-1 inhibitor, decitabine

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
PD-1 inhibitor combined with decitabine followed by ASCT
Arm Type
Experimental
Arm Description
Patients will receive salvage treatment of PD-1 inhibitor Tislelizumab combined with decitabine for four cycles, If PR or CR was obtained after salvage treatment, patients will receive GBM (gemcitabine, bulsufan and melphalan) conditioning regimen followed by ASCT. High-risk patients will receive PD-1 inhibitor for 1 year after ASCT as maintenance therapy.
Intervention Type
Drug
Intervention Name(s)
PD-1 inhibitor
Other Intervention Name(s)
decitabine, autologous stem cell transplantation
Intervention Description
decitabine 10mg on d1-5, Tislelizumab 200mg on d8,21 days as one cycle.
Primary Outcome Measure Information:
Title
Progression-free survival
Description
PFS
Time Frame
2 years
Secondary Outcome Measure Information:
Title
Objective response rate
Description
ORR
Time Frame
2 years
Title
Complete response rate
Description
CRR
Time Frame
2 years
Title
Duration of response
Description
DOR
Time Frame
2 years
Title
Overall survival rate
Description
OS
Time Frame
2 years
Title
Severity of the adverse events
Time Frame
2 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subjects must have histological confirmation of relapsed or refractory classic Hodgkin lymphoma (HL). 18 to 65 years of age. Subjects with lymphoma must have at least one measureable lesion >1 cm as defined by lymphoma response criteria. Proper functioning of the major organs: 1) The absolute value of neutrophils (≥1×10^9/L); 2) platelet count (≥75×10^9/L); 3) Serum creatinine <1.5 times Upper Limit Normal (ULN) ; 4) Serum total bilirubin < 1.5 times ULN; 5) Aspartate Aminotransferase (AST), Alanine Aminotransferase (ALT) ≤3 times ULN; 6) Serum creatinine (Cr) ≤2 ULN, or glomerular filtration rate ≥40ml/min; 7) Thyrotropin (TSH) or free thyroxine (FT4) or free triiodothyronine (FT3) were all within the normal range (±10%). Eastern Cooperative Oncology Group (ECOG) Performance status 0-2. LVEF value measured by echocardiography ≥50%. Life expectancy > 3 months. Exclusion Criteria: Patients with central nervous system involvement by lymphoma. Patients with active autoimmune diseases requiring systematic treatment in the past two years (hormone replacement therapy is not considered systematic treatment, such as type I diabetes mellitus, hypothyroidism requiring only thyroxine replacement therapy, adrenocortical dysfunction or pituitary dysfunction requiring only physiological doses of glucocorticoid replacement therapy); Patients with autoimmune diseases who do not require systematic treatment within two years can be enrolled. Known systemic vasculitides, primary or secondary immunodeficiency(such as HIV infection or severe inflammatory disease). Pregnant or breastfeeding women. Major surgery within 4 weeks before enrollment. Impaired cardiac function:Ejection fraction <50% on MUGA scan. QTc interval > 450msecs on baseline ECG. Myocardial infarction within 6 months prior to starting study; other clinically significant heart disease (e.g. unstable angina, congestive heart failure or uncontrolled hypertension, uncontrolled arrhythmias). Other concurrent severe and/or uncontrolled medical conditions: Patients with another primary malignant disease, except those that do not currently require treatment; acute or chronic liver, pancreatic or severe renal disease; another severe and/or life-threatening medical disease.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Dehui Zou, Dr.
Phone
86-022-23909282
Email
zoudehui@ihcams.ac.cn
First Name & Middle Initial & Last Name or Official Title & Degree
Huimin Liu, Dr
Phone
86-022-23909282
Email
liuhuimin@ihcams.ac.cn
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Dehui Zou, Dr.
Organizational Affiliation
Institute of Hematology & Blood Diseases Hospital, China
Official's Role
Principal Investigator
Facility Information:
Facility Name
Institute of Hematology & Blood Diseases Hospital
City
Tianjin
State/Province
Tianjin
ZIP/Postal Code
300020
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Dehui Zou, Dr.
Phone
86-022-23909282
Email
zoudehui@ihcams.ac.cn
First Name & Middle Initial & Last Name & Degree
Huimin Liu, Dr.
Phone
86-022-23909282
Email
liuhuimin@ihcams.ac.cn

12. IPD Sharing Statement

Plan to Share IPD
Undecided

Learn more about this trial

PD-1 Inhibitor Combined With Decitabine Followed by ASCT as Second-line Therapy for Relapsed or Refractory Classic Hodgkin's Lymphoma

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