Pembro + Blina Combination in Pediatric and Young Adult Patients With Relapsed/Refractory Acute Leukemia or Lymphoma
Leukemia, B-cell, Lymphoma, B-Cell
About this trial
This is an interventional treatment trial for Leukemia, B-cell focused on measuring Blinatumomab, Pembrolizumab, CD19 positive, Relapsed, Refractory
Eligibility Criteria
Inclusion Criteria:
- Age 1-40
- Diagnosis of CD19 positive B-cell acute lymphoblastic leukemia (ALL) positive B-cell acute lymphoblastic leukemia (ALL) or CD19 positive B-cell lymphoma
- Patients with CD19 positive B-ALL must have greater than or equal to 5% lymphoblast in the bone marrow AND meet one of the following criteria:
- 2nd or greater relapse
- Any relapse after allo-HSCT
- Refractory disease
- Patients with CD19 positive relapsed/refractory lymphoma must be in 2nd or greater relapse or have refractory disease with the markers of disease burden
- Patients with CNS 1 or CNS 2 leukemia are eligible.Patients with CNS 3 leukemia are not eligible. However, patients with a history of CNS 3 status who have been sufficiently treated are eligible if currently CNS 1 or 2. Patients with an isolated CNS relapse are not eligible.
- Karnofsky performance level greater than or equal to 50 % for patients older than 16
- Lansky performance level greater than or equal to 50 % less than or equal to 16
- Patients recovered from acute toxicities from prior anti-cancer chemotherapy including HSCT, cytotoxic therapy, prior blinatumomab, biologic, immunotherapy, monoclonal antibody, XRT and corticosteroid therapy
- Patients with adequate hematological, renal, liver, cardiac, pulmonary and CNS organ functions
- Female participants of child bearing age must have negative pregnancy test, abstain or use contraception for 120 days after last dose of pembrolizumab
Exclusion Criteria:
- Patients with the following diagnoses: CNS 3 leukemia, CNS lymphoma, active GVHD, Downs Syndrome, CNS or testicular relapse, optic nerve or retinal involvement requiring radiation therapy
- Pregnant or breastfeeding
- Concomitant corticosteroids, immunosuppressive therapies, investigational drugs, anti-cancer agents
- Concurrent illnesses including: history of any grade autoimmune disorder, Grade 2 or higher hypothyroidism die to autoimmunity, uncontrolled infection, interstitial lung disease or pneumonitis
- Patients with other concurrent malignancies
- Patients who have received live vaccines within the last 30 days
- Patients with history of solid organ transplant
Sites / Locations
- Cincinnati Children's Hospital Medical Center
Arms of the Study
Arm 1
Experimental
Blinatumomab and Pembrolizumab
Blinatumomab and Pembrolizumab will be given for 2 cycles (each cycle lasts 35 days). Blinatumomab administered as a continuous IV infusion. Patient Weight Greater Than or Equal to 45 kg (Fixed dose) Patient Weight Less Than 45 kg (BSA-based dose) Cycle 1 (Days 1-7): Patient Weight Greater Than or Equal to 45 kg: 9 mcg/day Patient Weight Less Than 45 kg: 5 mcg/m2/day Cycle 1(Days 8-28): Patient Weight Greater Than or Equal to 45 kg: 28 mcg/day Patient Weight Less Than 45 kg: 15 mcg/m2/day Cycle 2 (Days 1-28): Patient Weight Greater Than or Equal to 45 kg: 28 mcg/day Patient Weight Less Than 45 kg: 15 mcg/m2/day Pembrolizumab: 2 mg/kg (max dose 200 mg) administered as a 30 minute IV infusion on day 12 of cycle 1 and day 5 of cycle 2.