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Study of Pembrolizumab With Bendamustine in Hodgkin Lymphoma

Primary Purpose

Classical Hodgkin Lymphoma, Relapsed Cancer, Refractory Cancer

Status
Recruiting
Phase
Phase 2
Locations
Canada
Study Type
Interventional
Intervention
Pembrolizumab
Bendamustine Hydrochloride
Sponsored by
University Health Network, Toronto
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Classical Hodgkin Lymphoma

Eligibility Criteria

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

Inclusion Criteria:

  • Be willing and able to provide written informed consent for the trial and adhere to trial procedures.
  • Have histologically confirmed relapsed (disease progression after most recent therapy) or refractory (failure to achieve complete response [CR] or partial response [PR] to most recent therapy) classical Hodgkin Lymphoma).
  • Must have received at least standard first line chemotherapy for classical Hodgkin Lymphoma, containing an anthracycline.
  • Must have failed or declined autologous stem cell transplantation (ASCT), or not be a candidate for ASCT.
  • May have received prior therapy with pembrolizumab (or an equivalent checkpoint inhibitor or anti-PD-L1 antibody), but not in combination with bendamustine.
  • May have received a prior autologous stem cell transplant but must be at least ≥100 days post-auto-transplant, and all transplant- related adverse events must have resolved to a grade 1 or less, and patients are not on immunosuppression, and meet all other eligibility criteria.
  • Must have measurable or evaluable disease.
  • Must have Eastern Cooperative Group (ECOG) performance status 0-1.
  • Must have an estimated life expectancy of greater than 90 days.
  • Demonstrate adequate organ and bone marrow function.
  • If female of child-bearing potential, must have a negative pregnancy test within 72 hours prior to the first dose of study treatment.
  • All participants must be willing to use adequate contraception for the duration of treatment with study drugs and continue for 120 days after the last dose of study drug.
  • Must be available for treatment, assessment and follow-up.

Exclusion Criteria:

  • There is known severe (≥ Grade 3) hypersensitivity to pembrolizumab or bendamustine.
  • Patient receiving any other investigational agents, or has participated in a study of an investigational agent and has received study therapy or used an investigational device within 4 weeks of the first dose of treatment.
  • Patient is receiving any other, non-investigational, chemotherapy, radiotherapy, small molecule, or biologic agent within 4 weeks of the first dose of treatment, or who has not recovered from adverse events due to a previously administered agent.
  • Patient has had a prior monoclonal antibody within 4 weeks prior to first dose of therapy in the study, or who has not recovered from adverse events due to agents administered more than 4 weeks earlier.
  • Patient has received pembrolizumab, or another anti-PD1, or anti-PD-L1, anti-PD-L2, anti-CD137, anti-CTLA-4, or anti-OX-40 antibody, or any other antibody or drug specifically targeting T-cell co-stimulation or checkpoint pathways, with disease progression whilst on therapy, or within 3 months of completion of this line of therapy, without intervening systemic therapy (including chemotherapy, antibody drug conjugates or other targeted agents).
  • Patient has received prior treatment with bendamustine, either as monotherapy or as part of a combination regimen.
  • Patient has undergone prior allogeneic hematopoietic stem cell transplant.
  • Patient has another concurrent active malignancy (excluding non-melanoma skin cancer or carcinoma in situ of the cervix that has undergone potentially curative therapy), and must be disease-free and off treatment for > 3 years.
  • Patient has known active central nervous system or meningeal disease.
  • Patients with active or past documented autoimmune disease that has required treatment in the past 2 years.
  • Patient is receiving systemic steroid therapy at a dose of > 10 mg/day of prednisone (or equivalent) for 7 days prior to day 1 of study treatment.
  • Has an uncontrolled co-existing illness, including but not limited to: ongoing or active infection requiring systemic therapy; systemic congestive heart failure Class III or IV by NYHA criteria; unstable angina pectoris or cardiac arrhythmia; in patients status post allogeneic transplantation uncontrolled GVHD.
  • Patient has a history of (non-infectious) pneumonitis that has required steroid treatment, or concurrent active pneumonitis.
  • Patient is pregnant, or nursing, or expecting to conceive or father children within the projected duration of the trial, starting with the screening visit through 120 days after the last dose of pembrolizumab and/or bendamustine.
  • Has a known history of Human Immunodeficiency Virus (HIV), active tuberculosis (TB, Mycobacterium tuberculosis), or active hepatitis B or hepatitis C.
  • Patient has received a live vaccine within 30 days prior to first dose of study drugs.
  • Patient is eligible for autologous or allogeneic stem cell transplant, unless patient has declined this, therefore rendering themselves ineligible for stem cell transplantation.

Sites / Locations

  • Princess Margaret Cancer CentreRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Pembrolizumab and Bendamustine

Arm Description

The study drugs will be given in 3 week periods called cycles. Pembrolizumab is available in powder form or as a liquid for infusion. Pembrolizumab at a dose of 200 mg will be given over 30 minutes, once every cycle for up to 35 cycles (approximately 24 months). Bendamustine is available in powder form for injection. Bendamustine at a dose of 90 mg/m2 will be given over 60 minutes, on Days 1 and 2 of every cycle for up to 6 cycles.

Outcomes

Primary Outcome Measures

Overall response rate
Complete response + partial response
Complete response rate as determined by Lugano criteria
Assessed by positron emission tomography (PET)/computed tomography (CT) scans

Secondary Outcome Measures

Incidence of adverse events
Overall survival rate
Progression-free survival rate
Average duration of response

Full Information

First Posted
August 9, 2020
Last Updated
January 8, 2023
Sponsor
University Health Network, Toronto
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1. Study Identification

Unique Protocol Identification Number
NCT04510636
Brief Title
Study of Pembrolizumab With Bendamustine in Hodgkin Lymphoma
Official Title
Phase 2 Study Evaluating the Safety and Efficacy of Pembrolizumab (KEytruda) in Combination With Bendamustine (TREanda) in Relapsed/Refractory Hodgkin Lymphoma
Study Type
Interventional

2. Study Status

Record Verification Date
January 2023
Overall Recruitment Status
Recruiting
Study Start Date
December 20, 2021 (Actual)
Primary Completion Date
June 1, 2026 (Anticipated)
Study Completion Date
June 1, 2026 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University Health Network, Toronto

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 is a phase 2 open-label study to test the safety and effectiveness of combining pembrolizumab and bendamustine in patients with relapsed (cancer that has come back or started getting worse) or refractory (cancer that is not responding or has stopped responding to treatment) Hodgkin lymphoma.
Detailed Description
Pembrolizumab and bendamustine will be explored as a safe and effective treatment for these patients. Although current treatment options are available for patients in the relapsed state, once these therapies fail or are not tolerated, treatment options are quite limited. Pembrolizumab and bendamustine have both shown activity when used as a single agent as treatment for Hodgkin Lymphoma. Their side effect profiles also do not overlap, which makes them ideal to combine, with an intent to increase the amount and duration of complete responses while limiting the toxicities experienced by patients.

6. Conditions and Keywords

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

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Pembrolizumab and Bendamustine
Arm Type
Experimental
Arm Description
The study drugs will be given in 3 week periods called cycles. Pembrolizumab is available in powder form or as a liquid for infusion. Pembrolizumab at a dose of 200 mg will be given over 30 minutes, once every cycle for up to 35 cycles (approximately 24 months). Bendamustine is available in powder form for injection. Bendamustine at a dose of 90 mg/m2 will be given over 60 minutes, on Days 1 and 2 of every cycle for up to 6 cycles.
Intervention Type
Drug
Intervention Name(s)
Pembrolizumab
Other Intervention Name(s)
KEYTRUDA
Intervention Description
Pembrolizumab is a intravenously administered humanized monoclonal antibody that blocks the interaction between PD-1 and its ligands, PD-L1 and PD-L2.
Intervention Type
Drug
Intervention Name(s)
Bendamustine Hydrochloride
Other Intervention Name(s)
TREANDA
Intervention Description
Bendamustine is a unique alkylating agent with substantial activity in hematologic malignancies.
Primary Outcome Measure Information:
Title
Overall response rate
Description
Complete response + partial response
Time Frame
5 years
Title
Complete response rate as determined by Lugano criteria
Description
Assessed by positron emission tomography (PET)/computed tomography (CT) scans
Time Frame
5 years
Secondary Outcome Measure Information:
Title
Incidence of adverse events
Time Frame
5 years
Title
Overall survival rate
Time Frame
5 years
Title
Progression-free survival rate
Time Frame
5 years
Title
Average duration of response
Time Frame
5 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Be willing and able to provide written informed consent for the trial and adhere to trial procedures. Have histologically confirmed relapsed (disease progression after most recent therapy) or refractory (failure to achieve complete response [CR] or partial response [PR] to most recent therapy) classical Hodgkin Lymphoma). Must have received at least standard first line chemotherapy for classical Hodgkin Lymphoma, containing an anthracycline. Must have failed or declined autologous stem cell transplantation (ASCT), or not be a candidate for ASCT. May have received prior therapy with pembrolizumab (or an equivalent checkpoint inhibitor or anti-PD-L1 antibody), but not in combination with bendamustine. May have received a prior autologous stem cell transplant but must be at least ≥100 days post-auto-transplant, and all transplant- related adverse events must have resolved to a grade 1 or less, and patients are not on immunosuppression, and meet all other eligibility criteria. Must have measurable or evaluable disease. Must have Eastern Cooperative Group (ECOG) performance status 0-1. Must have an estimated life expectancy of greater than 90 days. Demonstrate adequate organ and bone marrow function. If female of child-bearing potential, must have a negative pregnancy test within 72 hours prior to the first dose of study treatment. All participants must be willing to use adequate contraception for the duration of treatment with study drugs and continue for 120 days after the last dose of study drug. Must be available for treatment, assessment and follow-up. Exclusion Criteria: There is known severe (≥ Grade 3) hypersensitivity to pembrolizumab or bendamustine. Patient receiving any other investigational agents, or has participated in a study of an investigational agent and has received study therapy or used an investigational device within 4 weeks of the first dose of treatment. Patient is receiving any other, non-investigational, chemotherapy, radiotherapy, small molecule, or biologic agent within 4 weeks of the first dose of treatment, or who has not recovered from adverse events due to a previously administered agent. Patient has had a prior monoclonal antibody within 4 weeks prior to first dose of therapy in the study, or who has not recovered from adverse events due to agents administered more than 4 weeks earlier. Patient has received pembrolizumab, or another anti-PD1, or anti-PD-L1, anti-PD-L2, anti-CD137, anti-CTLA-4, or anti-OX-40 antibody, or any other antibody or drug specifically targeting T-cell co-stimulation or checkpoint pathways, with disease progression whilst on therapy, or within 3 months of completion of this line of therapy, without intervening systemic therapy (including chemotherapy, antibody drug conjugates or other targeted agents). Patient has received prior treatment with bendamustine, either as monotherapy or as part of a combination regimen. Patient has undergone prior allogeneic hematopoietic stem cell transplant. Patient has another concurrent active malignancy (excluding non-melanoma skin cancer or carcinoma in situ of the cervix that has undergone potentially curative therapy), and must be disease-free and off treatment for > 3 years. Patient has known active central nervous system or meningeal disease. Patients with active or past documented autoimmune disease that has required treatment in the past 2 years. Patient is receiving systemic steroid therapy at a dose of > 10 mg/day of prednisone (or equivalent) for 7 days prior to day 1 of study treatment. Has an uncontrolled co-existing illness, including but not limited to: ongoing or active infection requiring systemic therapy; systemic congestive heart failure Class III or IV by NYHA criteria; unstable angina pectoris or cardiac arrhythmia; in patients status post allogeneic transplantation uncontrolled GVHD. Patient has a history of (non-infectious) pneumonitis that has required steroid treatment, or concurrent active pneumonitis. Patient is pregnant, or nursing, or expecting to conceive or father children within the projected duration of the trial, starting with the screening visit through 120 days after the last dose of pembrolizumab and/or bendamustine. Has a known history of Human Immunodeficiency Virus (HIV), active tuberculosis (TB, Mycobacterium tuberculosis), or active hepatitis B or hepatitis C. Patient has received a live vaccine within 30 days prior to first dose of study drugs. Patient is eligible for autologous or allogeneic stem cell transplant, unless patient has declined this, therefore rendering themselves ineligible for stem cell transplantation.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
John Kuruvilla, M.D.
Phone
416-946-2821
Email
john.kuruvilla@uhn.ca
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
John Kuruvilla, M.D.
Organizational Affiliation
Princess Margaret Cancer Centre
Official's Role
Principal Investigator
Facility Information:
Facility Name
Princess Margaret Cancer Centre
City
Toronto
State/Province
Ontario
ZIP/Postal Code
M5G 2M9
Country
Canada
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
John Kuruvilla, M.D.
Phone
416-946-2821
First Name & Middle Initial & Last Name & Degree
John Kuruvilla, M.D.

12. IPD Sharing Statement

Plan to Share IPD
No

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Study of Pembrolizumab With Bendamustine in Hodgkin Lymphoma

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