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Phase I/II Feasibility Study Combining Brentuximab Vedotin With Second Line Salvage Chemotherapy (DHAP) in Hodgkin Lymphoma Patients

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ClinicalTrials.gov Identifier: NCT02280993
Recruitment Status : Active, not recruiting
First Posted : November 3, 2014
Last Update Posted : March 13, 2018
Sponsor:
Collaborator:
Millennium: The Takeda Oncology Company
Information provided by (Responsible Party):
Marjolein Spiering, Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA)

Brief Summary:
To combine Brentuximab Vedotin with Dexamethasone, AraC and Cisplatin (DHAP) chemotherapy in patients with Hodgkin lymphoma (HL) refractory to first line chemotherapy or in first relapse is expected to induce a significantly higher (metabolic) complete remission (CR) rate prior to consolidation with BEAM, as judged by FDG (18F-2-fluoro-2-deoxy-D-glucose fluorodeoxyglucose)-PET negativity. This will be compared with published data on DHAP salvage only. Increasing the metabolic CR rate prior to consolidation with high dose chemotherapy and autologous stem cell transplantation (ASCT) is expected to improve progression free survival (PFS) and overall survival (OS).

Condition or disease Intervention/treatment Phase
Hodgkin Lymphoma Refractory Relapse Drug: DHAP Drug: Brentuximab Vedotin Other: Autologous Peripheral Blood Stem Cell Transplantation Phase 1

Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 72 participants
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Phase I/II Feasibility Study Combining Brentuximab Vedotin With Second Line Salvage Chemotherapy (DHAP) in Hodgkin Lymphoma Patients Refractory to First Line Chemotherapy or in First Relapse Who Are Eligible for High Dose Treatment Followed by Autologous Peripheral Blood Stem Cell Transplantation (ASCT)
Actual Study Start Date : May 2014
Estimated Primary Completion Date : November 2018
Estimated Study Completion Date : May 2020

Resource links provided by the National Library of Medicine


Arm Intervention/treatment
Experimental: DHAP-BV
Brentuximab Vedotin with DHAP chemotherapy follow by Autologous Peripheral Blood Stem Cell Transplantation
Drug: DHAP
DHAP
Other Names:
  • Dexamethasone
  • AraC
  • Cisplatin

Drug: Brentuximab Vedotin
Brentuximab Vedotin
Other Names:
  • Adcetris
  • SGN-35

Other: Autologous Peripheral Blood Stem Cell Transplantation
Autologous Peripheral Blood Stem Cell Transplantation
Other Name: ASCT




Primary Outcome Measures :
  1. rate of patient with grade 4 Adverse Events [ Time Frame: 12 weeks ]
    The rate of patients with severe toxicity during cycle I-III of the combination treatment (BV + DHAP)


Secondary Outcome Measures :
  1. (Severe) Adverse Event [ Time Frame: 12 weeks ]
    (Severe) Adverse Events during the combination treatment


Other Outcome Measures:
  1. Response [ Time Frame: 12 weeks ]
    Metabolic CR rate (PET-CT) after the third cycle of BV-DHAP reinduction therapy



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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Histologically confirmed CD30+ classical HL (central pathology review; results not required to enroll the patient in the study), primarily refractory to first line chemotherapy or in first relapse after any polychemotherapy regimen (e.g. ABVD (Adriamycin, bleomycin, vinblastine, and dacarbazine), baseline BEACOPP ( bleomycin, etoposide, Adriamycin, cyclophosphamide, Oncovin, procarbazine, and prednisone) or escalated BEACOPP, or other induction regimens)
  • In case of relapse, the relapse must be histologically confirmed. In case histology is not possible, at least confirmation of the relapse by fine-needle aspiration is required.
  • Measurable disease, as defined in Appendix C i.e. CT scans showing at least 2 or more clearly demarcated lesions with a long axis ≥ 1.5 cm and a short axis diameter ≥ 1.0 cm, or 1 clearly demarcated lesion with a long axis ≥ 2.0 cm and a short axis diameter ≥ 1.0 cm. These lesions must be FDG (18F-2-fluoro-2-deoxy-D-glucose fluorodeoxyglucose)-positive
  • Age ≥ 18 years (upper age limit for auto stem cell transplantation at the discretion of the participating center)
  • WHO ≤ 2 (see appendix A)
  • Life expectancy of > 3 months with treatment
  • No major organ dysfunction, unless HL-related
  • Total bilirubin < 1.5x ULN (unless due to lymphoma involvement of the liver or a known history of Gilbert's syndrome)
  • ALT/AST < 3x ULN (unless due to lymphoma involvement of the liver; in that case ALT/AST may be elevated up to 5 x ULN)
  • glomerular filtration rate (GFR) > 60 ml/min as estimated by the Cockcroft&Gault formula (appendix D)
  • Absolute neutrophil count ≥ 1.5x109/L, unless caused by diffuse bone marrow infiltration by the HL
  • Platelets ≥ 100x109/L, unless caused by diffuse bone marrow infiltration by the HL
  • Hemoglobin must be >8 g/dL
  • Written informed consent
  • Able to adhere to the study visit schedule and other protocol requirements
  • Female patient is either post-menopausal for at least 1 year before the screening visit or surgically sterile or if of childbearing potential, agrees 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, (i.e., status post vasectomy) 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.
  • Eligible for high dose chemotherapy and autologous peripheral blood stem cell transplantation
  • Resolution of toxicities from first-line therapy

Exclusion Criteria:

  • Peripheral sensory or motor neuropathy grade ≥ 2
  • Known cerebral or meningeal disease (HL or any other etiology), including signs or symptoms of progressive multifocal leukoencephalopathy
  • Symptomatic neurologic disease compromising normal activities of daily living or requiring medications
  • Patients who have been using other investigational agents within at least 5 half lives of the most recent agent used prior to enrollment in the study
  • Patients who were treated with myelosuppressive chemotherapy or biological therapy ≤ 4 weeks before study inclusion
  • Female patients who are both lactating and breast feeding or have a positive serum pregnancy test during the screening period or a positive pregnancy test on Day 1 before first dose of study drug or adults of reproductive potential who are not using effective birth control methods.
  • Patients with any active systemic viral, bacterial, or fungal infection requiring systemic antibiotics within 2 weeks prior to first study drug dose
  • Patients who have a history of another primary malignancy less than 3 years before study inclusion or previously diagnosed with another malignancy and have evidence of residual disease, with the exception of non-melanoma skin cancer, completely resected melanoma TNMpT1 and carcinoma in situ of the uterine cervix
  • Patients with known hypersensitivity to recombinant proteins, murine proteins, or to any excipient contained in the drug formulation of brentuximab vedotin.
  • Patients with known HIV seropositivity, known hepatitis B surface antigen-positivity, or known or suspected active hepatitis C infection
  • Patients receiving radiation therapy within 8 weeks prior to start of protocol treatment. Emergency radiation therapy is allowed, as long as measurable disease (at non-irradiated sites) persists.
  • Patients with a serious psychiatric disorder that could, in the investigator's opinion, potentially interfere with the completion of treatment according to the protocol

    • Patients who have any severe and/or uncontrolled medical condition or other conditions that could affect their participation in the study such as:Known history of symptomatic congestive heart failure (NYHA III, IV), myocardial infarction ≤ 6 months prior to first study drug
    • Evidence of current serious uncontrolled cardiac arrhythmia, angina pectoris, electrocardiographic evidence of acute ischemia or active conduction system abnormalities
    • Recent evidence (within 6 months before first dose of study drug) of a left-ventricular ejection fraction <50%
    • severely impaired pulmonary function as defined as spirometry and DLCO (diffusing capacity of the lung for carbon monoxide) that is 50% or less of the normal predicted value and/or O2 saturation that is 90% or less at rest on room air
    • any active (acute or chronic) or uncontrolled infection/disorders that impair the ability to evaluate the patient or for the patient to complete the study
  • nonmalignant medical illnesses that are uncontrolled or whose control may be jeopardized by this study drug, such as severe hypertension that is not controlled with medical management and thyroid abnormalities when thyroid function cannot be maintained in the normal range by medication

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02280993


Locations
Denmark
Rigshospitalet
Copenhagen, Denmark
France
Centre Hospitalier Universitaire
Lille, France
Hospices Civils de Lyon
Lyon, France
Centre Hospitalier et Universitaire
Nantes, France
Hôpital Saint Louis
Paris, France
Institut Gustave Roussy
Paris, France
Netherlands
Academic Medical Center
Amsterdam, Netherlands, 1105 AZ
Free University Medical Center
Amsterdam, Netherlands
University Medical Center Groningen
Groningen, Netherlands
Erasmus Medical Center
Rotterdam, Netherlands
United Kingdom
Cambridge University Hospitals NHS Foundation Trust | Addenbrooke's Hospital
Cambridge, United Kingdom
King's College Hospital NHS Foundation Trust
London, United Kingdom
Christie Hospital, Manchester
Manchester, United Kingdom
Sponsors and Collaborators
Marjolein Spiering
Millennium: The Takeda Oncology Company
Investigators
Principal Investigator: Anton Hagenbeek, PhD MD Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA)
Principal Investigator: Marie José Kersten, PhD MD Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA)
Study Director: Marjolein Spiering, MSc Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA)

Additional Information:
Responsible Party: Marjolein Spiering, MSc, Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA)
ClinicalTrials.gov Identifier: NCT02280993     History of Changes
Other Study ID Numbers: Transplant BRaVE
NL40688.018.12 ( Other Identifier: The Central Committee on Research Involving Human Subjects (CCMO) )
2012-003097-45 ( EudraCT Number )
First Posted: November 3, 2014    Key Record Dates
Last Update Posted: March 13, 2018
Last Verified: March 2018

Additional relevant MeSH terms:
Lymphoma
Hodgkin Disease
Recurrence
Neoplasms by Histologic Type
Neoplasms
Lymphoproliferative Disorders
Lymphatic Diseases
Immunoproliferative Disorders
Immune System Diseases
Disease Attributes
Pathologic Processes
Antibodies, Monoclonal
Immunologic Factors
Physiological Effects of Drugs