Clinical Trials /

Clinical Trial of Brentuximab Vedotin in Classical Hodgkin Lymphoma

NCT03646123

Description:

This trial will study two treatment combinations for classical Hodgkin lymphoma (cHL). This trial will find out if these two treatment combinations work to treat cHL. It will also find out what side effects occur. A side effect is anything the drug does besides treating cancer. This study will have three parts (Parts A, B, and C). The drugs used in Part A are a combination of targeted anticancer drug (brentuximab vedotin) and three chemotherapy drugs (doxorubicin, vinblastine, and dacarbazine). These four drugs are called "A+AVD." Participants will be treated with granulocyte colony stimulating factor (G-CSF) following every dose of A+AVD for 6 cycles of treatment (12 doses). Part A will look at whether the A+AVD drug combination reduces the number of participants who experience the side effect of febrile neutropenia. Febrile neutropenia is a very low white blood cell count and a fever, which can be life threatening. Parts B and C will use drug combination of brentuximab vedotin, plus nivolumab, doxorubicin, and dacarbazine. These four drugs are called "AN+AD." Parts B and C will study how well the drugs work to treat cHL and what side effects they cause.

Related Conditions:
  • Classical Hodgkin Lymphoma
Recruiting Status:

Recruiting

Phase:

Phase 2

Trial Eligibility

Document

Title

  • Brief Title: Clinical Trial of Brentuximab Vedotin in Classical Hodgkin Lymphoma
  • Official Title: Multiple Part Clinical Trial of Brentuximab Vedotin in Classical Hodgkin Lymphoma Subjects

Clinical Trial IDs

  • ORG STUDY ID: SGN35-027
  • NCT ID: NCT03646123

Conditions

  • Hodgkin Lymphoma

Interventions

DrugSynonymsArms
brentuximab vedotinAdcetris, SGN-35Part A: A+AVD
doxorubicinPart A: A+AVD
vinblastinePart A: A+AVD
dacarbazinePart A: A+AVD
G-CSFfilgrastim, pegfilgrastimPart A: A+AVD
nivolumabOpdivoPart B: AN+AD

Purpose

This trial will study two treatment combinations for classical Hodgkin lymphoma (cHL). This trial will find out if these two treatment combinations work to treat cHL. It will also find out what side effects occur. A side effect is anything the drug does besides treating cancer. This study will have three parts (Parts A, B, and C). The drugs used in Part A are a combination of targeted anticancer drug (brentuximab vedotin) and three chemotherapy drugs (doxorubicin, vinblastine, and dacarbazine). These four drugs are called "A+AVD." Participants will be treated with granulocyte colony stimulating factor (G-CSF) following every dose of A+AVD for 6 cycles of treatment (12 doses). Part A will look at whether the A+AVD drug combination reduces the number of participants who experience the side effect of febrile neutropenia. Febrile neutropenia is a very low white blood cell count and a fever, which can be life threatening. Parts B and C will use drug combination of brentuximab vedotin, plus nivolumab, doxorubicin, and dacarbazine. These four drugs are called "AN+AD." Parts B and C will study how well the drugs work to treat cHL and what side effects they cause.

Detailed Description

      This study will have three parts.

      Part A of the study is designed to evaluate the incidence of febrile neutropenia, efficacy,
      and dose intensity in participants with advanced stage classical Hodgkin lymphoma (cHL)
      receiving granulocyte colony stimulating factor primary prophylaxis (G-PP) administration
      during treatment with frontline A+AVD. In Part A, participants will be treated with
      granulocyte colony stimulating factor (G-CSF) following every dose of A+AVD for 6 cycles of
      treatment. Participants will be treated using institutional standard of care practices for
      the majority of treatment decisions.

      Part B is designed to evaluate the combination of brentuximab vedotin, nivolumab,
      doxorubicin, and dacarbazine (AN+AD) as frontline treatment in participants with advanced
      cHL. In Part B, participants will be given AN+AD combination for 6 cycles of treatment. This
      part of the trial will look at whether this combination of drugs is effective and tolerable
      in participants with Stage II with bulky mediastinal disease and Stage III or IV cHL.

      Part C is designed to evaluate AN+AD as frontline treatment in participants with early stage
      cHL. In Part C, participants will be given AN+AD combination for 4 cycles of treatment. This
      part of the trial will look at whether this combination of drugs is effective and tolerable
      in participants with Stage I or II cHL with non-bulky mediastinal disease.
    

Trial Arms

NameTypeDescriptionInterventions
Part A: A+AVDExperimentalBrentuximab vedotin (A) plus doxorubicin (+A), vinblastine (V), and dacarbazine (D) administered by intravenous (IV) infusion in participants with advanced stage classical Hodgkin lymphoma (cHL) during each treatment cycle.
  • brentuximab vedotin
  • doxorubicin
  • vinblastine
  • dacarbazine
  • G-CSF
Part B: AN+ADExperimentalBrentuximab vedotin (A) plus nivolumab (N), doxorubicin (+A), and dacarbazine (D) administered separately by IV infusion in participants with Stage II bulky mediastinal disease and Stage III or IV cHL during each treatment cycle.
  • brentuximab vedotin
  • doxorubicin
  • dacarbazine
  • nivolumab
Part C: AN+ADExperimentalBrentuximab vedotin (A) plus nivolumab (N), doxorubicin (+A), and dacarbazine (D) administered separately by IV infusion in participants with Stage I or II cHL with non-bulky mediastinal disease during each treatment cycle.
  • brentuximab vedotin
  • doxorubicin
  • dacarbazine
  • nivolumab

Eligibility Criteria

        Inclusion Criteria

          -  Treatment-naïve, classic Hodgkin lymphoma (cHL) participants

               -  Participants enrolling in Part A of the study must have Ann Arbor Stage III or IV
                  disease

               -  Participants enrolling in Part B of the study must have Ann Arbor Stage I or II
                  cH: with bulky mediastinal disease, or Stage III or IV

               -  Participants enrolling in Part C of the study must have Ann Arbor Stage I or II
                  cHL without bulky disease

          -  Histologically confirmed cHL according to the current World Health Organization (WHO)
             Classification

          -  Bidimensional measurable disease as documented by PET/CT or CT imaging

          -  Age 12 years or older in the United States. For regions outside of the US,
             participants must 18 years or older.

          -  Eastern Cooperative Oncology Group (ECOG) performance status of 0, 1, or 2

        Exclusion Criteria

          -  Nodular lymphocyte predominant HL

          -  History of another malignancy within 3 years of the first dose of study drug or any
             evidence of residual disease from a previously diagnosed malignancy. Exceptions are
             malignancies with a negligible risk or metastasis or death. Participants with
             nonmelanoma skin cancer, localized prostate cancer, or carcinoma in situ of any type
             are not excluded if they have undergone complete resection

          -  Prior immunosuppressive chemotherapy, therapeutic radiation, or any immunotherapy
             within 4 weeks of the first study drug dose

          -  Prior treatment with an anti-PD-1, anti-PD-L1, anti-PD-L2, or anti-CTLA-4 antibody, or
             any other antibody or drug specifically targeting T-cell co-stimulation or checkpoint
             pathways

          -  Active cerebral/meningeal disease related to the underlying malignancy

          -  Any active Grade 3 or higher viral, bacterial, or fungal infection within two weeks of
             the first dose of study drug (Grade 3 defined by the National Cancer Institute's
             Common Terminology Criteria for Adverse Events, NCI CTCAE Version 4.03)

          -  Current therapy with other systemic anti-neoplastic or investigational agents

          -  Planned consolidative radiotherapy (Parts B and C only)

          -  Active interstitial lung disease that is symptomatic or may interfere with the
             detection or management of suspected drug-related pulmonary toxicity (Parts B and C
             only)

          -  Grade 3 or higher pulmonary disease unrelated to underlying malignancy

          -  Documented history of idiopathic interstitial pneumonia or diffusing capacity of the
             lung for carbon monoxide <50% predicted

          -  History of a cerebral vascular event within 6 months of first dose of study drug

          -  Child-Pugh B or C hepatic impairment

          -  Grade 2 or higher peripheral sensory or motor neuropathy

          -  Participants with acute or chronic graft-versus-host-disease (GvHD) or receiving
             immunosuppressive therapy as treatment or as prophylaxis against GvHD

          -  Previous treatment with brentuximab vedotin

          -  Participants who are pregnant or breastfeeding

          -  Other serious condition that would impair the participant's ability to receive or
             tolerate the planned treatment and follow-up
      
Maximum Eligible Age:N/A
Minimum Eligible Age:12 Years
Eligible Gender:All
Healthy Volunteers:No

Primary Outcome Measures

Measure:Febrile Neutropenia (FN) Rate (Part A)
Time Frame:Up to 6 months
Safety Issue:
Description:Proportion of patients with treatment-emergent incidence of FN.

Secondary Outcome Measures

Measure:Primary Refractory Disease Rate (Part A)
Time Frame:Up to 9 months
Safety Issue:
Description:Proportion of participants with less than CR or relapse within 3 months of EOT.
Measure:CR Rate (Part A)
Time Frame:Up to 6 months
Safety Issue:
Description:Proportion of patients with CR at EOT.
Measure:Physician-reported Progression Free Survival (PFS) (Part A)
Time Frame:Up to 2 years
Safety Issue:
Description:The physician-reporting PFS is defined as the time from start of study treatment to first documentation of progression per investigator or to death due to any cause, whichever comes first.
Measure:Subsequent Anticancer Therapy Utilization Rate (Part A)
Time Frame:Up to 2.5 years
Safety Issue:
Description:Proportion of patients with subsequent anticancer therapies.
Measure:Mean Dose Intensity (Part A)
Time Frame:Up to 6 months
Safety Issue:
Description:
Measure:Rate of Dose Reduction and Delays (Part A)
Time Frame:Up to 6 months
Safety Issue:
Description:Proportion of patients with dose reductions or delays related to any component of A+AVD.
Measure:Incidence of adverse events (Parts B and C)
Time Frame:Up to 7 months
Safety Issue:
Description:
Measure:Incidence of laboratory abnormalities (Parts B and C)
Time Frame:Up to 7 months
Safety Issue:
Description:
Measure:Overall response rate (ORR) at EOT (Parts B and C)
Time Frame:Up to 6 months
Safety Issue:
Description:ORR is defined as the proportion of participants with CR or partial response (PR) at EOT.
Measure:Duration of response (DOR) (Parts B and C)
Time Frame:Up to 5 years
Safety Issue:
Description:DOR is defined as the time from the first documentation of objective tumor response (CR or PR) to the first documentation of tumor progression per LYRIC or death, whichever comes first.
Measure:Duration of complete response (DOCR) (Parts B and C)
Time Frame:Up to 5 years
Safety Issue:
Description:DOCR is defined as the time from the first documentation of complete tumor response (CR) to the first documentation of tumor progression per LYRIC or death, whichever comes first. DOCR will only be calculated for the subgroup of subjects achieving CR.
Measure:Event-free survival (EFS) (Parts B and C)
Time Frame:Up to 5 years
Safety Issue:
Description:EFS is defined as the time from start of study treatment to the first documentation of objective tumor progression, death due to any cause, or receipt of subsequent anticancer therapy to treat residual or progressive disease, whichever comes first.
Measure:PFS (Parts B and C)
Time Frame:Up to 5 years
Safety Issue:
Description:PFS is defined as the time from start of study treatment to first documentation of objective tumor progression or death.
Measure:Overall survival (OS) (Parts B and C)
Time Frame:Up to 5 years
Safety Issue:
Description:Overall survival is defined as the time from start of study treatment to the date of death due to any cause.

Details

Phase:Phase 2
Primary Purpose:Interventional
Overall Status:Recruiting
Lead Sponsor:Seagen Inc.

Trial Keywords

  • Brentuximab vedotin
  • Doxorubicin
  • Vinblastine
  • Dacarbazine
  • Nivolumab
  • Seattle Genetics

Last Updated

August 17, 2021