This study has been transitioned to CTIS with ID 2023-510556-22-00 check the CTIS register for the current data. Lead in phase 1Primary objective:• To identify the feasibility and RDL (recommended dose level) of brentuximab vedotin in combination…
ID
Source
Brief title
Condition
- Lymphomas non-Hodgkin's B-cell
Synonym
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
Phase 1 part
Primary endpoint
• The rate of patients with serious toxicity during cycle 1-2 of the
combination BV-R-DHAP
Phase 2 part
Primary efficacy endpoint
• Metabolic CR rate (PET-CT) after the third cycle of BV-R-DHAP salvage therapy
Primary feasibility/toxicity endpoints
• Rate of grade 3/4 non-hematological toxicity, including neurotoxicity after
each cycle of BV-R-DHAP
Secondary outcome
Phase 1 part
Secondary endpoints
• (Serious) Adverse Events during combination treatment
• Time to hematological recovery after each cycle of BV-R-DHAP
• Time to recovery from non-hematological toxicity after each cycle of BV-R-DHAP
• Administration of treatment: dose reductions, interval between cycles,
discontinuation rate
• Rate of successful PBSC collection (>= 2x106 CD34+ cells/kg) after the third
cycle of BV-R-DHAP
Phase 2 part
Secondary efficacy endpoints
• Overall response rate (PR + CR) after the third cycle of BV-R-DHAP salvage
therapy (based on the results of the FDG-PET/CT scan)
• Overall response rate (PR + CR) after ASCT (based on the results of the
FDG-PET/CT scan)
• Metabolic CR rate (PET-CT) after ASCT
• Fraction of patients (CR/PR) eligible for ASCT who actually undergo ASCT
• Progression free survival (PFS), Event free survival (EFS), Overall survival
(OS
Secondary feasibility/toxicity endpoints
• (Serious) Adverse Events during the combination treatment
• Time to hematological recovery after each cycle of BV + R-DHAP
• Administration of treatment: dose reductions, interval between courses,
discontinuation rate
• Rate of successful PBSC collection (>= 2 x106 CD34+ cells/kg) after the second
or third cycle of BV-R-DHAP
• Time to hematological recovery after ASCT
• (Serious) Adverse Events after ASCT
Background summary
Patients with primary refractory or relapse diffuse large B-cell lymphoma
(DLBCL) after R-CHOP have a dismal prognosis. Only 25% long term survivors are
observed after salvage with high-dose chemotherapy followed by autologous stem
cell transplantation (ASCT). CD30 expression is observed in 30% of
refractory/relapse DLBCL. Monotherapy with brentuximab vedotin is effective in
relapse CD30 positive DLBCL. The addition of brentuximab vedotin to R-DHAP
might improve the prognosis of these patients.
Study objective
This study has been transitioned to CTIS with ID 2023-510556-22-00 check the CTIS register for the current data.
Lead in phase 1
Primary objective:
• To identify the feasibility and RDL (recommended dose level) of brentuximab
vedotin in combination with R-DHAP
Secondary objective:
• To assess the toxicity of brentuximab vedotin in combination with R-DHAP
• To assess the success rate of autologous peripheral blood stem cell harvest
after brentuximab vedotin-R-DHAP
Phase 2
Primary objective:
• To evaluate the efficacy of the combination of brentuximab vedotin and
R-DHAP as salvage treatment in relapse/refractory DLBCL patients in terms of
metabolic CR rate after the third cycle
• To establish the rate of CTCAE grade 3/4 non-hematological toxicity,
including neurotoxicity after each cycle of brentuximab vedotin-R-DHAP
Secondary objectives:
• To asses the overall response rate (ORR) after 3 cycles and after ASCT
• To assess the toxicity profile of brentuximab vedotin in combination with
R-DHAP
• To assess hematological recovery after each cycle of brentuximab
vedotin-R-DHAP
• To assess the success rate of harvesting an autologous peripheral blood stem
cell graft
• To assess the fraction of patients (CR/PR) eligible for ASCT who actually
undergo ASCT
• To assess peripheral blood neutrophil and platelet recovery after ASCT
• To evaluate the progression free survival (PFS), event free survival (EFS),
and overall survival (OS)
• To identify predictive factors for response, PFS, EFS and OS (exploratory
analysis)
Study design
Phase I-II, multicenter, prospective, non-randomized
Intervention
Patients will receive brentuximab vedotin in combination with R-DHAP, followed
in responsive patients by high dose chemotherapy and ASCT
Study burden and risks
The prognosis of patients with refractory and relapse DLBCL is dismal. Only 25%
long term survivors are observed after salvage with high-dose chemotherapy
followed by autologous stem cell transplantation (ASCT). In approximately 30%
of relapse DLBCL the CD30 antigen is expressed. Brentuximab vedotin has shown
promising activity in DLBCL after relapse. Addition of brentuximab vedotin may
improve the prognosis for these patients.The hypothesis of this study is that
combination treatment with brentuximab vedotin and R-DHAP will induce higher
metabolic CR rates. Increasing metabolic CR rates prior to ASCT is expected to
improve PFS and OS. Risk for the patient relate to drug specific side-effects,
in particular relevant hematological toxicity and increased risk of
polyneuropathy. Patients will undergo extra diagnostic procedures, such as
extra laboratory controls (blood counts and chemistry), one extra PET-CT scan
and two extra CT scans.
VUMC, HOVON Centraal Bureau, De Boelelaan 1117
Amsterdam 1081 HV
NL
VUMC, HOVON Centraal Bureau, De Boelelaan 1117
Amsterdam 1081 HV
NL
Listed location countries
Age
Inclusion criteria
• CD30 positive DLBCL, i.e. more than 1% of DLBCL cells CD30 positive according to the WHO classification 2008:.
- CD30 positive DLBCL, including EBV positive DLBCL
- CD30 positive primary mediastinal B-cell lymphoma
• Primary refractory to or in first relapse after first line therapy with R-CHOP or R-CHOP-like therapy
• Age >= 18 years (upper age limit for ASCT at the discretion of the participating center)
• Measurable disease: on CT scan at least 1 lesion/node with a long axis of > 1.5 cm and at least one positive lesion on 18F-FDG PET scan
• WHO performance status 0-2
• Adequate hepatic function:
• Adequate renal function:
• Adequate bone marrow function:
• Hemoglobin must be >= 8 g/dL (5.0 mmol/L), transfusion is allowed
• Eligible for high-dose chemotherapy and ASCT
• Resolution of relevant toxicities from first-line therapy
• Life expectancy of > 3 months with treatment
• Negative pregnancy test at study entry, if applicable
• Female patient is either post-menopausal for at least 1 year before screening visit or surgically sterile or if of childbearing potential, agrees to practice 2 effective methods of contraception, at the same time, or agrees to completely abstain from heterosexual intercourse, from the time of signing the informed consent through 12 months after the last dose of study drug
• Male patients, even if surgically sterilized, (i.e. status post vasectomy) agree to practice effective barrier contraception, or agrees to completely abstain from heterosexual intercourse, during the entire study period and through 12 months after the last dose of study drug
• Written informed consent
• Patient is capable of giving informed consent
Exclusion criteria
• Peripheral sensory or motor neuropathy grade >= 2
• Known cerebral or meningeal disease (NHL or any other etiology), including signs and symptoms of progressive multifocal leukoencephalopathy (PML)
• Symptomatic neurological disease compromising normal activities of daily living or requiring medications
• Transformed lymphoma
• DLBCL after organ transplantation
• Immunodeficiency-associated B-cell lymphoproliferative disease
• Use of other investigational agents within at least 5 half-lives of the most recent agent used prior to study entry
• Treatment with myelosuppressive chemotherapy or biological therapy <= 4 weeks before study entry
• Female patients who are breast feeding
• History of another 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
• Known hypersensitivity to recombinant proteins, murine proteins, or to any excipient contained in the drug formulation of brentuximab vedotin
• Active hepatitis B or C infection
• HIV positivity
• 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 protocol
• Major organ dysfunction, unless NHL-related
• Patients who have any severe and/or uncontrolled medical condition or other conditions that could affect their participation in the study
• Thyroid abnormalities when thyroid function cannot be maintained in the normal range by medication
• Current participation in another clinical trial interfering with this trial
• Any psychological, familial, sociological and geographical condition potentially hampering compliance with the study protocol and follow-up schedule
• Claustrophobia to the extent that PET-CT is impossible
Design
Recruitment
Medical products/devices used
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
Register | ID |
---|---|
EU-CTR | CTIS2023-510556-22-00 |
EudraCT | EUCTR2016-001211-21-NL |
CCMO | NL58172.078.16 |