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CLASSICAL HODGKIN LYMPHOMAPhase 1/2NCT02243436

Brentuximab Vedotin in Pre-transplant Induction and Consolidation for Relapsed or Refractory Hodgkin Lymphoma

A Phase 1/2 study testing Brentuximab Vedotin, Etoposide and Soludomerin in people with CLASSICAL HODGKIN LYMPHOMA, run by Grupo Español de Linfomas y Transplante Autólogo de Médula Ósea at 14 sites in Spain.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Phase I trial aimed to determine the Maximum Tolerable Dose of the BV in combination with ESHAP in relapsed/resistant Hodgkin Lymphona patients and to evaluate response to treatment with BV-ESHAP as salvage regimen prior to autologous stem cell transplantation. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
CLASSICAL HODGKIN LYMPHOMA
What is being tested?
Brentuximab Vedotin, Etoposide and Soludomerin
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
67 participants
Where
14 sitesSpain
Study dates
11 Nov 2014to 14 Jan 2019
Phase
Phase 1/2
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Patients must have fully recovered from the acute toxic effects of all prior chemotherapy, immunotherapy, or radiotherapy prior to entering this study
  • Histologically confirmed relapsed or refractory classical HL after first line chemotherapy. CD30 has to be positive
  • Age 18 to 65 years. Patient >65 years old with ECOG ≤1 and absence of comorbidities will be included in the study
  • ECOG ≤2
  • Karnofsky performance status ≥ 60
  • No major organ dysfunction
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  • Biopsy at HL relapse or when refractoriness disease is diagnosed must be done prior to BV-ESHAP. If biopsy cannot be performed, tumor biopsy at initial diagnosis of HL must be available to be revised
  • Absence of prior history of other malignant diseases, except:
  • Basal cell carcinoma of the skin or uterine "in situ" carcinoma adequately treated Any curable neoplasia adequately treated that has achieved complete response and has remained in such status longer than 3 years
  • Female patient is either post-menopausal for at least 1 year before the screening visit or surgically sterile or if of childbearing potential, agree 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, 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
  • Life-expectancy >3 months
  • Platelet count ≥75•109/L (or 20 if due to Bone Marrow [BM] infiltration) absolute neutrophil count ≥1.5•109/L (or 0.5 if due to BM infiltration), and hemoglobin ≥ 8g/dL
  • Total Bilirubin: <1.5 x UNL, unless clearly related to the disease (Gilbert disease will be ruled out from this point)
  • AST and ALT: <3 xUNL except liver infiltration
  • Serum creatinine: < 2.0 mg/dL and/or creatinine clearance or calculated creatinine clearance > 40 mL/minute
  • Serum sodium >130 mmol/L
  • Voluntary written informed consent

Who cannot join

  • Current active hepatic or biliary disease (with exception of patients with Gilbert's syndrome, asymptomatic gallstones, liver metastases or stable chronic liver disease per investigator assessment)
  • Serious medical or psychiatric illness likely to interfere with participation in this clinical study
  • Patients that have been treated previously with anti-CD30 monoclonal antibodies
  • Myocardial infarction within 6 months prior to enrollment. Heart failure NYHA Class III-IV, severe uncontrolled ventricular arrhythmias, or electrocardiographic evidence of acute ischemia or active conduction system abnormalities. Recent evidence (within 6 months) of a left-ventricular ejection fraction <50%
  • Peripheral neuropathy or neuropathic pain grade ≥ 2
  • Known cerebral or meningeal disease, including signs or symptoms of PML
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  • Symptomatic neurologic disease compromising normal activities of daily living or requiring medication
  • Known hypersensitivity to recombinant proteins, murine proteins, or to any excipient contained in brentuximab vedotin
  • Pregnant women or in breast-feeding period, or adults in childbearing period not using an effective contraception method
  • Treatment with any known non-marketed drug substance or experimental therapy within the longer of 5 terminal half-lives or 4 weeks prior to enrollment or currently participating in any other interventional clinical study
  • Chronic or current infectious disease requiring systemic antibiotics, antifungal, or antiviral treatment within two weeks prior to first study drug dose
  • History of significant cerebrovascular disease in the past 6 months or ongoing event with active symptoms or sequelae
  • HIV positive
  • Significant concurrent, uncontrolled medical condition which may represent a risk for the patient
  • Positive serology for HBV
  • Positive serology for HCV

Trial locations and contacts

14 sites in 1 country.

14 sites in 1 country

Spain14 sites
  • Institut Català d'Oncologia, Hospital Germans Trias i Pujol

    Badalona, Barcelona, 08916

  • Hospital del Mar

    Barcelona, 08003

  • Hospital Clinic i Provincial de Barcelona

    Barcelona, 08036

  • Institut Català d'Oncologia, Hospital Duran i Reynals

    L'Hospitalet de Llobregat, Barcelona, 08908

  • Hospital General Universitario Gregorio Marañon

    Madrid, 28007

  • Hospital Universitario Ramón y Cajal

    Madrid, 28034

  • Hospital Universitario 12 de Octubre

    Madrid, 28041

  • Hospital Universitario La Paz

    Madrid, 28046

  • Hospital Universitario Central de Asturias

    Oviedo, Principality of Asturias, 33006

  • Hospital Son Espases

    Palma, Balearic Islands

  • Hospital Universitario de Salamanca

    Salamanca, 37007

  • Hospital Universitario de Canarias

    Santa Cruz de Tenerife, 38320

  • Hospital Universitario Virgen del Rocío

    Seville, 41013

  • Hospital Clínico de Valencia

    Valencia, 46010

Other trials in Spain

About this study

Official title: Phase I-II Clinical Trial for the Evaluation of Brentuximab Vedotin Plus Etoposide, Solumoderin (Methylprednisolone), High Dose ARA-C (Cytarabine) and Cisplatin in the Transplant and Post-transplant Management for Relapsed or Refractory Classical Hodgkin Lymphoma Patients

Phase I trial aimed to determine the Maximum Tolerable Dose of the BV in combination with ESHAP in relapsed/resistant Hodgkin Lymphona patients and to evaluate response to treatment with BV-ESHAP as salvage regimen prior to autologous stem cell transplantation.

Read the detailed description

Most patients suffering from Hodgkin's lymphoma (HL) can be successfully treated with standard chemo- and/or radiotherapy. However, in patients with refractory disease/relapsing after first line of therapy, conventional-dose chemotherapy regimens induce low remission rates, with long-term disease free survival not higher than 10% of patients.

High-dose chemotherapy followed by autologous stem cell transplantation (ASCT) has become the standard treatment for these patients. This treatment approach results in long-term remissions in approximately 40-50% of relapsed patients, and in up to 25-30% of those with primary refractory disease. The possibility of a cure depends on several prognostic factors, however, in almost all series, the strongest prognostic factor has been the disease status before ASCT. Patients with HL who do not achieve complete remission (CR) after induction chemotherapy and those with unresponsive relapse have a very poor prognosis. Therefore, the choice of a very active pre-transplant salvage chemotherapy regimen is extremely important to improve results after ASCT. In addition, this activity should also be combined with a good stem cell mobilizing potential and low toxicity profiled.

Several pre-transplant salvage regimens for refractory/relapsed HL are currently used with an overall response (OR) and CR rates ranging from 60% to 88% and from 17% to 49%, respectively. No randomized trial exists comparing the effectiveness of these regimens. ESHAP (Etoposide, Solumoderin (methylprednisolone), Ara-C (Cytarabine) and cisplatin) is one of the most commonly used regimens. ESHAP induces an OR and CR of 73% and 41%, respectively, with 5% toxic deaths. In the present study, a combination of ESHAP plus Brentuximab Vedotin (BV) is proposed as pre-transplant therapy with the aim to improve the CR rate before ASCT.

HL is characterized by the presence of CD30-positive Hodgkin Reed-Sternberg cells. The antibody-drug conjugate BV delivers the highly potent antimicrotubule agent monomethyl auristatin E (MMAE) to CD30-positive malignant cells by binding specifically to CD30 on the cell surface and releasing MMAE inside the cell via lysosomal degradation.

Binding of MMAE to tubulin results in apoptotic death of the CD30 expressing tumor cell.

Being tested
Brentuximab Vedotin, Etoposide, Soludomerin, Cisplatin, Ara C
Keywords
CLASSICAL HODGKIN LYMPHOMA, HODGKIN LYMPHOMA, LYMPHOMA, HL
Medical subject headings
Hodgkin Disease, Lymphoma

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Brentuximab VedotinDrug

    Also called ADCETRIS

    Brentuximab Vedotin, 0.9mg/kg, 1.2mg/kg, 1.8mg/kg, day 1

  • EtoposideDrug

    Intravenose use, 40mg/m2/day, on days 1 to 4

  • SoludomerinDrug

    Also called Methylprednisolone

    Intravenous use, 250mg/day, on days 1 to 4

  • CisplatinDrug

    Intravenous use, 25mg/m2/day, on days 1 to 4

  • Ara CDrug

    Also called Cytarabine

    Intravenous use, 2g/m2, day 5

Study groups in NCT02243436
Study groupRoleWhat they receive
BV-ESHAPExperimental1. - 3 cycles every 21 days: * Brentuximab Vedotin, on day 1 (BV will be administered at three different doses 0.9mg/kg, 1.2mg/kg, 1.8mg/kg) * Etoposide 40 mg/m2/day, on days 1 to 4 * Soludomerin (methylprednisolone) 250 mg/day, on days 1 to 4 * Cisplatin 25 mg/m2/day, on days 1 to 4 * Ara C (cytarabine) 2 g/m2, on day 5 2. - A fourth dose of BV will be given 21 days after the third BV dose during the evaluation of response before the transplant. 3. - Autologous peripheral blood stem cell transplant 4. - A fifth dose of BV (1.8mg/kg) will be given on between day 28 and 35 post-transplant, followed by two additional doses (1.8mg/kg) every 3 weeks, to complete a total of 7 BV infusions.
Receives: Drug: Brentuximab Vedotin; Drug: Etoposide; Drug: Soludomerin; Drug: Cisplatin; Drug: Ara C

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Recommended dose

    During phase I, defined as the maximum Tolerable Dose of the BV in combination with ESHAP in relapsed/resistant HL patients.

    Measured: Day 21 of cycle 1 (3 weeks after start of treatment)

  2. Global response rate prior to ASCT

    During phase II, Global response rate after BV-ESHAP as salvage regimen prior to ASCT.

    Measured: 9 weeks (after start of treatment)

  3. Complete response

    Percentage of patients with complete response rate after BV-ESHAP as salvage regimen prior to ASCT.

    Measured: 9 weeks (after start of treatment)

Secondary outcomes (11)
  1. Toxicity according to the CTC criteria

    To determine the toxicity of BV-ESHAP regimen

    Measured: Prior every cycle, 14th day of first three cycles, at week 12, 16, 19, 22, 25, 31. Every 12 weeks for 2 years and then every 24 week up to 5 years.

  2. Stem cell mobilization capacity

    To assess the stem cell mobilization capacity of the BV-ESHAP regimen: determine the expanse and effectiveness of the extraction of stem cells from peripheral blood.

    Measured: After first or second cycle of treatment

  3. Transplant-related mortality (TRM)

    Measured: Prior every cycle, 14th day of first three cycles, at week 12, 16, 19, 22, 25, 31. Every 12 weeks for 2 years and then every 24 week up to 5 years.

  4. Overall Survival (OS)

    Percentage of patients alive after first dose of treatment through follow-up

    Measured: Prior every cycle, 14th day of first three cycles, at week 12, 16, 19, 22, 25, 31. Every 12 weeks for 2 years and then every 24 week up to 5 years.

  5. Progression free survival (PFS)

    Percentage of patients without progression of disease

    Measured: Prior every cycle, 14th day of first three cycles, at week 12, 16, 19, 22, 25, 31. Every 12 weeks for 2 years and then every 24 week up to 5 years.

  6. Event-Free Survival

    Percentage of patients without event

    Measured: Prior every cycle, 14th day of first three cycles, at week 12, 16, 19, 22, 25, 31. Every 12 weeks for 2 years and then every 24 week up to 5 years.

  7. Time to HL Progression

    Measured: Prior every cycle, 14th day of first three cycles, at week 12, 16, 19, 22, 25, 31. Every 12 weeks for 2 years and then every 24 week up to 5 years.

  8. Disease-Free Survival

    Measured: Prior every cycle, 14th day of first three cycles, at week 12, 16, 19, 22, 25, 31. Every 12 weeks for 2 years and then every 24 week up to 5 years.

  9. Response Duration

    Length of time between date of evidenced response and progression of disease or death

    Measured: Prior every cycle, 14th day of first three cycles, at week 12, 16, 19, 22, 25, 31. Every 12 weeks for 2 years and then every 24 week up to 5 years.

  10. Lymphoma-Specific Survival

    Measured: Prior every cycle, 14th day of first three cycles, at week 12, 16, 19, 22, 25, 31. Every 12 weeks for 2 years and then every 24 week up to 5 years.

  11. Time to Next Treatment

    Measured: Prior every cycle, 14th day of first three cycles, at week 12, 16, 19, 22, 25, 31. Every 12 weeks for 2 years and then every 24 week up to 5 years.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted18 Sep 2014 (estimated)
  2. Study start11 Nov 2014
  3. Primary completionJan 2019
  4. Study completion14 Jan 2019

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 1/2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
67 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02243436
Sponsor's protocol ID
BRESHAP-GELTAMO.LH-2013
Other IDs
2014-000835-17, 2014
Status last verified
Apr 2019
First submitted
27 Aug 2014
Last updated
24 Apr 2019
Results posted
No
Data monitoring committee
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A Phase 1/2 study testing Brentuximab Vedotin, Etoposide and Soludomerin in people with CLASSICAL HODGKIN LYMPHOMA, run by Grupo Español de Linfomas y Transplante Autólogo de Médula Ósea at 14 sites in Spain.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 18 inclusion and 16 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 24 Apr 2019. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 14 sites in Spain. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this combined phase mean?

Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Recommended dose (time frame: Day 21 of cycle 1 (3 weeks after start of treatment)). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 24 Apr 2019.

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