Non Hodgkin Lymphoma Clinical Trial
Clinical Trial of Brentuximab Vedotin in Classical Hodgkin Lymphoma
Summary
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.
Full 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.
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
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There are 76 Locations for this study
Fountain Valley California, 92708, United States
Aurora Colorado, 80012, United States
Colorado Springs Colorado, 80909, United States
Denver Colorado, 80218, United States
Fort Collins Colorado, 80528, United States
Grand Junction Colorado, 81501, United States
Miami Florida, 33176, United States
Saint Petersburg Florida, 33705, United States
Maywood Illinois, 60153, United States
Niles Illinois, 60714, United States
Peoria Illinois, 61615, United States
Boston Massachusetts, 02114, United States
Boston Massachusetts, 02215, United States
Detroit Michigan, 48201, United States
Detroit Michigan, 48202, United States
Edina Minnesota, 55435, United States
Saint Louis Missouri, 63110, United States
Brick New Jersey, 08724, United States
Freehold New Jersey, 07728, United States
Hackensack New Jersey, 07601, United States
Howell New Jersey, 07731, United States
Morristown New Jersey, 07960, United States
Mount Holly New Jersey, 08060, United States
Somerville New Jersey, 08876, United States
Sparta New Jersey, 07871, United States
Albany New York, 12208, United States
Mount Kisco New York, 10549, United States
New York New York, 10029, United States
New York New York, 10065, United States
Purchase New York, 10577, United States
Westbury New York, 11590, United States
Winston-Salem North Carolina, 27157, United States
Cincinnati Ohio, 45242, United States
Cleveland Ohio, 44106, United States
Cleveland Ohio, 44195, United States
Toledo Ohio, 43623, United States
Eugene Oregon, 97401, United States
Portland Oregon, 97213, United States
Charleston South Carolina, 29425, United States
Knoxville Tennessee, 37920, United States
Nashville Tennessee, 37203, United States
Austin Texas, 78705, United States
Dallas Texas, 75230, United States
Flower Mound Texas, 75028, United States
Fort Sam Houston Texas, 78234, United States
Fort Worth Texas, 76104, United States
Houston Texas, 77030, United States
San Antonio Texas, 78240, United States
Tyler Texas, 75702, United States
Salt Lake City Utah, 84112, United States
Fairfax Virginia, 22031, United States
Salem Virginia, 24153, United States
Kennewick Washington, 99336, United States
Olympia Washington, 98506, United States
Seattle Washington, 98109, United States
Adelaide Other, 5000, Australia
Ballarat Other, 3350, Australia
Clayton Other, 3168, Australia
Victoria Other, 3002, Australia
Hradec Kralove Other, 500 0, Czechia
Praha 10 Other, 100 3, Czechia
Brescia Other, 25123, Italy
Pavia Other, 27100, Italy
Siena Other, 53100, Italy
Torino Other, 10126, Italy
Krakow Other, 30-51, Poland
Barcelona Other, 08003, Spain
Barcelona Other, 08035, Spain
Barcelona Other, 08908, Spain
Girona Other, 17007, Spain
Madrid Other, 28040, Spain
Madrid Other, 28041, Spain
Majadahonda Other, 28222, Spain
Oviedo Other, 33011, Spain
Salamanca Other, 37007, Spain
Valencia Other, 46026, Spain
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