Brentuximab Vedotin in Combination With CHEP in Patient With PTCL

Sponsor
Czech Lymphoma Study Group (Other)
Overall Status
Not yet recruiting
CT.gov ID
NCT05006664
Collaborator
(none)
33
Enrollment
7
Locations
1
Arm
36
Anticipated Duration (Months)
4.7
Patients Per Site
0.1
Patients Per Site Per Month

Study Details

Study Description

Brief Summary

A Phase II Open Label Study of Brentuximab Vedotin in Combination with CHEP in Patients with Previously Untreated CD30-expressing Peripheral T-cell Lymphomas (PTCL)

Condition or DiseaseIntervention/TreatmentPhase
Phase 2

Detailed Description

Efficacy assessments will be made according to the revised response criteria for malignant lymphoma based on the guidelines of the Lugano Classification (as reported by Cheson B et al. 2014) and will be based on investigator assessment Efficacy will be evaluated in terms of CR rate, ORR, PFS, EFS, OS.

The safety and tolerability of study treatment will be evaluated by means of AE reports (nature, severity, frequency, causality), performance status, physical examinations, ECG and laboratory safety evaluations.

Study Design

Study Type:
Interventional
Anticipated Enrollment :
33 participants
Allocation:
N/A
Intervention Model:
Single Group Assignment
Intervention Model Description:
Open label, single arm, combination - brentuximab vedotin+cyclophosphamide+doxorubicin+etoposide+prednisonOpen label, single arm, combination - brentuximab vedotin+cyclophosphamide+doxorubicin+etoposide+prednison
Masking:
None (Open Label)
Primary Purpose:
Treatment
Official Title:
A Phase II Open Label Study of Brentuximab Vedotin in Combination With CHEP in Patients With Previously Untreated CD30-expressing Peripheral T-cell Lymphomas (PTCL)
Anticipated Study Start Date :
Oct 1, 2021
Anticipated Primary Completion Date :
Oct 1, 2024
Anticipated Study Completion Date :
Oct 1, 2024

Arms and Interventions

ArmIntervention/Treatment
Experimental: Brentuximab Vedotin (Adcetris) in Combination with CHEP

Single arm, open label, Brentuximab Vedotin (Adcetris) in Combination with CHEP

Drug: Adcetris 50 MG Injection
Treatment by study drug Brentuximab Vedotin (Adcetris) in combination with CHEP.
Other Names:
  • Brentuximab Vedotin
  • Drug: Endoxan
    Treatment by study drug Cyclophosphamide (Endoxan) in combination.
    Other Names:
  • Cyclophosphamide
  • Drug: Doxorubicin
    Treatment by study drug Doxorubicin in combination.
    Other Names:
  • Doxorubicin Ebewe
  • Doxorubicin Medac
  • Drug: Etoposide
    Treatment by study drug Etoposide in combination.
    Other Names:
  • Etoposide ACCORD
  • Drug: Prednisone tablet
    Treatment by study drug Prednisone in combination.
    Other Names:
  • Prednison Léčiva
  • Outcome Measures

    Primary Outcome Measures

    1. PET-negative complete response (CR) rate at the end of treatment [6m months]

      Complete response

    Secondary Outcome Measures

    1. Type, incidence, severity, seriousness, and relatedness of treatment emergent adverse events. [38 months]

      Type, incidence, severity, seriousness, and relatedness of treatment emergent adverse events.

    2. Type, incidence, severity, seriousness, and relatedness of adverse events in the follow-up period. [38 months]

      ype, incidence, severity, seriousness, and relatedness of adverse events in the follow-up period.

    3. Progression-free survival (PFS) [12 months, 24 months]

      PFS is defined as the time from C1D1 to the date of the first clinically or radiologically or histologically/cytologically documented disease progression or death due to any cause. If a patient has not progressed, relapsed, or died as of the clinical cut-off date for final analysis, PFS will be censored on the date of last disease assessment when the patient is known to be alive and progression-free. If no tumour assessments are performed after the baseline visit or all post-baseline tumour assessment results have overall responses of "not evaluable", PFS will be censored on the date of study entry. Kaplan Meier plots will be used to estimate the distribution of PFS. The PFS probabilities at 12 and 24 months, and the associate 95% CI will be summarized.

    4. Overall survival (OS) [12months, 24 months,]

      Overall survival (OS) is defined as the time from C1D1 until death from any cause and documented by the date of death. Kaplan Meier plots will be used to estimate the distribution of OS. The OS probabilities at 12 and 24 months, and the associate 95% CI will be summarized for each treatment arm.

    5. Event-free survival (EFS) [12months, 24 months,]

      EFS is defined as the time from C1D1 to the date of the first clinically or radiologically documented disease progression or death due to any cause or start of new anti-lymphoma treatment (pre-planned radiotherapy or pre-planned HDT with ASCT are not counted as an event). If a patient has not progressed, relapsed, or died or started a new anti-lymphoma treatment at the analysis cut-off date, EFS will be censored on the date of last contact. Kaplan Meier plots will be used to estimate the distribution of EFS. The EFS probabilities at 12 and 24 months, and the associate 95% CI will be summarized.

    6. Objective Response Rate (ORR) at the end of treatment [38 months]

      The ORR is defined as the proportion of patients with CR or PR based on the response achieved at the end of treatment. The ORR along with 95% CI will be presented. The number and percentage of patients with CR and the number of patients with PR will also be presented.

    7. Rate of pre-planned upfront HDT/ASCT [38 months]

      The rate of pre-planned upfront HDT/ASCT is defined as the proportion of patients who underwent the pre-planned HDT/ASCT after end of treatment. The rate of pre-planned upfront HDT/ASCT along with 95% CI will be presented.

    8. Duration of response (DoR) [38 months]

      Duration of response (DoR) is defined as the time from the date of the first occurrence of a documented CR or PR to the date of disease progression, relapse or death from any cause (PFS), as assessed by the investigator for the subgroup of patients with the CR or PR assessment at EoT evaluation. For patients achieving a response who have not experienced disease progression, relapse, or died prior to the time of the analysis, the duration of response will be censored on the date of last disease assessment. Kaplan Meier plots will be used to estimate the distribution of DoR.

    Eligibility Criteria

    Criteria

    Ages Eligible for Study:
    18 Years and Older
    Sexes Eligible for Study:
    All
    Accepts Healthy Volunteers:
    No
    Inclusion Criteria:
    1. Age >18 years

    2. Written informed consent

    3. Histologically confirmed diagnosis of CD30-expressing PTCL. The following histological subtypes according to the Revised European-American Lymphoma World Health Organization (WHO) 2016 classification are eligible:

    4. Systemic anaplastic large cell lymphoma (ALCL) ALK+ with age-adjusted international prognostic index (aaIPI) ≥1

    5. Systemic anaplastic large cell lymphoma (ALCL) ALK-

    6. Peripheral T-cell lymphoma not otherwise specified (PTCL-NOS)

    7. Angioimmunoblastic T-cell lymphoma (AITL)

    8. Adult T-cell leukaemia/lymphoma (ATLL; acute and lymphoma types only, must be positive for human T cell leukaemia virus 1)

    9. Enteropathy-associated T-cell lymphoma (EATL)

    10. Hepatosplenic T-cell lymphoma

    11. Monomorphic epitheliotropic intestinal T-cell lymphoma (MEITCL)

    12. Indolent T-cell lymphoproliferative disorder (T-LPD) of the gastrointestinal (GI) tract

    13. Follicular T-cell lymphoma

    14. Nodal peripheral T-cell lymphoma with T-follicular helper (TFH) phenotype

    15. Positive CD30 expression by local pathology assessment.

    16. Patients must have at least one measurable disease site. The lesion must be fluorodeoxyglucose (FDG)-avid by PET and must have a greatest transverse diameter of ≥1.5 cm and greatest perpendicular diameter of ≥1.0 cm by CT, as assessed by the site radiologist.

    17. Eastern Cooperative Oncology Group (ECOG, Appendix B) performance status of 0 to 1

    18. Patient must be autologous stem cell transplant (ASCT)-eligible

    19. Patient must be appropriate candidate for treatment with anthracyclines

    20. Patient must have the following laboratory criteria at screening:

    21. Absolute neutrophil count (ANC) ≥ 1.0 x 109/L (unless secondary to bone marrow involvement by PTCL)

    22. Platelet count ≥ 50 x 109/L (unless secondary to bone marrow involvement by PTCL)

    23. Total serum bilirubin < 1.5 × upper limit of normal (ULN) unless secondary to Gilbert's syndrome or documented liver involvement by lymphoma. Patients with Gilbert's syndrome or documented liver involvement by lymphoma may be included if their total bilirubin is ≤3 × ULN

    24. Alanine transaminase (ALT), aspartate aminotransferase (AST) and alkaline phosphatase (ALP) ≤3 × ULN, or <5 × ULN in cases of documented liver involvement by lymphoma

    25. Serum creatinine clearance must be >40 mL/minute/1.73m2 either measured or calculated using a standard Cockcroft and Gault formula (Cockroft and Gault, 1976, Appendix A) and serum creatinine must be <175 µmol/L.

    26. Females of childbearing potential (FCBP) must not be pregnant or breastfeeding and must agree to use at least two effective contraception method during the study and for 6 months following the last dose of treatment.

    27. Male participants must: Males who have partners of childbearing potential must agree to use an effective contraceptive method during the study and for 6 months following the last dose of treatment.

    28. In the opinion of investigator, the patient must:

    29. be able to understand, give written informed consent, and comply with all study-related procedures, medication use, and evaluations

    30. not have a history of noncompliance in relation to medical regimens or be considered potentially unreliable and/or uncooperative

    Exclusion Criteria:
    1. Current diagnosis of any following lymphomas:

    2. Primary cutaneous CD30-positive T-cell lymphoproliferative disorders and lymphomas. Cutaneous ALCL with extracutaneous tumour spread beyond locoregional lymph nodes is eligible (previous single-agent treatment to address cutaneous and locoregional disease is permissible)

    3. Mycosis fungoides (MF), including transformed MF

    4. PTCL CD30-negative

    5. History of another primary invasive cancer, hematologic malignancy, or myelodysplastic syndrome that has not been in remission for at least 3 years. Exceptions are malignancies with a negligible risk of metastasis or death (e.g., 5-year OS ≥90%), such as carcinoma in situ of the cervix, non- melanoma skin carcinoma, localized prostate cancer, ductal carcinoma in situ, or Stage I uterine cancer.

    6. History of progressive multifocal leukoencephalopathy (PML).

    7. Known central nervous system (CNS) lymphoma involvement

    8. Prior treatment with brentuximab vedotin.

    9. Baseline peripheral neuropathy ≥Grade 2 (per the NCI CTCAE, Version 5.0)

    10. Left ventricular ejection fraction (LVEF) of < 45% or history of myocardial infarction ≤6 months, or symptomatic cardiac disease (including symptomatic ventricular dysfunction, symptomatic coronary artery disease, and symptomatic arrhythmias) or prior treatment with anthracyclines.

    11. Any uncontrolled Grade 3 or higher (per the National Cancer Institute's Common Terminology Criteria for Adverse Events, NCI CTCAE Version 5.0) viral, bacterial, or fungal infection within 2 weeks prior to the first dose of study treatment.

    12. Known human immunodeficiency virus (HIV) infection, hepatitis B surface antigen-positive status, or known or suspected active hepatitis C infection.

    13. History of hypersensitivity to any component of CHEP, to compounds of similar biological or chemical composition as brentuximab vedotin, and/or the excipients contained in any of the drug formulations of study treatment.

    14. Females who are pregnant or breastfeeding

    15. Planned CNS prophylaxis with intravenous high-dose methotrexate.

    Contacts and Locations

    Locations

    SiteCityStateCountryPostal Code
    1University Hospital BrnoBrnoCzechia625 00
    2University Hospital Hradec KrálovéHradec KrálovéCzechia500 05
    3University Hospital OlomoucOlomoucCzechia775 20
    4University Hospital OstravaOstravaCzechia70852
    5University Hospital PlzeňPlzeňCzechia323 00
    6University Hospital Kralovske VinohradyPrague 10Czechia100 00
    7Charles University General HospitalPrahaCzechia128 08

    Sponsors and Collaborators

    • Czech Lymphoma Study Group

    Investigators

    • Study Director: Magdaléna Zikmundová, MD, Ph.D., Subinvestigator, Protocol completation

    Study Documents (Full-Text)

    None provided.

    More Information

    Publications

    None provided.
    Responsible Party:
    Czech Lymphoma Study Group
    ClinicalTrials.gov Identifier:
    NCT05006664
    Other Study ID Numbers:
    • CLSG-PTCL-CHEPA
    First Posted:
    Aug 16, 2021
    Last Update Posted:
    Sep 1, 2021
    Last Verified:
    Aug 1, 2021
    Individual Participant Data (IPD) Sharing Statement:
    No
    Plan to Share IPD:
    No
    Studies a U.S. FDA-regulated Drug Product:
    No
    Studies a U.S. FDA-regulated Device Product:
    No
    Keywords provided by Czech Lymphoma Study Group
    Additional relevant MeSH terms:

    Study Results

    No Results Posted as of Sep 1, 2021