Brentuximab Vedotin and Gemcitabine Hydrochloride in Treating Younger Patients With Relapsed or Refractory Hodgkin Lymphoma

Official Title

A Phase 1/2 Study of Brentuximab Vedotin (SGN35) in Combination With Gemcitabine for Pediatric and Young Adult Patients With Relapsed or Refractory Hodgkin Lymphoma

Summary:

This phase I/II trial studies the side effects and the best dose of brentuximab vedotin when given together with gemcitabine hydrochloride and to see how well they work in treating younger patients with Hodgkin lymphoma that has returned or does not respond to treatment. Monoclonal antibodies, such as brentuximab vedotin, may find cancer cells and help kill them. Drugs used in chemotherapy, such as gemcitabine hydrochloride, work in different ways to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Giving brentuximab vedotin together with gemcitabine hydrochloride may kill more cancer cells.

Trial Description

Primary Outcome:

  • MTD of brentuximab vedotin in combination with gemcitabine hydrochloride defined as the maximum dose at which fewer than one-third of patients experience dose limiting toxicity (DLT) as assessed by National Cancer Institute (NCI) CTCAE v 4.0 (Part A)
  • Adverse events graded according to NCI CTCAE v4.0 (Part A)
  • Complete response (CR) rate
Secondary Outcome:
  • Describe disease response
  • Overall response rate (ORR) after four cycles of therapy
  • Describe proportion of Hodgkin Lymphoma (HL) patients with successful CD34+ stem cells collection after gemcitabine with brentuximab vedotin
  • Plasma level of thymus and activation-regulated chemokine (TARC)
  • Determine if micro ribonucleic acid (miRNA) profiles correlate with response to treatment
  • Frequency of the FcyRIIIa-158 V/F polymorphism
PRIMARY OBJECTIVES:
I. To estimate the maximum tolerated dose (MTD) and/or recommended Phase 2 dose of brentuximab vedotin in combination with gemcitabine administered every three weeks to children with relapsed or primary refractory Hodgkin lymphoma (HL). II. To define and describe the toxicities of brentuximab vedotin in combination with gemcitabine administered on this schedule. III. To determine the complete response (CR) rate after treatment with four cycles of gemcitabine with brentuximab vedotin among patients with relapsed or refractory HL. SECONDARY OBJECTIVES:
I. To preliminarily define the antitumour activity of brentuximab vedotin in combination with gemcitabine within the confines of a Phase 1 study. II. To describe the overall response rate (ORR) after 4 cycles of therapy among patients with relapsed or refractory HL. III. To describe the proportion of patients with HL able to mobilize an adequate yield of cluster of differentiation (CD) 34+ stem cells after gemcitabine with brentuximab vedotin. IV. To describe the relationship between disease response among patients with HL and changes in thymus and activation-regulated chemokine (TARC) during treatment, and to determine if specific micro ribonucleic acid (miRNA) profiles correlate with response to treatment. V. To describe the frequency of the Fc gamma receptor IIIa (FcγRIIIa)-158 valine (V)/phenylalanine (F) polymorphism among patients who experience pulmonary toxicity on this protocol. OUTLINE:

This is a phase I, dose-escalation study of brentuximab vedotin followed by a phase II study. (Phase I completed as of amendment 4) Patients receive brentuximab vedotin intravenously (IV) over 30 minutes on day 1 and gemcitabine hydrochloride IV over 100 minutes on days 1 and 8. Treatment repeats every 21 days for up to 15 more courses in the absence of disease progression or unacceptable toxicity. Patients with CR after any course may go off protocol therapy for stem cell transplant. After completion of study treatment, patients are followed up at 3, 6, 9, 12, 18, 24, 36, 48, and 60 months.

View this trial on ClinicalTrials.gov

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Resources

Canadian Cancer Society

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