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Brentuximab Vedotin (SGN-35) in Transplant Eligible Patients With Relapsed or Refractory Hodgkin Lymphoma

Brentuximab Vedotin (SGN-35) in Transplant Eligible Patients With Relapsed or Refractory Hodgkin Lymphoma

Status
Completed
Phases
Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT01508312
Enrollment
66
Registered
2012-01-11
Start date
2012-01-05
Completion date
2024-03-14
Last updated
2025-10-21

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Hodgkin's Lymphoma

Keywords

CARBOPLATIN, ETOPOSIDE (VP-16), IFOSFAMIDE, SGN-35 (BRENTUXIMAB VEDOTIN), 11-142

Brief summary

The purpose of this study is determine if 2 cycles of SGN-35 can be used instead of ICE prior to autologous stem cell transplant (ASCT) for relapsed and refractory HL. There are 2 steps to treating patients with relapsed or refractory HL. The first step is to shrink the lymphoma with chemotherapy. The chemotherapy regimen commonly used is called ICE. ICE is a combination of chemotherapy drugs: ifosfamide, carboplatin, and etoposide. The second step of treatment is to give high doses of chemotherapy and radiation therapy followed by infusion of stem cells. This is called an ASCT. This study will focus on the first step of treatment for relapsed and refractory HL. ICE chemotherapy can cause many side effects. We believe that there are patients who can receive less toxic treatments and still do well. We have learned from past studies that \[18F\]FDG-PET scans (which we will call PET scans) can be used to predict who will do well after ASCT. PET scans are tests used to measure the metabolic activity of the disease. Patients without abnormal activity on their PET scan (negative PET scan) before ASCT are much more likely to be cured than those with activity on their PET scan (positive PET scan). In this study, instead of beginning with ICE chemotherapy, the patient will receive a new drug called Brentuximab vedotin (SGN-35). SGN-35 is a type of drug called an antibody drug conjugate. SGN-35 has 2 parts; a part that targets cancer cells (the antibody) and a cell killing part (the chemotherapy). The antibody part of SGN-35 sticks to a target called CD30. CD30 is an important molecule on some cancer cells (including Hodgkin lymphoma) and some normal cells of the immune system. The cell killing part of SGN-35 is a chemotherapy called monomethyl auristatin E (MMAE). It can kill cells that the antibody part of SGN-35 sticks to. Compared to ICE chemotherapy, SGN-has fewer side effects and does not require inpatient admission for treatment. We aim to determine whether patients can avoid treatment with ICE prior to ASCT. We will use the results of the PET scan to determine whether the patient needs additional chemotherapy before ASCT. If the PET scan is negative, the patient will be referred to ASCT and not receive ICE chemotherapy. If the PET scan is positive, the physician will discuss further treatment options with the patient.

Interventions

Patients will receive 2 cycles of weekly brentuximab vedotin, 1.2mg/kg on days 1, 8, and 15 of each 28 day cycle. Patients with pre-treatment positive bone marrow biopsies will have repeat bone marrow biopsies if the PET scan is negative. FDG-PET/CT will be repeated after 2 cycles of treatment within 1 week of the last dose of cycle 2. Patients with persistent abnormalities on FDG-PET/CT following 2 cycles of brentuximab vedotin will receive 2 cycles of augmented ICE. The first cycle of augmented ICE will be initiated 7-14 days after the last dose of SGN-35. FDG-PET/CT will be repeated within 7-14 days following the second cycle of augmented ICE. Stem cell mobilization can be performed following the first or second cycle of augmented ICE.

Patients will receive 2 cycles of weekly brentuximab vedotin, 1.2mg/kg on days 1, 8, and 15 of each 28 day cycle. FDG-PET/CT will be repeated after 2 cycles of treatment within 1 week of the last dose of cycle 2. Patients with pre-treatment positive bone marrow biopsies will have repeat bone marrow biopsies if the PET scan is negative. Patients with normalization of FDG-PET/CT and negative bone marrow biopsies following 2 cycles of brentuximab vedotin will undergo stem cell mobilization in preparation for ASCT.

Sponsors

Seagen Inc.
CollaboratorINDUSTRY
Hôpitaux Universitaires Henri Mondor, France
CollaboratorUNKNOWN
Memorial Sloan Kettering Cancer Center
Lead SponsorOTHER

Study design

Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
12 Years to 72 Years
Healthy volunteers
No

Inclusion criteria

* Histologic diagnosis of cd30 positive classical Hodgkin's lymphoma. * Primary refractory or relapsed disease proven by biopsy or fine needle aspiration (cytology) of an involved site. Pathology must be reviewed at MSKCC. * Relapse or refractory disease following doxorubicin or nitrogen mustard containing front-line therapy * Fluorodeoxyglucose (FDG)-avid disease by FDG-PET/CT and measurable disease of at least 1.5 cm by spiral CT, as assessed by the site radiologist. * Cardiac ejection fraction of greater than 45%, measured since last chemotherapy. * Hemoglobin-adjusted diffusing capacity for carbon monoxide of greater than 50% on pulmonary function testing, measured since last chemotherapy * Serum creatinine \< or = to 1.5 mg/dl; if creatinine \>1.5 mg/dl then the measured 12- or 24-hour creatinine clearance must be \>60 ml/minute. * ANC\>1000/μl and Platelets\>50,000/μl * Total bilirubin \< 2.0 mg/dl in the absence of a history of Gilbert's disease. * Females of childbearing age must be on an acceptable form of birth control. * Age between 12 and 72 * HIV I and II negative.

Exclusion criteria

* Received more than 1 prior treatment (combined modality therapy represents 1 treatment) for Hodgkin Lymphoma * Hepatitis B surface antigen positive or hepatitis B core antibody positive. * Known pregnancy or breast-feeding. * Medical illness unrelated to Hodgkin's Lymphoma, which, in the opinion of the attending physician and/or principal investigator, makes participation in this study inappropriate. * Peripheral neuropathy \> grade 2

Design outcomes

Primary

MeasureTime frameDescription
FDG-PET/CT Standardized Uptake Value at 12 Months12 monthsFollowing salvage therapy with brentuximab vedotin (SGN-35) alone or followed by augmented ICE chemotherapy.

Secondary

MeasureTime frameDescription
Overall Response Rate2 yearsOverall Response Rate (CR and PR rate) to brentuximab vedotin alone
Participants Evaluated for Toxicity2 years

Countries

United States

Participant flow

Participants by arm

ArmCount
Cohort 1: FDG-PET Abnormal
Patients will receive 2 cycles of weekly brentuximab vedotin and then undergo evaluation with FDGPET/CT. Patients with normalization of FDG-PET/CT will proceed to ASCT. Patients with persistent abnormalities on FDG-PET/CT will receive 2 cycles of augmented ICE chemotherapy followed by repeat FDG-PET/CT prior to ASCT. Following augmented ICE, patients with negative FDG-PET/CT will proceed to ASCT. Those with persistent abnormalities on FDG-PET/CT will be treated according to their physician's recommendations.
33
Cohort 1: FDG-PET Normalization
Patients will receive 2 cycles of weekly brentuximab vedotin and then undergo evaluation with FDGPET/CT. Patients with normalization of FDG-PET/CT will proceed to ASCT. Patients with persistent abnormalities on FDG-PET/CT will receive 2 cycles of augmented ICE chemotherapy followed by repeat FDG-PET/CT prior to ASCT. Following augmented ICE, patients with negative FDG-PET/CT will proceed to ASCT. Those with persistent abnormalities on FDG-PET/CT will be treated according to their physician's recommendations.
12
Cohort 2, Expansion Cohort: FDG-PET Abnormal
Patients will receive 2 cycles of weekly brentuximab vedotin and then undergo evaluation with FDGPET/CT. Patients with normalization of FDG-PET/CT will proceed to ASCT. Patients with persistent abnormalities on FDG-PET/CT will receive 2 cycles of augmented ICE chemotherapy followed by repeat FDG-PET/CT prior to ASCT. Following augmented ICE, patients with negative FDG-PET/CT will proceed to ASCT. Those with persistent abnormalities on FDG-PET/CT will be treated according to their physician's recommendations.
14
Cohort 2, Expansion Cohort: FDG-PET Normalization
Patients will receive 2 cycles of weekly brentuximab vedotin and then undergo evaluation with FDGPET/CT. Patients with normalization of FDG-PET/CT will proceed to ASCT. Patients with persistent abnormalities on FDG-PET/CT will receive 2 cycles of augmented ICE chemotherapy followed by repeat FDG-PET/CT prior to ASCT. Following augmented ICE, patients with negative FDG-PET/CT will proceed to ASCT. Those with persistent abnormalities on FDG-PET/CT will be treated according to their physician's recommendations.
6
Total65

Withdrawals & dropouts

PeriodReasonFG000FG001FG002FG003
Overall StudyAdverse Event0020
Overall StudyLack of Efficacy0010
Overall StudyLost to Follow-up1000
Overall StudyParticipant's Hodgkin's lymphoma relapsed, proven by a biopsy sample.0100
Overall StudyWithdrawal by Subject0010

Baseline characteristics

CharacteristicCohort 1: FDG-PET AbnormalTotalCohort 2, Expansion Cohort: FDG-PET NormalizationCohort 2, Expansion Cohort: FDG-PET AbnormalCohort 1: FDG-PET Normalization
Age, Continuous31 years33 years39 years33 years37 years
Ethnicity (NIH/OMB)
Hispanic or Latino
1 Participants5 Participants0 Participants2 Participants2 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
30 Participants58 Participants6 Participants12 Participants10 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
2 Participants2 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
Asian
1 Participants2 Participants0 Participants0 Participants1 Participants
Race (NIH/OMB)
Black or African American
1 Participants2 Participants0 Participants0 Participants1 Participants
Race (NIH/OMB)
More than one race
0 Participants0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants3 Participants0 Participants2 Participants1 Participants
Race (NIH/OMB)
White
31 Participants58 Participants6 Participants12 Participants9 Participants
Region of Enrollment
United States
33 Participants65 Participants6 Participants14 Participants12 Participants
Sex: Female, Male
Female
16 Participants34 Participants5 Participants9 Participants4 Participants
Sex: Female, Male
Male
17 Participants31 Participants1 Participants5 Participants8 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
3 / 470 / 18
other
Total, other adverse events
47 / 4718 / 18
serious
Total, serious adverse events
21 / 473 / 18

Outcome results

Primary

FDG-PET/CT Standardized Uptake Value at 12 Months

Following salvage therapy with brentuximab vedotin (SGN-35) alone or followed by augmented ICE chemotherapy.

Time frame: 12 months

ArmMeasureValue (GEOMETRIC_MEAN)
Cohort 1: FDG-PET AbnormalFDG-PET/CT Standardized Uptake Value at 12 Months69 Standardized Uptake Value (SUV)
Cohort 1: FDG-PET NormalizationFDG-PET/CT Standardized Uptake Value at 12 Months27 Standardized Uptake Value (SUV)
Cohort 2, Expansion Cohort: FDG-PET AbnormalFDG-PET/CT Standardized Uptake Value at 12 Months69 Standardized Uptake Value (SUV)
Cohort 2, Expansion Cohort: FDG-PET NormalizationFDG-PET/CT Standardized Uptake Value at 12 Months30 Standardized Uptake Value (SUV)
Secondary

Overall Response Rate

Overall Response Rate (CR and PR rate) to brentuximab vedotin alone

Time frame: 2 years

ArmMeasureCategoryValue (COUNT_OF_PARTICIPANTS)
Cohort 1: FDG-PET AbnormalOverall Response RateComplete Response/CR13 Participants
Cohort 1: FDG-PET AbnormalOverall Response RateNo CR20 Participants
Cohort 1: FDG-PET NormalizationOverall Response RateNo CR12 Participants
Cohort 1: FDG-PET NormalizationOverall Response RateComplete Response/CR0 Participants
Cohort 2, Expansion Cohort: FDG-PET AbnormalOverall Response RateComplete Response/CR4 Participants
Cohort 2, Expansion Cohort: FDG-PET AbnormalOverall Response RateNo CR10 Participants
Cohort 2, Expansion Cohort: FDG-PET NormalizationOverall Response RateComplete Response/CR0 Participants
Cohort 2, Expansion Cohort: FDG-PET NormalizationOverall Response RateNo CR6 Participants
Secondary

Participants Evaluated for Toxicity

Time frame: 2 years

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Cohort 1: FDG-PET AbnormalParticipants Evaluated for Toxicity33 Participants
Cohort 1: FDG-PET NormalizationParticipants Evaluated for Toxicity12 Participants
Cohort 2, Expansion Cohort: FDG-PET AbnormalParticipants Evaluated for Toxicity14 Participants
Cohort 2, Expansion Cohort: FDG-PET NormalizationParticipants Evaluated for Toxicity6 Participants

Source: ClinicalTrials.gov · Data processed: Mar 18, 2026