Brentuximab + AVD Chemotherapy for Hodgkin's Lymphoma

Recruiting in Palo Alto (17 mi)

+10 other locations

Anita Kumar, MD - MSK Lymphoma Specialist

Overseen byAnita J Kumar

Age: 18+

Sex: Any

Travel: May Be Covered

Time Reimbursement: Varies

Trial Phase: Academic

Waitlist Available

Sponsor: Memorial Sloan Kettering Cancer Center

No Placebo Group

Breakthrough Therapy

Trial Summary

What is the purpose of this trial?

The purpose of this study is to compare the outcomes across the 4 different treatment groups. The investigators hope that this treatment will improve the ability to cure more patients with HL and also limit the long-term side effects from the treatment. Although eliminating radiation in cohort 4 will eliminate the risk for long-term side effects from radiation, it is also possible that with BV+AVD chemotherapy alone there may be an increased risk of the Hodgkin lymphoma coming back after initial treatment.

Eligibility Criteria

This trial is for adults over 18 with early stage, high-risk Hodgkin lymphoma. Participants must have FDG-avid and measurable disease, a specific size of lymph node mass, and agree to birth control if applicable. Excluded are those with certain blood counts, liver or kidney issues, pregnant or breastfeeding women, HIV/AIDS patients, individuals with peripheral neuropathy or on long-term steroids.

Inclusion Criteria

I am 18 years old or older.

Females of childbearing age must be on an acceptable form of birth control per institutional standards

I have a lymph node mass larger than 7.0 cm.

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Exclusion Criteria

Known history of testing positive for human immunodeficiency virus (HIV) or known acquired immunodeficiency syndrome (AIDS)

My heart's pumping ability is reduced.

My nerve damage does not severely affect my daily activities.

See 7 more

Treatment Details

Interventions

Brentuximab vedotin (SGN-35) (Monoclonal Antibodies)
Consolidation Volume RT (CVRT) (Radiation)
Dacarbazine (Chemotherapy)
Doxorubicin HCL (Chemotherapy)
Involved-Site Radiation Therapy (ISRT) (Radiation)
Vinblastine Sulfate (Chemotherapy)

Trial OverviewThe study tests Brentuximab Vedotin combined with AVD chemotherapy against three other treatment groups involving radiation therapy and interim PET scans. The goal is to cure more patients while reducing long-term side effects from treatments.

Participant Groups

4Treatment groups

Experimental Treatment

Group I: Cohort 4Experimental Treatment5 Interventions

Patients will have early stage, unfavorable risk classical Hodgkin lymphoma with disease bulk defined as the presence of any lymph node mass with transverse maximal diameter \> 7.0 cm or coronal maximal diameter \> 7.0 cm. In this cohort. Pts will receive 4 cycles of brentuximab vedotin \& AVD chemo. Brentuximab vedotin, 1.2 mg/kg, will be administered on days 1 \& 15 of each 28 day cycle. Doxorubicin 25 mg/m2, Vinblastine 6 mg/m2, \& Dacarbazine 375 mg/m2 will be administered on days 1 \& 15 of each 28 day cycle. Pts whose PET scan is negative after 4 cycles of brentuximab vedotin \& AVD chemotherapy will not receive RT. Pts whose PET scan is positive after 4 cycles of brentuximab vedotin \& AVD chemo, but subsequent biopsy is neg, will also receive no RT. Upon MSK PI approval, if the simulation can't be covered by the institution or the pts insurance, a diagnostic IV contrast CT neck \& diagnostic IV contrast CT CAP scan will be done in addition to the FDG-PET done after 4 cycles of chemo.

Group II: Cohort 3Experimental Treatment6 Interventions

Group III: Cohort 2Experimental Treatment6 Interventions

Patients with early stage, unfavorable risk Hodgkin lymphoma. The definition of disease bulk, one of the unfavorable risk features, has been updated, and is defined as the presence of any lymph node mass with transverse maximal diameter \> 7.0 cm OR coronal maximal diameter \> 7.0 cm. Patients will receive 4 cycles of brentuximab vedotin \& AVD chemotherapy. Brentuximab vedotin, 1.2 mg/kg, will be administered on days 1 and 15 of each 28 day cycle. Doxorubicin 25 mg/m2, Vinblastine 6 mg/m2, and Dacarbazine 375 mg/m2 will be administered on days 1 \& 15 of each 28 day cycle. This may be followed by 20 Gy involved site radiotherapy.

Group IV: Cohort 1 (completed accrual)Experimental Treatment6 Interventions

Patients received 4 cycles of brentuximab vedotin \& AVD chemotherapy. Brentuximab vedotin, 1.2 mg/kg, will be administered on days 1 and 15 of each 28 day cycle. Doxorubicin 25 mg/m2, Vinblastine 6 mg/m2, \& Dacarbazine 375 mg/m2 will be administered on days 1 and 15 of each 28 day cycle. This may be followed by 30 Gy involved site radiotherapy. Involved site radiotherapy should be initiated from 12 days to 42 days after completion of chemotherapy. It is mandatory to administer prophylactic growth factor support starting with cycle 1. Choice of growth factor and dosing can be determined at the discretion of the treating physican.