Follicular Lymphoma Clinical Trial
Official title:
Phase II Study of Brentuximab Vedotin in Combination With Bendamustine and Rituximab, in Patients With CD30 Positive, Relapsed or Refractory B Cell Non-Hodgkin Lymphoma (NHL)
This phase II trial studies how well brentuximab vedotin, bendamustine, and rituximab work in treating patients with B-cell non-Hodgkin lymphoma that has returned after a period of improvement or has not responded to previous treatment. Monoclonal antibody-drug conjugates, such as brentuximab vedotin, use antibody to target chemotherapy in cancer cells. Drugs used in chemotherapy, such as bendamustine, work in different ways to kill cancer cells. Monoclonal antibodies, such as rituximab, kill the cancer cells directly, but also harness the immune system to kill the cancer cells. Adding brentuximab to rituximab may improve response rates in CD30 positive, CD20 positive Relapsed Refactory NHL.
PRIMARY OBJECTIVES:
I. Complete response (CR) rate and overall response rate (ORR) for patients with relapsed
aggressive high-risk non-Hodgkin lymphoma (NHL) treated with brentuximab vedotin,
bendamustine and rituximab (S-BR).
SECONDARY OBJECTIVES:
I. To estimate 2-year progression-free survival (PFS). II. To evaluate rate of positron
emission tomography (PET)-CR and correlation to 2 year PFS.
III. To evaluate the toxicity of six cycles of S-BR. IV. To evaluate mobilization, stem cell
collection, engraftment in patients that proceed to salvage autologous stem cell transplant
(ASCT).
SCIENTIFIC OBJECTIVES:
I. To evaluate percentage of tumor cells that are positive or negative for cluster of
differentiation (CD)30 by immunohistochemistry (IHC), the subcellular location of CD30
(membrane or cytoplasmic only with absence of membrane expression), intensity of scoring,
and correlating with clinical outcomes.
II. To evaluate gene expression profiling (GEP) by Nanostring Technology and comparing
expression levels of target genes in CD30 membrane positive, CD30 cytoplasmic only positive
or CD30 negative tumor cells.
III. To evaluate correlation between mutations identified through next generation sequencing
(NGS) including ribonucleic acid (RNA) sequencing of the tumor transcriptome, and
correlating to GEP and CD30 IHC, and correlating to clinical outcomes.
IV. To evaluate the levels of soluble CD30 at baseline and in response to treatment.
SCHEDULE:
Patients receive brentuximab vedotin intravenously (IV) over 30 minutes on day 1,
bendamustine IV over 30-60 minutes on days 1-2, and rituximab IV on day 2. Treatment repeats
every 21 days for up to 6 courses in the absence of disease progression or unacceptable
toxicity.
After completion of study treatment, patients are followed up every 3 months for 2 years.
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