Mycosis Fungoides Clinical Trial
Official title:
Phase 1B Trial: Evaluation of the Safety of Adding Brentuximab Vedotin to Low-Dose Total Skin Electron Beam (TSEB) for Treatment of Patients With Mycosis Fungoides and Sézary Syndrome
The purpose of this study is to evaluate the cutaneous toxicity and treatment response associated with administering concurrent TSEB and brentuximab vedotin in patients with mycosis fungoides or Sézary Syndrome.
This study is a 2-cohort, open-label, phase 1B trial to evaluate the cutaneous toxicity,
overall toxicity, and treatment response associated with administering concurrent low-dose
TSEB and brentuximab vedotin in patients with mycosis fungoides or Sézary Syndrome. Duration
of complete skin response, DOCB, and tumor response in lymph nodes and blood will also be
evaluated. Additionally, skin-related QOL and neurotoxicity will be assessed.
Patients will be enrolled in 1 of 2 cohorts based on disease stage.
Cohort A will include patients with earlier stage disease (selected Stage IB in patients who
have had one previous course of therapy) and Stages IIA through IIIA [if N0-1]).
Cohort B will include patients with more advanced disease (Stage IIA through IIIA [if N2-3],
Stage IIIB, Stage IVA, and transformed CTCL) who are candidates for low-dose TSEB and/or
systemic therapy.
A standard dose of brentuximab vedotin will be administered to all patients by intravenous
infusion 3 weeks prior to initiation of low-dose TSEB and then every 3 weeks for a total of 3
cycles. Cohort A patients will complete brentuximab vedotin after 3 cycles; patients in
Cohort B will continue brentuximab vedotin until disease progression or unacceptable
toxicity, whichever occurs first. In the absence of progression or unacceptable toxicity, the
patient may receive brentuximab vedotin for up to 2 years as a study participant. A total of
12 Gy TSEB (ie, low-dose TSEB) will be administered to both cohorts per standard protocol in
6 fractions (2 fractions per week) beginning 3 weeks after the first dose of brentuximab
vedotin.
The Modified Severity Weighted Assessment Tool (mSWAT) (16), completed by the investigator,
will be used to determine skin involvement at baseline and skin response to treatment
beginning after administration of the 3 doses of brentuximab vedotin and low-dose TSEB.
Skindex-16, a patient-completed form that measures symptoms and perceptions of toxicity in
patients with skin disease will be used to assess skin-related QOL. Additionally, Form NTX
will be completed by patients in Cohort A to assess symptoms of CIPN which is a side effect
of brentuximab vedotin.
The sample size for this study will be a maximum of 15 patients for a total of 12 evaluable
patients with no more than 6 patients in Cohort B. However, if the number of patients with
severe toxicity exceeds the established acceptable incidence, accrual will end before
reaching the sample size goal of 12 evaluable patients.
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