- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02362997
Pembrolizumab After ASCT for Hodgkin Lymphoma, DLBCL and T-NHL
A Phase 2 Study of Pembrolizumab (MK-3475) After Autologous Stem Cell Transplantation in Patients With Relapsed/Refractory Classical Hodgkin Lymphoma and, Diffuse Large B Cell Lymphoma and T- Cell Non-Hodgkin Lymphoma
Study Overview
Status
Intervention / Treatment
Detailed Description
Pembrolizumab is an antibody drug that blocks a molecule called PD-1. PD-1 is a receptor molecule on the surface of immune cells that can be used to turn off the immune response. Some cancers use this as a way to turn off the immune response against them. Blocking PD-1 with pembrolizumabmay restore an effective immune attack against the lymphoma cells.
On this study, patients who undergo ASCT for R/R cHL, DLBCL or PTCL in 1st remission will receive pembrolizumab at a dose of 200mg intravenously every 3 weeks for up to 8 cycles, beginning within a few weeks of ASCT.
Study Type
Enrollment (Actual)
Phase
- Phase 2
Contacts and Locations
Study Locations
-
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California
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Duarte, California, United States, 91010
- City of Hope National Medical Center
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Massachusetts
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Boston, Massachusetts, United States, 02215
- Beth Israel Deaconess Medical Center
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Boston, Massachusetts, United States, 02114
- Massachusetts General Hospital
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Boston, Massachusetts, United States, 02215
- Dana Farber Cancer Institute
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New York
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New York, New York, United States, 10065
- Memorial Sloan Kettering Cancer Center
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Texas
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Houston, Texas, United States, 77030
- MD Anderson Cancer Center
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion criteria
• Histologically confirmed diagnosis with review of the diagnostic pathology specimen at one of the participating institutions. Eligible histologies are: Arm A: Diffuse large B cell lymphoma; patients with a prior history of indolent B-cell NHL are eligible, as long as they have histologically confirmed DLBCL prior to their pre-transplant salvage treatment. Patients with mediastinal large B cell lymphoma are also eligible.
Arm B: Classical Hodgkin lymphoma (patients with nodular lymphocyte predominant Hodgkin lymphoma [NLPHL] are NOT eligible) Arm C: Peripheral T cell lymphoma - eligible subtypes will include PTCL, NOS; AITL; and ALK-negative ALCL. Patients with other PTCL histologies, including ALK-positive PTCL, and cutaneous T-cell lymphoma will not be eligible..
- Age ≥ 18 at the time of enrollment.
- For arms A and B, participants must have relapsed after or been refractory to first-line chemotherapy, i.e., they must have failed to achieve CR after first-line therapy or must have relapsed subsequently if they achieved CR. For arm C, participants will be eligible if transplant is performed as consolidation of first remission (partial or complete).
- Participants must be planning to receive or have received autologous stem cell transplantation. Participants must have chemosensitive disease prior to ASCT, defined as achieving at least a partial remission (as determined with PET imaging) to salvage treatment. Participants with cHL or DLBCL (arms A and B) transplanted in 1st remission after only one line of treatment are not eligible. Participants with PTCL (arm C) transplanted beyond 1st remission are also not eligible.
- No more than 1 line of anthracycline-containing chemotherapy prior to ASCT, and no more than 3 lines of therapy total prior to ASCT for arms A and B; no more than 1 line of therapy prior to ASCT for arm C.
- Participants cannot have received any anti-neoplastic therapy (including radiotherapy, chemotherapy or immunotherapy) after ASCT
- Participants must have had PET-CT for restaging after salvage therapy and before ASCT.
- Participants must begin study treatment no later than 21 days from the post-ASCT discharge. Additionally, they must have recovered from ASCT toxicities at the time of first study treatment.
- ECOG performance status ≤2
Participants must have normal organ and marrow function as defined below:
- absolute neutrophil count ≥ 1,000/mcL
- platelets ≥ 50,000/mcL
- Hemoglobin ≥ 8 g/dl
- total bilirubin ≤ 1.5 × institutional upper limit of normal (ULN), or direct bilirubin ≤ ULN in patients with Gilbert's syndrome
- AST(SGOT)/ALT(SGPT) ≤ 2.5 × ULN
- Creatinine ≤ 1.5 × ULN or creatinine clearance ≥ 60 mL/min/1.73 m2
- Resting and ambulatory oxygen saturation ≥ 94% on room air
- FEV1 and DLCO (adjusted for Hemoglobin) ≥ 50% predicted
- Willigness to use contraception
- Ability to understand and the willingness to sign a written informed consent document.
Exclusion criteria
- Participants who are receiving any other investigational agents after ASCT.
- Participants with active CNS involvement are excluded.
- History of or active autoimmune disease, or other syndrome that requires systemic steroids or autoimmune agents. Participants with vitiligo, resolved childhood asthma or atopy, hypothyroidism, or Sjogren's syndrome, as well as participants requiring only intranasal steroids, intermittent use of bronchodilators, local steroid injections, or physiologic replacement doses of prednisone (≤ 10 mg/d) are not excluded from this study.
- History of allergic reactions attributed to compounds of similar chemical or biologic composition to pembrolizumab. Prior hypersensitivity reactions to anti-CD20 therapy or anti-CD30 therapy is not an exclusion criterion.
- Has a history of (non-infectious) pneumonitis that required steroids or current pneumonitis.
- Receipt of > 600 mg/m2 total dose of BCNU with prior treatments including transplant conditioning regimen.
- Uncontrolled illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements or pose excess risk to the participant in the opinion of the treating clinician..
- Pregnant or lactating women.
- HIV-positive.
- Participants with active viral hepatitis (positive HepB sAg, positive HepB core Ab with positive HepB viral load, or positive HepC antibody with positive HepC viral load).
- Receipt of a live vaccine within 30 days of the start of treatment. Examples are measles, mumps, rubella, varicella, yellow fever, rabies, BCG, oral polio vaccine, and oral typhoid vaccine.
- Prior treatment with an anti PD-1, anti PD-L1, or anti CTLA-4 agent. Participants who entered clinical remission with one of those agents and proceeded to ASCT without intervening relapse may be eligible after discussion with the Study Chair. Note that for patients who enter remission with checkpoint blockade therapy, this will not count towards the 3 lines of prior therapy.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Non-Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
|---|---|
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Experimental: Diffuse large B cell lymphoma
Pembrolizumab 200mg IV every 3 weeks up to 8 cycles
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Anti-PD-1 monoclonal antibody
Other Names:
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Experimental: Classical Hodgkin lymphoma
Pembrolizumab 200mg IV every 3 weeks up to 8 cycles
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Anti-PD-1 monoclonal antibody
Other Names:
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Experimental: Peripheral T cell lymphoma
Pembrolizumab 200mg IV every 3 weeks up to 8 cycles
|
Anti-PD-1 monoclonal antibody
Other Names:
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Progression-free Survival After ASCT
Time Frame: 18 Months
|
Proportion of patients alive and disease-free 18 months from autologous stem cell transplantation (ASCT).
Progression criteria are per Lugano 2014 criteria.
All patients receiving any amount of protocol treatment.
Patients who have progressed or lost to follow-up prior to 18 months are counted as failures; only patients followed and progression-free for at least 18 months are counted as successes.
|
18 Months
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Overall Survival
Time Frame: 18 Months
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Survival probability of patients alive 18 months from ASCT, time-to-event
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18 Months
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Relapse
Time Frame: 18 Months
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Number of patients who relapse within 18 months from autologous stem cell transplantation.
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18 Months
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Safety and Tolerability Assessed by CTCAE v4 Grade 2 and Above Toxicity Related to Study Treatment
Time Frame: 6 months
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Number of patients who experienced at least a grade 2 toxicity with "definite," "probable," or "possible" attribute to study treatment, according to the revised NCI Common Terminology Criteria for Adverse Events (CTCAE) version 4.0
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6 months
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Response Rate to Pembrolizumab
Time Frame: 18 months
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In patients with measurable disease after ASCT, rate of objective response after treatment.
Response was assessed using the Lugano 2014 criteria.
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18 months
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Progression-free Survival
Time Frame: 18 months
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Progression-free survival probability of patients who are alive and without progression 18 months from ASCT, time-to-event
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18 months
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Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Overall Survival After ASCT by PET Status
Time Frame: 18 months
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Survival probability of patients alive 18 months from ASCT stratified by PET status before transplantation, time-to-event.
Patients categorized by complete metabolic response (complete response by PET scan, assessed using the Lugano 2014 criteria), partial response (assessed using Lugano 2014 criteria) prior to transplantation.
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18 months
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Progression-free Survival After ASCT by PET Status
Time Frame: 18 months
|
Progression-free survival probability of patients alive and disease-free 18 months from ASCT stratified by PET status before transplantation, time-to-event
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18 months
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Completion Rate
Time Frame: 18 months
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Number of patients who complete the planned treatment
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18 months
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Minimal Residual Disease
Time Frame: 18 months
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Level of MRD detected by PCR (if feasible) before and after pembrolizumab
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18 months
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Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Reid Merryman, MD, Dana-Farber Cancer Institute
Publications and helpful links
General Publications
- Merryman RW, Redd R, Jeter E, Wong JL, McHugh K, Reynolds C, Nazzaro M, Varden A, Brown JR, Crombie JL, Davids MS, Fisher DC, Jacobsen E, Jacobson CA, Kim AI, LaCasce AS, Ng SY, Odejide OO, Parry EM, Dahi PB, Nieto Y, Joyce RM, Chen YB, Herrera AF, Armand P, Ritz J. Immune Reconstitution following High-Dose Chemotherapy and Autologous Stem Cell Transplantation with or without Pembrolizumab Maintenance Therapy in Patients with Lymphoma. Transplant Cell Ther. 2022 Jan;28(1):32.e1-32.e10. doi: 10.1016/j.jtct.2021.10.010. Epub 2021 Oct 17.
- Frigault MJ, Armand P, Redd RA, Jeter E, Merryman RW, Coleman KC, Herrera AF, Dahi P, Nieto Y, LaCasce AS, Fisher DC, Ng SY, Odejide OO, Freedman AS, Kim AI, Crombie JL, Jacobson CA, Jacobsen ED, Wong JL, Bsat J, Patel SS, Ritz J, Rodig SJ, Shipp MA, Chen YB, Joyce RM. PD-1 blockade for diffuse large B-cell lymphoma after autologous stem cell transplantation. Blood Adv. 2020 Jan 14;4(1):122-126. doi: 10.1182/bloodadvances.2019000784.
- Armand P, Chen YB, Redd RA, Joyce RM, Bsat J, Jeter E, Merryman RW, Coleman KC, Dahi PB, Nieto Y, LaCasce AS, Fisher DC, Ng SY, Odejide OO, Freedman AS, Kim AI, Crombie JL, Jacobson CA, Jacobsen ED, Wong JL, Patel SS, Ritz J, Rodig SJ, Shipp MA, Herrera AF. PD-1 blockade with pembrolizumab for classical Hodgkin lymphoma after autologous stem cell transplantation. Blood. 2019 Jul 4;134(1):22-29. doi: 10.1182/blood.2019000215. Epub 2019 Apr 5.
- Merrill MH, Dahi PB, Redd RA, McDonough MM, Chen YB, DeFilipp Z, Herrera AF, Fisher DC, LaCasce AS, Odejide OO, Ng SY, Jacobson CA, Merryman RW, Kim AI, Nieto YL, Sauter CS, Shah GL, Zain JM, Armand P, Jacobsen ED. A phase 2 study of pembrolizumab after autologous stem cell transplantation in patients with T-cell non-Hodgkin lymphoma. Blood. 2023 Aug 17;142(7):621-628. doi: 10.1182/blood.2023020244.
- Merryman RW, Redd RA, Taranto E, Ahmed G, Jeter E, McHugh KM, Brown JR, Crombie JL, Davids MS, Fisher DC, Freedman AS, Jacobsen E, Jacobson CA, Kim AI, LaCasce AS, Ng SY, Odejide OO, Parry EM, Jacene H, Park H, Dahi PB, Nieto Y, Joyce RM, Chen YB, Shipp MA, Herrera AF, Armand P. Minimal residual disease in patients with diffuse large B-cell lymphoma undergoing autologous stem cell transplantation. Blood Adv. 2023 Sep 12;7(17):4748-4759. doi: 10.1182/bloodadvances.2022007706.
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimated)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Neoplasms
- Immune System Diseases
- Neoplasms by Histologic Type
- Lymphatic Diseases
- Lymphoproliferative Disorders
- Immunoproliferative Disorders
- Lymphoma, Non-Hodgkin
- Lymphoma, B-Cell
- Lymphoma
- Lymphoma, T-Cell
- Hemic and Lymphatic Diseases
- Lymphoma, Large B-Cell, Diffuse
- Hodgkin Disease
- Lymphoma, T-Cell, Peripheral
- Molecular Mechanisms of Pharmacological Action
- Antineoplastic Agents
- Antineoplastic Agents, Immunological
- Immune Checkpoint Inhibitors
- pembrolizumab
Other Study ID Numbers
- 14-566
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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