Anti-PD-1 and Chemotherapy for R/R Hodgkin Lymphoma
7. september 2018 opdateret af: Hospices Civils de Lyon
Efficacy of Chemotherapy or Chemo-anti-PD-1 Combination After Failed Anti-PD-1 Therapy for Relapsed and Refractory Hodgkin Lymphoma: a Series From Lysa Centers.
Anti-PD-1 therapy provides high response rates in Hodgkin lymphoma (HL) patients who have relapsed or are refractory (R/R) to autologous stem cell transplantation (ASCT) and brentuximab vedotin (BV), but median progression free survival (PFS) is only one year. The efficacy of treatment following anti-PD-1 is not well known.
In this context, the optimal treatment for patients who failed after anti-PD-1 therapy is an issue. To better assess their outcome, the investigators retrospectively analyzed the characteristics and outcome of patients from 14 LYSA (The Lymphoma Study Association) centers who lost response to anti-PD-1 therapy and received additional CT.
Studieoversigt
Status
Afsluttet
Betingelser
Intervention / Behandling
Undersøgelsestype
Observationel
Tilmelding (Faktiske)
30
Kontakter og lokationer
Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.
Studiesteder
-
-
-
Pierre-Bénite, Frankrig
- Centre Hospitalier LYON SUD
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-
Deltagelseskriterier
Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.
Berettigelseskriterier
Aldre berettiget til at studere
18 år og ældre (Voksen, Ældre voksen)
Tager imod sunde frivillige
N/A
Køn, der er berettiget til at studere
Alle
Prøveudtagningsmetode
Ikke-sandsynlighedsprøve
Studiebefolkning
The initial diagnosis of classical HL was established from biopsies in accordance with the 2008 World Health Organization classification14.
We retrospectively analyzed 30 R/R classical HL patients from 14 LYSA centers who received anti-PD-1 therapy as part of a clinical trial (n=4), from an off-label program authorization for temporary use (ATU) from the French medical drug agency (Agence Nationale de Sécurité du Médicament, ANSM) (n=22), from the Belgian national system for the reimbursement of health care (Institut National d'Assurance Maladie Invalidité, INAMI) (n=4).
Beskrivelse
Inclusion Criteria:
- Initial diagnosis of classical HL
- Optional histopathology confirmation of relapse/refractory HL, (2) age ≥ 18 years
- Eastern Cooperative Oncology Group (ECOG) Performance Status from 0 to 2
- Patients must be have received: at least 2 prior regimens and have received or be ineligible for autologous stem cell transplant and must have received prior BV, and at least 2 cycles of single agent anti-PD-1 as last treatment before entering the study,
- Patients must have inadequate response to anti-PD-1 monotherapy (progressive disease or partial response according to Lugano criteria) with at least one hypermetabolic lesion over the liver and mediastinum background at time of inclusion in the study
- Previous allogeneic stem cell transplant was allowed. Patients treated with radiotherapy alone after anti-PD1 or combined with anti-PD1 treatment were not included in the study.
Exclusion Criteria:
- radiotherapy in the treatment after anti-PD1
Studieplan
Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
Kohorter og interventioner
Gruppe / kohorte |
Intervention / Behandling |
|---|---|
|
Group 1 Sequential strategy
Patients for whom anti-PD-1 therapy was stopped with the introduction of a new treatment line (19 patients, 63%).
|
Evaluate the improvement in response from the end of anti-PD-1 monotherapy to the first evaluation after introduction of CT alone (Group 1) or combined with anti-PD-1 (Group 2).
|
|
Group 2 Concomitant strategy
Patients for whom a combination of CT with anti-PD-1 therapy was initiated (11 patients, 37 %).
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Evaluate the improvement in response from the end of anti-PD-1 monotherapy to the first evaluation after introduction of CT alone (Group 1) or combined with anti-PD-1 (Group 2).
|
Hvad måler undersøgelsen?
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Overall response rate after re-exposure to chemotherapy
Tidsramme: 10 weeks
|
Patient evaluation was timed by treating physicians according to the policy of each center, and all patients were evaluated after a median of 10 weeks (min 7 weeks, max 12 weeks) with PET/CT using Lugano criteria
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10 weeks
|
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Best response obtained (Group 1)
Tidsramme: 10 weeks
|
the best response obtained with CT after anti-PD-1
|
10 weeks
|
|
Best response obtained (Group 2)
Tidsramme: 10 weeks
|
the best response obtained with CT after the combination anti-PD-1 and CT
|
10 weeks
|
|
The toxicities experienced during CT or anti-PD-1 plus CT combination
Tidsramme: 10 weeks
|
The toxicities were graded retrospectively according to the National Cancer Institute Common Toxicity Criteria for AEs (version 4.0).
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10 weeks
|
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Outcomes including PFS
Tidsramme: up to 12 months
|
PFS was defined as the time from first relapse, or progression, to the next event (defined as either second relapse/progression, change of therapy, or death from any cause)
|
up to 12 months
|
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Outcomes including overall survival (OS).
Tidsramme: up to 24 months
|
OS was defined as the time from first relapse, or progression, to death from any cause.
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up to 24 months
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Samarbejdspartnere og efterforskere
Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.
Sponsor
Efterforskere
- Ledende efterforsker: Hervé GHESQUIERES, MD, Hospices Civils de Lyon
Datoer for undersøgelser
Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.
Studer store datoer
Studiestart (Faktiske)
31. januar 2018
Primær færdiggørelse (Faktiske)
31. januar 2018
Studieafslutning (Faktiske)
30. juni 2018
Datoer for studieregistrering
Først indsendt
4. juni 2018
Først indsendt, der opfyldte QC-kriterier
7. september 2018
Først opslået (Faktiske)
10. september 2018
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
10. september 2018
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
7. september 2018
Sidst verificeret
1. september 2018
Mere information
Begreber relateret til denne undersøgelse
Nøgleord
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
- Anti-PD-1 Hodgkin
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