Anti-PD-1 and Chemotherapy for R/R Hodgkin Lymphoma
7. september 2018 oppdatert av: 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.
Studieoversikt
Status
Fullført
Forhold
Intervensjon / Behandling
Studietype
Observasjonsmessig
Registrering (Faktiske)
30
Kontakter og plasseringer
Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.
Studiesteder
-
-
-
Pierre-Bénite, Frankrike
- Centre Hospitalier LYON SUD
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-
Deltakelseskriterier
Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.
Kvalifikasjonskriterier
Alder som er kvalifisert for studier
18 år og eldre (Voksen, Eldre voksen)
Tar imot friske frivillige
N/A
Kjønn som er kvalifisert for studier
Alle
Prøvetakingsmetode
Ikke-sannsynlighetsprøve
Studiepopulasjon
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
Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.
Hvordan er studiet utformet?
Designdetaljer
Kohorter og intervensjoner
Gruppe / Kohort |
Intervensjon / 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 %).
|
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).
|
Hva måler studien?
Primære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
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 |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
|
Best response obtained (Group 1)
Tidsramme: 10 weeks
|
the best response obtained with CT after anti-PD-1
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10 weeks
|
|
Best response obtained (Group 2)
Tidsramme: 10 weeks
|
the best response obtained with CT after the combination anti-PD-1 and CT
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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).
|
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
|
|
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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Samarbeidspartnere og etterforskere
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Sponsor
Etterforskere
- Hovedetterforsker: Hervé GHESQUIERES, MD, Hospices Civils de Lyon
Studierekorddatoer
Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.
Studer hoveddatoer
Studiestart (Faktiske)
31. januar 2018
Primær fullføring (Faktiske)
31. januar 2018
Studiet fullført (Faktiske)
30. juni 2018
Datoer for studieregistrering
Først innsendt
4. juni 2018
Først innsendt som oppfylte QC-kriteriene
7. september 2018
Først lagt ut (Faktiske)
10. september 2018
Oppdateringer av studieposter
Sist oppdatering lagt ut (Faktiske)
10. september 2018
Siste oppdatering sendt inn som oppfylte QC-kriteriene
7. september 2018
Sist bekreftet
1. september 2018
Mer informasjon
Begreper knyttet til denne studien
Nøkkelord
Ytterligere relevante MeSH-vilkår
Andre studie-ID-numre
- Anti-PD-1 Hodgkin
Legemiddel- og utstyrsinformasjon, studiedokumenter
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Studerer et amerikansk FDA-regulert enhetsprodukt
Nei
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