ClinicalTrials.gg
WithdrawnNCT03373305Updated Apr 30, 2019

Brentuximab Vedotin and Lenalidomide in Treating Patients With Relapsed or Refractory T-Cell Lymphomas

A Phase 1 interventional study of Brentuximab Vedotin and Lenalidomide in CD30-Positive Neoplastic Cells Present, Folliculotropic Mycosis Fungoides and Recurrent Mycosis Fungoides, sponsored by City of Hope Medical Center. Withdrawn at 1 site in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2019-04-30.

Sponsored by City of Hope Medical Center · Phase 1, Interventional, and Treatment

Why this study was withdrawn
contract not executed
Phase
Phase 1
Study type
Interventional
Enrollment
0
Allocation
Not applicable
Ages
18 Years and older
Sex
All
01

Study summary

This phase I trial studies the side effects and best dose of lenalidomide when given together with brentuximab vedotin in treating patients with T-cell lymphomas that have come back or do not respond to treatment. Monoclonal antibodies, such as brentuximab vedotin, may interfere with the ability of cancer cells to grow and spread. Drugs used in chemotherapy, such as lenalidomide, work in different ways to stop the growth of cancer cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Giving brentuximab vedotin and lenalidomide may work better in treating patients with T-cell lymphomas.

Read the detailed description

PRIMARY OBJECTIVES:

I. Determine the maximum tolerated dose (MTD)/Recommended Phase 2 dose (RP2D) of brentuximab vedotin in combination with lenalidomide in patients with relapsed/ refractory cutaneous T-cell lymphoma (CTCL).

II. Assess safety and tolerability of brentuximab vedotin in combination with lenalidomide in patients with relapsed/ refractory CTCL.

SECONDARY OBJECTIVES:

I. Estimate the rate of objective global response that lasts at least 4 months (ORR4) , complete response (CR) rate, progression-free survival (PFS) of brentuximab vedotin in combination with lenalidomide in patients with relapsed/ refractory CTCL.

II. Estimate the rate and duration of clinically meaningful reduction in pruritus (CMRP).

III. Correlate response to baseline CD30 levels in tissue samples.

TERTIARY OBJECTIVES:

I. Estimate the response endpoints incorporating Lugano response criteria for patients with PET+ disease.

II. Explore temporal gene expression profile in skin/ blood samples that may predict response to combination therapy.

OUTLINE: This is a dose-escalation study of lenalidomide.

Patients receive brentuximab vedotin intravenously (IV) over 30 minutes on day 1 and lenalidomide orally (PO) once daily (QD) on days 1-14. Treatment repeats every 21 days for up to 17 courses in the absence of disease progression or unacceptable toxicity.

After completion of study treatment, patients are followed up at 30 days and then up to 12 months.

02

Conditions studied

  • CD30-Positive Neoplastic Cells Present
  • Folliculotropic Mycosis Fungoides
  • Recurrent Mycosis Fungoides
  • Recurrent Primary Cutaneous T-Cell Non-Hodgkin Lymphoma
  • Refractory Mycosis Fungoides
  • Refractory Primary Cutaneous T-Cell Non-Hodgkin Lymphoma
  • Sezary Syndrome
03

In context

Mycosis Fungoides

447 studies on the registry are indexed under Mycosis Fungoides; 42 are open to participants now.

Browse Mycosis Fungoides studies →

Lead sponsor

City of Hope Medical Center is the lead sponsor of 677 studies on the registry; 181 are open to participants now.

Of its 31 completed or terminated interventional studies of FDA-regulated products, 12 (39%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Documented of the participant and/or legally authorized representative
  • Registered into mandatory Revlimid Risk Evaluation and Mitigation Strategies (REMS) program
  • Women of : adhere to scheduled pregnancy testing as required in the Revlimid REMS program
  • (ECOG) performance status of 0-2
  • confirmed cutaneous T-cell non-Hodgkin lymphoma (CTCL) per World Health Organization (WHO) classification 2016 including, mycosis fungoides (MF) or Sezary syndrome (SS); phase 1 : >= stage IIB OR >= stage IB-IIA folliculotropic/transformed MF; expansion cohort: >= stage IB

    • MF/SS stage of disease according to TNMB classification
    • SS is defined as meeting T4 plus B2 criteria; where the of erythrodermic skin may only reveal suggestive but not diagnostic histopathologic features, the diagnosis may be based on either node biopsy or fulfillment of B2 criteria
    • For MF where the histological diagnosis by light microscopic examination is not confirmed, diagnostic criteria that been recommended by the International Society for Cutaneous Lymphomas (ISCL) should be used
  • disease
  • Failed >= 2 prior systemic therapies
  • CD30-positivity by immunohistochemistry of >= 1%
  • per modified Severity Weighted Assessment and/or Sezary count
  • Fully recovered from acute toxicities (except alopecia) of all prior therapies to (CTCAE) =\< grade 1
  • May have received either brentuximab vedotin or lenalidomide/immunomodulatory imide drugs (IMiD) without dose modification/delay due to toxicity

    * IMiDs defined as thalidomide analogues

  • If received prior brentuximab vedotin or lenalidomide, must be able to tolerate the dose level to which the participant will be enrolled to
  • Within 14 days prior to day 1 of protocol therapy unless otherwise stated: (ANC) >= 1,000/mm\^3

    * NOTE: Growth factor is not permitted within 14 days of ANC assessment unless cytopenia is secondary to disease involvement

  • Within 14 days prior to day 1 of protocol therapy unless otherwise stated: >= 75,000/mm\^3

    * NOTE: Platelet transfusions are not permitted within 14 days of platelet assessment unless cytopenia is secondary to disease involvement

  • Within 14 days prior to day 1 of protocol therapy unless otherwise stated: Total =\< 1.5 X (ULN) OR if Gilbert's syndrome =\< 3.0 X ULN
  • Within 14 days prior to day 1 of protocol therapy unless otherwise stated: (AST) =\< 2 x ULN
  • Within 14 days prior to day 1 of protocol therapy unless otherwise stated: Alanine aminotransferase (ALT) =\< 2 x ULN
  • Within 14 days prior to day 1 of protocol therapy unless otherwise stated: of >= 60 mL/min per 24 hour urine test or the Cockcroft-Gault formula
  • Within 14 days prior to day 1 of protocol therapy unless otherwise stated: Women of childbearing potential (WOCBP): negative urine or serum pregnancy test; if the urine test is positive or cannot be confirmed as negative, a serum pregnancy test will be required
  • Agreement by WOCBP and males of childbearing potential to use an effective method of or abstain from heterosexual activity for the course of the study through at least 6 months after the last dose of protocol therapy * Childbearing potential defined as not being surgically sterilized (men and women) or have not been free from menses for > 1 year (women only)

Exclusion criteria

Exclusion Criteria:

  • Stem cell transplantation
  • Monoclonal antibody within 28 days prior to day 1 of protocol therapy
  • Any systemic therapy, including monoclonal antibody within 28 days or 5 half-lives (whichever is shorter) of initiating day 1 of protocol therapy
  • Any skin-directed therapy within 14 days prior to day 1 of protocol therapy
  • Any radiation therapy within 21 days prior to day 1 of protocol therapy
  • medication within 14 days prior to day 1 of protocol therapy; the following are exceptions to this criterion:

    • Intranasal, inhaled, topical or local injections (e.g., intra-articular injection) and are on stable dose for at least 28 days
    • Systemic corticosteroids at physiologic doses of \< 10 mg/day of prednisone or equivalent
  • Live, attenuated vaccine within 30 days prior to day 1 of protocol therapy
  • Disease free of prior for >= 5 years with the exception of:

    • Currently treated squamous cell and basal cell carcinoma of the skin, or
    • Carcinoma in situ of the cervix, or
    • Surgically removed melanoma in situ of the skin (stage 0) with histological confirmed free margins of excision , or
    • Prostate cancer (T1a or T1b using the TNM [tumor, nodes, ] clinical staging system) that has/have been surgically cured, or
    • Any other malignancy that has/have been curatively treated with surgery and/or localized radiation
  • Allergic reaction/ to lenalidomide or history of anaphylactic shock to brentuximab vedotin in the past
  • Female only: pregnant or breastfeeding
  • Acute infection requiring systemic treatment
  • Known history of (HIV) infection
  • Active or C infection
  • Central nervous system involvement by lymphoma, including
  • History of progressive multifocal leukoencephalopathy (PML)
  • Current peripheral neuropathy >= grade 2 or patients with the demyelinating form of Charcot-Marie-Tooth syndrome
  • Unstable cardiac disease as defined by one of the following:

    • Cardiac events such as myocardial infarction (MI) within the past 6 months
    • (New York Heart Association) heart failure class III-IV
    • Uncontrolled atrial fibrillation or hypertension
  • History of vascular disease (e.g. deep vein thrombosis, stroke)
  • Major surgery (as defined by the investigator) within the 28 days prior to day 1 of protocol therapy
  • Incidence of gastrointestinal disease that may significantly alter the absorption of lenalidomide
  • Any other condition that would, in the investigator's judgment, contraindicate the patient's participation in the clinical study due to safety concerns or compliance with clinical study procedures, e.g., infection/inflammation, intestinal obstruction, unable to swallow medication, social/psychological issues, etc.
  • Prospective participants who, in the opinion of the investigator, may not be able to comply with all study procedures (including compliance issues related to feasibility/logistics)
Terms in these criteria, in plain language(24)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Childbearing potential

Able to become pregnant: from the first period until menopause, unless permanently unable to through surgery (removal of the womb, or of both ovaries or both fallopian tubes).

Criteria for people of childbearing potential usually ask for a negative pregnancy test and for contraception during the study and for a time after it.

ECOG performance status

A scale of how much an illness limits everyday activity. For people being assessed to join a study, scores run from 0 (fully active) to 4; lower is more active.

0
Fully active, no restrictions.
1
Limited in strenuous activity, but walking and able to do light work, such as housework or office work.
2
Walking and able to look after yourself, but unable to work; up and about more than half of waking hours.
3
Able to look after yourself only in part; in bed or a chair more than half of waking hours.
4
Unable to look after yourself at all; in bed or a chair all day.

Studies most often ask for 0–1 or 0–2. Your doctor gives the score; the WHO scale uses the same steps. The full scale also has 5, which records death.

Histologically or cytologically confirmed

The diagnosis was confirmed by looking at a sample under a microscope: tissue from a biopsy or surgery (histology), or cells from a fluid or needle sample (cytology).

Your pathology report is the document that shows this.

Biopsy and archival tissue

A biopsy takes a small piece of tissue to examine. “Archival tissue” is a sample already taken, for example at diagnosis, and kept by the hospital.

Whether a stored sample will do depends on when it was taken, how much there is and what the study needs. Ask whether the study accepts your stored sample or needs a new biopsy.

Relapsed and refractory

Relapsed: the illness came back after treatment had worked. Refractory: it did not respond to treatment, or stopped responding while still on it.

Measurable disease

The amount of disease can be tracked with a defined measurement, so the study can see whether it shrinks or grows. It might be a tumour measured on a scan or, in some blood cancers such as myeloma, a marker measured in blood or urine.

The criteria or the study team say which measurement counts — having no tumour visible on a scan does not by itself rule you out.

CTCAE grade

The US National Cancer Institute’s scale of how severe an adverse event is — any unwanted medical event during a study, such as a symptom, an illness or an abnormal test result, whether or not a treatment caused it. Whether it did is judged separately.

1
Mild.
2
Moderate.
3
Severe.
4
Life-threatening.
5
Death due to the event.

“Side effects of earlier treatment resolved to grade 1 or less” means they have settled to mild or gone.

Absolute neutrophil count (ANC)

The number of neutrophils, white blood cells that help fight infection, in a given amount of blood. Too few raises the risk of infection.

It is a count, not a percentage of the white cells. Limits are written in units that mean the same: ≥ 1.5 × 10⁹/L is ≥ 1,500 per mm³ (µL). Each lab has its own reference range.

Platelets

Blood cells that help blood clot. Too few raises the risk of bleeding and bruising. A usual adult range is about 150–400 × 10⁹/L (150,000–400,000 per µL); each lab has its own reference range.

Bilirubin

A yellow substance made when red blood cells are broken down, which the liver clears. A high level can mean a problem with the liver or the bile ducts.

Criteria often allow more for people with Gilbert’s syndrome, a harmless inherited condition that raises bilirubin.

ULN (upper limit of normal)

The top of the normal range for a blood test, as set by the laboratory that runs it. Each lab prints its own range next to your result.

“≤ 2.5 × ULN” means the result can be up to two and a half times that top value.

ALT and AST (liver enzymes)

Two enzymes measured in a routine blood test of the liver. Higher levels can mean the liver is under strain or damaged. SGPT and SGOT are older names for ALT and AST.

Criteria usually give a limit as a multiple of the upper limit of normal (ULN), often higher when cancer has spread to the liver.

Creatinine clearance (CrCl)

How quickly the kidneys clear creatinine, a waste product, from the blood. A study may estimate it from a blood test with age, weight and sex (often by the Cockcroft–Gault formula), or measure it using blood and urine collected over a set time. Given in mL/min; higher is better.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

Immunosuppression

A weakened immune system. It can come from an illness, such as HIV or some blood cancers, or from medicines that turn the immune system down, for example after an organ transplant or for an autoimmune disease; steroids at higher doses count.

Read whether the line is about a condition or about medicines, and which medicines and doses it means.

Corticosteroids (steroids)

Anti-inflammatory medicines such as prednisone, prednisolone and dexamethasone — not the anabolic steroids used for muscle.

Studies differ in what they allow: check which steroid medicines, routes (tablets, injections, creams, inhalers, eye drops) and doses this study accepts.

Cancer (malignancy)

Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.

Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.

Metastases

Cancer that has spread from where it began to other parts of the body. “Metastatic” cancer is cancer that has spread this way.

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

HIV

The human immunodeficiency virus, which weakens the immune system.

Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.

Hepatitis B tests

Hepatitis B is a virus that infects the liver. These are separate tests: HBsAg positive usually means a current infection (a recent vaccination can briefly cause it too); total anti-HBc (HBcAb) positive means an infection now or in the past; HBV DNA measures how much virus is in the blood.

Some studies accept a past infection if HBV DNA is undetectable, sometimes with antiviral medicine during the study. Check what this study allows.

Leptomeningeal disease

Cancer that has spread to the leptomeninges, the thin layers covering the brain and spinal cord, and the fluid between them. It is not the same as brain metastases.

Criteria often treat it separately, and many studies leave it out even where treated brain metastases are allowed.

NYHA class (heart failure)

The New York Heart Association’s four classes of how much heart failure limits physical activity.

I
No limits: ordinary activity causes no undue tiredness or breathlessness.
II
Slight limits: comfortable at rest, ordinary activity causes symptoms.
III
Marked limits: comfortable at rest, less than ordinary activity causes symptoms.
IV
Symptoms even at rest; any activity makes them worse.

Studies set their own limit — many outside heart failure leave out class III–IV, while heart failure studies may ask for a particular class. Check the class this study names.

05

Study design

Phase
Phase 1
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
0 participants (actual)

Study arms

  • Experimental
    Treatment (brentuximab vedotin, lenalidomide)

    Patients receive brentuximab vedotin IV over 30 minutes on day 1 and lenalidomide PO QD on days 1-14. Treatment repeats every 21 days for up to 17 courses in the absence of disease progression or unacceptable toxicity.

    Drug: Brentuximab Vedotin · Drug: Lenalidomide · Other: Laboratory Biomarker Analysis

Interventions

  • Given IV

    Also known as: 914088-09-8, ADC SGN-35, Adcetris, Anti-CD30 Antibody-Drug Conjugate SGN-35, Anti-CD30 Monoclonal Antibody-MMAE SGN-35, Anti-CD30 Monoclonal Antibody-Monomethylauristatin E SGN-35, Brentuximab Vedotin, cAC10-vcMMAE, SGN-35

  • Given PO

    Also known as: 191732-72-6, 3-(4-Amino-1-oxo-1,3-dihydro-2H-isoindol-2-yl)piperidine-2,6-dione, 703813, CC-5013, CC5013, CDC 501, Revlimid

  • OtherLaboratory Biomarker Analysis

    Correlative studies

06

What researchers measure

Primary outcomes

  1. Dose limiting toxicity (DLT) assessed per CTCAE v4.0

    Time frame: Up to 21 days

Secondary outcomes

  1. Rate of objective global response defined as proportion of patients achieving complete response (CR)/partial response (PR) that lasts at least 4 months

    Will be estimated by the proportion of patients achieving a CR/PR that lasts at least 4 months, along with the 95% exact binomial confidence interval.

    Time frame: At 4 months

  2. Complete response defined as proportion of patients achieving CR according to Olsen criteria

    Complete response rate will be estimated by the proportion of evaluable patients achieving CR, along with the 95% exact binomial confidence interval.

    Time frame: Up to 1 year

  3. Progression free survival (PFS) according to Olsen criteria

    PFS will be estimated using the product-limit method of Kaplan and Meier along with the Greenwood estimator of standard error.

    Time frame: From start of protocol treatment to first observation of disease relapse/ progression or death from any cause, whichever occurs first, assessed up to 1 year

  4. Change in pruritus visual analogue scale (VAS)

    Pruritus visual analogue scale (VAS) is a horizontal 100mm long line on which the patients make a vertical mark to indicate their subjective assessment of pruritus intensity; the patients are informed that the scale represents no pruritus (0 points) to severe pruritus (100 points). Changes from baseline over time in pruritus VAS score will be assessed using descriptive statistics.

    Time frame: Up to 1 year

  5. CD30 expression assessed by lymph node and/or skin biopsies via immunochemistry

    Baseline CD30 levels in tissue samples by immunochemistry will be compared between responders and non-responders by Fisher's exact test. Log rank test will be used to explore the association between baseline CD30 levels in tissue samples with PFS.

    Time frame: Baseline

07

Study locations

1 site
  • City of Hope Medical Center
    Duarte, California 91010, United States
08

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reached

Start is estimated for Mar 2019.

How these figures are worked out, and which studies are left out of them.

Registered
Nov 28, 2017
First posted
Dec 14, 2017
StartEst.
Mar 2019
Primary completionActual
Apr 26, 2019
CompletionActual
Apr 26, 2019
Last update
Apr 30, 2019
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Apr 30, 2019, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
09

Registry details

Key details

Study ID
NCT03373305
Responsible party
Sponsor
First posted
Dec 14, 2017
Start date
Mar 2019 (estimated)
Primary completion
Apr 26, 2019
Completion
Apr 26, 2019
Last update
Apr 30, 2019

Study contacts

Jasmine Zain, MD
principal investigator · City of Hope Medical Center

Oversight

Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is withdrawn, as verified in Apr 2019. You cannot join it, but the record below documents what was studied.

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Studies of the drugs tested here: Brentuximab Vedotin · Lenalidomide

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