ClinicalTrials.gg
Active, not recruitingNCT03385226PORTUpdated Dec 9, 2024

A Trial Assessing the Effect of Pembrolizumab Combined with Radiotherapy in Patients with Relapsed, Refractory, Specified Stages of Cutaneous T-cell Lymphoma (CTCL) Mycosis Fungoides (MF)/Sezary Syndrome (SS)

A Phase 2 interventional study of Pembrolizumab and Radiotherapy in Cutaneous T Cell Lymphoma and Mycosis Fungoides/Sezary Syndrome, sponsored by University College, London. Active, not recruiting at 11 sites in United Kingdom. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2024-12-09.

Sponsored by University College, London · Phase 2, Interventional, and Treatment

Phase
Phase 2
Study type
Interventional
Enrollment
46
Allocation
Not applicable
Ages
18 Years and older
Sex
All
01

Study summary

Trial Subjects (patients), will receive single infusions of pembrolizumab every 3 weeks until disease progression or unacceptable toxicity develops. They will receive radiotherapy at week 12.

Read the detailed description

Trial Subjects (patients) who are deemed eligible for the trial will be administered a single infusion of pembrolizumab (200mg) every 3 weeks. At week 12, patients will be planned to start radiotherapy at a dose of 12 Gray (Gy) in 3 fractions which will be given concomitantly with pembrolizumab. Patients who progress on pembrolizumab before week 12 will start radiotherapy as soon as possible after progression. Following completion of radiotherapy, patients will continue receiving pembrolizumab at 3 weekly intervals for a maximum of 2 years until disease progression or unacceptable toxicity develops. Patients on pembrolizumab will be seen every 3 weeks until 2 years after study entry, while Patients who progressed/ stopped pembrolizumab will be seen annually for survival/disease status only. Patients completing 2 years of treatment will then be followed up annually for survival and disease status until the end of trial is declared (2 years after the last patient is registered).

02

Conditions studied

  • Cutaneous T Cell Lymphoma
  • Mycosis Fungoides/Sezary Syndrome

Keywords

  • Relapsed
  • Refractory
03

In context

Lymphoma, T-Cell, Cutaneous

554 studies on the registry are indexed under Lymphoma, T-Cell, Cutaneous; 63 are open to participants now.

This study's enrollment of 46 is above the median of 35 across 405 interventional studies indexed under Lymphoma, T-Cell, Cutaneous.

Browse Lymphoma, T-Cell, Cutaneous studies →

Lead sponsor

University College, London is the lead sponsor of 651 studies on the registry; 149 are open to participants now.

Of its 6 completed or terminated interventional studies of FDA-regulated products, 2 (33%) 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

  • Age ≥ 18 years
  • Diagnosis of Stage IB-IVB CTCL mycosis fungoides (MF)/Sézary Syndrome (SS)
  • Have , are refractory or progressed after at least 1 systemic therapy
  • Skin at the time of or within 6 months prior to study entry
  • Patients must have a total mSWAT (modified Severity Weighted Assessment Tool) score of ≥10 OR have 2 or more measurable tumours of any size. Of this area: there should be at least 1 cutaneous lesion (MF) or a defined area of involved skin (erythrodermic MF or SS) which is an appropriate target for palliative radiotherapy. There should be an area of skin involved by measurable Mycosis Fungoides/SS that will not be irradiated (To assess the abscopal effect of radiotherapy)
  • Have a minimum and adverse event (AE) recovery period from previous treatments (e.g. topical therapy, phototherapy, local radiotherapy, monoclonal antibody, systemic cytotoxic anticancer treatment or other novel agents) prior to the first dose of pembrolizumab
  • Have performance status of 0 or 1
  • of at least 6 months
  • Demonstrate adequate organ function
  • Female patients of must have a negative urine or serum pregnancy test at pre-registration. If the urine test is positive or cannot be confirmed as negative, a serum pregnancy test will be required
  • Willing to comply with the requirements
  • Written

Exclusion criteria

•Exclusion Criteria:

  • Received chemotherapy or targeted small molecule therapy within 4 weeks prior to study entry or has not recovered from adverse events due to agents administered >4 weeks earlier (except patients with ≤ grade 2 neuropathy)
  • Is currently or has participated in an IMP or device study within 4 weeks prior to the first dose of pembrolizumab
  • Received any other monoclonal antibody within 15 weeks prior to the first dose of pembrolizumab or has not recovered (≤ grade 1 or to baseline level) from adverse events due to agents administered >4 weeks earlier. The exception to this is alemtuzumab which should not have been administered in the previous 12 weeks
  • Additional that is progressing or requires active treatment
  • Patients with known central nervous system (CNS) involvement with lymphoma
  • to pembrolizumab or its
  • Active disease that has required systemic treatment in the past 2 years (i.e. with use of disease modifying agents, or drugs). Replacement therapy (such as thyroxine, insulin, or physiologic corticosteroid replacement therapy for adrenal or pituitary insufficiency, etc.) is not considered a form of systemic treatment. Stable use of corticosteroids (at a dose no higher than 10mg prednisolone per day over the preceding 4 weeks) is allowed
  • Diagnosis of prior immunodeficiency or organ-transplant requiring immunosuppressive therapy
  • Current or prior use of immunosuppressive therapy within 7 days prior to start of treatment except the following: intranasal, inhaled, topical steroids or local steroid injections (eg. Intra-articular injection); systemic corticosteroids at physiologic doses (10mg/day or less of prednisolone or equivalent)
  • Prior treatment with , anti-PD-L1, anti-PD-L2 therapy
  • Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris or cardiac arrhythmia
  • Has known history of, or any evidence of active, non-infectious pneumonitis
  • History of other pulmonary disease such as interstitial lung disease, emphysema or
  • Is pregnant or breastfeeding
  • Has a known history of active TB
  • Has a history or current evidence of any condition, therapy, or laboratory abnormality that might confound the results of the trial or interfere with the subject's participation for the full duration of the trial or to participate in the trial is not in the patient's best interest, in the opinion of the treating investigator
  • Has known psychiatric or substance abuse disorders that would interfere with the requirements of the trial
  • Has a known history of
  • Has known active or
  • Has received a within 30 days prior to the planned start of study medication
  • Patients who have previously received a solid organ transplant
  • Patients who have previously received any transplantation
Terms in these criteria, in plain language(21)

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.

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.

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.

Washout period

A planned gap after a treatment, so that its effects can lessen before the study treatment or a study assessment. Ask the study team and the doctor who prescribed it before changing any medicine.

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.

Life expectancy

The study doctor’s estimate of how long someone is likely to live. Criteria use it so that people can stay in the study long enough for it to answer its question.

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.

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.

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.

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.

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.

Excipients

The other ingredients in a medicine besides the active drug, such as fillers, colours or preservatives.

Autoimmune disease

A condition in which the immune system attacks the body’s own tissues, such as rheumatoid arthritis, lupus, psoriasis, type 1 diabetes or inflammatory bowel disease.

Immunotherapy studies often leave out active autoimmune disease, and some name exceptions, such as thyroid disease on replacement hormone. Check the exceptions this study lists.

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.

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.

PD-1, PD-L1 and checkpoint inhibitors

PD-1, PD-L1 and CTLA-4 are proteins that act as brakes on the immune system. Checkpoint inhibitors, such as pembrolizumab or nivolumab, block them so the immune system can attack a cancer.

PD-L1 can also be measured in a tumour sample. Some scores count stained tumour cells only (TPS); others also count certain immune cells (CPS). The study names the score and the minimum it uses.

COPD

Chronic obstructive pulmonary disease: long-term lung disease that makes it hard to breathe out, including emphysema and chronic bronchitis.

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.

Hepatitis C tests

Hepatitis C is a virus that infects the liver. An HCV antibody test can stay positive after an infection has cleared (and is occasionally positive without one); an HCV RNA test shows whether the virus is there now.

After treatment, hepatitis C counts as cured when HCV RNA is still undetectable 12 weeks or more after the treatment ended. Studies often accept people cured this way.

Live vaccines

Vaccines made with a weakened form of the germ, such as measles–mumps–rubella (MMR), chickenpox and yellow fever. They can be risky when the immune system is weakened. Flu injections are not live; the nasal flu spray is.

Allogeneic and autologous transplant

Stem cell (bone marrow) transplants. Allogeneic uses cells from a donor; autologous uses your own cells, collected earlier and given back.

05

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
46 participants (actual)

Study arms

  • Experimental
    Pembrolizumab with radiotherapy

    All patients will receive * single 200mg pembrolizumab IV infusions given 3-weekly until 2 years post study entry, termination of treatment, disease progression or unacceptable toxicity * radiotherapy, 12Gy in 3 fractions

    Drug: Pembrolizumab · Radiation: Radiotherapy

Interventions

  • Pembrolizumab is a humanised monoclonal antibody which targets the programmed cell death 1 (PD-1) receptor. It blocks a protective mechanism on cancer cells, and allows the immune system to destroy those cancer cells.

    Also known as: Chemical Abstract Service (CAS) number - 1374853-91-4

  • RadiationRadiotherapy

    12Gy in 3 fractions

06

What researchers measure

Primary outcomes

  1. Overall Response (Global Assessment)

    Overall Response of the combination of pembrolizumab plus radiotherapy

    Time frame: 24 weeks after commencement of pembrolizumab

Secondary outcomes

  1. Response

    Response at the 5th infusion of pembrolizumab, typically 12 weeks after start of treatment

    Time frame: 12 weeks after start of pembrolizumab

  2. Change in Global Response

    Change in Global Response from the 5th infusion to the 9th infusion, typically from week 12 to week 24

    Time frame: 24 weeks after start of pembrolizumab

  3. Safety and toxicity

    Number \& Percentage of patients who suffer grade 3 or 4 toxicity

    Time frame: 5 months after last dose of pembrolizumab (anticipated 2 years and 5 months after last patient being registered)

  4. Response Duration

    Duration of tumour response

    Time frame: Time from date of first confirmed response to the first date of diagnosis of progressive disease or death from any cause (anticipated by 2 years and 5 months after the last patient being registered)

  5. Progression Free Survival

    Disease progression or death

    Time frame: Time from date of registration to the date of first progression or death from any cause ((anticipated by 2 years and 5 months after the last patient being registered)

  6. Overall Survival

    Death

    Time frame: Time from date of registration to the date of death from any cause ((anticipated by 2 years and 5 months after the last patient being registered)

  7. Number of patients achieving abscopal effect

    Time frame: Through study completion, 2 years post last patient being registered

Other outcomes

  1. Assessment of changes in the immune status

    Peripheral blood mononuclear cell phenotyping

    Time frame: 24 weeks after start of pembrolizumab

  2. Analysis of plasma High Mobility Group Box 1 (HMGB-1) isoform levels

    Peripheral blood mononuclear cell phenotyping

    Time frame: 24 weeks after start of pembrolizumab

  3. Functional analysis of isolated cell populations

    Peripheral blood mononuclear cell phenotyping

    Time frame: 24 weeks after start of pembrolizumab

  4. Assessment of diversity and clonality of T cell clones

    DNA extraction for T cell receptor sequencing

    Time frame: 24 weeks after start of pembrolizumab

  5. Evaluation of immune signatures for responders and non-responders

    Peripheral blood mononuclear cell phenotyping

    Time frame: 24 weeks after start of pembrolizumab

  6. Epitope screening for tumour infiltrating lymphocyte specific neo-antigens

    Peripheral blood mononuclear cell phenotyping

    Time frame: 24 weeks after start of pembrolizumab

  7. Immunohistochemical analysis of expression of immunological checkpoints

    Assessment of PD-L1 expression

    Time frame: At baseline

  8. Investigation of the baseline tumour immune microenvironment

    Immune cell infiltration

    Time frame: At baseline

07

Study locations

11 sites
08

References and documents

Publications

  • Narducci MG, Tosi A, Frezzolini A, Scala E, Passarelli F, Bonmassar L, Monopoli A, Accetturi MP, Cantonetti M, Antonini Cappellini GC, De Galitiis F, Rosato A, Picozza M, Russo G, D'Atri S. Reduction of T Lymphoma Cells and Immunological Invigoration in a Patient Concurrently Affected by Melanoma and Sezary Syndrome Treated With Nivolumab. Front Immunol. 2020 Sep 25;11:579894. doi: 10.3389/fimmu.2020.579894. eCollection 2020. PubMed 33072126 ↗

Individual participant data

Plan to share: No

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Dec 9, 2024, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT03385226
Responsible party
Sponsor
First posted
Dec 28, 2017
Start date
Jan 15, 2019
Primary completion
Sep 1, 2023
Completion
Sep 2025 (estimated)
Last update
Dec 9, 2024

Study contacts

Tim Illidge
principal investigator · University of Manchester

Oversight

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

Not currently enrolling

This study is active, not recruiting, as verified in Dec 2024. You cannot join it, but the record below documents what was studied.

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Studies of the drug tested here: Pembrolizumab

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