Safety and Efficacy of Pembrolizumab (MK-3475) in Children and Young Adults With Classical Hodgkin Lymphoma (MK-3475-667/KEYNOTE-667)

NCT ID: NCT03407144

Last Updated: 2024-11-20

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

ACTIVE_NOT_RECRUITING

Clinical Phase

PHASE2

Total Enrollment

340 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-04-09

Study Completion Date

2027-02-13

Brief Summary

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This study will examine the safety and efficacy of pembrolizumab (MK-3475) in combination with chemotherapy in children and young adults with newly diagnosed classical Hodgkin Lymphoma (cHL) who are slow early responders (SERs) to frontline chemotherapy.

Detailed Description

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Group 1 will consist of low-risk participants with cHL Stages IA, IB and IIA without bulky disease. Group 2 will consist of high-risk participants with cHL Stages IIEB, IIIEA, IIIEB, IIIB, IVA and IVB.

Conditions

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Hodgkin Lymphoma

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Pembrolizumab + AVD (Group 1)

After receiving two 4-week cycles of ABVD (doxorubicin, bleomycin, vinblastine and dacarbazine) induction therapy, SER participants in Group 1 will receive pembrolizumab 2 mg/kg up to a maximum of 200 mg (3 to 17 years of age) or 200 mg (18 to 25 years of age) on Day 1 of each 3-week cycle (Q3W) in combination with two cycles of AVD chemotherapy (doxorubicin 25 mg/m\^2, vinblastine 6 mg/m\^2 and dacarbazine 375 mg/m\^2 on Days 1 and 15; cycle frequency every 4 weeks \[Q4W\]). All SERs in Group 1 will receive radiotherapy (RT) after completing AVD chemotherapy.

Group Type EXPERIMENTAL

pembrolizumab

Intervention Type BIOLOGICAL

2 mg/kg intravenous (IV) up to a max of 200 mg (3 to 17 years of age) or 200 mg IV (18 to 25 years of age); cycle frequency Q3W

doxorubicin

Intervention Type DRUG

25 mg/m\^2 IV on Days 1 and 15 as part of ABVD induction therapy (cycle frequency: Q4W, Group 1)

40 mg/m\^2 IV on Days 1 and 15 as part of OEPA induction therapy (cycle frequency: Q4W, Group 2)

25 mg/m\^2 IV on Days 1 and 15 as part of AVD chemotherapy (cycle frequency: Q4W, Group 1)

vinblastine

Intervention Type DRUG

6 mg/m\^2 IV on Days 1 and 15 as part of ABVD induction therapy (cycle frequency: Q4W, Group 1)

6 mg/m\^2 IV on Days 1 and 15 as part of AVD chemotherapy (cycle frequency: Q4W, Group 1)

dacarbazine

Intervention Type DRUG

375 mg/m\^2 IV on Days 1 and 15 as part of ABVD induction therapy (cycle frequency: Q4W, Group 1)

375 mg/m\^2 IV on Days 1 and 15 as part of AVD chemotherapy (cycle frequency: Q4W, Group 1)

250 mg/m\^2 IV on Days 1 to 3 as part of COPDAC-28 chemotherapy (cycle frequency: Q4W, Group 2)

bleomycin

Intervention Type DRUG

10 units/m\^2 IV on Days 1 and 15 as part of ABVD induction therapy (cycle frequency: Q4W, Group 1)

Radiotherapy (RT)

Intervention Type RADIATION

RT administered daily, dose dependent on randomization group and disease response.

Pembrolizumab + COPDAC-28 (Group 2)

After receiving two 4-week cycles of OEPA (vincristine, etoposide/etopophos, prednisone/prednisolone and doxorubicin) induction therapy, SER participants in Group 2 will receive pembrolizumab 2 mg/kg up to a maximum of 200 mg (3 to 17 years of age) or 200 mg (18 to 25 years of age) Q3W, in combination with 4 cycles of COPDAC-28 chemotherapy (cyclophosphamide 500 mg/m\^2 on Days 1 and 8, vincristine 1.5 mg/m\^2 with maximum single dose 2 mg on Days 1 and 8, prednisone/prednisolone 40 mg/m\^2/day divided in 3 doses on Days 1 to 15, dacarbazine 250 mg/m\^2 on Days 1 to 3; cycle frequency Q4W). SERs in Group 2 will receive RT if they have a positive Positron Emission Tomography (PET) response after completing COPDAC-28 chemotherapy.

Group Type EXPERIMENTAL

pembrolizumab

Intervention Type BIOLOGICAL

2 mg/kg intravenous (IV) up to a max of 200 mg (3 to 17 years of age) or 200 mg IV (18 to 25 years of age); cycle frequency Q3W

doxorubicin

Intervention Type DRUG

25 mg/m\^2 IV on Days 1 and 15 as part of ABVD induction therapy (cycle frequency: Q4W, Group 1)

40 mg/m\^2 IV on Days 1 and 15 as part of OEPA induction therapy (cycle frequency: Q4W, Group 2)

25 mg/m\^2 IV on Days 1 and 15 as part of AVD chemotherapy (cycle frequency: Q4W, Group 1)

dacarbazine

Intervention Type DRUG

375 mg/m\^2 IV on Days 1 and 15 as part of ABVD induction therapy (cycle frequency: Q4W, Group 1)

375 mg/m\^2 IV on Days 1 and 15 as part of AVD chemotherapy (cycle frequency: Q4W, Group 1)

250 mg/m\^2 IV on Days 1 to 3 as part of COPDAC-28 chemotherapy (cycle frequency: Q4W, Group 2)

cyclophosphamide

Intervention Type DRUG

500 mg/m\^2 IV on days 1 and 8 as part of COPDAC-28 chemotherapy (cycle frequency: Q4W, Group 2)

vincristine

Intervention Type DRUG

1.5 mg/m\^2 IV with maximum single dose 2 mg on Days 1, 8, and 15 as part of OEPA induction therapy (cycle frequency: Q4W, Group 2)

1.5 mg/m\^2 IV with maximum single dose 2 mg on Days 1 and 8 as part of COPDAC-28 chemotherapy (cycle frequency: Q4W, Group 2)

prednisone/prednisolone

Intervention Type DRUG

60 mg/m\^2/day orally divided in 3 doses on Days 1 to 15 as part of OEPA induction therapy (cycle frequency: Q4W, Group 2)

40 mg/m\^2/day orally divided in 3 doses on Days 1 to 15 as part of COPDAC-28 chemotherapy (cycle frequency: Q4W, Group 2)

etoposide

Intervention Type DRUG

125 mg/m\^2 IV on Days 1 to 5 as part of OEPA induction therapy (cycle frequency: Q4W, Group 2)

Radiotherapy (RT)

Intervention Type RADIATION

RT administered daily, dose dependent on randomization group and disease response.

Interventions

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pembrolizumab

2 mg/kg intravenous (IV) up to a max of 200 mg (3 to 17 years of age) or 200 mg IV (18 to 25 years of age); cycle frequency Q3W

Intervention Type BIOLOGICAL

doxorubicin

25 mg/m\^2 IV on Days 1 and 15 as part of ABVD induction therapy (cycle frequency: Q4W, Group 1)

40 mg/m\^2 IV on Days 1 and 15 as part of OEPA induction therapy (cycle frequency: Q4W, Group 2)

25 mg/m\^2 IV on Days 1 and 15 as part of AVD chemotherapy (cycle frequency: Q4W, Group 1)

Intervention Type DRUG

vinblastine

6 mg/m\^2 IV on Days 1 and 15 as part of ABVD induction therapy (cycle frequency: Q4W, Group 1)

6 mg/m\^2 IV on Days 1 and 15 as part of AVD chemotherapy (cycle frequency: Q4W, Group 1)

Intervention Type DRUG

dacarbazine

375 mg/m\^2 IV on Days 1 and 15 as part of ABVD induction therapy (cycle frequency: Q4W, Group 1)

375 mg/m\^2 IV on Days 1 and 15 as part of AVD chemotherapy (cycle frequency: Q4W, Group 1)

250 mg/m\^2 IV on Days 1 to 3 as part of COPDAC-28 chemotherapy (cycle frequency: Q4W, Group 2)

Intervention Type DRUG

cyclophosphamide

500 mg/m\^2 IV on days 1 and 8 as part of COPDAC-28 chemotherapy (cycle frequency: Q4W, Group 2)

Intervention Type DRUG

vincristine

1.5 mg/m\^2 IV with maximum single dose 2 mg on Days 1, 8, and 15 as part of OEPA induction therapy (cycle frequency: Q4W, Group 2)

1.5 mg/m\^2 IV with maximum single dose 2 mg on Days 1 and 8 as part of COPDAC-28 chemotherapy (cycle frequency: Q4W, Group 2)

Intervention Type DRUG

prednisone/prednisolone

60 mg/m\^2/day orally divided in 3 doses on Days 1 to 15 as part of OEPA induction therapy (cycle frequency: Q4W, Group 2)

40 mg/m\^2/day orally divided in 3 doses on Days 1 to 15 as part of COPDAC-28 chemotherapy (cycle frequency: Q4W, Group 2)

Intervention Type DRUG

bleomycin

10 units/m\^2 IV on Days 1 and 15 as part of ABVD induction therapy (cycle frequency: Q4W, Group 1)

Intervention Type DRUG

etoposide

125 mg/m\^2 IV on Days 1 to 5 as part of OEPA induction therapy (cycle frequency: Q4W, Group 2)

Intervention Type DRUG

Radiotherapy (RT)

RT administered daily, dose dependent on randomization group and disease response.

Intervention Type RADIATION

Other Intervention Names

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MK-3475 Etoposide Phosphate

Eligibility Criteria

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Inclusion Criteria

* Group 1: Must have newly diagnosed, pathologically confirmed classical Hodgkin Lymphoma (cHL) at Stages IA, IB and IIA without bulky disease. Group 2: Must have newly diagnosed, pathologically confirmed cHL at Stages IIEB, IIIEA,IIIEB, IIIB, IVA and IVB
* Has measurable disease per investigator assessment.
* Male participants are eligible to participate if they agree to the following during the intervention period: refrain from donating sperm plus either be abstinent from heterosexual intercourse as their preferred and usual lifestyle and agree to remain abstinent or must agree to use contraception per protocol unless confirmed to be azoospermic.
* Female participants who are not pregnant or breastfeeding, and who are either not a woman of childbearing potential (WOCBP), or are a WOCBP who agrees to use approved contraception during the intervention period and for at least 120 days after the last dose of study intervention and agrees not to donate eggs (ova, oocytes) to others or freeze/store for her own use for the purpose of reproduction during this period.
* Performance status: Lansky Play-Performance Scale ≥50 for children up to 16 years of age OR Karnofsky score ≥50 for participants ≥ 16 years of age
* Has adequate organ function

Exclusion Criteria

* Has undergone solid organ transplant at any time, or prior allogeneic hematopoietic stem cell transplantation within the last 5 years
* WOCBP who has a positive urine pregnancy test within 24 hours before the first dose of study treatment
* Baseline left ventricular ejection fraction value \<50% or shortening fraction of \<27%
* Has received prior therapy with an anti-Programmed Death (PD)-1, anti-Programmed Death-Ligand 1 (PD-L1), or anti-PD-L2 agent or with an agent directed to another co-inhibitory T-cell receptor or has previously participated in a MSD pembrolizumab (MK-3475) clinical study
* Has received any prior systemic anti-cancer therapy,including investigational agents for current diagnosis before randomization
* Has received a live vaccine or live-attenuated vaccine within 30 days before the first dose of study intervention. Administration of killed vaccines are allowed
* Has received an investigational agent or has used an investigational device within 4 weeks prior to study intervention administration
* Has a diagnosis of lymphocyte-predominant Hodgkin Lymphoma (HL)
* Has a diagnosis of immunodeficiency or is receiving chronic systemic steroid therapy or any other form of immunosuppressive therapy within 7 days prior to the first dose of pembrolizumab
* Has a known additional malignancy that is progressing or requires active treatment within the past 3 years
* Has radiographically detectable central nervous system metastases and/or carcinomatous meningitis as assessed by local site investigator at the time of diagnosis
* Has severe hypersensitivity (≥Grade 3) to any study therapies including any excipients
* An active autoimmune disease that has required systemic treatment in past 2 years
* Has a history of (non-infectious) pneumonitis/interstitial lung disease that required steroids or has current pneumonitis/interstitial lung disease
* Has an active infection requiring systemic therapy
* Has a known history of human immunodeficiency virus (HIV) infection
* Has a known history of Hepatitis B or known active Hepatitis C virus infection
* Has a history or current evidence of any condition, therapy, or laboratory abnormality that might confound the results of the study, interfere with the participant's participation for the full duration of the study, or is not in the best interest of the participant to participate, in the opinion of the treating investigator
* Has known psychiatric or substance abuse disorders that would interfere with cooperating with the requirements of the study
* Participants who have not adequately recovered from major surgery or have ongoing surgical complications
Minimum Eligible Age

3 Years

Maximum Eligible Age

25 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Merck Sharp & Dohme LLC

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Medical Director

Role: STUDY_DIRECTOR

Merck Sharp & Dohme LLC

Locations

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Children's Hospital of Alabama ( Site 0023)

Birmingham, Alabama, United States

Site Status

Phoenix Childrens Hospital ( Site 0034)

Phoenix, Arizona, United States

Site Status

Arkansas Children's Hospital ( Site 0046)

Little Rock, Arkansas, United States

Site Status

Kaiser - Orange County ( Site 0084)

Anaheim, California, United States

Site Status

Kaiser Permanente ( Site 0082)

Downey, California, United States

Site Status

Kaiser - Fontana ( Site 0083)

Fontana, California, United States

Site Status

MemorialCare Health System - Long Beach Medical Center-Cherese Mari Laulhere Children's Village ( Si

Long Beach, California, United States

Site Status

Kaiser Permanente Downey Medical Center ( Site 0024)

Los Angeles, California, United States

Site Status

Kaiser Permanente - Oakland ( Site 0047)

Oakland, California, United States

Site Status

Kaiser Permanente - Roseville ( Site 0080)

Roseville, California, United States

Site Status

Kaiser Permanente - Santa Clara ( Site 0079)

Santa Clara, California, United States

Site Status

Children's Hospital - Colorado ( Site 0028)

Aurora, Colorado, United States

Site Status

Connecticut Children's Medical Center ( Site 0045)

Hartford, Connecticut, United States

Site Status

Yale Cancer Center ( Site 0061)

New Haven, Connecticut, United States

Site Status

Children's National Medical Center ( Site 0090)

Washington D.C., District of Columbia, United States

Site Status

University of Florida ( Site 0051)

Gainesville, Florida, United States

Site Status

Memorial Regional Hospital/Joe DiMaggio Children's Hospital ( Site 0048)

Hollywood, Florida, United States

Site Status

Arnold Palmer Hospital ( Site 0065)

Orlando, Florida, United States

Site Status

Children's Healthcare of Atlanta at Egleston ( Site 0033)

Atlanta, Georgia, United States

Site Status

University of Chicago ( Site 0066)

Chicago, Illinois, United States

Site Status

Riley Hospital for Children ( Site 0091)

Indianapolis, Indiana, United States

Site Status

University of Kentucky Markey Cancer Center ( Site 0057)

Lexington, Kentucky, United States

Site Status

University of Louisville-Norton Children's Hospital ( Site 0059)

Louisville, Kentucky, United States

Site Status

Johns Hopkins University ( Site 0025)

Baltimore, Maryland, United States

Site Status

Children's Hospital of Michigan ( Site 0056)

Detroit, Michigan, United States

Site Status

Karmanos Cancer Institute ( Site 0002)

Detroit, Michigan, United States

Site Status

Children's Hospitals and Clinics of Minnesota ( Site 0036)

Minneapolis, Minnesota, United States

Site Status

St. Louis Children's Hospital ( Site 0038)

St Louis, Missouri, United States

Site Status

Alliance for Childhood Diseases ( Site 0064)

Las Vegas, Nevada, United States

Site Status

Hackensack University Medical Center ( Site 0026)

Hackensack, New Jersey, United States

Site Status

Rutgers Cancer Institute of New Jersey ( Site 0027)

New Brunswick, New Jersey, United States

Site Status

Roswell Park Cancer Institute ( Site 0040)

Buffalo, New York, United States

Site Status

Cohen Children's Medical Center of New York ( Site 0052)

New Hyde Park, New York, United States

Site Status

Columbia University/Herbert Irving Cancer Center ( Site 0063)

New York, New York, United States

Site Status

Memorial Sloan Kettering Cancer Center ( Site 0060)

New York, New York, United States

Site Status

Weill Cornell Medicine ( Site 0032)

New York, New York, United States

Site Status

UNC Lineberger Comprehensive Cancer ( Site 0044)

Chapel Hill, North Carolina, United States

Site Status

Cincinnati Children's Hospital Medical Center ( Site 0035)

Cincinnati, Ohio, United States

Site Status

Nationwide Children's Hospital ( Site 0037)

Columbus, Ohio, United States

Site Status

St. Francis Hospital Cancer Center ( Site 0001)

Greenville, South Carolina, United States

Site Status

Vanderbilt University Medical Center-Ingram Cancer Center ( Site 0054)

Nashville, Tennessee, United States

Site Status

Dell Children's Medical Center Of Central Texas ( Site 0058)

Austin, Texas, United States

Site Status

Children's Medical Center ( Site 0030)

Dallas, Texas, United States

Site Status

Texas Children's Hospital ( Site 0042)

Houston, Texas, United States

Site Status

Methodist HealthCare System of San Antonio Clinical Trials Office, Texas Transplant Institute ( Site

San Antonio, Texas, United States

Site Status

Inova Fairfax Hospital ( Site 0031)

Falls Church, Virginia, United States

Site Status

Seattle Childrens Hospital ( Site 0022)

Seattle, Washington, United States

Site Status

Hospital Erasto Gaertner-CEPEP - Pesquisa Clínica ( Site 0507)

Curitiba, Paraná, Brazil

Site Status

Liga Norte Riograndense Contra o Câncer-Centro de Pesquisa Clínica ( Site 0510)

Natal, Rio Grande do Norte, Brazil

Site Status

Instituto de Oncologia Pediatrica - GRAACC - Unifesp ( Site 0500)

São Paulo, , Brazil

Site Status

Hospital Pablo Tobon Uribe-Hematology ( Site 0565)

Medellín, Antioquia, Colombia

Site Status

Organizacion Clinica Bonnadona-Prevenir S.A.S. ( Site 0529)

Barranquilla, Atlántico, Colombia

Site Status

Instituto Nacional De Cancerologia ( Site 0566)

Bogotá, Bogota D.C., Colombia

Site Status

Oncomédica S.A.S ( Site 0527)

Montería, Departamento de Córdoba, Colombia

Site Status

Fakultni nemocnice v Motole ( Site 0356)

Prague, , Czechia

Site Status

Institut d'Hematologie-Oncologie Pediatrique (IHOP) ( Site 0448)

Lyon, Auvergne-Rhône-Alpes, France

Site Status

CHU de Marseille Hopital de la Timone Enfants ( Site 0449)

Marseille, Bouches-du-Rhone, France

Site Status

CHU de Bordeaux. Hopital Pellegrin ( Site 0447)

Bordeaux, Gironde, France

Site Status

Hôpital Jeanne de Flandre ( Site 0450)

Lille, Nord, France

Site Status

Institut Gustave Roussy ( Site 0445)

Villejuif, Val-de-Marne, France

Site Status

Hopital d'Enfants Armand Trousseau ( Site 0443)

Paris, , France

Site Status

Hopital Universitaire Robert Debre ( Site 0446)

Paris, , France

Site Status

Klinikum der Universitaet Muenchen-Campus Innenstadt ( Site 0414)

Munich, Bavaria, Germany

Site Status

Universitaetsklinikum Giessen und Marburg GmbH ( Site 0411)

Giessen, Hesse, Germany

Site Status

Universitaetsklinikum Essen ( Site 0415)

Essen, North Rhine-Westphalia, Germany

Site Status

Universitätsklinikum Münster - Albert Schweitzer Campus-Pädiatrische Hämatologie und Onkologie ( Sit

Münster, North Rhine-Westphalia, Germany

Site Status

Charite-Universitaetsmedizin Berlin Campus Virchow-Klinikum ( Site 0413)

Berlin, , Germany

Site Status

Athens Childrens Hospital Aglaia Kyriakou ( Site 0361)

Athens, Attica, Greece

Site Status

University of Athens - Aghia Sophia Childrens Hospital ( Site 0362)

Athens, Attica, Greece

Site Status

University General Hospital of Thessaloniki "AHEPA" ( Site 0363)

Thessaloniki, Central Macedonia, Greece

Site Status

Oncomedica ( Site 0545)

Guatemala City, , Guatemala

Site Status

Unidad Nacional de Oncologia Pediatrica ( Site 0542)

Guatemala City, , Guatemala

Site Status

Medi-K Cayala ( Site 0544)

Guatemala City, , Guatemala

Site Status

Universita degli Studi di Roma La Sapienza ( Site 0403)

Roma, Abruzzo, Italy

Site Status

Centro di Riferimento Oncologico CRO ( Site 0404)

Aviano, Pordenone, Italy

Site Status

Azienda Ospedaliera Santobono - Pausilipon ( Site 0402)

Napoli, , Italy

Site Status

IRCCS Ospedale Pediatrico Bambino Gesu ( Site 0400)

Roma, , Italy

Site Status

Ospedale Infantile Regina Margherita ( Site 0401)

Torino, , Italy

Site Status

Hospital Infantil de Mexico Federico Gomez ( Site 0535)

Mexico City, Mexico City, Mexico

Site Status

Hospital Universitario "Dr. Jose Eleuterio Gonzalez" ( Site 0531)

Monterrey, Nuevo León, Mexico

Site Status

UMAE Hospital de Especialidades - CMN La Raza ( Site 0536)

Azcapotzalco, , Mexico

Site Status

Hematologica Alta Especialidad ( Site 0532)

Huixquilucan, , Mexico

Site Status

Prinses Maxima Centrum ( Site 0461)

Utrecht, , Netherlands

Site Status

Narodny ustav detskych chorob ( Site 0372)

Bratislava, Bratislava Region, Slovakia

Site Status

Wits Clinical Research ( Site 0323)

Johannesburg, Gauteng, South Africa

Site Status

Albert Alberts Stem Cell Transplant Centre ( Site 0324)

Pretoria, Gauteng, South Africa

Site Status

Wits Clinical Research ( Site 0321)

Soweto, Gauteng, South Africa

Site Status

Severance Hospital Yonsei University Health System ( Site 0221)

Seoul, , South Korea

Site Status

Samsung Medical Center ( Site 0222)

Seoul, , South Korea

Site Status

Hospital Universitari Vall d Hebron ( Site 0432)

Barcelona, , Spain

Site Status

Hospital Infantil Universitario Nino Jesus ( Site 0433)

Madrid, , Spain

Site Status

Hospital Universitario La Paz ( Site 0434)

Madrid, , Spain

Site Status

University College London Hospitals NHS Foundation Trust ( Site 0454)

London, London, City of, United Kingdom

Site Status

Countries

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United States Brazil Colombia Czechia France Germany Greece Guatemala Italy Mexico Netherlands Slovakia South Africa South Korea Spain United Kingdom

References

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Castellino SM, Giulino-Roth L, Harker-Murray P, Kahn JM, Forlenza C, Cho S, Hoppe B, Parsons SK, Kelly KM; COG Hodgkin Lymphoma Committee. Children's Oncology Group's 2023 blueprint for research: Hodgkin lymphoma. Pediatr Blood Cancer. 2023 Sep;70 Suppl 6(Suppl 6):e30580. doi: 10.1002/pbc.30580. Epub 2023 Jul 28.

Reference Type DERIVED
PMID: 37505794 (View on PubMed)

Related Links

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Other Identifiers

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MK-3475-667

Identifier Type: OTHER

Identifier Source: secondary_id

2023-504821-38

Identifier Type: REGISTRY

Identifier Source: secondary_id

2017-001123-53

Identifier Type: EUDRACT_NUMBER

Identifier Source: secondary_id

3475-667

Identifier Type: -

Identifier Source: org_study_id

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