Brentuximab Vedotin for Newly Diagnosed CHL in Chinese CAYA Based on PET/CT Assessment

NCT ID: NCT06563245

Last Updated: 2025-02-13

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

RECRUITING

Clinical Phase

PHASE2/PHASE3

Total Enrollment

96 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-09-25

Study Completion Date

2039-11-15

Brief Summary

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Generally, pediatric patients tolerate acute toxicities but are vulnerable to late effects. Thus, increasing chemotherapy intensity to achieve more rapid complete early response to limit radiation therapy is worth testing. In this CCCG-HL-2024 study, Brentuximab vedotin (Bv) was used to replace VCR and bleomycin in the ABVE-PC regimen in the previous CCCG-HD-2018 study, respectively, to form a Bv-AEPC regimen for the treatment of newly diagnosed classic Hodgkin lymphoma (cHL) in children, adolescents and young adults. On the premise of maintaining a 4-year event free survival (EFS)\>90% in the low-, intermediate-and high-risk groups, increase the early assessment complete response rate (the overall early complete response rate increased by 20%, that is, from 54.0% to 74.0%) to further reduce the proportion of children receiving radiotherapy to benefit them.

Detailed Description

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In this CCCG-HL-2024 study, Brentuximab vedotin (Bv) was used to replace VCR and bleomycin in the ABVE-PC regimen in the previous CCCG-HD-2018 study, respectively, to form a Bv-AEPC regimen for the treatment of newly diagnosed classic Hodgkin lymphoma (cHL) in children, adolescents and young adults. Bv is currently the most widely used "new drug" in childhood cHL.

For patients in the intermediate/high-risk group who did not achieve metabolic complete remission rate (CMR) at the early assessment based on PET/CT results, an intensive regimen of Bv-Dac-APC (Bv-APC plus dacarbazine) was applied for 2 or 3 courses to further improve event-free survival without increasing long-term reproductive toxicity.

For patients in the intermediate/high-risk group who did not achieve CMR after the Bv-Dac-AEPC regimen, a modified Check Mate 744 regimen (PD-1 monoclonal antibody, Bv,+/-bedamostine, autologous stem cell transplantation/radiotherapy) was applied to improve the CMR of patients before irradiation, hoping to reduce the primary treatment failure rate to almost zero.

Conditions

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Classical Hodgkin Lymphoma Child Adolescent Young Adult Metabolic Response Survival Treatment Brentuximab Vedotin PET Scan

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Low risk group

Stage IA , no bulky Stage IIA, no bulky

Group Type EXPERIMENTAL

Brentuximab Vedotin for Injection

Intervention Type DRUG

1.8mg/kg/dose (MAX 180 mg)

response-adapted radiation

Intervention Type RADIATION

For patients who did not achieve complete metabolic response at early response assessment based on PET/CT result.

Doxorubicin

Intervention Type DRUG

25mg/m2/dose,

Etoposide

Intervention Type DRUG

125 mg/m2/dose

Prednisone

Intervention Type DRUG

20 mg/m2, BID, orally

Cyclophosphamide

Intervention Type DRUG

600 mg/m2/dose

Intermediate risk group

Stage IA, with bulky Stage IIA, with bulky Stage IB, with/without bulky Stage IAE, with/without bulky Stage IIAE, with/without bulky Stage IIIA, with/without bulky

Group Type EXPERIMENTAL

Brentuximab Vedotin for Injection

Intervention Type DRUG

1.8mg/kg/dose (MAX 180 mg)

response-adapted radiation

Intervention Type RADIATION

For patients who did not achieve complete metabolic response at early response assessment based on PET/CT result.

Doxorubicin

Intervention Type DRUG

25mg/m2/dose,

Etoposide

Intervention Type DRUG

125 mg/m2/dose

Prednisone

Intervention Type DRUG

20 mg/m2, BID, orally

Cyclophosphamide

Intervention Type DRUG

600 mg/m2/dose

Dacarbazine

Intervention Type DRUG

250 mg/m2/dose; For patients in intermediate/high risk group who did not achieve complete metabolic response at early assessment based on PET/CT results.

Tislelizumab Injection

Intervention Type DRUG

3mg/kg/dose; For patients in intermediate/high risk group who did not achieve complete metabolic response at late assessment based on PET/CT results.

Bedamustine

Intervention Type DRUG

180mg/m2/dose; For patients in intermediate/high risk group who did not achieve complete metabolic response at late assessment based on PET/CT results.

High risk group

Stage IIB Stage IIIB Stage IV

Group Type EXPERIMENTAL

Brentuximab Vedotin for Injection

Intervention Type DRUG

1.8mg/kg/dose (MAX 180 mg)

response-adapted radiation

Intervention Type RADIATION

For patients who did not achieve complete metabolic response at early response assessment based on PET/CT result.

Doxorubicin

Intervention Type DRUG

25mg/m2/dose,

Etoposide

Intervention Type DRUG

125 mg/m2/dose

Prednisone

Intervention Type DRUG

20 mg/m2, BID, orally

Cyclophosphamide

Intervention Type DRUG

600 mg/m2/dose

Dacarbazine

Intervention Type DRUG

250 mg/m2/dose; For patients in intermediate/high risk group who did not achieve complete metabolic response at early assessment based on PET/CT results.

Tislelizumab Injection

Intervention Type DRUG

3mg/kg/dose; For patients in intermediate/high risk group who did not achieve complete metabolic response at late assessment based on PET/CT results.

Bedamustine

Intervention Type DRUG

180mg/m2/dose; For patients in intermediate/high risk group who did not achieve complete metabolic response at late assessment based on PET/CT results.

Interventions

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Brentuximab Vedotin for Injection

1.8mg/kg/dose (MAX 180 mg)

Intervention Type DRUG

response-adapted radiation

For patients who did not achieve complete metabolic response at early response assessment based on PET/CT result.

Intervention Type RADIATION

Doxorubicin

25mg/m2/dose,

Intervention Type DRUG

Etoposide

125 mg/m2/dose

Intervention Type DRUG

Prednisone

20 mg/m2, BID, orally

Intervention Type DRUG

Cyclophosphamide

600 mg/m2/dose

Intervention Type DRUG

Dacarbazine

250 mg/m2/dose; For patients in intermediate/high risk group who did not achieve complete metabolic response at early assessment based on PET/CT results.

Intervention Type DRUG

Tislelizumab Injection

3mg/kg/dose; For patients in intermediate/high risk group who did not achieve complete metabolic response at late assessment based on PET/CT results.

Intervention Type DRUG

Bedamustine

180mg/m2/dose; For patients in intermediate/high risk group who did not achieve complete metabolic response at late assessment based on PET/CT results.

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Ages \>=2\~\<35 years at the time of enrollment;
* Patients with newly diagnosed, pathologically confirmed classical Hodgkin lymphoma (HL) by at least 2 tertiary referral centers for pathology;
* Adequate organ function;
* Patients and/or their parents or legal guardians sign a written informed consent;

Exclusion Criteria

* Patients with nodular lymphocyte-predominant HL;
* Patients with an immunodeficiency that existed prior to diagnosis; such as primary immunodeficiency syndromes, organ transplant recipients and children on current systemic immunosuppressive agents are not eligible;Patients known to be positive for HIV are not eligible.
* Patients who are pregnant; Lactating females who plan to breastfeed.
* Patients who received systemic corticosteroids within 28 days of enrollment on this protocol
Minimum Eligible Age

2 Years

Maximum Eligible Age

35 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Shanghai Children's Medical Center

OTHER

Sponsor Role collaborator

Najing Children's Hospital

UNKNOWN

Sponsor Role collaborator

West China Second University Hospital

OTHER

Sponsor Role collaborator

Qilu Hospital of Shandong University

OTHER

Sponsor Role collaborator

Tianjin Medical University Cancer Institute and Hospital

OTHER

Sponsor Role collaborator

Tongji Hospital

OTHER

Sponsor Role collaborator

Xiangya Hospital of Central South University

OTHER

Sponsor Role collaborator

The First Affiliated Hospital of Zhengzhou University

OTHER

Sponsor Role collaborator

Second Affiliated Hospital of Anhui Medical University

UNKNOWN

Sponsor Role collaborator

Children's Hospital of Hebei Province

OTHER

Sponsor Role collaborator

Children's Hospital of Henan Province

UNKNOWN

Sponsor Role collaborator

Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University

OTHER

Sponsor Role collaborator

Children's Cancer Group, China

NETWORK

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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YI JIN GAO, MD

Role: PRINCIPAL_INVESTIGATOR

Shanghai Children&#39;s Medical Center

Locations

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Shanghai Children's Medical Center

Shanghai, , China

Site Status RECRUITING

Countries

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China

Central Contacts

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YI JIN GAO, MD

Role: CONTACT

86-21-38087513

JIE ZHAO

Role: CONTACT

References

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Huang J, Pang WS, Lok V, Zhang L, Lucero-Prisno DE 3rd, Xu W, Zheng ZJ, Elcarte E, Withers M, Wong MCS; NCD Global Health Research Group, Association of Pacific Rim Universities (APRU). Incidence, mortality, risk factors, and trends for Hodgkin lymphoma: a global data analysis. J Hematol Oncol. 2022 May 11;15(1):57. doi: 10.1186/s13045-022-01281-9.

Reference Type BACKGROUND
PMID: 35546241 (View on PubMed)

Bao PP, Li K, Wu CX, Huang ZZ, Wang CF, Xiang YM, Peng P, Gong YM, Xiao XM, Zheng Y. [Recent incidences and trends of childhood malignant solid tumors in Shanghai, 2002-2010]. Zhonghua Er Ke Za Zhi. 2013 Apr;51(4):288-94. Chinese.

Reference Type BACKGROUND
PMID: 23927803 (View on PubMed)

Nie DM, Yuan Q, Yu Y, Wu CJ, Guo X, Zhang AJ, Wang J, Xiao LY, Weng KZ, Fang YJ, Ju XL, Gao J, Xu ZJ, Yang LC, Liu AG, Gao YJ. [A multicenter study on childhood Hodgkin lymphoma treated with HL-2013 regimen in China]. Zhonghua Er Ke Za Zhi. 2022 Nov 2;60(11):1172-1177. doi: 10.3760/cma.j.cn112140-20220312-00196. Chinese.

Reference Type BACKGROUND
PMID: 36319153 (View on PubMed)

Castellino SM, Pei Q, Parsons SK, Hodgson D, McCarten K, Horton T, Cho S, Wu Y, Punnett A, Dave H, Henderson TO, Hoppe BS, Charpentier AM, Keller FG, Kelly KM. Brentuximab Vedotin with Chemotherapy in Pediatric High-Risk Hodgkin's Lymphoma. N Engl J Med. 2022 Nov 3;387(18):1649-1660. doi: 10.1056/NEJMoa2206660.

Reference Type BACKGROUND
PMID: 36322844 (View on PubMed)

Metzger ML, Link MP, Billett AL, Flerlage J, Lucas JT Jr, Mandrell BN, Ehrhardt MJ, Bhakta N, Yock TI, Friedmann AM, de Alarcon P, Luna-Fineman S, Larsen E, Kaste SC, Shulkin B, Lu Z, Li C, Hiniker SM, Donaldson SS, Hudson MM, Krasin MJ. Excellent Outcome for Pediatric Patients With High-Risk Hodgkin Lymphoma Treated With Brentuximab Vedotin and Risk-Adapted Residual Node Radiation. J Clin Oncol. 2021 Jul 10;39(20):2276-2283. doi: 10.1200/JCO.20.03286. Epub 2021 Apr 7.

Reference Type BACKGROUND
PMID: 33826362 (View on PubMed)

Vardhana S, Cicero K, Velez MJ, Moskowitz CH. Strategies for Recognizing and Managing Immune-Mediated Adverse Events in the Treatment of Hodgkin Lymphoma with Checkpoint Inhibitors. Oncologist. 2019 Jan;24(1):86-95. doi: 10.1634/theoncologist.2018-0045. Epub 2018 Aug 6.

Reference Type BACKGROUND
PMID: 30082490 (View on PubMed)

Harker-Murray P, Mauz-Korholz C, Leblanc T, Mascarin M, Michel G, Cooper S, Beishuizen A, Leger KJ, Amoroso L, Buffardi S, Rigaud C, Hoppe BS, Lisano J, Francis S, Sacchi M, Cole PD, Drachtman RA, Kelly KM, Daw S. Nivolumab and brentuximab vedotin with or without bendamustine for R/R Hodgkin lymphoma in children, adolescents, and young adults. Blood. 2023 Apr 27;141(17):2075-2084. doi: 10.1182/blood.2022017118.

Reference Type BACKGROUND
PMID: 36564047 (View on PubMed)

Friedman DL, Chen L, Wolden S, Buxton A, McCarten K, FitzGerald TJ, Kessel S, De Alarcon PA, Chen AR, Kobrinsky N, Ehrlich P, Hutchison RE, Constine LS, Schwartz CL. Dose-intensive response-based chemotherapy and radiation therapy for children and adolescents with newly diagnosed intermediate-risk hodgkin lymphoma: a report from the Children's Oncology Group Study AHOD0031. J Clin Oncol. 2014 Nov 10;32(32):3651-8. doi: 10.1200/JCO.2013.52.5410. Epub 2014 Oct 13.

Reference Type BACKGROUND
PMID: 25311218 (View on PubMed)

Kluge R, Kurch L, Georgi T, Metzger M. Current Role of FDG-PET in Pediatric Hodgkin's Lymphoma. Semin Nucl Med. 2017 May;47(3):242-257. doi: 10.1053/j.semnuclmed.2017.01.001. Epub 2017 Mar 6.

Reference Type BACKGROUND
PMID: 28417854 (View on PubMed)

Mauz-Korholz C, Metzger ML, Kelly KM, Schwartz CL, Castellanos ME, Dieckmann K, Kluge R, Korholz D. Pediatric Hodgkin Lymphoma. J Clin Oncol. 2015 Sep 20;33(27):2975-85. doi: 10.1200/JCO.2014.59.4853. Epub 2015 Aug 24.

Reference Type BACKGROUND
PMID: 26304892 (View on PubMed)

Other Identifiers

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CCCG-HL-2024

Identifier Type: -

Identifier Source: org_study_id

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