Brentuximab Vedotin Plus AD in Non-bulky Limited Stage Hodgkin Lymphoma
Condition: Hodgkin Lymphoma
MeSH terms: Lymphoma; Hodgkin Disease
Intervention: Brentuximab Vedotin; Adriamycin; Dacarbazine
Intervention MeSH terms: Doxorubicin; Liposomal doxorubicin; Dacarbazine; Brentuximab Vedotin; Imidazole
Phase: Phase 2
Study type: Interventional
Primary purpose: Treatment
Intervention model: Single Group Assignment
Masking: None (Open Label)
Enrollment: 34.0
Sex: All
Minimum age: 18 Years
Healthy volunteers: No
Keywords: limited stage; Hodgkin's disease; non-bulky

Summary:

      Limited stage Hodgkin lymphoma is a highly curable disease, but standard treatment with ABVD
      chemotherapy and radiation can lead to late risks of secondary cancers, lung injury, heart
      injury, and others. This trial eliminates radiation therapy and reduces intensity of
      chemotherapy by incorporating the highly active FDA-approved targeted therapy brentuximab
      vedotin, an antibody-drug conjugate specifically against the lymphoma cells, combined with
      the standard chemotherapy drugs Adriamycin and Dacarbazine (AD).
    

Eligibility criteria:

        Inclusion Criteria:

          -  Previously untreated stage IA, IB, or IIA classical Hodgkin Lymphoma

          -  Non-bulky disease defined as less than 10 cm in maximal diameter

          -  Measurable disease ≥1.5 cm

          -  Age ≥18

          -  ECOG performance status 0-2 (see Appendix B)

          -  Participants must have initial organ and marrow function as defined below:

               -  Absolute neutrophil count ≥ 1,000/mcL

               -  Platelets ≥100,000/mcL

               -  Total bilirubin ≤ 2, unless due to Gilbert's disease

               -  AST (SGOT)/ALT (SGPT) ≤ 2.5 X institutional upper limit of normal

               -  Creatinine clearance ≥ 30 mL/min

          -  LVEF by echocardiogram or MUGA within institutional normal limits

          -  Participant must be willing to use two effective forms of birth control during
             protocol therapy. Men and women must continue using two effective forms of birth
             control for 6 months following treatment.

          -  Ability to understand and the willingness to sign a written informed consent document

        Exclusion Criteria:

          -  Participants who have had prior cHL-directed chemotherapy or radiotherapy

          -  Participants may not be receiving any other investigational agents

          -  Participants with known CNS involvement of lymphoma

          -  History of allergic reactions attributed to compounds of similar chemical or biologic
             composition to Adriamycin, Dacarbazine, or brentuximab

          -  Pre-existing grade 2 or greater neuropathy

          -  Uncontrolled intercurrent illness including, but not limited to ongoing or active
             infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac
             arrhythmia, or psychiatric illness/social situations that would limit compliance with
             study requirements

          -  Pregnant women are excluded from this study because brentuximab is an antibody drug
             conjugate with a linked potent anti-tubule agent with the potential for teratogenic or
             abortifacient effects. Because there is an unknown but potential risk of adverse
             events in nursing infants secondary to treatment of the mother with brentuximab,
             breastfeeding should be discontinued if the mother is treated with brentuximab. These
             potential risks may also apply to other agents used in this study.

          -  Participants with a history of a different malignancy are ineligible unless they have
             been disease free for 1 year and considered at low risk for relapse, except for:
             cervical cancer in situ, ductal carcinoma in situ, localized prostate cancer with no
             detectable disease by imaging studies, and non-melanoma cancers of the skin, which are
             eligible at any time.

          -  Known HIV positivity