About this trial
The phase I part (safety assessment of the combination treatment) is aimed at determining the MTD of atezolizumab when combined with BEGEV schedule.
6-18 patients enrolled in this part will be treated with atezolizumab in combination with BEGEV regimen every 3 weeks for 4 cycles.
Patients without a DLT in the first cycle and without disease progression after cycle 2, will undergo stem cell mobilization with 3-4 cycle of A-BEGEV + granulocyte colony-stimulating factor (G-CSF) and subsequently receive a myeloablative therapy followed by ASCT.
The phase IIb part (expansion cohort) plans to randomize 122 patients in two arms (A and B, 61 per arm):
1. arm A will receive the BEGEV regimen followed by ASCT for patients achieving CR. 2. arm B will receive combination treatment with Atezolizumab and BEGEV regimen followed for patients reaching CR by ASCT plus a consolidation with 6 doses of atezolizumab at 1200 mg every 4 weeks.
After the last treatment date of the last patient (LPLT), the phase IIb will be ended. A long term follow up will start, in order to better assess patients' prognosis. All evaluable patients from phase I and phase IIb study will enter in the long term follow up phase and will be followed for 18 months.
Eligibility criteria
Qualifiers
18-60 years old (upper limit valid only for phase I).
Histologically confirmed cHL, at first disease relapse or refractory to a first-line treatment or with documented persistent disease at interim positron emission tomography (PET) performed after 2 cycles of first line (ABVD/ABVD like/BEACOPP).
Only one prior systemic therapy for Hodgkin's lymphoma (HL).
First disease relapse or refractory to a first-line treatment.
Disqualifiers
More than one prior systemic therapy for HL.
Presence of autoimmune disease (based on medical history): systemic lupus erythematosus, autoimmune thyroid disease (Hashimoto's thyroiditis, Basedow's disease), Sjögren's syndrome, glomerulonephritis, multiple sclerosis, rheumatoid arthritis, vasculitis, idiopathic pulmonary fibrosis (includine bronchiolitis obliterans organizing pneumonia) and inflammatory bowel disease (Crohn's disease, ulcerative colitis).
Previous skin toxicity (i.e. Steven-Johnson Sdr, severe skin reactions.
Prior allogeneic stem cell transplantation or prior solid organ transplant.
Trial design
Treatments tested in this trial
- Atezolizumab
- BEGEV
Treatment groups
Sponsors and collaborators
Fondazione Italiana Linfomi - ETS
Lead sponsor
Roche Pharma AG
Collaborator