Brentuximab Vedotin or Crizotinib and Combination Chemotherapy in Treating Patients With Newly Diagnosed Stage II-IV Anaplastic Large Cell Lymphoma

Not Recruiting

Trial ID: NCT01979536


This partially randomized phase II trial studies how well brentuximab vedotin or crizotinib and combination chemotherapy works in treating patients with newly diagnosed stage II-IV anaplastic large cell lymphoma. Brentuximab vedotin is a monoclonal antibody, called brentuximab, linked to a toxic agent called vedotin. Brentuximab attaches to CD30 positive cancer cells in targeted way and delivers vedotin to kill them. Crizotinib and methotrexate may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth. Drugs used in chemotherapy work in different ways to stop the growth of cancer cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. It is not yet known whether brentuximab vedotin and combination chemotherapy is more effective than crizotinib and combination chemotherapy in treating anaplastic large cell lymphoma.

Official Title

A Randomized Phase 2 Trial of Brentuximab Vedotin (SGN35, NSC# 749710), or Crizotinib (NSC#749005, Commercially Labeled) in Combination With Chemotherapy for Newly Diagnosed Patients With Anaplastic Large Cell Lymphoma (ALCL)

Stanford Investigator(s)


Inclusion Criteria:

   - Newly diagnosed patients with histologically proven ALCL (International Classification
   of Diseases for Oncology [ICD-0] code: 9714/3)

   - Disease must be cluster of differentiation (CD)30 positive

   - Disease must be anaplastic lymphoma kinase (ALK) positive (defined by local
   institutional standards)

   - Patients must have stage II, III, or IV disease

   - Patients must have a life expectancy of >= 8 weeks

   - Adequate Liver Function Defined As:

   - Total bilirubin =< 1.5 x upper limit of normal (ULN) for age (within 7 days prior to

   - Alanine aminotransferase (ALT) (serum glutamate pyruvate transaminase [SGPT]) < 2.5 x
   upper limit of normal (ULN) for age; for the purpose of this study, the ULN for ALT is
   45 U/L (within 7 days prior to enrollment)

   - If the lab abnormality is thought to be due to the lymphoma the patient is eligible
   and dose adjustments should be made

   - Adequate Cardiac Function Defined As:

   - Shortening fraction of >= 27% by echocardiogram, or

   - Ejection fraction of >= 50% by radionuclide angiogram

   - Adequate Pulmonary Function Defined As:

   - Patients with a history of pulmonary dysfunction must have no evidence of dyspnea at
   rest, no exercise intolerance due to pulmonary insufficiency, and a pulse oximetry >
   92% while breathing room air unless current dysfunction is due to the lymphoma in
   which case the patient is eligible

Exclusion Criteria:

   - Patients with central nervous system (CNS) disease are not eligible

   - Patients with disease limited to the skin are not eligible, regardless of how

   - Patients with stage I disease are not eligible

   - Patients who have received any prior cytotoxic chemotherapy for the current diagnosis
   of ALCL or any cancer diagnosed previously are not eligible

   - Previous steroid treatment and/or radiation treatment is not allowed unless it is for
   the emergent management of a mediastinal mass; emergent steroid treatment and/or
   radiation treatment should stop once protocol therapy is initiated

   - Intrathecal chemotherapy prior to enrollment is allowed for the current diagnosis of
   ALCL as long as adequate cerebrospinal fluid (CSF) is obtained prior to administration
   of the intrathecal chemotherapy and subsequently demonstrated to be negative for ALCL

   - Female patients who are pregnant are not eligible; pregnancy tests must be obtained in
   girls who are post menarchal

   - Lactating females are not eligible unless they have agreed not to breastfeed their

   - Sexually active patients of reproductive potential are not eligible unless they agree
   to use an effective contraceptive method for the duration of treatment and for 3
   months after stopping treatment

   - Patients with Down syndrome are not eligible due to the amount of methotrexate and
   potential for side effects

   - Patients with an immunodeficiency that existed prior to diagnosis such as primary
   immunodeficiency syndromes or organ transplant recipients are not eligible

   - Cytochrome P450, family 3, subfamily A, polypeptide 4 (CYP3A4) substrates with narrow
   therapeutic indices: Patients chronically receiving medications known to be
   metabolized by CYP3A4 and with narrow therapeutic indices including pimozide,
   aripiprazole, triazolam, ergotamine and halofantrine are not eligible; the topical use
   of these medications (if applicable) is allowed

   - CYP3A4 inhibitors: patients chronically receiving drugs that are known potent CYP3A4
   inhibitors within 7 days prior to study enrollment, including but not limited to
   ketoconazole, itraconazole, clarithromycin, erythromycin, ritonavir, indinavir,
   nelfinavir, saquinavir, delavirdine, nefazodone, diltiazem, verapamil, and grapefruit
   juice are not eligible; the topical use of these medications (if applicable), e.g. 2%
   ketoconazole cream, is allowed

   - CYP3A4 inducers: patients chronically receiving drugs that are known potent CYP3A4
   inducers within 12 days prior to study enrollment, including but not limited to
   carbamazepine, phenobarbital, phenytoin, rifabutin, rifampin, ritonavir, and St.
   John's wort are not eligible; the topical use of these medications (if applicable) is

   - Patients that are known to be positive for human immunodeficiency virus (HIV) are not
   eligible; note: inclusion of HIV positive patients will be considered at a later date

   - Patients who weigh < 10 kg are not eligible


drug: Ifosfamide

drug: Methotrexate

drug: Doxorubicin Hydrochloride

drug: Brentuximab Vedotin

drug: Crizotinib

drug: Cyclophosphamide

drug: Cytarabine

drug: Dexamethasone

drug: Etoposide

Not Recruiting

Contact Information

Stanford University
School of Medicine
300 Pasteur Drive
Stanford, CA 94305
Christin New

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