Mogamulizumab + Low-Dose Total Skin Electron Beam Tx in Mycosis Fungoides & Sézary Syndrome

Launched by STANFORD UNIVERSITY · Feb 3, 2020

Keywords

ClinConnect Summary

This clinical trial is studying a new treatment approach for patients with two types of skin lymphomas called Mycosis Fungoides (MF) and Sézary Syndrome (SS). The researchers want to find out if combining a medication called mogamulizumab with a type of radiation therapy known as low-dose total skin electron beam therapy (LD-TSEBT) is effective in treating these conditions. They are also looking at how safe this combination is and how well it helps patients compared to previous treatments.

To take part in the trial, participants need to be at least 18 years old and have specific stages of MF or SS, with at least one prior treatment for their condition. They must also meet certain health criteria, such as having adequate blood and liver function. Participants can expect to receive the combined treatment and will be monitored closely for any side effects and changes in their condition. It’s important to note that the trial is currently recruiting participants, so those interested should discuss this opportunity with their healthcare provider.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Stages 1B IV MF or SS
• • 1 prior standard of care therapy
• • Prior LD-TSEBT (\> 3 months prior) and prior mogamulizumab is allowed, as long as progressive disease (PD) did not occur while on therapy, and did not discontinue due to toxicities
• • ≥ 18 years of age
• • The Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 2
• • All clinically-significant toxic effects of prior cancer therapy resolved to Grade ≤ 1 by the National Cancer Institute Common Terminology Criteria for Adverse Events, version 5.0 (NCI-CTCAE, v 5.0).
• • MF and a known history of non-complicated staphylococcus colonization/infection is eligible provided that stable doses of prophylactic antibiotics continue.
• • The following minimum wash-out from previous treatments are required, if applicable.
• • ≥ 4 weeks for retinoids, interferons, Vorinostat, romidepsin, pralatrexate, or other systemic anti-cancer/CTCL therapies
• • ≥ 2 weeks for phototherapy, local radiation therapy
• • ≥ 2 weeks for topical therapy (including topical steroid, retinoid, nitrogen mustard, or imiquimod)
• • ≥ 12 weeks for total skin electron beam therapy
• • ≥ 4 weeks for monoclonal antibodies; except \> 12 weeks for alemtuzumab
• • Rapidly progressive malignant disease may be enrolled prior to above periods after discussion with the Protocol Director.
• • Adequate hematologic function
• • Absolute neutrophil count (ANC) ≥ 1,500 cells/μL (≥ 1,500/mm3); or if known bone marrow involvement, then ANC ≥ 1,000 cells/μL (≥ 1,000/mm3)
• • Platelets ≥ 100,000 cells/μL (≥ 100,000/mm3); or if known bone marrow involvement, then platelets ≥ 75,000 cells/μL (≥ 75,000/mm3).
• • Adequate hepatic function
• • Bilirubin ≤ 1.5 times the specific institutional upper limit of normal (ULN). Exception: If Gilbert's syndrome; then ≤ 5 times ULN.
• • Aspartate transaminase (AST) and alanine transaminase (ALT) each ≤ 2.5 x ULN; or ≤ 5.0 x ULN in the presence of known hepatic involvement by CTCL.
• • Adequate renal function
• • Serum creatinine ≤ 1.5 x ULN; or
• • Calculated creatinine clearance \> 50 mL/min using the Cockcroft Gault formula.
• • If prior allogeneic hematopoietic stem cell transplant (HSCT), then must be free of graft vs host disease (GvHD) and receiving immunosuppressive therapy.
• • Women of childbearing potential (WOCBP) must have a negative pregnancy test.
• • WOCBP must agree to use effective contraception during the study and for 3 months after the last dose.
• • Male participants and their female partners of child bearing potential must be willing to use an appropriate method of contraception during the study and for 3 months after the last dose.
• Exclusion Criteria:
• • MF with limited disease (Stage IA) or central nervous system (CNS) disease
• • Concomitant corticosteroid use. (with the exception that topical steroid and oral prednisone are allowed at ≤ 20 mg/day, if patient has been on a stable dose for at least 4 weeks prior to study treatment)
• • Pregnant or breastfeeding
• • Active autoimmune disease or history deemed by the investigator to be clinically significant
• • Known human immunodeficiency virus (HIV) positivity; known human T-cell lymphotropic virus (HTLV-1) infection; or active hepatitis B or C.
• • Active herpes simplex or herpes zoster. Those receiving prophylaxis for herpes and who started taking medication at least 30 days prior to the Screening Visit, and have no active signs of active infection, and whose last active infection was more than 6 months ago, may enter the study, and should continue to take the prescribed medication for the duration of the study.