| E.1 Medical condition or disease under investigation |
| E.1.1 | Medical condition(s) being investigated |
| Nodular lymphocyte-predominant Hodgkin’s lymphoma in childhood and adolescence. |
|
| E.1.1.1 | Medical condition in easily understood language |
| Patients with nodular lymphocyte-predominant Hodgkin’s lymphomastage IA and IIA under 18 years of age. |
|
| E.1.1.2 | Therapeutic area | Diseases [C] - Cancer [C04] |
| MedDRA Classification |
| E.1.2 Medical condition or disease under investigation |
| E.1.2 | Version | 17.1 |
| E.1.2 | Level | LLT |
| E.1.2 | Classification code | 10020328 |
| E.1.2 | Term | Hodgkin's lymphoma |
| E.1.2 | System Organ Class | 100000004864 |
|
| E.1.3 | Condition being studied is a rare disease | Yes |
| E.2 Objective of the trial |
| E.2.1 | Main objective of the trial |
Building on the experience of the European PHL study groups since 1978, first line therapy for childhood nodular lymphocytepredominant Hodgkin’s lymphoma shall be further optimised to avoid over-treatment and decrease long-term complications.
- Surgery alone for patients with stage IA disease and
complete resection.
- Low intensity chemotherapy with CVP (Cyclophosphamide, Vinblastine and Prednisolone (or Prednisone)) for patients with stage IA and incomplete resection or stage IIA disease.
The aim objective of this study is, for patients with complete resection group: Statistically estimate the five year event free survival rate with meaningful precision and show it is at least above 50% (target 70%) ; and for patients with residual disease receiving 3 CVP: Statistically estimate the 5 year event free survival rate in all patients receiving CVP chemotherapy. |
|
| E.2.2 | Secondary objectives of the trial |
| Low intensity of treatment of early stage LPHL does not result in reduction in overall OS rates or in significant upstaging at relapse or increased rates of histological transformation. |
|
| E.2.3 | Trial contains a sub-study | No |
| E.3 | Principal inclusion criteria |
Trial sites register patients at their corresponding study office if the following requirements are met:
• nodular lymphocyte-predominant Hodgkin’s lymphoma confirmed by reference
pathology
• initial stage IA/IIA (according to local staging) or relapse stage IA or IIA and residual tumour after relapse biopsy and no additional surgery planned in nLP patients relapsing after surgery alone
• patient aged under 18 years at time of diagnosis
• written informed consent of the patient and/or the patient’s parents or guardian according to national laws. |
|
| E.4 | Principal exclusion criteria |
Patients with one of the following circumstances are excluded :
• Pre-treatment of Hodgkin’s lymphoma differing from study protocol
• Any extra-nodal involvement
• Inability to fulfil protocol requirements for imaging (CT, MRI, FDG-PET) at staging and response assessment
• Known hypersensitivity or contraindication to study drugs
• Prior chemotherapy or radiotherapy
• Current or recent therapy (within 30 days prior to the start of trial treatment) with steroids
• Current or recent (within 30 days prior to the start of trial treatment) treatment with another investigational drug or participation in another investigational trial
• Other (simultaneous) malignancies
• Severe concomitant diseases (e.g. immune deficiency syndrome)
• Known HIV positivity
• Pregnancy and / or lactation
• Females who are sexually active refusing to use effective contraception (oral
contraception, intrauterine devices, barrier method of contraception in conjunction with spermicidal jelly or surgical sterile) (except for surgery only) |
|
| E.5 End points |
| E.5.1 | Primary end point(s) |
Event free survival (EFS):= time from registration until the first of the following events:
• additional treatment for Hodgkin’s Lymphoma
• progression/relapse of disease
• occurrence of a secondary malignancy
• death by any cause
For patients allocated to the CVP group failure to achieve a good response constitutes an indication for additional treatment and counts as event. |
|
| E.5.1.1 | Timepoint(s) of evaluation of this end point |
|
| E.5.2 | Secondary end point(s) |
1. Significant upstaging at relapse defined as development of symptoms or extra-nodal disease or relapse stage > II.
2. Overall survival (OS).
3. CTC (Common toxicity criteria) toxicity levels of therapy elements.
4. Complications of surgery. |
|
| E.5.2.1 | Timepoint(s) of evaluation of this end point |
|
| E.6 and E.7 Scope of the trial |
| E.6 | Scope of the trial |
| E.6.1 | Diagnosis | No |
| E.6.2 | Prophylaxis | No |
| E.6.3 | Therapy | Yes |
| E.6.4 | Safety | No |
| E.6.5 | Efficacy | Yes |
| E.6.6 | Pharmacokinetic | No |
| E.6.7 | Pharmacodynamic | No |
| E.6.8 | Bioequivalence | No |
| E.6.9 | Dose response | No |
| E.6.10 | Pharmacogenetic | No |
| E.6.11 | Pharmacogenomic | No |
| E.6.12 | Pharmacoeconomic | No |
| E.6.13 | Others | No |
| E.7 | Trial type and phase |
| E.7.1 | Human pharmacology (Phase I) | No |
| E.7.1.1 | First administration to humans | No |
| E.7.1.2 | Bioequivalence study | No |
| E.7.1.3 | Other | No |
| E.7.1.3.1 | Other trial type description | |
| E.7.2 | Therapeutic exploratory (Phase II) | Yes |
| E.7.3 | Therapeutic confirmatory (Phase III) | No |
| E.7.4 | Therapeutic use (Phase IV) | No |
| E.8 Design of the trial |
| E.8.1 | Controlled | No |
| E.8.1.1 | Randomised | No |
| E.8.1.2 | Open | Yes |
| E.8.1.3 | Single blind | No |
| E.8.1.4 | Double blind | No |
| E.8.1.5 | Parallel group | No |
| E.8.1.6 | Cross over | No |
| E.8.1.7 | Other | No |
| E.8.2 | Comparator of controlled trial |
| E.8.2.1 | Other medicinal product(s) | No |
| E.8.2.2 | Placebo | No |
| E.8.2.3 | Other | No |
| E.8.3 |
The trial involves single site in the Member State concerned
| No |
| E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
| E.8.4.1 | Number of sites anticipated in Member State concerned | 29 |
| E.8.5 | The trial involves multiple Member States | Yes |
| E.8.5.1 | Number of sites anticipated in the EEA | 46 |
| E.8.6 Trial involving sites outside the EEA |
| E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
| E.8.6.2 | Trial being conducted completely outside of the EEA | No |
| E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
| Switzerland |
| United States |
|
| E.8.7 | Trial has a data monitoring committee | Yes |
| E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
|
|
| E.8.9 Initial estimate of the duration of the trial |
| E.8.9.1 | In the Member State concerned years | 1 |
| E.8.9.1 | In the Member State concerned months | 6 |
| E.8.9.1 | In the Member State concerned days | 0 |
| E.8.9.2 | In all countries concerned by the trial years | 4 |
| E.8.9.2 | In all countries concerned by the trial months | 11 |
| E.8.9.2 | In all countries concerned by the trial days | 30 |