To determine the recommended phase 2 dose of chemotherapy in combination with Pembrolizumab
in subjects with advanced lymphoma and determine the complete response rate.
1. Patient at least 18 years old and has definitive histologically or cytologically
confirmed: classical Hodgkin lymphoma (HL) or diffuse large B-Cell lymphoma (DLBCL)
non-Hodgkin lymphoma (NHL).
2. Patient has one or more metastatic lesions >1.5 cm as defined by lymphoma response
criteria by PET-CT scan. If CT scan is needed for clarification of findings on PET-CT
it may be done additionally. Tumor sites that are considered measureable must not
have received prior radiation therapy.
3. Patients can be enrolled only on one of the treatment arms on this trial.
4. The investigator will select the appropriate treatment arm for the patient with the
following requirements: (a) Patients cannot have had prior progression or intolerance
on the single agent chemotherapy and then enrolled on an arm with that same single
agent chemotherapy plus pembro (b) The chemotherapy on the arm selected must be
considered standard of care or listed in www.nccn.org for that cancer type.
5. Have recovered from acute toxicities of prior treatment:
- > 3 weeks must have elapsed since receiving any investigational agent.
- > 2 weeks must have elapsed since receiving any radiotherapy, or ≥ 3 weeks or 5
half-lives whichever is shorter for treatment with cytotoxic or biologic agents
( ≥ 6 weeks for mitomycin or nitrosoureas). Chronic treatment with
non-investigational gonadotropin-releasing hormone analogs or other hormonal or
supportive care is permitted.
6. Patient has adequate biological parameters as demonstrated by the following blood
counts at time of screening:
7. Absolute neutrophil count (ANC) > 1000/ microliter, platelet count ≥ 75,000/
microliter, hemoglobin ≥ 9 g/dL. Subject can be given packed red blood cell
8. Calculated creatinine clearance > 50 ml/min by Cockroft-Gault equation, total
bilirubin 1.5 times the upper limit of normal (ULN) range, AST/ALT ≤ 3 times the
upper limit of normal (ULN) range.
9. Thyroid stimulating hormone (TSH) within institutional normal limits. If TSH is above
the upper limit of normal range, then a free T4 within institutional normal limits is
10. At least 100 days must have elapsed in subjects that had a prior autologous
11. Resolution of prior systemic therapy non-hematologic AE to grade ≤ 2 (except alopecia
or correctable electrolyte abnormality with supplementation)
12. Patient has a Karnofsky performance status (KPS) ≥ 60.
13. Women of child-bearing potential (i.e., women who are pre-menopausal or not
surgically sterile) must be willing to use an acceptable contraceptive method
(abstinence, oral contraceptive or double barrier method) for the duration of the
study and for 4 months following the last dose of Pembrolizumab, brentuximab vedotin,
or for 2 years following the last dose of chemotherapy on this trial, and must have a
negative urine or serum pregnancy test within 2 weeks prior to beginning treatment on
this trial. If a female subject or female partner of a male subject becomes pregnant
during this period then patient will be recommended to seek appropriate obstetric
care. The study will not be monitoring subjects or female partners of subjects for
pregnancy after the last dose of study drug or chemotherapy.
1. Active clinically serious infection > Grade 2.
2. Serious non-healing wound, ulcer, or bone fracture.
3. Patient has known brain metastases.
4. Patient has with myelodysplasia, polycythemia vera, idiopathic thrombocythemia,
myelofibrosis, or acute leukemia.
5. Inability to complete informed consent process and adhere to the protocol treatment
plan and follow-up requirements.
6. Patient has known active infection with HIV, hepatitis B, or hepatitis C (patients
will be required to be tested for the presence of such viruses prior to therapy on
7. Ejection fraction measuring less than 45% (measurement of ejection fraction is
required only for subjects with prior anthracycline exposure).
8. Requiring daily corticosteroid dose ≥ 10 mg prednisone or equivalent per day.
9. Patient has undergone major surgery, other than diagnostic surgery (e.g., surgery
done to obtain a biopsy for diagnosis without removal of an organ), within 4 weeks
prior to Day 1 of treatment in this study.
10. Patient has a history of allergy or hypersensitivity to any of the study drugs or any
of their excipients, or the patient exhibits any of the events outlined in the
Contraindication or Special Warnings and Precautions sections of the product or
comparator SmPC or Prescribing Information.
11. Patient has serious medical risk factors involving any of the major organ systems, or
serious psychiatric disorders, which could compromise the patient's safety or the
study data integrity.
12. Patient will be receiving any other anti-cancer therapy during participation in this
13. Prior treatment with Pembrolizumab is not allowed. Prior receipt of other PD-1
inhibitors or PD-L1 inhibitors is allowed.
14. Active or prior documented autoimmune disease requiring systemic treatment within the
past 2 years.