This phase I/II trial studies the side effects of pembrolizumab and romidepsin and to see how well they work in treating participants with peripheral T-cell lymphoma that has come back or that does not respond to treatment. Immunotherapy with monoclonal antibodies, such as pembrolizumab, may help the body's immune system attack the cancer, and may interfere with the ability of tumor cells to grow and spread. Romidepsin may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Giving pembrolizumab and romidepsin may work better than pembrolizumab alone in treating participants with recurrent or refractory peripheral T-cell lymphoma.
Primary Objectives: 1. Evaluate the safety of pembrolizumab in combination with romidepsin. 2. Estimate the response rate of the combination therapy in refractory or recurrent PTCL Secondary Objectives: 1. Estimate progression free survival (PFS). 2. Estimate overall survival (OS). 3. Estimate complete response (CR) and duration of response (DOR). 4. Estimate the event-free survival (EFS) and the failure free survival (FFS) 5. Estimate the overall response rate (ORR) per Lugano criteria. Exploratory Objectives: 1. Assess activation of T-cells after treatment in peripheral blood and tumor microenvironment. 2. Correlate features of peripheral blood T-cell activation with toxicities, clinical response, and PFS. OUTLINE: Participants receive romidepsin intravenously (IV) over 4 hours on days 1 and 8 or day 8 of cycle 1 and days 1 and 8 of subsequent cycles and pembrolizumab IV over 30 minutes on day 1. Cycles repeat every 21 days for up to 36 cycles in the absence of disease progression or unacceptable toxicity. After completion of study treatment, participants are followed up at 30 days and then every 12 weeks.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
39
Given IV
Given IV
M D Anderson Cancer Center
Houston, Texas, United States
Dose limiting toxicity (Phase I)
As determined by incidence of adverse events graded according to Common Terminology Criteria for Adverse Events (CTCAE) version 4.0. The phase I portion of the study follows standard 3+3 design. The 6 patients tested in the phase I at the dose finally determined as recommended phase II dose (RP2D) will be included in the response assessment of phase II study. Toxicity data will be summarized by type and severity for all patients who received the treatment regardless of the eligibility nor the duration or dose of the treatment received.
Time frame: Up to 21 days
Overall response (OR) (Phase II)
As determined by Lugano Revised Response Criteria, International Society for Cutaneous Lymphomas (ISCL) for Research, and the European Organization for Research and Treatment of Cancer (EORTC) criteria. Response is defined by the best response during the therapy, as defined by the schedule of response evaluation. Summary statistics will be provided for continuous variables and categorical variables. The complete response (CR) and OR rates and their 95% confidence intervals will be reported. Fisher's exact test will be used to evaluate the association between two categorical variables. Wilcoxon rank sum test will be used to assess the difference in a continuous variable between patient groups.
Time frame: Up to 3 years
Progression-free survival (PFS)
Patients alive without progression are censored at the date they were last known to be without progression or recurrence and alive for PFS. Will be estimated using the method of Kaplan and Meier.
Time frame: From the date of study registration and the date of progression, recurrence, or death without progression, whichever comes first, assessed up to 3 years
Overall survival
Will be estimated using the method of Kaplan and Meier.
Time frame: From the date of study registration to the date of death from any cause, assessed up to 3 years
Complete response
As determined by Lugano Revised Response Criteria, ISCL for Research and the EORTC criteria. Response is defined by the best response during the therapy, as defined by the schedule of response evaluation. Summary statistics will be provided for continuous variables and categorical variables. The CR and OR rates and their 95% confidence intervals will be reported. Fisher's exact test will be used to evaluate the association between two categorical variables. Wilcoxon rank sum test will be used to assess the difference in a continuous variable between patient groups.
Time frame: Up to 3 years
Duration of response
As determined by Lugano Revised Response Criteria, ISCL for Research, and the EORTC criteria. Response is defined by the best response during the therapy, as defined by the schedule of response evaluation. Summary statistics will be provided for continuous variables and categorical variables Fisher's exact test will be used to evaluate the association between two categorical variables. Wilcoxon rank sum test will be used to assess the difference in a continuous variable between patient groups. Will be estimated using the method of Kaplan and Meier.
Time frame: Up to 3 years
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.