Dosing of Brentuximab Vedotin for Mycosis Fungoides, Sezary Syndrome Patients

Inclusion Criteria:

Mycosis fungoides (MF) and Sezary Syndrome (SS)

   1. Pathologically confirmed mycosis fungoides/sezary syndrome at the enrolling
   institution, disease stage IB (defined as patches, plaque, or papules that involve 10%
   of the skin surface viscera) or higher

   ° CD30 negative mycosis fungoides patients are eligible.

   2. Age ≥ 18 years

   3. ECOG Performance Score ≤ 2

   4. For Cohort 1, patients who have not received brentuximab vedotin are eligible.

   5. For Cohort 2, patients who have previously had brentuximab vedotin for MF/SS are
   eligible. Patients previously treated on Cohort 1 who were discontinued due to
   toxicity are not eligible for Cohort 2.

   6. Previous systemic anti-cancer therapy must have been discontinued at least 2 weeks
   prior to treatment.

   ° See section 6.2 Subject Exclusion Criteria for guidelines regarding adjuvant and
   maintenance therapy for prior malignancy.

   7. Topical or systemic steroids (equivalent to ≤ 10 mg/day of prednisone) may be
   considered if dose has been constant and discontinuation may lead to rebound flare in
   disease, adrenal insufficiency, and/or unnecessary suffering, after discussion with
   PI.

   8. If HIV+, patient must be on stable anti-retroviral treatment for 12 weeks prior to
   C1D1, with CD4 count >200 within 7 days prior to C1D1.

   9. Females of childbearing potential must be on acceptable form of birth control per
   instutional standard.

Lymphomatoid papulosis (LyP)

   1. Pathologically confirmed lymphomatoid papulosis at the enrolling institution

   2. Requiring systemic treatment per investigator's discretion

   3. Age ≥ 18 years

   4. ECOG Performance Score ≤ 2

   5. Previous systemic anti-cancer therapy must have been discontinued at least 2 weeks
   prior to treatment.

   6. Topical or systemic steroids (equivalent to ≤ 10 mg/day of prednisone) may be
   considered if dose has been constant and discontinuation may lead to rebound flare in
   disease, adrenal insufficiency, and/or unnecessary suffering.

   7. If HIV+, patient must be on stable anti-retroviral treatment for 12 weeks prior to
   C1D1, with CD4 count >200 within 7 days prior to C1D1.

   8. Females of childbearing potential must be on acceptable form of birth control per
   institutional standard

Exclusion Criteria:

   1. Concurrent use of other systemic anti-cancer agents or treatments for mycosis
   fungoides/sezary syndrome, or lymphomatoid papulosis.

   2. Grade 2 or greater neuropathy

   3. Severe renal impairment (CrCL <30 mL/min)

   4. Moderate or severe hepatic impairment (Child-Pugh B or Child-Pugh C)

   ° See Appendix E for Child Pugh Classification chart

   5. Women of reproductive potential† must have a negative Serum ß human chorionic
   gonadotropin (ß-HCG) pregnancy test within 1 week of C1D1. They should discuss
   contraception with treating provider.

   6. Previous use of brentuximab vedotin (for Cohort 1 ONLY)

   7. Receiving systemic therapy for another primary malignancy (other than T-cell
   lymphoma).

      - Patients with more than one type of lymphoma may be enrolled after discussion
      with the MSK Principal Investigator.

      - Adjuvant or maintenance therapy to reduce the risk of recurrence of other
      malignancy (other than T-cell lymphoma) is permissible after discussion with the
      MSK Principal Investigator.

   8. For Cohort 2, patients who previously progressed on the standard 1.8mg/kg dose and
   schedule of brentuximab vedotin are ineligible.

      - A female of reproductive potential is a sexually mature female who: has not
      undergone a hysterectomy or bilateral oophorectomy; or has not been naturally
      postmenopausal for at least 24 consecutive months (i.e. has had menses at any
      time in the preceding 24 consecutive months).