- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT00068315
Bortezomib and Fludarabine With or Without Rituximab in Treating Patients With Relapsed or Refractory Indolent Non-Hodgkin's Lymphoma or Chronic Lymphocytic Leukemia
A Phase I Trial of PS-341 and Fludarabine for Relapsed and Refractory Indolent Non-Hodgkin's Lymphoma and Chronic Lymphocytic Leukemia
Study Overview
Status
Conditions
- Extranodal Marginal Zone B-cell Lymphoma of Mucosa-associated Lymphoid Tissue
- Nodal Marginal Zone B-cell Lymphoma
- Recurrent Adult Diffuse Small Cleaved Cell Lymphoma
- Recurrent Grade 1 Follicular Lymphoma
- Recurrent Grade 2 Follicular Lymphoma
- Recurrent Mantle Cell Lymphoma
- Recurrent Marginal Zone Lymphoma
- Splenic Marginal Zone Lymphoma
- Waldenström Macroglobulinemia
- Hematopoietic/Lymphoid Cancer
- Recurrent Small Lymphocytic Lymphoma
- Refractory Chronic Lymphocytic Leukemia
Intervention / Treatment
Detailed Description
OBJECTIVES:
I. Determine the safety and toxicity of bortezomib and fludarabine with or without rituximab in patients with relapsed or refractory indolent non-Hodgkin's lymphoma or chronic lymphocytic leukemia.
II. Determine the maximum tolerated dose of bortezomib in combination with fludarabine in these patients.
III. Determine the biological effect of this regimen on apoptotic markers, cell cycle kinase inhibitors, and DNA repair in these patients.
OUTLINE: This is a multicenter, dose-escalation study of bortezomib.
Patients receive bortezomib IV over 3-5 seconds on days 1, 4, 8, and 11 and fludarabine IV over 30 minutes on days 1-3 or 1-5. Patients may also receive rituximab IV over 1 hour on day 1. Treatment repeats every 3 weeks for up to 8 courses in the absence of disease progression or unacceptable toxicity. Cohorts of 3-6 patients receive escalating doses of bortezomib until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity.
Patients are followed every 3 months for 2 years, every 6 months for 3 years, and then annually thereafter.
Study Type
Enrollment (Actual)
Phase
- Phase 1
Contacts and Locations
Study Locations
-
-
Ohio
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Canton, Ohio, United States, 44708
- Mercy Medical Center
-
Cleveland, Ohio, United States, 44106
- Case Western Reserve University
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Cleveland, Ohio, United States, 44106
- Seidman Cancer Center at University Hospitals Case Medical Center, Case Comprehensive Cancer Center
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Middleburg Heights, Ohio, United States, 44130
- Southwest General Health Center Ireland Cancer Center
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Orange Village, Ohio, United States, 44122
- UHHS-Chagrin Highlands Medical Center
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South Euclid, Ohio, United States, 44121
- University Suburban Medical Center
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Westlake, Ohio, United States, 44145
- UHHS-Westlake Medical Center
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-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
Diagnosis of chronic lymphocytic leukemia (CLL) OR indolent non-Hodgkin's lymphoma (NHL) of any of the following subtypes:
Follicular lymphoma:
- Grade I follicular small cleaved cell;
- Grade II follicular mixed cell;
- Grade II follicular large cell;
- Diffuse small cleaved cell;
- Small lymphocytic lymphoma;
- Lymphoplasmacytic lymphoma (Waldenstrom's macroglobulinemia)
AND
- Extranodal marginal zone B-cell lymphoma (mucosa-associated lymphoid tissue [MALT] lymphoma);
- Nodal marginal zone B-cell lymphoma (monocytoid B-cell lymphoma);
- Splenic marginal zone lymphoma (splenic lymphoma with villous lymphocytes);
Mantle cell lymphoma:
- No blastic phase mantle cell lymphoma
Relapsed or refractory, progressive disease:
- First, second, or third relapse
Measurable disease, meeting 1 of the following criteria:
- At least 1 unidimensionally measurable lesion at least 20 mm by conventional techniques OR at least 10 mm by spiral CT scan (for NHL patients);
OR:
- Lymphocytosis > 50,000/mm3 OR evidence of progressive bone marrow infiltration failure (e.g., hemoglobin 10 g/dL) OR thrombocytopenia (i.e., platelet count < 100,000/mm3) with > 30% infiltration of bone marrow by leukemia (for CLL patients)
- No measurable lymphadenopathy (for CLL and Waldenstrom's macroglobulinemia patients)
- No evidence of CNS lymphoma
Performance status:
- ECOG 0-2
Life expectancy:
- More than 12 weeks
- No history of uncontrolled orthostatic hypotension
- No symptomatic congestive heart failure
- No unstable angina pectoris
- No cardiac arrhythmia
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective contraception
- HIV negative
- No uncontrolled concurrent illness
- No grade 2 or greater neuropathy
- No history of allergy or anaphylaxis to mannitol, bortezomib, fludarabine, or boron
- No ongoing or active infection
- No psychiatric illness or social situation that would preclude study compliance
At least 4 weeks since prior monoclonal antibody (MoAB) therapy:
- Patients who have received MoAB therapy within the past 3 months must have documented disease progression since receiving this therapy
- No prior allogeneic stem cell transplantation
- More than 4 weeks since prior chemotherapy
- Prior fludarabine allowed
- At least 1 week since prior steroids
- At least 3 months since prior radio-immunotherapy
- More than 4 weeks since prior radiotherapy
- No prior bortezomib
- Absolute neutrophil count at least 1,500/mm3
- Platelet count at least 75,000/mm3 (greater than 50,000/mm3 if lymphomatous bone marrow involvement is present)
- Bilirubin no greater than 2.0 mg/dL
- AST/ALT no greater than 4 times normal
- Creatinine clearance greater than 40 mL/min
- No other concurrent investigational agents or treatments for the malignancy
- No brain metastases
- OR:
Quantitation of IgM paraprotein (for Waldenstrom's macroglobulinemia patients)
Study Plan
How is the study designed?
Design Details
- Primary Purpose: TREATMENT
- Allocation: NA
- Interventional Model: SINGLE_GROUP
- Masking: NONE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Treatment (bortezomib, fludarabine, rituximab)
Patients receive bortezomib IV over 3-5 seconds on days 1, 4, 8, and 11 and fludarabine IV over 30 minutes on days 1-3 or 1-5. Patients may also receive rituximab IV over 1 hour on day 1. Treatment repeats every 3 weeks for up to 8 courses in the absence of disease progression or unacceptable toxicity. Cohorts of 3-6 patients receive escalating doses of bortezomib until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity. |
Given IV
Other Names:
Given IV
Other Names:
Given IV
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Maximum tolerated dose (MTD) assessed by Common Toxicity Criteria version 2.0
Time Frame: 3 weeks
|
3 weeks
|
Collaborators and Investigators
Sponsor
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Pathologic Processes
- Cardiovascular Diseases
- Vascular Diseases
- Immune System Diseases
- Neoplasms by Histologic Type
- Neoplasms
- Lymphoproliferative Disorders
- Lymphatic Diseases
- Immunoproliferative Disorders
- Disease Attributes
- Hematologic Diseases
- Hemorrhagic Disorders
- Hemostatic Disorders
- Paraproteinemias
- Blood Protein Disorders
- Neoplasms, Plasma Cell
- Leukemia, B-Cell
- Lymphoma
- Lymphoma, Follicular
- Lymphoma, B-Cell
- Leukemia
- Recurrence
- Lymphoma, Non-Hodgkin
- Lymphoma, Mantle-Cell
- Lymphoma, B-Cell, Marginal Zone
- Waldenstrom Macroglobulinemia
- Leukemia, Lymphocytic, Chronic, B-Cell
- Leukemia, Lymphoid
- Physiological Effects of Drugs
- Molecular Mechanisms of Pharmacological Action
- Antirheumatic Agents
- Antimetabolites, Antineoplastic
- Antimetabolites
- Antineoplastic Agents
- Immunosuppressive Agents
- Immunologic Factors
- Antineoplastic Agents, Immunological
- Rituximab
- Bortezomib
- Fludarabine
- Fludarabine phosphate
Other Study ID Numbers
- NCI-2009-00044 (Registry Identifier: CTRP (Clinical Trial Reporting Program))
- U01CA062502 (U.S. NIH Grant/Contract)
- ICC 3402 (Other Identifier: Case Western Reserve University)
- CDR0000321394
- 6126 (CTEP)
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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