17-AAG in Treating Patients With Relapsed or Refractory Anaplastic Large Cell Lymphoma, Mantle Cell Lymphoma, or Hodgkin's Lymphoma

A Phase II Study of 17-AAG in Patients With Relapsed/Refractory CD30+ Anaplastic Large Cell Lymphoma (ALCL), Relapsed/Refractory Mantle Cell Lymphoma (MCL), and Relapsed/Refractory Classical Hodgkin's Lymphoma (HL)

This phase II trial is studying how well 17-AAG works in treating patients with relapsed or refractory anaplastic large cell lymphoma, mantle cell lymphoma, or Hodgkin's lymphoma. Drugs used in chemotherapy, such as 17-AAG, work in different ways to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing.

Study Overview

• Status: Completed
• Conditions: Recurrent Mantle Cell Lymphoma; Anaplastic Large Cell Lymphoma; Recurrent Adult Hodgkin Lymphoma
• Intervention / Treatment: Drug: tanespimycin

Detailed Description

PRIMARY OBJECTIVE:

I. Determine the complete and partial response rates and time to treatment failure in patients with relapsed or refractory anaplastic large cell lymphoma, mantle cell lymphoma, or classical Hodgkin's lymphoma treated with 17-N-allylamino-17-demethoxygeldanamycin (17-AAG).

SECONDARY OBJECTIVES:

I. Determine the safety of this drug in these patients. II. Determine the biologic effect of this drug on selected molecular targets in primary lymphoma cells from these patients.

OUTLINE: This is a multicenter study. Patients are stratified according to disease type (anaplastic large cell lymphoma vs mantle cell lymphoma vs Hodgkin's lymphoma).

Patients receive 17-N-allylamino-17-demethoxygeldanamycin (17-AAG) IV over 1 hour on days 1, 4, 8, and 11. Treatment repeats every 21 days for up to 8 courses in the absence of disease progression or unacceptable toxicity. Patients experiencing disease regression after completion of 8 courses may receive 2 additional courses of treatment beyond their maximal response.

After completion of study treatment, patients are followed every 3 months until disease progression.

• Study Type: Interventional
• Enrollment (Actual): 22
• Phase: Phase 2

Contacts and Locations

Study Locations

• United States
  • Texas
    • Houston, Texas, United States, 77030
      • M D Anderson Cancer Center

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 16 years and older (Child, Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Negative pregnancy test
• Fertile patients must use effective contraception prior to and during study treatment
• Must have normal organ and marrow function
• Not a candidate for stem cell transplantation
• ECOG 0-2 OR Karnofsky 60-100%
• Bilirubin normal
• Creatinine normal
• Histologically or cytologically confirmed relapsed or refractory mantle cell lymphoma, anaplastic large cell lymphoma (CD30-positive disease), or classical Hodgkin's lymphoma
• Recovered from prior biologic therapy or autologous stem cell transplantation
• Prior antibody therapy within the past 3 months allowed
• More than 4 weeks since prior chemotherapy (6 weeks for nitrosoureas or mitomycin) and recovered
• More than 4 weeks since prior radiotherapy (12 weeks for radioimmunotherapy) and recovered
• Recovered from prior investigational drugs
• Recovered from prior surgery
• More than 4 weeks since other prior anticancer therapy
• Concurrent low-molecular weight heparin is allowed
• Measurable disease, defined as >= 1 unidimensionally measurable lesion >= 20 mm
• Absolute neutrophil count >= 1,500/mm3
• Received >= 1, but =< 3, prior treatment regimens for lymphoma (salvage therapy followed immediately by stem cell transplantation is considered 1 regimen). Single-agent monoclonal antibody therapy, cytokine therapy, or involved field radiotherapy are not considered prior treatment regimens. All prior treatments and prior antibody therapy within the past 3 months are recorded.
• Platelet count >= 75,000/mm3
• AST and ALT =< 1.5 times upper limit of normal
• Understand and provide signed informed consent.

Exclusion Criteria:

• No cardiac arrhythmia or uncontrolled dysrhythmia
• No history of myocardial infarction within the past year
• No New York Heart Association class III or IV heart failure
• No other significant cardiac disease
• No paroxysmal nocturnal dyspnea
• No oxygen requirement
• No AIDS
• No history cardiac toxicity after receiving anthracyclines (e.g., doxorubicin hydrochloride, daunorubcin hydrochloride, mitoxantrone, bleomycin, or carmustine)
• No pulmonary lymphoma
• No known CNS lymphoma
• QTc >/= 450 msec for men
• QTc >/= 470 msec for women
• LVEF </= 40% by MUGA
• No symptomatic congestive heart failure
• No unstable angina pectoris
• No symptomatic pulmonary disease requiring medication
• No significant pulmonary disease including chronic obstructive or restrictive pulmonary disease
• No dyspnea on or off exertion
• No history of pulmonary toxicity after receiving anthracyclines (e.g., doxorubicin hydrochloride, daunorubcin hydrochloride, mitoxantrone, bleomycin, or carmustine)
• Not pregnant or nursing
• No other uncontrolled illness
• No other active* malignancy except nonmelanoma skin cancer or carcinoma in situ of the cervix
• No prior allogeneic stem cell transplantation
• No history of allergic reaction to eggs
• No ongoing or active infection
• No psychiatric illness or social situation that would preclude study compliance
• No prior chest radiation or prior radiation that potentially included the heart in the field (e.g.,mantle).
• No concurrent medications that prolong or may prolong QTc
• No concurrent combination antiretroviral therapy for HIV-positive patients
• No other concurrent investigational agents
• No other concurrent anticancer therapy
• No prior cardiac symptoms >= grade 2
• No sufficiently compromised pulmonary status (i.e., DLCO =< 80%)
• No history of serious ventricular arrhythmia (e.g., ventricular tachycardia or ventricular fibrillation >= 3 beats in a row)
• No prior pulmonary symptoms >= grade 2
• HIV negative
• No active ischemic heart disease within 12 months.
• No congenital long QT syndrome.
• No left bundle branch block.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm

Intervention / Treatment

Experimental: Arm I; Patients receive 17-N-allylamino-17-demethoxygeldanamycin (17-AAG) IV over 1 hour on days 1, 4, 8, and 11. Treatment repeats every 21 days for up to 8 courses in the absence of disease progression or unacceptable toxicity. Patients experiencing disease regression after completion of 8 courses may receive 2 additional courses of treatment beyond their maximal response. After completion of study treatment, patients are followed every 3 months until disease progression.

Drug: tanespimycin; Other Names: 17-AAG

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Number of Patients With Response	Number of participants who experience complete response or partial response. Partial Response=>50% decrease in lympho node masses. Complete Response=>-75% decrease in lymph node masses.	Baseline to time to best response; Every 6 weeks

Collaborators and Investigators

• Sponsor: National Cancer Institute (NCI)
• Investigators: Principal Investigator: Anas Younes, M.D. Anderson Cancer Center

Study record dates

Study Major Dates

• Study Start: February 1, 2005
• Primary Completion (Actual): April 1, 2010
• Study Completion (Actual): April 1, 2010

Study Registration Dates

• First Submitted: July 8, 2005
• First Submitted That Met QC Criteria: July 8, 2005
• First Posted (Estimate): July 11, 2005

Study Record Updates

• Last Update Posted (Estimate): May 30, 2014
• Last Update Submitted That Met QC Criteria: May 21, 2014
• Last Verified: February 1, 2013

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Pathologic Processes; Immune System Diseases; Neoplasms by Histologic Type; Neoplasms; Lymphoproliferative Disorders; Lymphatic Diseases; Immunoproliferative Disorders; Disease Attributes; Lymphoma, T-Cell; Lymphoma; Hodgkin Disease; Recurrence; Lymphoma, Non-Hodgkin; Lymphoma, Mantle-Cell; Lymphoma, Large-Cell, Anaplastic
• Other Study ID Numbers: NCI-2009-00101 (Registry Identifier: CTRP (Clinical Trial Reporting Program)); P30CA016672 (U.S. NIH Grant/Contract); CDR0000433593; 2004-0792 (Other Identifier: M D Anderson Cancer Center); 6936 (Other Identifier: CTEP); R21CA117070 (U.S. NIH Grant/Contract)