- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01745354
Immunostimulatory CpG SD-101 + RT in Recurrent/Progressive Lymphoma After Allogeneic Hematopoietic Cell Transplantation (HCT)
November 17, 2016 updated by: Robert Lowsky
Intratumoral Injection of an Immunostimulatory CpG, SD-101, Combined With Local Radiation for the Treatment of Recurrent or Progressive Lymphoma After Allogeneic Hematopoietic Cell Transplantation
For patients with lymphoma that recurs after chemotherapy, bone marrow transplantation using cells from a healthy donor represents potentially curative treatment.
In these individuals, cure is possible because transplantation of healthy donor immune cells can fight the lymphoma in the patient.
The goal of this work is to test a strategy that activates the healthy donor immune cells so that they more effectively fight lymphoma and can result in an increased cure rate for these patients.
Our group has previously studied CpG, an immune activating medication, in patients with lymphoma and demonstrated modest anti-tumor responses.
We now have a more potent form of CpG which we intend to test to see if it will better activate the donor immune cells and result in shrinkage of tumor throughout the entire body, not just at the injected site.
Study Overview
Status
Terminated
Conditions
Intervention / Treatment
Detailed Description
Patients will receive low dose radiation to all bulky or symptomatic lymph nodes on days -2 and -1.
SD-101 will be administered intratumorally to the single largest palpable node within 24 hours after completion of radiation, on day 0. Two additional intratumoral SD-101 injections will be performed on days 7 (+/- 2 days) and 14 (+/- 2 days).
This is a dose ranging study using a 3+3 design with a definition of maximum tolerated dose (MTD) which our group has found acceptable in the past.
The first cohort of patients will receive a SD-101 dose of 0.3 mg per injection.
The dose will be escalated to 1 mg and 3 mg based on dose limiting toxicity (DLT).
Study Type
Interventional
Enrollment (Actual)
6
Phase
- Phase 1
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
-
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California
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Palo Alto, California, United States, 94305
- Stanford University School of Medicine
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-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
18 years and older (ADULT, OLDER_ADULT)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- Biopsy-confirmed relapsed, refractory, or progressive NHL or HL (Refer to Section 3.2.1 for excluded subtypes)
At least 3 sites of disease
- One for diagnosis (lymph node or bone marrow biopsy)
- One palpable for treatment
- One measurable radiographically
- > 60 days after RIC allogeneic transplant for lymphoma
- 18 years of age or older
- Mixed (5-95%) or complete (>95%) chimerism
- Eastern Oncology Cooperative Group (ECOG) performance status ≤ 2
- ANC >1000/mm3, platelets >50,000/mm3
- Total bilirubin ≤ 2.5 mg/dL, AST and ALT < 3 times upper limit of normal
- Serum creatinine ≤ 3 mg/dL
- No chemotherapy, RT, DLI or biologic therapy for lymphoma at least 4 weeks prior to scheduled treatment
- Minimal immunosuppression (defined as monotherapy with ≤ 10 mg prednisone daily, ≤ 200 mg cyclosporine daily, or ≤ 2 mg tacrolimus daily) at least 2 weeks prior to scheduled treatment
Exclusion Criteria:
- HIV associated lymphoma
- Acute GVHD at time of enrollment (history of treated and resolved GVHD is permitted)
- Active infection within 14 days prior to scheduled treatment
- Active Cytomegalovirus (CMV) disease at the time of enrollment
- Pre-existing autoimmune or antibody mediated disease (including systemic lupus erythematosus, rheumatoid arthritis, multiple sclerosis, Sjogren's syndrome, and autoimmune thrombocytopenia)
- Pregnant
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
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: SD-101 + Combined with Local Radiation
|
SD-101 will be administered after radiation to only the largest palpable lymph node as an intratumoral injection weekly for 3 weeks at three dosing cohorts: 0.3 mg, 1 mg, and 3 mg
Other Names:
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Determination of the maximum tolerated dose based on dose limiting toxicity defined as any new grade 3-4 toxicity after the first SD-101 administration
Time Frame: 60 Days
|
60 Days
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Measure cytotoxic T-cell activity changes pre- and post-treatment of tumor infiltrating lymphocytes and peripheral blood lymphocytes using ELISA and Immunohistochemistry.
Time Frame: 2, 3, 8 weeks after treatment
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2, 3, 8 weeks after treatment
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Measure tumor response by PET-CT scan imaging
Time Frame: 8 weeks after treatment
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8 weeks after treatment
|
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Measure level of donor specific tumor infiltrating lymphocytes by flow cytometry and Immunofluorescence
Time Frame: 2, 3, 8 weeks after treatment
|
Collect PBMCs
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2, 3, 8 weeks after treatment
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Investigators
- Principal Investigator: Lauren Maeda, Stanford University
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start
August 1, 2012
Primary Completion (ACTUAL)
November 1, 2014
Study Completion (ACTUAL)
November 1, 2014
Study Registration Dates
First Submitted
December 6, 2012
First Submitted That Met QC Criteria
December 6, 2012
First Posted (ESTIMATE)
December 10, 2012
Study Record Updates
Last Update Posted (ESTIMATE)
November 18, 2016
Last Update Submitted That Met QC Criteria
November 17, 2016
Last Verified
November 1, 2015
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- BMT235
- SU-07212011-8129 (OTHER: Stanford University)
- 20741 (OTHER: stanford IRB)
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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