Phase I/II Trial of VELCADE Plus Zevalin in Patients With Relapsed or Refractory Follicular Lymphoma
A Phase I/II Trial of Combined Weekly Bortezomib (VELCADE®) and Y-90-Ibritumomab Tiuxetan (Zevalin) in Patients With Relapsed or Refractory Follicular Lymphoma and Transformed Non-Hodgkin's Lymphoma
Bortezomib may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth. Monoclonal antibodies, such as rituximab, can block cancer growth in different ways. Some block the ability of cancer cells to grow and spread. Others find cancer cells and help kill them or carry cancer-killing substances to them. Radiolabeled monoclonal antibodies, such as yttrium Y 90 ibritumomab tiuxetan, can find cancer cells and carry cancer-killing substances to them without harming normal cells. Giving bortezomib together with rituximab and yttrium Y 90 ibritumomab tiuxetan may kill more cancer cells.
This phase I/II trial is studying the side effects and best dose of bortezomib when given together with rituximab and yttrium Y 90 ibritumomab tiuxetan and to see how well they work in treating patients with relapsed or refractory follicular non-Hodgkin's lymphoma.
Descripción general del estudio
Estado
Condiciones
Intervención / Tratamiento
Descripción detallada
This is a phase I, dose-escalation study of bortezomib followed by a phase II study.
Phase I:
- Induction therapy: Patients receive bortezomib IV over 3-5 seconds on days 1, 8, 15, and 22, rituximab IV on days 8 and 15, and yttrium Y 90 ibritumomab tiuxetan IV over 10 minutes on day 15.
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 6 patients experience dose-limiting toxicity.
- Consolidation therapy: Beginning 6-7 weeks after completing induction therapy, patients receive bortezomib IV over 3-5 seconds on days 1, 8, and 15. Treatment repeats every 28 days for 3 courses in the absence of disease progression or unacceptable toxicity.
Phase II: Patients receive induction therapy and consolidation therapy as in phase I, with bortezomib administered at the MTD determined in phase I.
After completion of study treatment, patients are followed every 3 months for 1 year, every 6 months for 1 year, and then annually thereafter.
A total of 24 patients will be accrued for this study.
Tipo de estudio
Inscripción (Actual)
Fase
- Fase 2
- Fase 1
Contactos y Ubicaciones
Ubicaciones de estudio
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Georgia
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Atlanta, Georgia, Estados Unidos, 30322
- Emory University School of Medicine
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Illinois
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Chicago, Illinois, Estados Unidos, 60611
- Northwestern University
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Criterios de participación
Criterio de elegibilidad
Edades elegibles para estudiar
Acepta Voluntarios Saludables
Géneros elegibles para el estudio
Descripción
Inclusion Criteria:
- Histologically confirmed follicular lymphoma
- CD20+ at time of diagnosis or subsequently
- More than 4 weeks since prior rituximab
- More than 3 weeks since prior anticancer therapy (6 weeks for nitrosourea or mitomycin C)
- More than 4 weeks since prior major surgery
- More than 2 weeks since prior investigational drugs
Exclusion Criteria:
- AIDS-related lymphoma
- History or evidence of CNS involvement
- Pregnant or nursing
- known HIV positivity
- serious medical or psychiatric illness that would preclude study participation
- myocardial infarction within the past 6 months
- congestive heart failure, uncontrolled angina, severe uncontrolled ventricular arrhythmias, or ECG evidence of acute ischemia or active conduction system abnormalities
- known hypersensitivity to rituximab, bortezomib, boron, or mannitol
- prior autologous or allogeneic stem cell transplantation
- prior radioimmunoconjugate therapy or prior exposure to murine antibodies
- prior external-beam irradiation to > 25% of active bone marrow
Plan de estudios
¿Cómo está diseñado el estudio?
Detalles de diseño
- Propósito principal: Tratamiento
- Asignación: N / A
- Modelo Intervencionista: Asignación de un solo grupo
- Enmascaramiento: Ninguno (etiqueta abierta)
Armas e Intervenciones
Grupo de participantes/brazo |
Intervención / Tratamiento |
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Experimental: bortezomib, Ibritumomab tiuxetan, rituximab
Induction therapy will last 28 days.
Bortezomib will be given on days 1, 8, 15, and 22. Rituximab will be given on days 8 and 15 along with 111-indium-ibritumomab tiuxetan.
During consolidation therapy, Bortezomib will be given intravenously on days 1, 8, and 15 of each cycle for a maximum of 3 cycles.
Rituximab or Y-90-ibritumomab tiuxetan will not be given during consolidation therapy.
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Induction therapy will last 28 days.
Bortezomib will be given on days 1, 8, 15, and 22. Rituximab will be given on days 8 and 15 along with 111-indium-ibritumomab tiuxetan.
During consolidation therapy, Bortezomib will be given intravenously on days 1, 8, and 15 of each cycle for a maximum of 3 cycles.
Rituximab or Y-90-ibritumomab tiuxetan will not be given during consolidation therapy.
Otros nombres:
Induction therapy will last 28 days.
Bortezomib will be given on days 1, 8, 15, and 22. Rituximab will be given on days 8 and 15 along with 111-indium-ibritumomab tiuxetan.
During consolidation therapy, Bortezomib will be given intravenously on days 1, 8, and 15 of each cycle for a maximum of 3 cycles.
Rituximab or Y-90-ibritumomab tiuxetan will not be given during consolidation therapy.
Otros nombres:
Induction therapy will last 28 days.
Bortezomib will be given on days 1, 8, 15, and 22. Rituximab will be given on days 8 and 15 along with 111-indium-ibritumomab tiuxetan.
During consolidation therapy, Bortezomib will be given intravenously on days 1, 8, and 15 of each cycle for a maximum of 3 cycles.
Rituximab or Y-90-ibritumomab tiuxetan will not be given during consolidation therapy.
Otros nombres:
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¿Qué mide el estudio?
Medidas de resultado primarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
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Maximum Tolerated Dose (MTD) and Tolerability of Bortezomib Combined With Y-90-Ibritumomab Tiuxetan Determined by Number of Dose Limiting Toxicities in a Cohort.
Periodo de tiempo: During induction therapy, the first 28 days of treatment.
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To determine the MTD using a 3+3 dose escalating design. There will be 3 dose cohorts:1.0mg/m2,1.3mg/m2 and1.6 mg/m2. 3 patients will be enrolled at dose of 1.0mg/m2 bortezomib. If no dose limiting toxicities (DLTs) are seen in the first 3 patients then dose will be escalated to next level and 3 patients will be treated at that dose level. If a DLT is seen at any dose, then 3 more patients will be enrolled at that dose level. If 1 patient out of 6, experience a DLT then MTD will be determined to be at this dose level. If 2 or more DLTs are seen in first 3 patients at that dose, then MTD will be one dose lower to the level where the DLTs were experienced. DLTs were defined using the National Cancer Institute Common Toxicity Criteria Version 3.0. DLTs=grade 3 nausea, vomiting, diarrhea or ileus more than 96h; grade 4 nausea, vomiting, diarrhea or ileus,neuropathic pain, peripheral sensory neuropathy, neutropenia, thrombocytopenia. |
During induction therapy, the first 28 days of treatment.
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Medidas de resultado secundarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
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Number of Patients With Adverse Events Related to Treatment of Bortezomib Combined With Y-90-ibritumomab Tiuxetan
Periodo de tiempo: At start of treatment on days 1, 8, 15, 22 of induction, days 36 and 50 of recovery, days 1, 8, 15 of consolidation cycles for up to 3 cycles and 4 weeks after the completion of treatment.
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To further explore the toxicity bortezomib combined with Y-90-ibritumomab tiuxetan by collecting data on adverse events (AE) reported by patient or collected lab results that are grade 3 or grade 4 that were determined to be at least possible related to any of the studies drugs. Toxicity will be collected on treatment days according to the National Cancer Institute's Common Toxicity Criteria for adverse events version 3.0 (CTCAE v3.0). In general adverse events (AEs) will be graded according to the following: Grade 1 Mild AE Grade 2 Moderate AE Grade 3 Severe AE Grade 4 Life-threatening or disabling AE Grade 5 Death related to AE |
At start of treatment on days 1, 8, 15, 22 of induction, days 36 and 50 of recovery, days 1, 8, 15 of consolidation cycles for up to 3 cycles and 4 weeks after the completion of treatment.
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Colaboradores e Investigadores
Patrocinador
Colaboradores
Fechas de registro del estudio
Fechas importantes del estudio
Inicio del estudio (Actual)
Finalización primaria (Actual)
Finalización del estudio (Actual)
Fechas de registro del estudio
Enviado por primera vez
Primero enviado que cumplió con los criterios de control de calidad
Publicado por primera vez (Estimar)
Actualizaciones de registros de estudio
Última actualización publicada (Actual)
Última actualización enviada que cumplió con los criterios de control de calidad
Última verificación
Más información
Términos relacionados con este estudio
Palabras clave
Términos MeSH relevantes adicionales
- Enfermedades del sistema inmunológico
- Neoplasias por tipo histológico
- Neoplasias
- Trastornos linfoproliferativos
- Enfermedades linfáticas
- Trastornos inmunoproliferativos
- Linfoma No Hodgkin
- Linfoma
- Linfoma Folicular
- Efectos fisiológicos de las drogas
- Agentes antirreumáticos
- Agentes antineoplásicos
- Factores inmunológicos
- Agentes antineoplásicos inmunológicos
- Rituximab
- Bortezomib
- Anticuerpos Monoclonales
Otros números de identificación del estudio
- NU 05H9
- STU00004871 (Otro identificador: Northwestern University IRB)
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Ensayos clínicos sobre rituximab
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Children's Oncology GroupNational Cancer Institute (NCI)Activo, no reclutandoTrastorno linfoproliferativo posterior al trasplante relacionado con el VEB | Trastorno linfoproliferativo postrasplante monomórfico | Trastorno linfoproliferativo polimórfico postrasplante | Trastorno linfoproliferativo monomórfico recurrente posrasplante | Trastorno linfoproliferativo polimórfico... y otras condicionesEstados Unidos
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M.D. Anderson Cancer CenterNational Cancer Institute (NCI)Activo, no reclutandoLinfoma de linfocitos pequeños recidivante | Leucemia prolinfocítica | Leucemia linfocítica crónica recurrenteEstados Unidos
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Academic and Community Cancer Research UnitedNational Cancer Institute (NCI)Activo, no reclutandoLinfoma folicular de grado 1 recidivante | Linfoma folicular de grado 2 recidivante | Linfoma de células del manto recidivante | Linfoma recidivante de la zona marginal | Linfoma no Hodgkin de células B refractario | Linfoma de linfocitos pequeños recidivante | Linfoma no Hodgkin de células B recurrente y otras condicionesEstados Unidos
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M.D. Anderson Cancer CenterNational Cancer Institute (NCI)ReclutamientoLinfoma folicular de grado 1 en estadio I de Ann Arbor | Linfoma folicular de grado 2 en estadio I de Ann Arbor | Linfoma folicular de grado 1 en estadio II de Ann Arbor | Linfoma folicular de grado 2 en estadio II de Ann ArborEstados Unidos
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National Cancer Institute (NCI)Activo, no reclutandoLinfoma de células del manto recidivante | Linfoma no Hodgkin de células B refractario | Linfoma no Hodgkin de células B recurrente | Linfoma de células del manto refractarioEstados Unidos
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National Cancer Institute (NCI)TerminadoLinfoma folicular de grado 1 en estadio III de Ann Arbor | Linfoma folicular de grado 2 en estadio III de Ann Arbor | Linfoma folicular de grado 1 en estadio IV de Ann Arbor | Linfoma folicular de grado 2 en estadio IV de Ann Arbor | Linfoma folicular contiguo grado 3 en estadio II de Ann... y otras condicionesEstados Unidos
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Mabion SAParexelRetirado
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M.D. Anderson Cancer CenterNational Cancer Institute (NCI)ReclutamientoLeucemia linfocítica crónica/linfoma linfocítico de células pequeñasEstados Unidos
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M.D. Anderson Cancer CenterNational Cancer Institute (NCI)ReclutamientoLeucemia de células peludas | Leucemia de células peludas recurrenteEstados Unidos
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Mayo ClinicNational Cancer Institute (NCI)TerminadoLinfoma folicular de grado 1 en estadio I de Ann Arbor | Linfoma folicular de grado 2 en estadio I de Ann Arbor | Linfoma folicular de grado 1 en estadio III de Ann Arbor | Linfoma folicular de grado 2 en estadio III de Ann Arbor | Linfoma folicular de grado 1 en estadio IV de Ann Arbor | Linfoma... y otras condicionesEstados Unidos