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Bortezomib (Velcade) With Standard Chemotherapy for Relapsed or Refractory Follicular Lymphoma

29 april 2014 uppdaterad av: Duke University

A Phase II Study of Bortezomib in Combination With Rituximab, Fludarabine, Mitoxantrone, and Dexamethasone (VR-FND) for Relapsed or Refractory Follicular Lymphoma

The purpose of this study is to evaluate the effectiveness and safety of combining bortezomib (Velcade) with rituximab, fludarabine, mitoxantrone, and dexamethasone in treating patients with follicular cell lymphoma.

Studieöversikt

Detaljerad beskrivning

This is a phase II study using the combination of bortezomib, rituximab, fludarabine, mitoxantrone and dexamethasone. The combination will given over a 28 day cycle. In addition each patient will receive Pneumocystis carinii Pneumonia (PCP) prophylaxis with Trimethoprim/sulfamethoxazole (TMP/Sulfa) or equivalent agent. On day 4 the physician has the option of starting granulocyte colony-stimulating factor (GCSF), granulocyte macrophage colony-stimulating factor (GMCSF), or pegylated GCSF.

All patients who receive at least one dose of the drug will be evaluated for toxicity. Patients will be treated with the agent for at least 2 cycles to be considered eligible for evaluation of response. The chemotherapy dosing will continue until there is evidence of disease progression, a second recurrence of unacceptable toxicity, or a maximum of 8 courses of therapy.

Studietyp

Interventionell

Inskrivning (Faktisk)

14

Fas

  • Fas 2

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studieorter

    • North Carolina
      • Durham, North Carolina, Förenta staterna, 27710
        • Duke University Medical Center

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

18 år och äldre (Vuxen, Äldre vuxen)

Tar emot friska volontärer

Nej

Kön som är behöriga för studier

Allt

Beskrivning

Inclusion Criteria:

  • Diagnosis of grade 1-3 follicular lymphoma with persistent, relapsed, or refractory disease to at least one prior regimen.
  • No prior bortezomib therapy.
  • Voluntary written informed consent.
  • Female subject is either post-menopausal or surgically sterilized or willing to use an acceptable method of birth control.
  • Male subject agrees to use an acceptable method for contraception for the duration of the study therapy.
  • 18 years of age or older.
  • aspartate aminotransferase (AST),alanine aminotransferase (ALT), total bilirubin < 3 times the upper limit of normal unless documented by the treating physician to be secondary to underlying lymphoma.
  • Eastern Cooperative Oncology Group (ECOG) performance status 0-2.

Exclusion Criteria:

  • Platelet count of < 50,000 within 14 days before enrollment unless documented by the treating physician to be due to the disease.
  • Absolute neutrophil count of < 1000 within 14 days before enrollment unless documented by the treating physician to be due to disease.
  • Estimated or measured creatinine clearance of less than 30 ml/min within 14 days before enrollment.
  • ≥Grade 2 peripheral neuropathy within 14 days before enrollment.
  • Myocardial infarction within 6 months prior to enrollment or has New York Hospital Association (NYHA) Class III or IV heart failure, uncontrolled angina, severe uncontrolled ventricular arrhythmias, or electrocardiographic evidence of acute ischemia.
  • Patient has hypersensitivity to boron, mannitol or any drug included in the current protocol.
  • Female subject is pregnant or lactating.
  • Received other investigational drugs for this disease within 14 days of enrollment
  • Serious medical or psychiatric illness likely to interfere with participation in this clinical study.
  • Known HIV+ status.
  • Cardiac ejection fraction less than 35% at study entry measured by echocardiogram, Multigated Acquisition (MUGA) or cardiac MRI.

Studieplan

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Behandling
  • Tilldelning: N/A
  • Interventionsmodell: Enskild gruppuppgift
  • Maskning: Ingen (Open Label)

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Experimentell: VR-FND

Bortezomib (VELCADER) 1.6 mg/m2 IV days 1 and 8 Rituximab 375 mg/m2 IV on day 1 Fludarabine 25 mg/m2 IV on days 1,2,3 Mitoxantrone 10 mg/m2 IV on day 2 Dexamethasone 20 mg orally on days 1,2,3,4,5 On day 1 the sequence of drug administration will be Bortezomib followed by Fludarabine followed by Rituximab.

Each cycle will be repeated every 28 days for 8 cycles maximum.

Bortezomib 1.6 mg/m2 on days 1 and 8 of each 28-day cycle
Andra namn:
  • Velcade
Rituximab 375 mg/m2 IV on day 1
Fludarabine 25 mg/m2 IV on days 1,2,3
Mitoxantrone 10 mg/m2 IV on day 2
Andra namn:
  • Novantrone
Dexamethasone 20 mg orally on days 1,2,3,4,5

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Complete and Partial Response
Tidsram: 1 year
  • Complete Response: Complete disappearance of all detectable clinical and radiographic evidence of disease, disappearance of all disease-related symptoms and normalization of biochemical abnormalities (eg. LDH) definitely assignable to follicular lymphoma.
  • Partial Response requires the following:

    • greater than or equal to 50% decrease in the SPD of the 6 largest dominant nodes of nodal masses.
    • No increase in size of other nodes, liver, or spleen.
    • Splenic and hepatic nodes must regress by at least 50% in sum of the products (SPD).
    • Bone marrow assessment in irrelevant for determination of Partial Response since it is not measurable disease; however, if positive the type of cell should be reported.
    • No new lesions.
1 year

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Duration of Response
Tidsram: up to 4 years
Duration of response is measured from time of treatment to time of disease progression
up to 4 years
Percentage of Subjects Experiencing Progression Free Survival
Tidsram: up to 2 years
Progression free survival is measured from treatment to progression or death, whichever comes first. Progressive disease is measured as: 50% or greater increase from nadir in the sum of the products (SPD) of any previously identified abnormal node and the appearance of any new lesions during or at the end of treatment.
up to 2 years
Percentage of Subjects Experiencing Overall Survival
Tidsram: up to 2 years
Overall survival is from the day of enrollment to date of death from any cause.
up to 2 years
Number of Participants With a Grade 3-4 Hematologic Toxicity.
Tidsram: up to 1 year
Before each drug dose, the patient will be evaluated for possible toxicities that may have occurred after the previous dose(s). Toxicities are to be assessed according to the NCI Common Toxicity Criteria (CTC).
up to 1 year
Number of Participants With Neuropathy, Any Grade
Tidsram: up to 1 year
Before each drug dose, the patient will be evaluated for possible toxicities that may have occurred after the previous dose(s). Toxicities are to be assessed according to the NCI Common Toxicity Criteria (CTC).
up to 1 year

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart

1 januari 2007

Primärt slutförande (Faktisk)

1 november 2012

Avslutad studie (Faktisk)

1 september 2013

Studieregistreringsdatum

Först inskickad

1 augusti 2007

Först inskickad som uppfyllde QC-kriterierna

1 augusti 2007

Första postat (Uppskatta)

2 augusti 2007

Uppdateringar av studier

Senaste uppdatering publicerad (Uppskatta)

12 maj 2014

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

29 april 2014

Senast verifierad

1 april 2014

Mer information

Denna information hämtades direkt från webbplatsen clinicaltrials.gov utan några ändringar. Om du har några önskemål om att ändra, ta bort eller uppdatera dina studieuppgifter, vänligen kontakta register@clinicaltrials.gov. Så snart en ändring har implementerats på clinicaltrials.gov, kommer denna att uppdateras automatiskt även på vår webbplats .

Kliniska prövningar på Bortezomib

3
Prenumerera