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Monoclonal Antibody Therapy in Treating Patients With Leukemia

Primary Purpose

Lymphoma, Radiation Toxicity

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
pentetic acid calcium
yttrium Y 90 daclizumab
Sponsored by
National Cancer Institute (NCI)
About
Eligibility
Locations
Outcomes
Full info

About this trial

This is an interventional treatment trial for Lymphoma focused on measuring stage I adult T-cell leukemia/lymphoma, stage II adult T-cell leukemia/lymphoma, stage III adult T-cell leukemia/lymphoma, stage IV adult T-cell leukemia/lymphoma, recurrent adult T-cell leukemia/lymphoma, radiation toxicity

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

DISEASE CHARACTERISTICS: Histologically confirmed adult T-cell leukemia or lymphoma (ATL) of any stage Tac expression of malignant cells confirmed by one of the following: At least 10% of peripheral blood, lymph node, or dermal malignant cells reactive with anti-Tac by immunofluorescent staining Soluble interleukin-2 receptor levels greater than 1,000 U/mL (normal geometric mean = 235; 95% confidence intervals = 112-502 U/mL) Measurable disease required More than 10% (i.e., strongly Tac-expressing) abnormal cells in peripheral blood considered measurable disease All stages of Tac-expressing adult T-cell leukemia are eligible Smoldering ATL patients are eligible only if the symptoms and sites of involvement by ATL are such that there is a medical indication to treat Smoldering ATL, defined as: Lymphocyte count less than 4,000/mm^3 Less than 5% abnormal lymphocytes on morphologic exam of peripheral blood No hypercalcemia Lactate dehydrogenase no greater than 1.5 times normal No lymphadenopathy No involvement of extranodal organs except skin or lung No malignant pleural effusion or ascites No symptomatic CNS disease due to ATL Concurrent diagnosis of tropical spastic paraparesis allowed No detectable levels (i.e., greater than 250 ng/mL) of antibody to study drug as assessed by ELISA PATIENT CHARACTERISTICS: Age: 18 and over Performance status: Not specified Life expectancy: Greater than 2 months Hematopoietic: Absolute granulocyte count at least 1,000/mm^3 Platelet count at least 75,000/mm^3 Hepatic: Bilirubin less than 2.0 mg/dL (unless directly due to ATL) AST/ALT less than 2.5 times normal Renal: Creatinine less than 1.5 mg/dL OR Creatinine clearance greater than 35 mL/min Cardiovascular: No clinical cardiac failure Pulmonary: No symptomatic pulmonary dysfunction unless due to underlying malignancy Other: HIV negative Not pregnant or nursing Negative pregnancy test PRIOR CONCURRENT THERAPY: Biologic therapy Not specified Chemotherapy At least 4 weeks since prior cytotoxic chemotherapy Endocrine therapy Concurrent corticosteroids allowed Radiotherapy Not specified Surgery Not specified Other Not specified

Sites / Locations

  • Warren Grant Magnuson Clinical Center - NCI Clinical Studies Support

Outcomes

Primary Outcome Measures

Secondary Outcome Measures

Full Information

First Posted
July 11, 2001
Last Updated
June 19, 2013
Sponsor
National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT00019227
Brief Title
Monoclonal Antibody Therapy in Treating Patients With Leukemia
Official Title
PHASE I/II STUDY OF TAC-EXPRESSING ADULT T-CELL LEUKEMIA (ATL) WITH YTTRIUM-90 (90Y)-RADIOLABELED HUMANIZED ANTI-TAC AND CALCIUM-DTPA
Study Type
Interventional

2. Study Status

Record Verification Date
March 2003
Overall Recruitment Status
Completed
Study Start Date
October 1996 (undefined)
Primary Completion Date
undefined (undefined)
Study Completion Date
July 2006 (Actual)

3. Sponsor/Collaborators

Name of the Sponsor
National Cancer Institute (NCI)

4. Oversight

5. Study Description

Brief Summary
RATIONALE: Monoclonal antibodies can locate tumor cells and either kill them or deliver tumor-killing substances to them without harming normal cells. PURPOSE: Phase I/II trial to study the effectiveness of radiolabeled monoclonal antibody plus pentetic acid calcium in patients with leukemia.
Detailed Description
OBJECTIVES: Determine the maximum tolerated dose of yttrium Y 90 daclizumab (90Y daclizumab) when combined with pentetic acid calcium in adults with Tac-expressing T-cell leukemia. Determine the therapeutic efficacy and toxicity of this regimen in these patients. Monitor patients treated on this regimen for circulating infused antibody (free and labeled) and for the serum concentration of soluble interleukin-2 receptor. Evaluate, in a preliminary manner, the immunogenicity of daclizumab. Determine the effect of 90Y daclizumab on various components of the circulating cellular immune system. Determine whether there is additional urinary excretion of yttrium Y 90 when compared to that observed previously in patients treated without pentetic acid calcium. OUTLINE: This is a dose escalation study of yttrium Y 90 daclizumab (90Y daclizumab). Patients receive 90Y daclizumab IV over 2 hours on day 1 and a fixed dose of pentetic acid calcium IV over 5 hours for 3 days. Treatment repeats every 6 weeks for a maximum of 9 courses in the absence of disease progression or circulating antibodies to humanized anti-Tac. Cohorts of 3-6 patients receive escalating doses of 90Y daclizumab 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 toxicities. Additional patients are treated at the MTD. Patients are followed at 4-6 weeks. PROJECTED ACCRUAL: Up to 15 patients will be accrued for the phase I portion of the study. A total of 30 patients will be accrued for the phase II portion of the study.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Lymphoma, Radiation Toxicity
Keywords
stage I adult T-cell leukemia/lymphoma, stage II adult T-cell leukemia/lymphoma, stage III adult T-cell leukemia/lymphoma, stage IV adult T-cell leukemia/lymphoma, recurrent adult T-cell leukemia/lymphoma, radiation toxicity

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2

8. Arms, Groups, and Interventions

Intervention Type
Drug
Intervention Name(s)
pentetic acid calcium
Intervention Type
Radiation
Intervention Name(s)
yttrium Y 90 daclizumab

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
DISEASE CHARACTERISTICS: Histologically confirmed adult T-cell leukemia or lymphoma (ATL) of any stage Tac expression of malignant cells confirmed by one of the following: At least 10% of peripheral blood, lymph node, or dermal malignant cells reactive with anti-Tac by immunofluorescent staining Soluble interleukin-2 receptor levels greater than 1,000 U/mL (normal geometric mean = 235; 95% confidence intervals = 112-502 U/mL) Measurable disease required More than 10% (i.e., strongly Tac-expressing) abnormal cells in peripheral blood considered measurable disease All stages of Tac-expressing adult T-cell leukemia are eligible Smoldering ATL patients are eligible only if the symptoms and sites of involvement by ATL are such that there is a medical indication to treat Smoldering ATL, defined as: Lymphocyte count less than 4,000/mm^3 Less than 5% abnormal lymphocytes on morphologic exam of peripheral blood No hypercalcemia Lactate dehydrogenase no greater than 1.5 times normal No lymphadenopathy No involvement of extranodal organs except skin or lung No malignant pleural effusion or ascites No symptomatic CNS disease due to ATL Concurrent diagnosis of tropical spastic paraparesis allowed No detectable levels (i.e., greater than 250 ng/mL) of antibody to study drug as assessed by ELISA PATIENT CHARACTERISTICS: Age: 18 and over Performance status: Not specified Life expectancy: Greater than 2 months Hematopoietic: Absolute granulocyte count at least 1,000/mm^3 Platelet count at least 75,000/mm^3 Hepatic: Bilirubin less than 2.0 mg/dL (unless directly due to ATL) AST/ALT less than 2.5 times normal Renal: Creatinine less than 1.5 mg/dL OR Creatinine clearance greater than 35 mL/min Cardiovascular: No clinical cardiac failure Pulmonary: No symptomatic pulmonary dysfunction unless due to underlying malignancy Other: HIV negative Not pregnant or nursing Negative pregnancy test PRIOR CONCURRENT THERAPY: Biologic therapy Not specified Chemotherapy At least 4 weeks since prior cytotoxic chemotherapy Endocrine therapy Concurrent corticosteroids allowed Radiotherapy Not specified Surgery Not specified Other Not specified
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Thomas A. Waldmann, MD
Organizational Affiliation
NCI - Metabolism Branch;MET
Official's Role
Study Chair
Facility Information:
Facility Name
Warren Grant Magnuson Clinical Center - NCI Clinical Studies Support
City
Bethesda
State/Province
Maryland
ZIP/Postal Code
20892-1182
Country
United States

12. IPD Sharing Statement

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Monoclonal Antibody Therapy in Treating Patients With Leukemia

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