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BL22 Immunotoxin In Treating Young Patients With Relapsed or Refractory Acute Lymphoblastic Leukemia or Non-Hodgkin's Lymphoma

Primary Purpose

Leukemia, Lymphoma

Status
Suspended
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
BL22 immunotoxin
antibody-drug conjugate therapy
immunotoxin therapy
monoclonal antibody therapy
Sponsored by
MedImmune LLC
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Leukemia focused on measuring recurrent childhood acute lymphoblastic leukemia, Burkitt lymphoma, recurrent childhood large cell lymphoma, recurrent childhood lymphoblastic lymphoma, childhood non-Hodgkin lymphoma

Eligibility Criteria

6 Months - 24 Years (Child, Adult)All SexesDoes not accept healthy volunteers

DISEASE CHARACTERISTICS: Histologically confirmed acute lymphoblastic leukemia (ALL) or non-Hodgkin's lymphoma (including lymphoblastic lymphoma, Burkitt's lymphoma, and large cell lymphoma) Not amenable to available curative therapies Relapsed or refractory disease after at least 1 standard chemotherapy and 1 salvage regimen CD22 positive according to at least 1 of the following criteria: More than 15% CD22-positive malignant cells by immunohistochemistry More than 30% CD22-positive malignant cells by fluorescent-activated cell sorter analysis Measurable or evaluable disease Prior CNS involvement allowed provided there is no current evidence of CNS malignancy No CNS leukemia or lymphoma as manifested by any of the following: Cerebrospinal fluid (CSF) WBC ≥ 5/mm^3 and confirmation of CSF blasts Cranial neuropathies secondary to underlying malignancy Radiologically detected CNS lymphoma No isolated testicular ALL Ineligible for or refused hematopoietic stem cell transplantation OR has disease activity that prohibits the time required to identify a suitable stem cell donor PATIENT CHARACTERISTICS: Age 6 months to 24 years Performance status ECOG 0-3 (12 to 24 years of age) Lansky 40-100% (under 12 years of age) Life expectancy Not specified Hematopoietic See Disease Characteristics Absolute neutrophil count > 1,000/mm^3 * Platelet count > 50,000/mm^3 * NOTE: *Non-leukemic patients only Hepatic Bilirubin ≤ 2.0 mg/dL AST and ALT ≤ 5 times upper limit of normal No active hepatitis B or C infection Renal Creatinine normal for age OR Creatinine clearance ≥ 60 mL/min Immunologic No serum neutralization of more than 75% of the activity of 1 µg/mL of study drug HIV negative Other Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception No clinically significant unrelated systemic illness that would preclude study participation No other significant organ dysfunction that would preclude study participation No psychiatric illness or social situation that would preclude study compliance PRIOR CONCURRENT THERAPY: Biologic therapy See Disease Characteristics At least 1 week since prior colony-stimulating factors (e.g., filgrastim [G-CSF], sargramostim [GM-CSF], or epoetin alfa) Prior autologous or allogeneic hematopoietic stem cell transplantation (HSCT) allowed More than 100 days since prior allogeneic HSCT Chemotherapy See Disease Characteristics At least 2 weeks since prior chemotherapy (6 weeks for nitrosoureas) Endocrine therapy Concurrent corticosteroids allowed provided there has been no increase in the dose 1 week prior to and after study entry Steroid taper allowed Radiotherapy At least 3 weeks since prior radiotherapy Allowed in the past 3 weeks provided the volume of the bone marrow treated is < 10% AND the patients has measurable disease outside of the radiation port Surgery Not specified Other Recovered from prior therapy At least 30 days since prior investigational drugs No other concurrent investigational drugs

Sites / Locations

  • Warren Grant Magnuson Clinical Center - NCI Clinical Trials Referral Office

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Active Comparator

Active Comparator

Active Comparator

Active Comparator

Arm Label

1

2

3

4

Arm Description

BL22 immunotoxin

antibody therapy

immunotoxin therapy

monoclonal antibody therapy

Outcomes

Primary Outcome Measures

assessment of efficacy, safety, pharmacokinetics, immunogenicity.

Secondary Outcome Measures

Expansion of MTD

Full Information

First Posted
February 10, 2004
Last Updated
December 21, 2007
Sponsor
MedImmune LLC
Collaborators
Cambridge Antibody Technology
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1. Study Identification

Unique Protocol Identification Number
NCT00077493
Brief Title
BL22 Immunotoxin In Treating Young Patients With Relapsed or Refractory Acute Lymphoblastic Leukemia or Non-Hodgkin's Lymphoma
Official Title
Pediatric Phase I Trial of BL22 for Refractory CD22-Positive Leukemias and Lymphomas
Study Type
Interventional

2. Study Status

Record Verification Date
December 2007
Overall Recruitment Status
Suspended
Why Stopped
protocol development and Amended protocol revision
Study Start Date
January 2004 (undefined)
Primary Completion Date
October 2008 (Anticipated)
Study Completion Date
October 2008 (Anticipated)

3. Sponsor/Collaborators

Name of the Sponsor
MedImmune LLC
Collaborators
Cambridge Antibody Technology

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
RATIONALE: BL22 immunotoxin can locate tumor cells and kill them without harming normal cells. BL22 immunotoxin may be effective in treating relapsed or refractory acute lymphoblastic leukemia and non-Hodgkin's lymphoma. PURPOSE: This phase I trial is studying the side effects and best dose of BL22 immunotoxin in treating young patients with relapsed or refractory acute lymphoblastic leukemia or non-Hodgkin's lymphoma.
Detailed Description
OBJECTIVES: Primary Determine the toxic effects of BL22 immunotoxin in pediatric patients with relapsed or refractory CD22-positive acute lymphoblastic leukemia or non-Hodgkin's lymphoma. Determine the maximum tolerated dose of this drug in these patients. Determine the immunogenicity of this drug in these patients. Determine the pharmacokinetics of this drug in these patients. Secondary Determine the in vitro cytotoxicity of this drug against lymphoblasts from patients with acute lymphoblastic leukemia. Determine the therapeutic efficacy of this drug in inducing remissions in these patients. Determine changes in lymphocyte subsets, immunoglobulin levels, serum cytokines, and soluble cytokine receptor levels in patients treated with this drug. OUTLINE: This is a non-randomized, dose-escalation study. Patients receive BL22 immunotoxin IV over 30 minutes on days 1, 3, and 5 OR on days 1, 3, 5, 7, 9, and 11. Treatment repeats every 21 days for up to 6 courses in the absence of disease progression or unacceptable toxicity. Patients who achieve a complete response (CR) or unconfirmed CR (CRu) receive 2 additional courses beyond CR or CRu for a maximum of 6 courses. Cohorts of 3-6 patients receive escalating doses of BL22 immunotoxin until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity. Once the MTD is determined, the cohort is expanded and a total of 12 patients are treated at that dose. Patients are followed weekly for at least 1 month and then every 1-3 months thereafter. PROJECTED ACCRUAL: A total of 95 patients will be accrued for this study.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Leukemia, Lymphoma
Keywords
recurrent childhood acute lymphoblastic leukemia, Burkitt lymphoma, recurrent childhood large cell lymphoma, recurrent childhood lymphoblastic lymphoma, childhood non-Hodgkin lymphoma

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
95 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
1
Arm Type
Active Comparator
Arm Description
BL22 immunotoxin
Arm Title
2
Arm Type
Active Comparator
Arm Description
antibody therapy
Arm Title
3
Arm Type
Active Comparator
Arm Description
immunotoxin therapy
Arm Title
4
Arm Type
Active Comparator
Arm Description
monoclonal antibody therapy
Intervention Type
Drug
Intervention Name(s)
BL22 immunotoxin
Intervention Description
BL22 immunotoxin IV over 30 minutes on days 1, 3, and 5 OR on days 1, 3, 5, 7, 9, and 11. Treatment repeats every 21 days for up to 6 courses in the absence of disease progression or unacceptable toxicity. Patients who achieve a complete response (CR) or unconfirmed CR (CRu) receive 2 additional courses beyond CR or CRu for a maximum of 6 courses.
Intervention Type
Procedure
Intervention Name(s)
antibody-drug conjugate therapy
Intervention Description
CD22 antibody, RFB4 on day 7
Intervention Type
Procedure
Intervention Name(s)
immunotoxin therapy
Intervention Description
tested for immunogenicity to CAT-8015 before each cycle and at end of study.
Intervention Type
Procedure
Intervention Name(s)
monoclonal antibody therapy
Intervention Description
administered intravenously over 30 minutes.
Primary Outcome Measure Information:
Title
assessment of efficacy, safety, pharmacokinetics, immunogenicity.
Time Frame
end of study
Secondary Outcome Measure Information:
Title
Expansion of MTD
Time Frame
end of study

10. Eligibility

Sex
All
Minimum Age & Unit of Time
6 Months
Maximum Age & Unit of Time
24 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
DISEASE CHARACTERISTICS: Histologically confirmed acute lymphoblastic leukemia (ALL) or non-Hodgkin's lymphoma (including lymphoblastic lymphoma, Burkitt's lymphoma, and large cell lymphoma) Not amenable to available curative therapies Relapsed or refractory disease after at least 1 standard chemotherapy and 1 salvage regimen CD22 positive according to at least 1 of the following criteria: More than 15% CD22-positive malignant cells by immunohistochemistry More than 30% CD22-positive malignant cells by fluorescent-activated cell sorter analysis Measurable or evaluable disease Prior CNS involvement allowed provided there is no current evidence of CNS malignancy No CNS leukemia or lymphoma as manifested by any of the following: Cerebrospinal fluid (CSF) WBC ≥ 5/mm^3 and confirmation of CSF blasts Cranial neuropathies secondary to underlying malignancy Radiologically detected CNS lymphoma No isolated testicular ALL Ineligible for or refused hematopoietic stem cell transplantation OR has disease activity that prohibits the time required to identify a suitable stem cell donor PATIENT CHARACTERISTICS: Age 6 months to 24 years Performance status ECOG 0-3 (12 to 24 years of age) Lansky 40-100% (under 12 years of age) Life expectancy Not specified Hematopoietic See Disease Characteristics Absolute neutrophil count > 1,000/mm^3 * Platelet count > 50,000/mm^3 * NOTE: *Non-leukemic patients only Hepatic Bilirubin ≤ 2.0 mg/dL AST and ALT ≤ 5 times upper limit of normal No active hepatitis B or C infection Renal Creatinine normal for age OR Creatinine clearance ≥ 60 mL/min Immunologic No serum neutralization of more than 75% of the activity of 1 µg/mL of study drug HIV negative Other Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception No clinically significant unrelated systemic illness that would preclude study participation No other significant organ dysfunction that would preclude study participation No psychiatric illness or social situation that would preclude study compliance PRIOR CONCURRENT THERAPY: Biologic therapy See Disease Characteristics At least 1 week since prior colony-stimulating factors (e.g., filgrastim [G-CSF], sargramostim [GM-CSF], or epoetin alfa) Prior autologous or allogeneic hematopoietic stem cell transplantation (HSCT) allowed More than 100 days since prior allogeneic HSCT Chemotherapy See Disease Characteristics At least 2 weeks since prior chemotherapy (6 weeks for nitrosoureas) Endocrine therapy Concurrent corticosteroids allowed provided there has been no increase in the dose 1 week prior to and after study entry Steroid taper allowed Radiotherapy At least 3 weeks since prior radiotherapy Allowed in the past 3 weeks provided the volume of the bone marrow treated is < 10% AND the patients has measurable disease outside of the radiation port Surgery Not specified Other Recovered from prior therapy At least 30 days since prior investigational drugs No other concurrent investigational drugs
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Alan S. Wayne, MD
Organizational Affiliation
National Cancer Institute (NCI)
Official's Role
Principal Investigator
Facility Information:
Facility Name
Warren Grant Magnuson Clinical Center - NCI Clinical Trials Referral Office
City
Bethesda
State/Province
Maryland
ZIP/Postal Code
20892-1182
Country
United States

12. IPD Sharing Statement

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BL22 Immunotoxin In Treating Young Patients With Relapsed or Refractory Acute Lymphoblastic Leukemia or Non-Hodgkin's Lymphoma

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