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Rituximab and Yttrium Y 90 Ibritumomab Tiuxetan in Treating Patients With Non-Hodgkin's Lymphoma

Primary Purpose

Lymphoma

Status
Terminated
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
rituximab
yttrium Y 90 ibritumomab tiuxetan
Sponsored by
Beth Israel Deaconess Medical Center
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Lymphoma focused on measuring contiguous stage II grade 1 follicular lymphoma, noncontiguous stage II grade 1 follicular lymphoma, stage I grade 1 follicular lymphoma, stage III grade 1 follicular lymphoma, stage IV grade 1 follicular lymphoma, contiguous stage II grade 2 follicular lymphoma, noncontiguous stage II grade 2 follicular lymphoma, stage I grade 2 follicular lymphoma, stage III grade 2 follicular lymphoma, stage IV grade 2 follicular lymphoma, contiguous stage II marginal zone lymphoma, noncontiguous stage II marginal zone lymphoma, splenic marginal zone lymphoma, stage I marginal zone lymphoma, stage III marginal zone lymphoma, stage IV marginal zone lymphoma, extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue, nodal marginal zone B-cell lymphoma, contiguous stage II small lymphocytic lymphoma, noncontiguous stage II small lymphocytic lymphoma, stage I small lymphocytic lymphoma, stage III small lymphocytic lymphoma, stage IV small lymphocytic lymphoma

Eligibility Criteria

18 Years - 120 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

DISEASE CHARACTERISTICS: Histologically confirmed indolent non-Hodgkin's lymphoma (NHL), including 1 of the following histologic subtypes: Grade1 or 2 follicular lymphoma Small lymphocytic lymphoma (SLL) Marginal zone B-cell lymphoma CD20-positive disease confirmed by immunohistochemistry or flow cytometry Bidimensionally measurable disease At least 1 lesion measuring ≥ 2.0 cm in a single dimension by CT scan Less than 25% bone marrow involvement with lymphoma by bilateral iliac crest bone marrow aspiration and biopsy within the past 6 weeks No clinically significant impaired bone marrow reserve as evidenced by any of the following: Hypocellular marrow, as evidenced by 1 of the following: ≤ 15% cellularity Marked reduction in bone marrow precursors Platelet count < 100,000/mm^3 Absolute neutrophil count < 1,500/mm^3 History of failed stem cell collection Prior myeloablative therapy No greater than 5,000/mm^3 circulating tumor cells in peripheral blood Requires antilymphoma therapy, as indicated by any of the following: Systemic symptoms B symptoms Cytopenias Malaise Organ compromise Discomfort Pain Disfigurement Rapidly progressive disease Undue anxiety related to not receiving treatment No transformation to intermediate or high-grade NHL No known brain metastases or CNS involvement by lymphoma NOTE: A new classification scheme for adult non-Hodgkin's lymphoma has been adopted by PDQ. The terminology of "indolent" or "aggressive" lymphoma will replace the former terminology of "low", "intermediate", or "high" grade lymphoma. However, this protocol uses the former terminology. PATIENT CHARACTERISTICS: Age Over 18 Performance status ECOG 0-2 OR WHO 0-2 OR Karnofsky 70-100% Life expectancy More than 3 months Hematopoietic See Disease Characteristics WBC ≥ 3,000/mm^3 Absolute neutrophil count ≥ 1,500/mm^3 Platelet count ≥ 100,000/mm^3 Lymphocyte count < 5,000/mm^3 (for patients with SLL ) Hepatic Bilirubin ≤ 2.0 mg/dL AST and ALT ≤ 2.5 times upper limit of normal Renal Creatinine ≤ 2.0 mg/dL OR Creatinine clearance > 60 mL/min Cardiovascular No symptomatic congestive heart failure No unstable angina pectoris No cardiac arrhythmia Immunologic No anti-murine antibody reactivity (in patients with prior exposure to murine antibodies or proteins) No ongoing or active infection No history of allergic reaction attributed to compounds of similar chemical or biologic composition to yttrium Y 90 ibritumomab tiuxetan Other Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception during and for at least 1 year after study treatment No other active malignancy except non-melanoma skin cancer No other serious nonmalignant disease that would preclude study participation No psychiatric illness or social situation that would preclude study compliance No other uncontrolled illness PRIOR CONCURRENT THERAPY: Biologic therapy More than 4 weeks since prior pegfilgrastim More than 2 weeks since prior filgrastim (G-CSF) or sargramostim (GM-CSF) Chemotherapy No prior chemotherapy Endocrine therapy Not specified Radiotherapy No prior external beam radiotherapy to > 25% of active bone marrow (involved field or regional) Surgery More than 4 weeks since prior major surgery except diagnostic surgery Other No prior systemic antilymphoma therapy No concurrent combination antiretroviral therapy for HIV-positive patients No other concurrent anticancer therapy No other concurrent investigational agents No other concurrent antilymphoma therapy

Sites / Locations

  • Beth Israel Deaconess Medical Center
  • Norris Cotton Cancer Center at Dartmouth-Hitchcock Medical Center
  • Vermont Cancer Center at University of Vermont

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Rituximab and Yttrium Y 90 Ibritumomab Tiuxetan

Arm Description

Rituximab and Yttrium Y 90 Ibritumomab Tiuxetan

Outcomes

Primary Outcome Measures

Response Rate (Complete Response, Unconfirmed Complete Response, and Partial Response) at 12 Weeks
INTERNATIONAL WORKSHOP RESPONSE CRITERIA FOR NON HODGKIN'S LYMPHOMA Cheson BD, Horning SJ, Coiffier B, Shipp MA, Fisher RI, Connors JM, et al. Report of an international workshop to standardize response criteria for non Hodgkin's lymphoma. J Clin Oncol 1999;17(4):1244-53.
EFS
Event = Death, second malignancy , disease progression.

Secondary Outcome Measures

Full Information

First Posted
May 3, 2005
Last Updated
October 19, 2017
Sponsor
Beth Israel Deaconess Medical Center
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1. Study Identification

Unique Protocol Identification Number
NCT00110149
Brief Title
Rituximab and Yttrium Y 90 Ibritumomab Tiuxetan in Treating Patients With Non-Hodgkin's Lymphoma
Official Title
A Phase II Study of Yttrium-90-Labeled Ibritumomab Tiuxetan (Zevalin) Radioimmunotherapy as First Line Treatment in Indolent Non-Hodgkin's Lymphoma
Study Type
Interventional

2. Study Status

Record Verification Date
October 2017
Overall Recruitment Status
Terminated
Why Stopped
Company withdrew drug supply
Study Start Date
May 2004 (undefined)
Primary Completion Date
May 2012 (Actual)
Study Completion Date
March 2015 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Beth Israel Deaconess Medical Center

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No

5. Study Description

Brief Summary
RATIONALE: Monoclonal antibodies, such as rituximab, can block cancer growth in different ways. Some block the ability of cancer cells to grow and spread. Others, such as yttrium Y 90 ibritumomab tiuxetan, find cancer cells and help kill them or carry cancer-killing substances to them without harming normal cells. Giving rituximab together with yttrium Y 90 ibritumomab tiuxetan may kill more cancer cells. PURPOSE: This phase II trial is studying how well giving rituximab together with yttrium Y 90 ibritumomab tiuxetan works in treating patients with indolent non-Hodgkin's lymphoma.
Detailed Description
OBJECTIVES: Primary Determine 12-week overall and complete response rate in patients with indolent non-Hodgkin's lymphoma treated with rituximab and yttrium Y 90 ibritumomab tiuxetan as first-line treatment. Secondary Determine 1-year event-free survival of patients treated with this regimen. Determine time to progression and time to next antilymphoma therapy in patients treated with this regimen. Determine the molecular response rate in patients treated with this regimen. Determine the hematological and non-hematological toxicity of this regimen in these patients. Assess the quality of life of patients treated with this regimen. OUTLINE: This is an open-label, multicenter study. Patients receive rituximab IV followed, no more than 4 hours later, by indium In 111 ibritumomab tiuxetan (for imaging) IV over 10 minutes on day 1. If biodistribution is acceptable, patients receive rituximab IV followed, no more than 4 hours later, by a single dose of yttrium Y 90 ibritumomab tiuxetan IV over 10 minutes on day 7, 8, or 9 in the absence of disease progression or unacceptable toxicity. Quality of life is assessed at baseline, weeks 6, 10, and 14, every 3 months for 2 years, and then every 6 months for 2 years. After completion of study treatment, patients are followed weekly for 3 months, every 3 months for 2 years, and then every 6 months for 2 years. PROJECTED ACCRUAL: A total of 18-28 patients will be accrued for this study within 2 years.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Lymphoma
Keywords
contiguous stage II grade 1 follicular lymphoma, noncontiguous stage II grade 1 follicular lymphoma, stage I grade 1 follicular lymphoma, stage III grade 1 follicular lymphoma, stage IV grade 1 follicular lymphoma, contiguous stage II grade 2 follicular lymphoma, noncontiguous stage II grade 2 follicular lymphoma, stage I grade 2 follicular lymphoma, stage III grade 2 follicular lymphoma, stage IV grade 2 follicular lymphoma, contiguous stage II marginal zone lymphoma, noncontiguous stage II marginal zone lymphoma, splenic marginal zone lymphoma, stage I marginal zone lymphoma, stage III marginal zone lymphoma, stage IV marginal zone lymphoma, extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue, nodal marginal zone B-cell lymphoma, contiguous stage II small lymphocytic lymphoma, noncontiguous stage II small lymphocytic lymphoma, stage I small lymphocytic lymphoma, stage III small lymphocytic lymphoma, stage IV small lymphocytic lymphoma

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
12 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Rituximab and Yttrium Y 90 Ibritumomab Tiuxetan
Arm Type
Experimental
Arm Description
Rituximab and Yttrium Y 90 Ibritumomab Tiuxetan
Intervention Type
Biological
Intervention Name(s)
rituximab
Intervention Type
Radiation
Intervention Name(s)
yttrium Y 90 ibritumomab tiuxetan
Primary Outcome Measure Information:
Title
Response Rate (Complete Response, Unconfirmed Complete Response, and Partial Response) at 12 Weeks
Description
INTERNATIONAL WORKSHOP RESPONSE CRITERIA FOR NON HODGKIN'S LYMPHOMA Cheson BD, Horning SJ, Coiffier B, Shipp MA, Fisher RI, Connors JM, et al. Report of an international workshop to standardize response criteria for non Hodgkin's lymphoma. J Clin Oncol 1999;17(4):1244-53.
Time Frame
14 weeks
Title
EFS
Description
Event = Death, second malignancy , disease progression.
Time Frame
1 year

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
120 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
DISEASE CHARACTERISTICS: Histologically confirmed indolent non-Hodgkin's lymphoma (NHL), including 1 of the following histologic subtypes: Grade1 or 2 follicular lymphoma Small lymphocytic lymphoma (SLL) Marginal zone B-cell lymphoma CD20-positive disease confirmed by immunohistochemistry or flow cytometry Bidimensionally measurable disease At least 1 lesion measuring ≥ 2.0 cm in a single dimension by CT scan Less than 25% bone marrow involvement with lymphoma by bilateral iliac crest bone marrow aspiration and biopsy within the past 6 weeks No clinically significant impaired bone marrow reserve as evidenced by any of the following: Hypocellular marrow, as evidenced by 1 of the following: ≤ 15% cellularity Marked reduction in bone marrow precursors Platelet count < 100,000/mm^3 Absolute neutrophil count < 1,500/mm^3 History of failed stem cell collection Prior myeloablative therapy No greater than 5,000/mm^3 circulating tumor cells in peripheral blood Requires antilymphoma therapy, as indicated by any of the following: Systemic symptoms B symptoms Cytopenias Malaise Organ compromise Discomfort Pain Disfigurement Rapidly progressive disease Undue anxiety related to not receiving treatment No transformation to intermediate or high-grade NHL No known brain metastases or CNS involvement by lymphoma NOTE: A new classification scheme for adult non-Hodgkin's lymphoma has been adopted by PDQ. The terminology of "indolent" or "aggressive" lymphoma will replace the former terminology of "low", "intermediate", or "high" grade lymphoma. However, this protocol uses the former terminology. PATIENT CHARACTERISTICS: Age Over 18 Performance status ECOG 0-2 OR WHO 0-2 OR Karnofsky 70-100% Life expectancy More than 3 months Hematopoietic See Disease Characteristics WBC ≥ 3,000/mm^3 Absolute neutrophil count ≥ 1,500/mm^3 Platelet count ≥ 100,000/mm^3 Lymphocyte count < 5,000/mm^3 (for patients with SLL ) Hepatic Bilirubin ≤ 2.0 mg/dL AST and ALT ≤ 2.5 times upper limit of normal Renal Creatinine ≤ 2.0 mg/dL OR Creatinine clearance > 60 mL/min Cardiovascular No symptomatic congestive heart failure No unstable angina pectoris No cardiac arrhythmia Immunologic No anti-murine antibody reactivity (in patients with prior exposure to murine antibodies or proteins) No ongoing or active infection No history of allergic reaction attributed to compounds of similar chemical or biologic composition to yttrium Y 90 ibritumomab tiuxetan Other Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception during and for at least 1 year after study treatment No other active malignancy except non-melanoma skin cancer No other serious nonmalignant disease that would preclude study participation No psychiatric illness or social situation that would preclude study compliance No other uncontrolled illness PRIOR CONCURRENT THERAPY: Biologic therapy More than 4 weeks since prior pegfilgrastim More than 2 weeks since prior filgrastim (G-CSF) or sargramostim (GM-CSF) Chemotherapy No prior chemotherapy Endocrine therapy Not specified Radiotherapy No prior external beam radiotherapy to > 25% of active bone marrow (involved field or regional) Surgery More than 4 weeks since prior major surgery except diagnostic surgery Other No prior systemic antilymphoma therapy No concurrent combination antiretroviral therapy for HIV-positive patients No other concurrent anticancer therapy No other concurrent investigational agents No other concurrent antilymphoma therapy
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Robin Joyce, MD
Organizational Affiliation
Beth Israel Deaconess Medical Center
Official's Role
Study Chair
Facility Information:
Facility Name
Beth Israel Deaconess Medical Center
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02215
Country
United States
Facility Name
Norris Cotton Cancer Center at Dartmouth-Hitchcock Medical Center
City
Lebanon
State/Province
New Hampshire
ZIP/Postal Code
03756-0002
Country
United States
Facility Name
Vermont Cancer Center at University of Vermont
City
Burlington
State/Province
Vermont
ZIP/Postal Code
05401-3498
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Rituximab and Yttrium Y 90 Ibritumomab Tiuxetan in Treating Patients With Non-Hodgkin's Lymphoma

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