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Denileukin Diftitox in Treating Patients With Relapsed or Refractory Non-Hodgkin's Lymphoma

Primary Purpose

Lymphoma

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
denileukin diftitox
Sponsored by
Jonsson Comprehensive Cancer Center
About
Eligibility
Locations
Outcomes
Full info

About this trial

This is an interventional treatment trial for Lymphoma focused on measuring recurrent adult diffuse large cell lymphoma, recurrent grade 1 follicular lymphoma, recurrent grade 2 follicular lymphoma, recurrent grade 3 follicular lymphoma, recurrent small lymphocytic lymphoma

Eligibility Criteria

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

DISEASE CHARACTERISTICS: Histologically confirmed B-cell non-Hodgkin's lymphoma (NHL) of 1 of the following subtypes: Diffuse large B-cell lymphoma Follicular lymphoma (grades 1-3) Small lymphocytic lymphoma Transformed B-cell lymphoma Relapsed or refractory disease Disease failed to respond to or progressed after ≥ 2 prior treatment regimens (e.g., high-dose therapy [HDT] with stem cell transplantation [SCT]*) NOTE: *Patients who have received HDT with SCT are considered to have diminished bone marrow reserve Diminished bone marrow reserve AND/OR mild to moderate cytopenia, meeting 1 of the following criteria: Absolute neutrophil count ≥ 1,000/mm^3 but < 1,500/mm^3 (growth factor independent) WBC ≥ 2,000/mm^3 but < 4,000/mm^3 (growth factor independent) Platelet count ≥ 40,000/mm^3 (25,000/mm^3 if thrombocytopenia is secondary to marrow involvement by lymphoma) but < 150,000/mm^3 (platelet transfusion independent) At least 1 bidimensionally measurable lymph node or tumor mass ≥ 4 cm PATIENT CHARACTERISTICS: Age 18 and over Performance status ECOG 0-2 Life expectancy At least 16 weeks Hematopoietic See Disease Characteristics Hepatic Bilirubin ≤ 1.5 times upper limit of normal (ULN) AST and ALT ≤ 2 times ULN Albumin ≥ 3.0 g/dL No history of veno-occlusive disease of the liver No chronic hepatitis Renal Creatinine < 2 times ULN Cardiovascular No congestive heart failure No New York Heart Association class III-IV cardiac disease No ventricular tachycardia No fibrillation No myocardial infarction within the past 12 months Other Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception No known HIV positivity No active GVHD ≥ grade 2 within the past 6 months No other serious medical illness or active infection that would preclude study participation No known hypersensitivity to denileukin diftitox or any of its components (e.g., diphtheria toxin, interleukin-2, or their excipients) No other malignancy within the past 5 years except successfully treated carcinoma in situ of the cervix or basal cell carcinoma PRIOR CONCURRENT THERAPY: Biologic therapy See Disease Characteristics At least 6 months since prior allogeneic SCT No concurrent immunotherapy Chemotherapy No concurrent chemotherapy Endocrine therapy No concurrent anticancer hormonal therapy No concurrent corticosteroids for the treatment of NHL Concurrent corticosteroids allowed for the following conditions: Tapering doses of corticosteroids for resolving graft-versus-host disease (GVHD) Low-dose maintenance corticosteroids for the treatment of an autoimmune disorder Corticosteroids as premedication prior to denileukin diftitox administration or as transient treatment for hypersensitivity reactions Radiotherapy More than 4 weeks since prior and no concurrent radiotherapy No prior radiotherapy to the only site of evaluable disease unless disease progression has occurred at that site Surgery Not specified Other At least 3 weeks since prior antilymphoma therapy More than 4 weeks since prior and no other concurrent experimental therapy, including approved drugs tested in an investigational setting

Sites / Locations

  • Jonsson Comprehensive Cancer Center at UCLA

Outcomes

Primary Outcome Measures

Objective clinical response (complete or partial response)

Secondary Outcome Measures

Time to progression
Overall survival at 1 year
Safety

Full Information

First Posted
August 29, 2005
Last Updated
May 29, 2013
Sponsor
Jonsson Comprehensive Cancer Center
Collaborators
National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT00138164
Brief Title
Denileukin Diftitox in Treating Patients With Relapsed or Refractory Non-Hodgkin's Lymphoma
Official Title
A Phase II Multicenter Study of Ontak® (Denileukin Diftitox) in Patients With Relapsed or Refractory B-Cell Non-Hodgkin's Lymphoma
Study Type
Interventional

2. Study Status

Record Verification Date
November 2008
Overall Recruitment Status
Completed
Study Start Date
December 2004 (undefined)
Primary Completion Date
February 2006 (Actual)
Study Completion Date
November 2008 (Actual)

3. Sponsor/Collaborators

Name of the Sponsor
Jonsson Comprehensive Cancer Center
Collaborators
National Cancer Institute (NCI)

4. Oversight

5. Study Description

Brief Summary
RATIONALE: Biological therapies, such as denileukin diftitox, may be able to carry cancer-killing substances directly to non-Hodgkin's lymphoma cells. PURPOSE: This phase II trial is studying how well denileukin diftitox works in treating patients with relapsed or refractory B-cell non-Hodgkin's lymphoma.
Detailed Description
OBJECTIVES: Primary Determine the efficacy of denileukin diftitox, in terms of objective response and time to progression, in patients with relapsed or refractory B-cell non-Hodgkin's lymphoma. Secondary Determine the safety of this drug in these patients. Determine the 1-year overall survival of patients treated with this drug. OUTLINE: This is an open-label, multicenter study. Patients receive denileukin diftitox IV over 20-80 minutes on days 1-3, 8, 15, 22, 29, 36, 43, 50, 57, 64, 71, 78, 85, 92, and 99 (weeks 1-16) in the absence of disease progression or unacceptable toxicity. Patients achieving a partial response at week 16 may continue treatment once monthly for up to 8 additional doses or until a complete response (CR) is achieved. Patients achieving a CR (at any time) receive 2 additional monthly doses of denileukin diftitox beyond CR. After completion of study treatment, patients are followed at 4 weeks and then every 3 months thereafter. PROJECTED ACCRUAL: A total of 25-50 patients will be accrued for this study within 1 year.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Lymphoma
Keywords
recurrent adult diffuse large cell lymphoma, recurrent grade 1 follicular lymphoma, recurrent grade 2 follicular lymphoma, recurrent grade 3 follicular lymphoma, recurrent small lymphocytic lymphoma

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Masking
None (Open Label)
Enrollment
50 (Anticipated)

8. Arms, Groups, and Interventions

Intervention Type
Biological
Intervention Name(s)
denileukin diftitox
Primary Outcome Measure Information:
Title
Objective clinical response (complete or partial response)
Secondary Outcome Measure Information:
Title
Time to progression
Title
Overall survival at 1 year
Title
Safety

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
DISEASE CHARACTERISTICS: Histologically confirmed B-cell non-Hodgkin's lymphoma (NHL) of 1 of the following subtypes: Diffuse large B-cell lymphoma Follicular lymphoma (grades 1-3) Small lymphocytic lymphoma Transformed B-cell lymphoma Relapsed or refractory disease Disease failed to respond to or progressed after ≥ 2 prior treatment regimens (e.g., high-dose therapy [HDT] with stem cell transplantation [SCT]*) NOTE: *Patients who have received HDT with SCT are considered to have diminished bone marrow reserve Diminished bone marrow reserve AND/OR mild to moderate cytopenia, meeting 1 of the following criteria: Absolute neutrophil count ≥ 1,000/mm^3 but < 1,500/mm^3 (growth factor independent) WBC ≥ 2,000/mm^3 but < 4,000/mm^3 (growth factor independent) Platelet count ≥ 40,000/mm^3 (25,000/mm^3 if thrombocytopenia is secondary to marrow involvement by lymphoma) but < 150,000/mm^3 (platelet transfusion independent) At least 1 bidimensionally measurable lymph node or tumor mass ≥ 4 cm PATIENT CHARACTERISTICS: Age 18 and over Performance status ECOG 0-2 Life expectancy At least 16 weeks Hematopoietic See Disease Characteristics Hepatic Bilirubin ≤ 1.5 times upper limit of normal (ULN) AST and ALT ≤ 2 times ULN Albumin ≥ 3.0 g/dL No history of veno-occlusive disease of the liver No chronic hepatitis Renal Creatinine < 2 times ULN Cardiovascular No congestive heart failure No New York Heart Association class III-IV cardiac disease No ventricular tachycardia No fibrillation No myocardial infarction within the past 12 months Other Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception No known HIV positivity No active GVHD ≥ grade 2 within the past 6 months No other serious medical illness or active infection that would preclude study participation No known hypersensitivity to denileukin diftitox or any of its components (e.g., diphtheria toxin, interleukin-2, or their excipients) No other malignancy within the past 5 years except successfully treated carcinoma in situ of the cervix or basal cell carcinoma PRIOR CONCURRENT THERAPY: Biologic therapy See Disease Characteristics At least 6 months since prior allogeneic SCT No concurrent immunotherapy Chemotherapy No concurrent chemotherapy Endocrine therapy No concurrent anticancer hormonal therapy No concurrent corticosteroids for the treatment of NHL Concurrent corticosteroids allowed for the following conditions: Tapering doses of corticosteroids for resolving graft-versus-host disease (GVHD) Low-dose maintenance corticosteroids for the treatment of an autoimmune disorder Corticosteroids as premedication prior to denileukin diftitox administration or as transient treatment for hypersensitivity reactions Radiotherapy More than 4 weeks since prior and no concurrent radiotherapy No prior radiotherapy to the only site of evaluable disease unless disease progression has occurred at that site Surgery Not specified Other At least 3 weeks since prior antilymphoma therapy More than 4 weeks since prior and no other concurrent experimental therapy, including approved drugs tested in an investigational setting
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Lauren C. Pinter-Brown, MD
Organizational Affiliation
Jonsson Comprehensive Cancer Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
Jonsson Comprehensive Cancer Center at UCLA
City
Los Angeles
State/Province
California
ZIP/Postal Code
90095-1781
Country
United States

12. IPD Sharing Statement

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Denileukin Diftitox in Treating Patients With Relapsed or Refractory Non-Hodgkin's Lymphoma

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