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Tositumomab and Iodine I 131 Tositumomab in Treating Patients With Chronic Lymphocytic Leukemia or Small Lymphocytic Lymphoma in First Remission

Primary Purpose

Lymphoid Leukemia in Remission, Stage I Chronic Lymphocytic Leukemia, Stage II Chronic Lymphocytic Leukemia

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Tositumomab and Iodine I 131 Tositumomab
Sponsored by
Fred Hutchinson Cancer Center
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Lymphoid Leukemia in Remission

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  • Patients with a diagnosis of cluster of differentiation (CD)20+ CLL/SLL; prior to the first treatment patients with CLL must have been either Rai stage III/IV disease or Rai stage I/II with evidence of disease activity as defined by the National Cancer Institute (NCI) 1996 guidelines, and patients with SLL must have been Stage III or IV per Ann Arbor staging system
  • Patient has received prior therapy and is in 1st remission with a partial or complete response to treatment
  • Patients must have no more than 25% of the intratrabecular marrow space involved by leukemia in bone marrow biopsy specimens as assessed microscopically after completion of treatment; bilateral posterior iliac crest core biopsies are required if the percentage of intratrabecular space involved exceeds 10% on a unilateral biopsy; the mean of bilateral biopsies must be no more than 25%
  • Patient must have consented to participate in the study and signed and dated an appropriate institutional review board (IRB)-approved consent form that conforms to federal and institutional guidelines
  • Patient must have a Eastern Cooperative Oncology Group (ECOG) performance status of 0, 1 or 2 (0 = fully active, able to carry on all pre-disease performance without restriction; 1 = restricted in physically strenuous activity but ambulatory and ambulatory and able to carry out work of a light or sedentary nature, e.g., light house work, office work; 2 = ambulatory and capable of all self-care but unable to carry out any work activities and is up and about more than 50% of waking hours)
  • Patient must have an anticipated survival of at least 3 months
  • Granulocytes >= 1,500/uL within 14 days of planned dosimetric infusion
  • Platelets >= 100,000/uL within 14 days of planned dosimetric infusion
  • White blood count =< 20,000/mm^3
  • Serum creatinine < 2 times upper limit of normal
  • Total bilirubin < 2 times upper limit of normal
  • Aspartate aminotransferase (AST) < 5 times upper limit of normal
  • Males and females must agree to use a contraceptive method from enrollment to 6 months after receiving I-131 labeled tositumomab

Exclusion Criteria:

  • Patients who have received prior radiolabeled antibody
  • Patients with active hemolysis
  • Patients must not require sustained transfusion support of blood products
  • Patients in 2nd remission or beyond
  • Patients who have undergone treatment with either stem cell or bone marrow transplant
  • Patients with active obstructive hydronephrosis
  • Patients with evidence of any significant systemic illness, active hepatitis B infection or other active infection at the time of study entry
  • Patients with New York Heart Association class III or IV heart disease or other serious illness that would preclude evaluation
  • Patients with known human immunodeficiency virus (HIV) infection
  • Patients who are pregnant or nursing
  • Patients with prior malignancy other than CLL/SLL, except for adequately treated skin cancer (basal cell or squamous cell carcinoma), in situ cervical cancer, or other cancer for which the patient has been disease-free for 5 years unless approved by the principal investigator (PI)
  • Patients with active brain or leptomeningeal involvement by malignancy
  • Patients who have, in the opinion of the investigator, other medical, social, or psychosocial factors that may negatively impact compliance or their safety by participation in this study

Sites / Locations

  • Fred Hutchinson Cancer Research Center/University of Washington Cancer Consortium

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Treatment (monoclonal antibody therapy)

Arm Description

Patients receive tositumomab and iodine I 131 tositumomab IV over 90 minutes on day 0 and then again 7-14 days later over 30-60 minutes.

Outcomes

Primary Outcome Measures

Probability of Progression-free Survival (PFS)
Progression free survival (PFS) is defined as the interval between the first treatment day to the first sign of disease progression. This outcome measures the percentage of participants with PFS at 36 months.
Improved Response Rate After Treatment With 131I-tositumomab for Patients Who Had Evidence of CLL at the End of Initial Chemotherapy
Response rates determined using National Cancer Institute (NCI) working group guidelines plus computed tomography (CT) scan criteria. Participants were assessed for response after initial chemotherapy and again 3 months after 131I-tositumomab treatment.Only patients who had less than a complete response (CR) after initial chemotherapy were assessed for improved response after 131I-tositumomab.
Minimal Residual Disease (MRD) by Flow Cytometry or Polymerase Chain Reaction (PCR) in Patients Who Had a Complete Remission (CR) After Any Prior Therapy

Secondary Outcome Measures

Evaluate Toxicities of 131I-tositumomab
Adverse events following treatment of 131I-tositumomab

Full Information

First Posted
May 17, 2007
Last Updated
October 10, 2017
Sponsor
Fred Hutchinson Cancer Center
Collaborators
National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT00476047
Brief Title
Tositumomab and Iodine I 131 Tositumomab in Treating Patients With Chronic Lymphocytic Leukemia or Small Lymphocytic Lymphoma in First Remission
Official Title
A Study of 131I-Tositumomab (Bexxar®) Consolidation in Patients With B-Cell Chronic Lymphocytic Leukemia or Small Lymphocytic Lymphoma in First Remission
Study Type
Interventional

2. Study Status

Record Verification Date
October 2017
Overall Recruitment Status
Completed
Study Start Date
February 2007 (undefined)
Primary Completion Date
February 2015 (Actual)
Study Completion Date
February 2015 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Fred Hutchinson Cancer Center
Collaborators
National Cancer Institute (NCI)

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
This phase II trial studies how well tositumomab and iodine I 131 tositumomab works in treating patients with chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL) that have had their first decrease in or disappearance of signs and symptoms of cancer (first remission). Monoclonal antibodies, such as tositumomab and iodine I 131 tositumomab, may block cancer growth in different ways by targeting certain cells.
Detailed Description
PRIMARY OBJECTIVES: I. To estimate the progression-free survival at 2 years following administration of 131I-tositumomab (tositumomab and iodine I 131 tositumomab) in patients with CLL/SLL who achieve a complete remission (CR) or partial remission (PR) with prior therapy. II. To improve the response rate by administering 131I-tositumomab to patients who have achieved a PR not a CR after any prior therapy. III. To eliminate residual disease (documented by flow cytometry or polymerase chain reaction [PCR]) using 131I-tositumomab in patients who have achieved a CR after any prior therapy. SECONDARY OBJECTIVES: I. To evaluate the toxicities of 131I-tositumomab in 1st remission patients with previously treated CLL/SLL. OUTLINE: Patients receive tositumomab and iodine I 131 tositumomab intravenously (IV) over 90 minutes on day 0 and then again 7-14 days later over 30-60 minutes. After completion of study treatment, patients are followed up weekly for 3 months, every 3 months for 2 years, every 6 months for 3 years, and then annually thereafter.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Lymphoid Leukemia in Remission, Stage I Chronic Lymphocytic Leukemia, Stage II Chronic Lymphocytic Leukemia, Stage III Chronic Lymphocytic Leukemia, Stage III Small Lymphocytic Lymphoma, Stage IV Chronic Lymphocytic Leukemia, 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
16 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Treatment (monoclonal antibody therapy)
Arm Type
Experimental
Arm Description
Patients receive tositumomab and iodine I 131 tositumomab IV over 90 minutes on day 0 and then again 7-14 days later over 30-60 minutes.
Intervention Type
Combination Product
Intervention Name(s)
Tositumomab and Iodine I 131 Tositumomab
Other Intervention Name(s)
Bexxar, Bexxar Therapeutic Regimen, Bexxar Therapy
Intervention Description
Give IV
Primary Outcome Measure Information:
Title
Probability of Progression-free Survival (PFS)
Description
Progression free survival (PFS) is defined as the interval between the first treatment day to the first sign of disease progression. This outcome measures the percentage of participants with PFS at 36 months.
Time Frame
36 months
Title
Improved Response Rate After Treatment With 131I-tositumomab for Patients Who Had Evidence of CLL at the End of Initial Chemotherapy
Description
Response rates determined using National Cancer Institute (NCI) working group guidelines plus computed tomography (CT) scan criteria. Participants were assessed for response after initial chemotherapy and again 3 months after 131I-tositumomab treatment.Only patients who had less than a complete response (CR) after initial chemotherapy were assessed for improved response after 131I-tositumomab.
Time Frame
3 months after 131I-tositumomab consolidation
Title
Minimal Residual Disease (MRD) by Flow Cytometry or Polymerase Chain Reaction (PCR) in Patients Who Had a Complete Remission (CR) After Any Prior Therapy
Time Frame
3 months after 131I-tositumomab consolidation
Secondary Outcome Measure Information:
Title
Evaluate Toxicities of 131I-tositumomab
Description
Adverse events following treatment of 131I-tositumomab
Time Frame
48 months (median)

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Patients with a diagnosis of cluster of differentiation (CD)20+ CLL/SLL; prior to the first treatment patients with CLL must have been either Rai stage III/IV disease or Rai stage I/II with evidence of disease activity as defined by the National Cancer Institute (NCI) 1996 guidelines, and patients with SLL must have been Stage III or IV per Ann Arbor staging system Patient has received prior therapy and is in 1st remission with a partial or complete response to treatment Patients must have no more than 25% of the intratrabecular marrow space involved by leukemia in bone marrow biopsy specimens as assessed microscopically after completion of treatment; bilateral posterior iliac crest core biopsies are required if the percentage of intratrabecular space involved exceeds 10% on a unilateral biopsy; the mean of bilateral biopsies must be no more than 25% Patient must have consented to participate in the study and signed and dated an appropriate institutional review board (IRB)-approved consent form that conforms to federal and institutional guidelines Patient must have a Eastern Cooperative Oncology Group (ECOG) performance status of 0, 1 or 2 (0 = fully active, able to carry on all pre-disease performance without restriction; 1 = restricted in physically strenuous activity but ambulatory and ambulatory and able to carry out work of a light or sedentary nature, e.g., light house work, office work; 2 = ambulatory and capable of all self-care but unable to carry out any work activities and is up and about more than 50% of waking hours) Patient must have an anticipated survival of at least 3 months Granulocytes >= 1,500/uL within 14 days of planned dosimetric infusion Platelets >= 100,000/uL within 14 days of planned dosimetric infusion White blood count =< 20,000/mm^3 Serum creatinine < 2 times upper limit of normal Total bilirubin < 2 times upper limit of normal Aspartate aminotransferase (AST) < 5 times upper limit of normal Males and females must agree to use a contraceptive method from enrollment to 6 months after receiving I-131 labeled tositumomab Exclusion Criteria: Patients who have received prior radiolabeled antibody Patients with active hemolysis Patients must not require sustained transfusion support of blood products Patients in 2nd remission or beyond Patients who have undergone treatment with either stem cell or bone marrow transplant Patients with active obstructive hydronephrosis Patients with evidence of any significant systemic illness, active hepatitis B infection or other active infection at the time of study entry Patients with New York Heart Association class III or IV heart disease or other serious illness that would preclude evaluation Patients with known human immunodeficiency virus (HIV) infection Patients who are pregnant or nursing Patients with prior malignancy other than CLL/SLL, except for adequately treated skin cancer (basal cell or squamous cell carcinoma), in situ cervical cancer, or other cancer for which the patient has been disease-free for 5 years unless approved by the principal investigator (PI) Patients with active brain or leptomeningeal involvement by malignancy Patients who have, in the opinion of the investigator, other medical, social, or psychosocial factors that may negatively impact compliance or their safety by participation in this study
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Mazyar Shadman
Organizational Affiliation
Fred Hutchinson Cancer Research Center/University of Washington Cancer Consortium
Official's Role
Principal Investigator
Facility Information:
Facility Name
Fred Hutchinson Cancer Research Center/University of Washington Cancer Consortium
City
Seattle
State/Province
Washington
ZIP/Postal Code
98109
Country
United States

12. IPD Sharing Statement

Learn more about this trial

Tositumomab and Iodine I 131 Tositumomab in Treating Patients With Chronic Lymphocytic Leukemia or Small Lymphocytic Lymphoma in First Remission

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