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DepoCyt for Active Lymphomatous or Leukemic Meningitis

Primary Purpose

Neoplastic Meningitis, Lymphoma, B Cell

Status
Terminated
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
cytarabine liposome injection
Sponsored by
Duke University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Neoplastic Meningitis focused on measuring Lymphoma, Leukemia, Leukemic Meningitis, Lymphomatous Meningitis

Eligibility Criteria

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

Inclusion Criteria:

  • Cytologically confirmed, or radiographic evidence for lymphomatous or leukemic meningitis. If the CSF cytology is negative, patients must have MRI/CT brain and clinical findings consistent with neoplastic meningitis.
  • Karnofsky Performance Score of 60 or above.
  • Age ≥ 18 years.
  • Patients must have adequate hematologic, renal and liver function. Laboratory
  • Absolute neutrophil count (ANC) ≥ 1,500/mm3 or white blood cell count > 3,000/mm3
  • Platelet count ≥ 100, 000/mm3
  • BUN and serum creatinine must be ≤ 1.5 times upper limit of laboratory normal
  • Total and direct serum bilirubin must be ≤ 1.5 times upper limit of laboratory normal
  • SGOT and SGPT ≤ 3.0 times upper limit of laboratory normal
  • Alkaline phosphatase derived from liver ≤ 2.0 times upper limit of laboratory normal
  • No uncontrolled infection other than human immunodeficiency virus that is being treated with anti-retroviral therapy
  • Patients who have had prior CNS radiation, prior intrathecal methotrexate, and prior CNS prophylaxis with intrathecal or intravenous cytarabine or methotrexate are eligible
  • Written informed consent

Exclusion Criteria:

  • Experimental/Investigational chemotherapy, immunotherapy, or biologic therapy within four weeks prior to study
  • Concurrent systemic chemotherapy with high dose methotrexate, high dose cytarabine, or high dose thiotepa (they cross the blood brain barrier at high levels)
  • Patients receiving whole brain radiotherapy or craniospinal irradiation
  • Previous (less than 2 years from diagnosis) or concurrent malignancies at other sites with the exception of fully treated carcinoma in situ of the cervix, basal cell carcinoma of the skin, and squamous cell carcinoma of the skin, or prostate cancer not requiring ongoing chemotherapy
  • Pregnant or lactating women
  • Known active meningeal infection
  • Evidence of obstructive hydrocephalus requiring neurosurgical intervention

Sites / Locations

  • Duke University Medical Center

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

Lymphomatous

Leukemic

Arm Description

Subjects with Lymphomatous Meningitis

Subjects with Leukemic Meningitis

Outcomes

Primary Outcome Measures

Response Rate
To evaluate response rate using intrathecal DepoCytTM in two cohorts of patients, one with active lymphomatous meningitis and another with active leukemic meningitis.

Secondary Outcome Measures

Time to Neurologic Progression

Full Information

First Posted
August 31, 2007
Last Updated
June 7, 2013
Sponsor
Duke University
Collaborators
Enzon Pharmaceuticals, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT00523939
Brief Title
DepoCyt for Active Lymphomatous or Leukemic Meningitis
Official Title
Phase II Study of Intrathecal Therapy With DepoCyt for Active Lymphomatous or Leukemic Meningitis
Study Type
Interventional

2. Study Status

Record Verification Date
November 2012
Overall Recruitment Status
Terminated
Why Stopped
Low accrual.
Study Start Date
June 2006 (undefined)
Primary Completion Date
June 2009 (Actual)
Study Completion Date
June 2009 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Duke University
Collaborators
Enzon Pharmaceuticals, Inc.

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study is to determine the response rate of lymphomatous meningitis or leukemic meningitis to DepoCyt. The safety of DepoCyt, the number of people who respond well to the study drug, and the response of symptoms to the study drug will also be determined.
Detailed Description
DepoCyt is a sustained-release formulation of the chemotherapy drug, cytarabine (Ara-C), which is used for the treatment of patients with lymphomatous or leukemic meningitis, a complication of lymphoma/leukemia that is characterized by the spread of cancer to the central nervous system. DepoCyt is introduced into the spinal fluid, through a needle inserted into the spinal canal or through a reservoir placed under the scalp by a neurosurgeon. DepoCyt will be given every two weeks i.e. week 1 and week 3 initially. After the second dose, a lumbar puncture will be done to check the spinal fluid for cancer cells. If there has been a good response, DepoCyt will be given every 14 days for 6 doses i.e., weeks 5, 7, 9, 11, 13, 15 and then every 28 days for six doses i.e., weeks 19, 23, 27, 31, 35, and 39. Blood tests and lumbar punctures will be done throughout the study.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Neoplastic Meningitis, Lymphoma, B Cell
Keywords
Lymphoma, Leukemia, Leukemic Meningitis, Lymphomatous Meningitis

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
4 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Lymphomatous
Arm Type
Experimental
Arm Description
Subjects with Lymphomatous Meningitis
Arm Title
Leukemic
Arm Type
Experimental
Arm Description
Subjects with Leukemic Meningitis
Intervention Type
Drug
Intervention Name(s)
cytarabine liposome injection
Other Intervention Name(s)
DepoCyt
Intervention Description
50 mg intrathecal every 14 days for 8 doses, then every 28 days for six doses
Primary Outcome Measure Information:
Title
Response Rate
Description
To evaluate response rate using intrathecal DepoCytTM in two cohorts of patients, one with active lymphomatous meningitis and another with active leukemic meningitis.
Time Frame
1 year
Secondary Outcome Measure Information:
Title
Time to Neurologic Progression
Time Frame
2 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Cytologically confirmed, or radiographic evidence for lymphomatous or leukemic meningitis. If the CSF cytology is negative, patients must have MRI/CT brain and clinical findings consistent with neoplastic meningitis. Karnofsky Performance Score of 60 or above. Age ≥ 18 years. Patients must have adequate hematologic, renal and liver function. Laboratory Absolute neutrophil count (ANC) ≥ 1,500/mm3 or white blood cell count > 3,000/mm3 Platelet count ≥ 100, 000/mm3 BUN and serum creatinine must be ≤ 1.5 times upper limit of laboratory normal Total and direct serum bilirubin must be ≤ 1.5 times upper limit of laboratory normal SGOT and SGPT ≤ 3.0 times upper limit of laboratory normal Alkaline phosphatase derived from liver ≤ 2.0 times upper limit of laboratory normal No uncontrolled infection other than human immunodeficiency virus that is being treated with anti-retroviral therapy Patients who have had prior CNS radiation, prior intrathecal methotrexate, and prior CNS prophylaxis with intrathecal or intravenous cytarabine or methotrexate are eligible Written informed consent Exclusion Criteria: Experimental/Investigational chemotherapy, immunotherapy, or biologic therapy within four weeks prior to study Concurrent systemic chemotherapy with high dose methotrexate, high dose cytarabine, or high dose thiotepa (they cross the blood brain barrier at high levels) Patients receiving whole brain radiotherapy or craniospinal irradiation Previous (less than 2 years from diagnosis) or concurrent malignancies at other sites with the exception of fully treated carcinoma in situ of the cervix, basal cell carcinoma of the skin, and squamous cell carcinoma of the skin, or prostate cancer not requiring ongoing chemotherapy Pregnant or lactating women Known active meningeal infection Evidence of obstructive hydrocephalus requiring neurosurgical intervention
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
David Rizzieri, MD
Organizational Affiliation
Duke University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Duke University Medical Center
City
Durham
State/Province
North Carolina
ZIP/Postal Code
27710
Country
United States

12. IPD Sharing Statement

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DepoCyt for Active Lymphomatous or Leukemic Meningitis

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