Obinutuzumab and ICE Chemotherapy in Refractory/Recurrent CD20+ Mature NHL (O-ICE)
Non-Hodgkin Lymphoma, Burkitt Lymphoma, Diffuse Large B-Cell Lymphoma
About this trial
This is an interventional treatment trial for Non-Hodgkin Lymphoma
Eligibility Criteria
Inclusion Criteria:
Patients in first relapse or primary induction failure CD20 positive B-cell leukemia/lymphoma including:
- Diffuse Large B-Cell Lymphoma
- Burkitt Lymphoma
- High Grade B-cell Lymphoma: Not Otherwise Specified (NOS)
- Primary mediastinal B-cell lymphoma (PMBL)
- CD20+ B-lymphoblastic lymphoma
- Follicular lymphoma, Grade III
- Karnofsky ≥ 60% for patients > 16 years of age and
- Lansky ≥ 60 for patients ≤ 16 years of age.
- Myelosuppressive chemotherapy: Must not have received within 2 weeks of entry onto this study.
- Patients may not have received prior therapy with obinutuzumab (GA101)
- Radiation Therapy (XRT): Date of receiving prior XRT must be > 2 weeks for local palliative XRT (small port); > 6 months must have elapsed if prior craniospinal XRT or if > 50% radiation of pelvis; > 6 weeks must have elapsed if other substantial bone marrow radiation.
- Steroids: Patients may have received prior steroid treatment, but not started greater than 7 days prior to initiation of protocol therapy.
- Adequate organ function.
Exclusion Criteria:
- Patients with newly diagnosed, previously untreated B-NHL.
- Known congenital or acquired immune deficiency.
- Prior solid organ transplantation.
- Prior allogeneic stem cell transplant within 60 days or active acute Graft-vs-Host-Disease (GVHD) grade 3 or higher.
- History of grade 4 anaphylactic reactions to humanized or murine monoclonal antibodies
- Uncontrolled hepatitis B and/or C infection
Sites / Locations
- New York Medical CollegeRecruiting
Arms of the Study
Arm 1
Arm 2
Experimental
Experimental
Central Nervous System (CNS) Negative
CNS Positive
All patients will receive 4 doses of obinutuzumab on days -14, -10, -6 and -2. Patients without CNS involvement will receive one dose of Liposomal cytarabine for CNS prophylaxis on day -13. Dexamethasone will be given for 5 days with each Liposomal cytarabine dose starting one day prior to the Liposomal cytarabine. Dexamethasone 0.15 mg/kg/dose (max 4mg) IV BID will be given days -14 to -10. Following completion of the Prephase (or at the first sign of progressive disease), all patients will proceed to cycle 1 of O-ICE. O-ICE chemotherapy is given in 21-day (3-week) cycles. Three weekly doses of obinutuzumab will be given days -2 (during the prephase), +6 and +13. Patients will receive ICE chemotherapy (ifosfamide-carboplatin-etoposide) administered on Days 0-2 of Cycle 1.
All patients will receive 4 doses of obinutuzumab on days -14, -10, -6 and -2. Patients with positive CSF prior to enrollment will receive treatment with two doses of Liposomal cytarabine during the prephase portion of therapy. Liposomal cytarabine will be given intrathecally on days -13 and -5. Dexamethasone will be given for 5 days with each Liposomal cytarabine dose starting the day prior to the Liposomal cytarabine. Dexamethasone will be given days -14 to -10 and days -6 through -2. Following completion of the Prephase (or at the first sign of progressive disease), all patients will proceed to cycle 1 of O-ICE. O-ICE chemotherapy is given in 21-day (3-week) cycles. Three weekly doses of obinutuzumab will be given days -2 (during the prephase), +6 and +13. Patients will receive ICE chemotherapy (ifosfamide-carboplatin-etoposide) administered on Days 0-2 of Cycle 1.