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Monoclonal Antibody Therapy in Treating Patients With Non-Hodgkin's Lymphoma That Has Relapsed After High-Dose Chemotherapy and Autologous Stem Cell Transplantation

Primary Purpose

Lymphoma

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
rituximab
yttrium Y 90 ibritumomab tiuxetan
Sponsored by
University of Nebraska
About
Eligibility
Locations
Outcomes
Full info

About this trial

This is an interventional treatment trial for Lymphoma focused on measuring recurrent grade 1 follicular lymphoma, recurrent grade 2 follicular lymphoma, recurrent grade 3 follicular lymphoma, recurrent adult diffuse small cleaved cell lymphoma, recurrent adult diffuse mixed cell lymphoma, recurrent adult diffuse large cell lymphoma, recurrent adult immunoblastic large cell lymphoma, recurrent adult Burkitt lymphoma, recurrent mantle cell lymphoma, recurrent marginal zone lymphoma, recurrent small lymphocytic lymphoma, extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue, nodal marginal zone B-cell lymphoma, splenic marginal zone lymphoma

Eligibility Criteria

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

DISEASE CHARACTERISTICS: Diagnosis of relapsed B-cell non-Hodgkin's lymphoma (NHL) after high-dose chemotherapy and autologous stem cell transplantation Less than 25% bone marrow involvement with NHL as evidenced by unilateral or bilateral biopsy within the past 6 weeks Bone marrow biopsy should demonstrate 15-20% of cellular space occupied by normal hematopoiesis CD20 antigen expression in tumor tissue within the past year as evidenced by 1 of the following: Immunoperoxidase stains of tissue showing positive reactivity with L26 antibody Flow cytometry studies Measurable disease More than 2 cm bidimensionally No active CNS lymphoma No HIV- or AIDS-related lymphoma PATIENT CHARACTERISTICS: Age: 19 and over Performance status: WHO 0-2 Life expectancy: At least 3 months Hematopoietic: Absolute neutrophil count greater than 1,500/mm^3 Platelet count greater than 150,000/mm^3 No transfusion dependency Hepatic: Bilirubin less than 2.0 mg/dL SGOT or SGPT no greater than 2.5 times upper limit of normal (unless due to lymphomatous infiltration of the liver) Renal: Creatinine less than 2.0 mg/dL No active obstructive hydronephrosis Other: Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception during and for 6 months after study therapy HIV negative No active infection requiring oral or IV antibiotics No human antimurine antibody positivity No other major medical problems PRIOR CONCURRENT THERAPY: Biologic therapy: See Disease Characteristics At least 4 weeks since prior growth factors At least 4 weeks since prior biologic therapy No dependency on hematopoietic growth factors (e.g., epoetin alfa, interleukin-11, filgrastim [G-CSF], or sargramostim [GM-CSF]) No prior radioimmunotherapy No other concurrent biologic therapy of any kind Chemotherapy: See Disease Characteristics At least 4 weeks since any prior cytotoxic chemotherapy (6 weeks for nitrosoureas) No prior fludarabine No concurrent chemotherapy Endocrine therapy: No concurrent steroids except as maintenance for non-cancerous disease Radiotherapy: See Biologic therapy At least 4 weeks since prior radiotherapy No prior pelvic radiotherapy No prior radiotherapy to more than 25% of estimated bone marrow reserve No concurrent external beam radiotherapy Surgery: Not specified Other: Recovered from all prior therapy At least 4 weeks since prior immunosuppressants No other concurrent investigational drugs No other concurrent anti-cancer therapy

Sites / Locations

  • UNMC Eppley Cancer Center at the University of Nebraska Medical Center

Outcomes

Primary Outcome Measures

Maximum tolerated dose
Safety and efficacy

Secondary Outcome Measures

Full Information

First Posted
March 8, 2002
Last Updated
December 13, 2013
Sponsor
University of Nebraska
Collaborators
Biogen
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1. Study Identification

Unique Protocol Identification Number
NCT00031642
Brief Title
Monoclonal Antibody Therapy in Treating Patients With Non-Hodgkin's Lymphoma That Has Relapsed After High-Dose Chemotherapy and Autologous Stem Cell Transplantation
Official Title
Phase I/II Study of IDEC-Y2B8 (Zevalin) for Post Transplant Relapses of B-Cell Non-Hodgkin's Lymphoma
Study Type
Interventional

2. Study Status

Record Verification Date
December 2013
Overall Recruitment Status
Completed
Study Start Date
January 2002 (undefined)
Primary Completion Date
November 2005 (Actual)
Study Completion Date
March 2008 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
University of Nebraska
Collaborators
Biogen

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
RATIONALE: Monoclonal antibodies such as rituximab can locate cancer cells and deliver cancer-killing substances to them without harming normal cells. Radiolabeled monoclonal antibodies can locate and deliver radioactive cancer-killing substances. PURPOSE: Phase I/II trial to study the effectiveness of combining radiolabeled monoclonal antibodies with rituximab in treating patients who have non-Hodgkin's lymphoma that has not responded to high-dose chemotherapy and autologous stem cell transplantation.
Detailed Description
OBJECTIVES: Determine the maximum tolerated dose of yttrium Y 90-labeled ibritumomab tiuxetan when administered with rituximab in patients with B-cell non-Hodgkin's lymphoma who have relapsed after high-dose chemotherapy and autologous hematopoietic stem cell transplantation. Determine the safety and efficacy of this regimen in these patients. OUTLINE: This is a dose-escalation study of yttrium Y 90-labeled ibritumomab tiuxetan (IDEC-Y2B8). Phase I: Patients receive rituximab IV over 4-6 hours followed by indium In 111-labeled ibritumomab tiuxetan (IDEC-In2B8) IV over 10 minutes on day 0. Patients receive rituximab IV again on day 7 followed by IDEC-Y2B8 IV over 10 minutes. Cohorts of 3-6 patients receive escalating doses of IDEC-Y2B8 until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose at which 3 of 6 patients experience dose-limiting toxicity. Phase II: Once the MTD is determined, 58 additional patients are treated at that dose level as in phase I. Patients are followed at 6 weeks, every 3 months for 1 year, every 6 months for 2 years, and then annually thereafter. PROJECTED ACCRUAL: Approximately 78 patients (20 for phase I and 58 for phase II) 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
recurrent grade 1 follicular lymphoma, recurrent grade 2 follicular lymphoma, recurrent grade 3 follicular lymphoma, recurrent adult diffuse small cleaved cell lymphoma, recurrent adult diffuse mixed cell lymphoma, recurrent adult diffuse large cell lymphoma, recurrent adult immunoblastic large cell lymphoma, recurrent adult Burkitt lymphoma, recurrent mantle cell lymphoma, recurrent marginal zone lymphoma, recurrent small lymphocytic lymphoma, extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue, nodal marginal zone B-cell lymphoma, splenic marginal zone lymphoma

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
26 (Actual)

8. Arms, Groups, and Interventions

Intervention Type
Biological
Intervention Name(s)
rituximab
Intervention Type
Radiation
Intervention Name(s)
yttrium Y 90 ibritumomab tiuxetan
Primary Outcome Measure Information:
Title
Maximum tolerated dose
Title
Safety and efficacy

10. Eligibility

Sex
All
Minimum Age & Unit of Time
19 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
DISEASE CHARACTERISTICS: Diagnosis of relapsed B-cell non-Hodgkin's lymphoma (NHL) after high-dose chemotherapy and autologous stem cell transplantation Less than 25% bone marrow involvement with NHL as evidenced by unilateral or bilateral biopsy within the past 6 weeks Bone marrow biopsy should demonstrate 15-20% of cellular space occupied by normal hematopoiesis CD20 antigen expression in tumor tissue within the past year as evidenced by 1 of the following: Immunoperoxidase stains of tissue showing positive reactivity with L26 antibody Flow cytometry studies Measurable disease More than 2 cm bidimensionally No active CNS lymphoma No HIV- or AIDS-related lymphoma PATIENT CHARACTERISTICS: Age: 19 and over Performance status: WHO 0-2 Life expectancy: At least 3 months Hematopoietic: Absolute neutrophil count greater than 1,500/mm^3 Platelet count greater than 150,000/mm^3 No transfusion dependency Hepatic: Bilirubin less than 2.0 mg/dL SGOT or SGPT no greater than 2.5 times upper limit of normal (unless due to lymphomatous infiltration of the liver) Renal: Creatinine less than 2.0 mg/dL No active obstructive hydronephrosis Other: Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception during and for 6 months after study therapy HIV negative No active infection requiring oral or IV antibiotics No human antimurine antibody positivity No other major medical problems PRIOR CONCURRENT THERAPY: Biologic therapy: See Disease Characteristics At least 4 weeks since prior growth factors At least 4 weeks since prior biologic therapy No dependency on hematopoietic growth factors (e.g., epoetin alfa, interleukin-11, filgrastim [G-CSF], or sargramostim [GM-CSF]) No prior radioimmunotherapy No other concurrent biologic therapy of any kind Chemotherapy: See Disease Characteristics At least 4 weeks since any prior cytotoxic chemotherapy (6 weeks for nitrosoureas) No prior fludarabine No concurrent chemotherapy Endocrine therapy: No concurrent steroids except as maintenance for non-cancerous disease Radiotherapy: See Biologic therapy At least 4 weeks since prior radiotherapy No prior pelvic radiotherapy No prior radiotherapy to more than 25% of estimated bone marrow reserve No concurrent external beam radiotherapy Surgery: Not specified Other: Recovered from all prior therapy At least 4 weeks since prior immunosuppressants No other concurrent investigational drugs No other concurrent anti-cancer therapy
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Julie M. Vose, MD
Organizational Affiliation
University of Nebraska
Official's Role
Study Chair
Facility Information:
Facility Name
UNMC Eppley Cancer Center at the University of Nebraska Medical Center
City
Omaha
State/Province
Nebraska
ZIP/Postal Code
68198-7680
Country
United States

12. IPD Sharing Statement

Learn more about this trial

Monoclonal Antibody Therapy in Treating Patients With Non-Hodgkin's Lymphoma That Has Relapsed After High-Dose Chemotherapy and Autologous Stem Cell Transplantation

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