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Phase I Trial of Clofarabine in Combo w/ HD Etoposide & Cyclophosphamide and APBSCT for Pts w/ High-Risk or Refractory NHL

Primary Purpose

Non Hodgkin's Lymphoma

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
clofarabine
Sponsored by
Indiana University School of Medicine
About
Eligibility
Locations
Outcomes
Full info

About this trial

This is an interventional treatment trial for Non Hodgkin's Lymphoma focused on measuring Non Hodgkin's Lymphoma, High Risk or Refractory Non Hodgkin's Lymphoma, APBSCT, clofarabine

Eligibility Criteria

18 Years - 70 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Documentation of disease. Patients must have one of the following disease types:

    • Diffuse large cell non-Hodgkin's lymphoma, mediastinal B-cell lymphoma, or peripheral T-cell lymphoma that is:

      • Primary refractory (achievement less than complete response)
      • Relapsed and refractory (achievement less than a partial response) to at least a single salvage therapy
    • Relapsed or primary refractory Follicular lymphoma (FL) with a high FL International Prognostic Index.
    • Large cell transformation of lymphoma from a more indolent lymphoma (e.g., follicular, marginal zone, etc.)
    • Mantle cell lymphoma that is:

      • Primary Refractory (achievement less than complete response)
      • Relapsed (regardless of chemosensitivity of relapsed disease)
  2. Patients who received prior autologous stem cell transplantation are not eligible.
  3. Patient age 18-70 years
  4. Performance status ECOG 0-1
  5. Required baseline laboratory values:

    • LVEF > 45% corrected
    • DLCO > 50% of predicted value (corrected for hemoglobin)
    • Serum creatinine ≤ 2.0 mg/dl or estimated creatinine clearance of ≥60 ml/min
    • Bilirubin < 1 x upper limit of normal value.
    • AST and ALT < 1 x upper limit of normal value.
  6. Signed written informed consent. Patient must be capable of understanding the investigational nature of the investigational nature, potential risks and benefits of the study, and able to provide valid informed consent

Exclusion Criteria:

  1. No active infection. Patients with active infections requiring oral or intravenous antibiotics are not eligible for enrollment until resolution of infection.
  2. No HIV disease. Patients with immune dysfunction are at a significantly higher risk of infection from intensive immunosuppressive therapies.
  3. Non-pregnant and non-nursing. Treatment under this protocol would expose a fetus to significant risks. Women of childbearing potential should have a negative pregnancy test prior to study entry. Women and men of reproductive potential should agree to use an appropriate method of birth control throughout their participation in this study due to the teratogenic potential of the therapy utilized in this trial. Appropriate methods of birth control include oral contraceptives, implantable hormonal contraceptives (Norplant®), or double barrier method (diaphragm plus condom).

Sites / Locations

  • Indiana University Cancer Center

Outcomes

Primary Outcome Measures

Determine the maximum tolerated dose (MTD) of clofarabine in association with high-dose etoposide and cyclophosphamide followed by ASCT in patients with refractory lymphoma malignancies.

Secondary Outcome Measures

Assessment of the toxicity of the combination of clofarabine, and high-dose etoposide and cyclophosphamide-- Describe engraftment kinetics-- Describe the response rate-- Describe relapse rate and event-free survival-- Assess clofarabine p

Full Information

First Posted
May 22, 2007
Last Updated
September 10, 2014
Sponsor
Indiana University School of Medicine
Collaborators
Genzyme, a Sanofi Company
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1. Study Identification

Unique Protocol Identification Number
NCT00477945
Brief Title
Phase I Trial of Clofarabine in Combo w/ HD Etoposide & Cyclophosphamide and APBSCT for Pts w/ High-Risk or Refractory NHL
Official Title
A Phase I Trial of Clofarabine in Combination With High-Dose Etoposide and Cyclophosphamide and Autologous Peripheral Blood Stem Cell Transplantation for Patients With High-Risk or Refractory Non-Hodgkin's Lymphoma
Study Type
Interventional

2. Study Status

Record Verification Date
September 2014
Overall Recruitment Status
Completed
Study Start Date
May 2007 (undefined)
Primary Completion Date
November 2010 (Actual)
Study Completion Date
November 2010 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Indiana University School of Medicine
Collaborators
Genzyme, a Sanofi Company

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This is a phase I trial to determine the maximum tolerated dose (MTD) of clofarabine in a combination with high-dose etoposide and cyclophosphamide. This is an initial step in developing a novel myeloablative preparative regimen for autologous hematopoietic stem cell transplantation (ASCT). While this phase I trial will initially develop the regimen in patients with refractory disease, it is expected that it will find its best application in patients with less advanced disease.
Detailed Description
All patients will receive the same doses of etoposide and cyclophosphamide. The dose of clofarabine will be escalated in successive cohorts of patients. Using a standard dose escalation design, successive cohorts of 3 patients will be treated with escalating doses of clofarabine (see Section 5.5 below). At the MTD (or highest dose-level if the MTD is not reached), the cohort will be expanded to 10 patients to better investigate correlative studies and give some preliminary idea of efficacy.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Non Hodgkin's Lymphoma
Keywords
Non Hodgkin's Lymphoma, High Risk or Refractory Non Hodgkin's Lymphoma, APBSCT, clofarabine

7. Study Design

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

8. Arms, Groups, and Interventions

Intervention Type
Drug
Intervention Name(s)
clofarabine
Intervention Description
Cohort N Clofarabine (mg/m2/day) 3-6 30 3-6 40 3-6 50 3-6 60 6-10 70
Primary Outcome Measure Information:
Title
Determine the maximum tolerated dose (MTD) of clofarabine in association with high-dose etoposide and cyclophosphamide followed by ASCT in patients with refractory lymphoma malignancies.
Time Frame
1 yr
Secondary Outcome Measure Information:
Title
Assessment of the toxicity of the combination of clofarabine, and high-dose etoposide and cyclophosphamide-- Describe engraftment kinetics-- Describe the response rate-- Describe relapse rate and event-free survival-- Assess clofarabine p
Time Frame
1 year

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Documentation of disease. Patients must have one of the following disease types: Diffuse large cell non-Hodgkin's lymphoma, mediastinal B-cell lymphoma, or peripheral T-cell lymphoma that is: Primary refractory (achievement less than complete response) Relapsed and refractory (achievement less than a partial response) to at least a single salvage therapy Relapsed or primary refractory Follicular lymphoma (FL) with a high FL International Prognostic Index. Large cell transformation of lymphoma from a more indolent lymphoma (e.g., follicular, marginal zone, etc.) Mantle cell lymphoma that is: Primary Refractory (achievement less than complete response) Relapsed (regardless of chemosensitivity of relapsed disease) Patients who received prior autologous stem cell transplantation are not eligible. Patient age 18-70 years Performance status ECOG 0-1 Required baseline laboratory values: LVEF > 45% corrected DLCO > 50% of predicted value (corrected for hemoglobin) Serum creatinine ≤ 2.0 mg/dl or estimated creatinine clearance of ≥60 ml/min Bilirubin < 1 x upper limit of normal value. AST and ALT < 1 x upper limit of normal value. Signed written informed consent. Patient must be capable of understanding the investigational nature of the investigational nature, potential risks and benefits of the study, and able to provide valid informed consent Exclusion Criteria: No active infection. Patients with active infections requiring oral or intravenous antibiotics are not eligible for enrollment until resolution of infection. No HIV disease. Patients with immune dysfunction are at a significantly higher risk of infection from intensive immunosuppressive therapies. Non-pregnant and non-nursing. Treatment under this protocol would expose a fetus to significant risks. Women of childbearing potential should have a negative pregnancy test prior to study entry. Women and men of reproductive potential should agree to use an appropriate method of birth control throughout their participation in this study due to the teratogenic potential of the therapy utilized in this trial. Appropriate methods of birth control include oral contraceptives, implantable hormonal contraceptives (Norplant®), or double barrier method (diaphragm plus condom).
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Sherif Farag, MD, PhD
Organizational Affiliation
Indiana University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Indiana University Cancer Center
City
Indianapolis
State/Province
Indiana
ZIP/Postal Code
46202
Country
United States

12. IPD Sharing Statement

Learn more about this trial

Phase I Trial of Clofarabine in Combo w/ HD Etoposide & Cyclophosphamide and APBSCT for Pts w/ High-Risk or Refractory NHL

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