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Phase I/II Study of Abraxane in Recurrent and Refractory Lymphoma

Primary Purpose

Lymphoma, Non-Hodgkin, Hodgkin Disease

Status
Terminated
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Abraxane
Sponsored by
Washington University School of Medicine
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Lymphoma, Non-Hodgkin

Eligibility Criteria

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

Inclusion Criteria:

  • Patient must have histologically confirmed B-cell non-Hodgkin lymphoma or classical Hodgkin lymphoma:

    • Diffuse large B-cell lymphoma (including transformed large cell lymphoma and primary mediastinal B cell lymphoma)
    • Mantle cell lymphoma
    • Burkitt's lymphoma
    • Follicular lymphoma
    • Small lymphocytic lymphoma
    • Marginal zone lymphoma
    • Lymphoplasmacytic lymphoma
    • Classical Hodgkin lymphoma (including nodular sclerosis, mixed cellularity, lymphocyte rich, and lymphocyte deplete)
  • Patient must have measurable disease, defined as the presence of ≥ 1 lymph node or tumor mass measuring ≥ 1 cm in a single dimension as assessed by CT or MRI.
  • Patient must have had prior treatment with ≥ 2 chemotherapy or chemo-immunotherapy regimens. Prior autologous stem cell transplant is allowed, and prior allogeneic stem cell transplant is allowed as long as the patient has recovered from acute toxicities and is off immunosuppression without evidence of graft versus host disease (GVHD).
  • Patient must be ≥ 18 years of age.
  • Patient must have an ECOG performance status ≤ 2.
  • Patient must have adequate bone marrow reserve at the time of therapy initiation, defined as ANC ≥ 1.0 x 109/L and platelets ≥ 50 x 109/L.
  • Patient must have adequate hepatic function, defined as total bilirubin ≤ 1.5 x ULN and AST/ALT ≤ 3 x ULN.
  • Patient must have adequate renal function, defined as serum creatinine ≤ 2.0 x ULN.
  • Patient must have recovered from any acute toxicities associated with prior therapy to ≤ grade 1.
  • Women of childbearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control, abstinence) prior to study entry and for the duration of study participation. Should a woman become pregnant or suspect she is pregnant while participating in this study, she must inform her treating physician immediately.
  • Patient (or legally authorized representative, if applicable) must be able to understand and willing to sign an IRB approved written informed consent document.
  • Both men and women and members of all races and ethnic groups are eligible for this trial.

Exclusion Criteria:

  • Patient must not have nodular lymphocyte predominant Hodgkin lymphoma subtype.
  • Patient must not have a history of a non-lymphoma malignancy except for the following: adequately treated localized basal cell or squamous cell carcinoma of the skin, carcinoma in situ of the cervix, superficial bladder cancer, localized prostate cancer, any adequately treated stage I or stage II cancer currently in complete remission, or any other cancer in complete remission for at least 5 years.
  • Patient must not be receiving any other investigational agents, and must not have taken any other investigational agents within ≤ 3 weeks of study entry chemotherapy, immunotherapy, radiotherapy, and/or investigational agents while on study.
  • Patients with Hodgkin's lymphoma must not otherwise be eligible for treatment with brentuximab vedotin.
  • Patient must not have central nervous system or leptomeningeal lymphoma.
  • Patient must not have with history of allergic reactions attributed to compounds of similar chemical or biologic composition to Abraxane.
  • Patient must not have any uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements.
  • Patient must not be pregnant and/or breastfeeding.
  • Patient must not be known to be HIV-positive.
  • Patient must not have any pre-existing peripheral neuropathy > grade 1.
  • Patient must not have received any chemotherapy, immunotherapy, and/or investigational agents and/or radiotherapy < 3 weeks prior to starting study drug.

Sites / Locations

  • St. Louis University School of Medicine
  • Washington University School of Medicine

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Experimental

Experimental

Experimental

Experimental

Arm Label

Phase I-Dose Level 0

Phase I-Dose Level 1

Phase I-Dose Level 2

Phase II

Arm Description

Abraxane 100 mg/m2 IV on Days 1, 8, and 15 of each 28 day cycle for a maximum of 6 cycles.

Abraxane 125 mg/m2 IV on Days 1, 8, and 15 of each 28 day cycle for a maximum of 6 cycles.

Abraxane 150 mg/m2 IV on Days 1, 8, and 15 of each 28 day cycle for a maximum of 6 cycles.

Abraxane (dose to be determined in Phase I) IV on Days 1, 8, and 15 of each 28 day cycle for a maximum of 6 cycles.

Outcomes

Primary Outcome Measures

Phase I: Maximum tolerated dose (MTD) of Abraxane in patients with recurrent or refractory lymphoma
Graded and described using National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) v 4.
Phase I: Dose-limiting toxicities (DLTs) of Abraxane in patients with recurrent or refractory lymphoma
Graded and described using National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) v 4
Phase II: Overall response rate (CR + PR)

Secondary Outcome Measures

Phase I: Toxicity associated with Abraxane
Phase II: Time to progression.
Response and progression will be recorded with each imaging evaluation according to the 2007 revised response criteria for malignant lymphoma by Cheson BD, Pfistner B, Juweid ME, et al. Revised response criteria for malignant lymphoma. J Clin Oncol 2007;25:579-86.
Phase II: Duration of remission
Phase II: Overall survival.
Phase II: Clinical benefit (CR + PR + SD)

Full Information

First Posted
March 13, 2012
Last Updated
December 5, 2016
Sponsor
Washington University School of Medicine
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1. Study Identification

Unique Protocol Identification Number
NCT01555853
Brief Title
Phase I/II Study of Abraxane in Recurrent and Refractory Lymphoma
Official Title
A Phase I/II Institutional Study of Abraxane in Recurrent and Refractory Lymphoma
Study Type
Interventional

2. Study Status

Record Verification Date
December 2016
Overall Recruitment Status
Terminated
Why Stopped
completed accrual to phase I but drug did not show activity, so halted before initiation of phase II
Study Start Date
July 2012 (undefined)
Primary Completion Date
June 2016 (Actual)
Study Completion Date
June 2016 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Washington University School of Medicine

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
This phase I/II trial studies the side effects, maximum tolerated dose, and effectiveness of paclitaxel albumin-stabilized nanoparticle formulation (nab-paclitaxel) in treating patients with recurrent or refractory Hodgkin or B-cell non-Hodgkin lymphoma. More effective and well tolerated therapies are needed to treat patients with relapsed and refractory lymphomas. Nab-paclitaxel combines a chemotherapeutic agent with a protein which may increase the anticancer drug concentration in the tumor while reducing toxic effects in normal tissue and may be an effective treatment for lymphoma.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Lymphoma, Non-Hodgkin, Hodgkin Disease

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
20 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Phase I-Dose Level 0
Arm Type
Experimental
Arm Description
Abraxane 100 mg/m2 IV on Days 1, 8, and 15 of each 28 day cycle for a maximum of 6 cycles.
Arm Title
Phase I-Dose Level 1
Arm Type
Experimental
Arm Description
Abraxane 125 mg/m2 IV on Days 1, 8, and 15 of each 28 day cycle for a maximum of 6 cycles.
Arm Title
Phase I-Dose Level 2
Arm Type
Experimental
Arm Description
Abraxane 150 mg/m2 IV on Days 1, 8, and 15 of each 28 day cycle for a maximum of 6 cycles.
Arm Title
Phase II
Arm Type
Experimental
Arm Description
Abraxane (dose to be determined in Phase I) IV on Days 1, 8, and 15 of each 28 day cycle for a maximum of 6 cycles.
Intervention Type
Drug
Intervention Name(s)
Abraxane
Other Intervention Name(s)
ABI-007
Primary Outcome Measure Information:
Title
Phase I: Maximum tolerated dose (MTD) of Abraxane in patients with recurrent or refractory lymphoma
Description
Graded and described using National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) v 4.
Time Frame
28 days (completion of cycle 1) for all patients in Phase I portion
Title
Phase I: Dose-limiting toxicities (DLTs) of Abraxane in patients with recurrent or refractory lymphoma
Description
Graded and described using National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) v 4
Time Frame
28 days (completion of cycle 1)
Title
Phase II: Overall response rate (CR + PR)
Time Frame
24 weeks (end of study)
Secondary Outcome Measure Information:
Title
Phase I: Toxicity associated with Abraxane
Time Frame
28 weeks (30 days after completion of study treatment)
Title
Phase II: Time to progression.
Description
Response and progression will be recorded with each imaging evaluation according to the 2007 revised response criteria for malignant lymphoma by Cheson BD, Pfistner B, Juweid ME, et al. Revised response criteria for malignant lymphoma. J Clin Oncol 2007;25:579-86.
Time Frame
24 weeks (end of study)
Title
Phase II: Duration of remission
Time Frame
24 weeks (end of study)
Title
Phase II: Overall survival.
Time Frame
3 years
Title
Phase II: Clinical benefit (CR + PR + SD)
Time Frame
24 weeks (end of study)

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patient must have histologically confirmed B-cell non-Hodgkin lymphoma or classical Hodgkin lymphoma: Diffuse large B-cell lymphoma (including transformed large cell lymphoma and primary mediastinal B cell lymphoma) Mantle cell lymphoma Burkitt's lymphoma Follicular lymphoma Small lymphocytic lymphoma Marginal zone lymphoma Lymphoplasmacytic lymphoma Classical Hodgkin lymphoma (including nodular sclerosis, mixed cellularity, lymphocyte rich, and lymphocyte deplete) Patient must have measurable disease, defined as the presence of ≥ 1 lymph node or tumor mass measuring ≥ 1 cm in a single dimension as assessed by CT or MRI. Patient must have had prior treatment with ≥ 2 chemotherapy or chemo-immunotherapy regimens. Prior autologous stem cell transplant is allowed, and prior allogeneic stem cell transplant is allowed as long as the patient has recovered from acute toxicities and is off immunosuppression without evidence of graft versus host disease (GVHD). Patient must be ≥ 18 years of age. Patient must have an ECOG performance status ≤ 2. Patient must have adequate bone marrow reserve at the time of therapy initiation, defined as ANC ≥ 1.0 x 109/L and platelets ≥ 50 x 109/L. Patient must have adequate hepatic function, defined as total bilirubin ≤ 1.5 x ULN and AST/ALT ≤ 3 x ULN. Patient must have adequate renal function, defined as serum creatinine ≤ 2.0 x ULN. Patient must have recovered from any acute toxicities associated with prior therapy to ≤ grade 1. Women of childbearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control, abstinence) prior to study entry and for the duration of study participation. Should a woman become pregnant or suspect she is pregnant while participating in this study, she must inform her treating physician immediately. Patient (or legally authorized representative, if applicable) must be able to understand and willing to sign an IRB approved written informed consent document. Both men and women and members of all races and ethnic groups are eligible for this trial. Exclusion Criteria: Patient must not have nodular lymphocyte predominant Hodgkin lymphoma subtype. Patient must not have a history of a non-lymphoma malignancy except for the following: adequately treated localized basal cell or squamous cell carcinoma of the skin, carcinoma in situ of the cervix, superficial bladder cancer, localized prostate cancer, any adequately treated stage I or stage II cancer currently in complete remission, or any other cancer in complete remission for at least 5 years. Patient must not be receiving any other investigational agents, and must not have taken any other investigational agents within ≤ 3 weeks of study entry chemotherapy, immunotherapy, radiotherapy, and/or investigational agents while on study. Patients with Hodgkin's lymphoma must not otherwise be eligible for treatment with brentuximab vedotin. Patient must not have central nervous system or leptomeningeal lymphoma. Patient must not have with history of allergic reactions attributed to compounds of similar chemical or biologic composition to Abraxane. Patient must not have any uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements. Patient must not be pregnant and/or breastfeeding. Patient must not be known to be HIV-positive. Patient must not have any pre-existing peripheral neuropathy > grade 1. Patient must not have received any chemotherapy, immunotherapy, and/or investigational agents and/or radiotherapy < 3 weeks prior to starting study drug.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Nancy Bartlett, M.D.
Organizational Affiliation
Washington University School of Medicine
Official's Role
Principal Investigator
Facility Information:
Facility Name
St. Louis University School of Medicine
City
St. Louis
State/Province
Missouri
ZIP/Postal Code
63110
Country
United States
Facility Name
Washington University School of Medicine
City
St. Louis
State/Province
Missouri
ZIP/Postal Code
63110
Country
United States

12. IPD Sharing Statement

Links:
URL
http://www.siteman.wustl.edu
Description
Alvin J. Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine

Learn more about this trial

Phase I/II Study of Abraxane in Recurrent and Refractory Lymphoma

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