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Safety Study of CAT-8015 Immunooxin in Patients With HCL With Advance Disease

Primary Purpose

Leukemia, Hairy Cell Leukemia, HCL

Status
Unknown status
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
Immunotoxin therapy
CAT-8015 Immunotoxin
Biological therapy
Sponsored by
Cambridge Antibody Technology
About
Eligibility
Locations
Outcomes
Full info

About this trial

This is an interventional treatment trial for Leukemia focused on measuring CAT-8015, HA22, HCL, Relapse, Refractory, immunotherapy, immunotoxin

Eligibility Criteria

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

INCLUSION CRITERIA:

DISEASE CHARACTERISTICS:

  • Confirmed diagnosis of hairy cell leukemia
  • Measurable disease

At least one of the following indications for treatment:

  • Neutropenia (ANC <1000 cells/µL)
  • Anemia (Hgb <10g/dL)
  • Thrombocytopenia (Plt <100,000/µL)
  • An absolute lymphocyte count of >20,000 cells/µL, or
  • Symptomatic splenomegaly
  • Patient's must have had at least 2 prior systemic therapies. There must have been at least 2 prior courses of purine analog, or 1 if the response to this course lasted <2 years, or if the patient had unacceptable toxicity to purine analog.

PATIENT CHARACTERISTICS:

Performance status • ECOG 0-2

Life expectancy

• Life expectancy of greater than 6 months, as assessed by the principal investigator

Other

  • Patients with other cancers who meet eligibility criteria and have had less than 5 years of disease free survival will be considered on a case-by-case basis
  • Ability to understand and sign informed consent
  • Female and male patients agree to use an approved method of contraception during the study

EXCLUSION CRITERIA:

  • Documented and ongoing central nervous system involvement with their malignant disease (history of CNS involvement is not an exclusion criterion)
  • History of bone marrow transplant
  • Pregnant or breast-feeding females
  • Patients whose plasma contains either a significant level of antibody to CAT-8015 as measured by ELISA, or antibody that neutralizes the binding of CAT-8015 to CD22 as measured by a competition ELISA.
  • HIV positive serology (due to increased risk of severe infection and unknown interaction of CAT-8015 with antiretroviral drugs)
  • Hepatitis B surface antigen positive
  • Uncontrolled, symptomatic, intercurrent illness including but not limited to: infections requiring systemic antibiotics, congestive heart failure, unstable angina pectoris, cardiac arrhythmia, psychiatric illness, or social situations that would limit compliance with study requirements

Hepatic function: serum transaminases (either ALT or AST) or bilirubin:

• ≥ Grade 2, unless bilirubin is due to Gilbert's disease

Renal function: serum creatinine clearance ≤60mL/min as estimated by Cockroft-Gault formula

Hematologic function:

  • The ANC <1000/cmm, or platelet count <50,000/cmm, if these cytopenias are not judged by the investigator to be due to underlying disease (i.e. potentially reversible with anti-neoplastic therapy)
  • Baseline coagulopathy > grade 3 unless due to anticoagulant therapy
  • A patient will not be excluded because of pancytopenia ≥ Grade 3, or erythropoietin dependence, if it is due to disease, based on the results of bone marrow studies

Pulmonary function:

• Patients with < 50% of predicted forced expiratory volume (FEV1) or <50% of predicted diffusing capacity for carbon monoxide (DLCO), corrected for hemoglobin concentration and alveolar volume. Note: Patients with no prior history of pulmonary illness are not required to have PFTs. FEV1 will be assessed following bronchodilator therapy.

Recent prior therapy:

  • Cytotoxic chemotherapy (except stable doses of prednisone), whole body electron beam radiation therapy, interferon, retinoids or other systemic therapy, or investigational therapy of the malignancy for 3 weeks prior to entry into the trial
  • Less than or equal to < 3 months prior monoclonal antibody therapy (i.e. rituximab)
  • Patients who have received or are receiving radiation therapy less than 3 weeks prior to study entry will be not be excluded providing the volume of bone marrow treated is less than 10% and also the patient has measurable disease outside the radiation port
  • Any history of pseudomonas-exotoxin (PE) immunotoxin administration

Sites / Locations

  • Stanford University School of Medicine
  • Cancer Center of Northwestern University
  • Warren Grant Megnuson Clinical Center - NCI Clinical Trials Referral OfficeRecruiting
  • Klinika Hamtologii Uniwersytetu Medycznego (Medical University of Lodz)
  • Royal Marsden Hospital and Institute of Cancer Research

Outcomes

Primary Outcome Measures

Estimate the maximum dose that can be safely administered to a patient
Characterize the toxicity profile of CAT-8015
Study the clinical pharmacology of CAT-8015
Observe anti-tumor activity, if any.

Secondary Outcome Measures

To assess the immunogenic potential of CAT-8015 to induce antibodies
To investigate the potential of biomarkers to predict any therapeutic or toxic response.

Full Information

First Posted
April 16, 2007
Last Updated
April 16, 2007
Sponsor
Cambridge Antibody Technology
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1. Study Identification

Unique Protocol Identification Number
NCT00462189
Brief Title
Safety Study of CAT-8015 Immunooxin in Patients With HCL With Advance Disease
Official Title
A Phase 1, Multicenter, Dose Escalation Study of CAT-8015 in Patient With Relapsed or Refractory Hairy Cell Leukemia (HCL)
Study Type
Interventional

2. Study Status

Record Verification Date
April 2007
Overall Recruitment Status
Unknown status
Study Start Date
April 2007 (undefined)
Primary Completion Date
undefined (undefined)
Study Completion Date
undefined (undefined)

3. Sponsor/Collaborators

Name of the Sponsor
Cambridge Antibody Technology

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
RATIONALE: The CAT-8015 immunotoxin can bind tumor cells and kill them without harming normal cells. This may be an effective treatment for hairy cell leukemia(HCL) that has not responded to chemotherapy, surgery or radiation therapy. PURPOSE: Phase I dose escalation study to determine the maximum tolerated dose of CAT-8015 immunotoxin in treating patients who have hairy cell leukemia (HCL) that has not responded to treatment.
Detailed Description
OUTLINE: Patients receive CAT-8015 IV over 30 minutes on days 1, 3, and 5 followed by rest. Treatment repeats every 4 weeks for up to a total of 10 courses in the absence of dose limiting toxicity, complete response or disease progression. Patients are followed at 1, 3, 6,12,15,18, 21, 24 months following the start of the last treatment cycle. Cohorts of 3-6 patients each will receive escalating doses of recombinant CAT-8015 until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose proceeding that at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity. Once the MTD is determined, between16 to 25 new patients will be added to the MTD cohort depending on how well the CAT-8015 is tolerated.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Leukemia, Hairy Cell Leukemia, HCL
Keywords
CAT-8015, HA22, HCL, Relapse, Refractory, immunotherapy, immunotoxin

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
40 (false)

8. Arms, Groups, and Interventions

Intervention Type
Drug
Intervention Name(s)
Immunotoxin therapy
Intervention Type
Drug
Intervention Name(s)
CAT-8015 Immunotoxin
Intervention Type
Procedure
Intervention Name(s)
Biological therapy
Primary Outcome Measure Information:
Title
Estimate the maximum dose that can be safely administered to a patient
Title
Characterize the toxicity profile of CAT-8015
Title
Study the clinical pharmacology of CAT-8015
Title
Observe anti-tumor activity, if any.
Secondary Outcome Measure Information:
Title
To assess the immunogenic potential of CAT-8015 to induce antibodies
Title
To investigate the potential of biomarkers to predict any therapeutic or toxic response.

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
INCLUSION CRITERIA: DISEASE CHARACTERISTICS: Confirmed diagnosis of hairy cell leukemia Measurable disease At least one of the following indications for treatment: Neutropenia (ANC <1000 cells/µL) Anemia (Hgb <10g/dL) Thrombocytopenia (Plt <100,000/µL) An absolute lymphocyte count of >20,000 cells/µL, or Symptomatic splenomegaly Patient's must have had at least 2 prior systemic therapies. There must have been at least 2 prior courses of purine analog, or 1 if the response to this course lasted <2 years, or if the patient had unacceptable toxicity to purine analog. PATIENT CHARACTERISTICS: Performance status • ECOG 0-2 Life expectancy • Life expectancy of greater than 6 months, as assessed by the principal investigator Other Patients with other cancers who meet eligibility criteria and have had less than 5 years of disease free survival will be considered on a case-by-case basis Ability to understand and sign informed consent Female and male patients agree to use an approved method of contraception during the study EXCLUSION CRITERIA: Documented and ongoing central nervous system involvement with their malignant disease (history of CNS involvement is not an exclusion criterion) History of bone marrow transplant Pregnant or breast-feeding females Patients whose plasma contains either a significant level of antibody to CAT-8015 as measured by ELISA, or antibody that neutralizes the binding of CAT-8015 to CD22 as measured by a competition ELISA. HIV positive serology (due to increased risk of severe infection and unknown interaction of CAT-8015 with antiretroviral drugs) Hepatitis B surface antigen positive Uncontrolled, symptomatic, intercurrent illness including but not limited to: infections requiring systemic antibiotics, congestive heart failure, unstable angina pectoris, cardiac arrhythmia, psychiatric illness, or social situations that would limit compliance with study requirements Hepatic function: serum transaminases (either ALT or AST) or bilirubin: • ≥ Grade 2, unless bilirubin is due to Gilbert's disease Renal function: serum creatinine clearance ≤60mL/min as estimated by Cockroft-Gault formula Hematologic function: The ANC <1000/cmm, or platelet count <50,000/cmm, if these cytopenias are not judged by the investigator to be due to underlying disease (i.e. potentially reversible with anti-neoplastic therapy) Baseline coagulopathy > grade 3 unless due to anticoagulant therapy A patient will not be excluded because of pancytopenia ≥ Grade 3, or erythropoietin dependence, if it is due to disease, based on the results of bone marrow studies Pulmonary function: • Patients with < 50% of predicted forced expiratory volume (FEV1) or <50% of predicted diffusing capacity for carbon monoxide (DLCO), corrected for hemoglobin concentration and alveolar volume. Note: Patients with no prior history of pulmonary illness are not required to have PFTs. FEV1 will be assessed following bronchodilator therapy. Recent prior therapy: Cytotoxic chemotherapy (except stable doses of prednisone), whole body electron beam radiation therapy, interferon, retinoids or other systemic therapy, or investigational therapy of the malignancy for 3 weeks prior to entry into the trial Less than or equal to < 3 months prior monoclonal antibody therapy (i.e. rituximab) Patients who have received or are receiving radiation therapy less than 3 weeks prior to study entry will be not be excluded providing the volume of bone marrow treated is less than 10% and also the patient has measurable disease outside the radiation port Any history of pseudomonas-exotoxin (PE) immunotoxin administration
Facility Information:
Facility Name
Stanford University School of Medicine
City
Stanford
State/Province
California
ZIP/Postal Code
94305
Country
United States
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Sylvia Quesada, RN
Phone
650-725-4041
First Name & Middle Initial & Last Name & Degree
Steven E Coutre, MD
Facility Name
Cancer Center of Northwestern University
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60611
Country
United States
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Simbi Acharya
Phone
312-695-1383
First Name & Middle Initial & Last Name & Degree
Martin Tallman, MD
Facility Name
Warren Grant Megnuson Clinical Center - NCI Clinical Trials Referral Office
City
Bethesda
State/Province
Maryland
ZIP/Postal Code
20892
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
NCI Clinical Trials Referral
Phone
888-624-1937
First Name & Middle Initial & Last Name & Degree
Robert J Kreitman, MD
Facility Name
Klinika Hamtologii Uniwersytetu Medycznego (Medical University of Lodz)
City
Lodz
Country
Poland
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Krzysztof Jamroziak, MD
Phone
(48) 42 689-5191
First Name & Middle Initial & Last Name & Degree
Tadeusz Robak, Professor
Facility Name
Royal Marsden Hospital and Institute of Cancer Research
City
Surrey
Country
United Kingdom
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Claire Dearden, MD
Phone
(44) 20 7352 8171
First Name & Middle Initial & Last Name & Degree
Claire Dearden, MD

12. IPD Sharing Statement

Citations:
PubMed Identifier
16061911
Citation
Kreitman RJ, Squires DR, Stetler-Stevenson M, Noel P, FitzGerald DJ, Wilson WH, Pastan I. Phase I trial of recombinant immunotoxin RFB4(dsFv)-PE38 (BL22) in patients with B-cell malignancies. J Clin Oncol. 2005 Sep 20;23(27):6719-29. doi: 10.1200/JCO.2005.11.437. Epub 2005 Aug 1.
Results Reference
background
PubMed Identifier
18596230
Citation
Matsushita K, Margulies I, Onda M, Nagata S, Stetler-Stevenson M, Kreitman RJ. Soluble CD22 as a tumor marker for hairy cell leukemia. Blood. 2008 Sep 15;112(6):2272-7. doi: 10.1182/blood-2008-01-131987. Epub 2008 Jul 2.
Results Reference
derived

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Safety Study of CAT-8015 Immunooxin in Patients With HCL With Advance Disease

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