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Phase I Study of Yttrium Y 90 Monoclonal Antibody Lym-1, Cyclosporine, and Paclitaxel Followed By Autologous Peripheral Blood Stem Cell Transplantation in Patients With Refractory Non-Hodgkin's Lymphoma
Alternate Title Basic Trial Information Objectives Entry Criteria Expected Enrollment Outline Trial Contact Information Registry Information
Alternate Title
Monoclonal Antibody Therapy, Chemotherapy, and Peripheral Stem Cell Transplantation in Treating Patients With Refractory Non-Hodgkin's Lymphoma
Basic Trial Information
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Protocol IDs
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Phase I
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Treatment
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Closed
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18 and over
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UCD-991860 NCI-V00-1638, NCT00008021
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Objectives - Determine the maximum tolerated dose of yttrium Y 90 monoclonal antibody Lym-1 administered with cyclosporine and paclitaxel followed by autologous peripheral blood stem cell transplantation in patients with refractory non-Hodgkin's lymphoma.
- Determine the toxicity of this treatment regimen in these patients.
Entry Criteria Disease Characteristics:
- Histologically confirmed non-Hodgkin's lymphoma (NHL) that has failed
standard
therapy
- Any grade allowed
- Intermediate or high grade NHL must have failed
standard therapy with curative intent
- Measurable disease
- HAMA titer negative
- NHL tissue Lym-1 reactive in vitro
- Bilateral bone marrow biopsy less than 25% NHL
- No evidence of myelodysplastic syndrome in bone marrow
[Note: A new classification scheme for adult non-Hodgkin's lymphoma has been
adopted
by PDQ. The terminology of "indolent" or "aggressive" lymphoma will
replace
the former terminology of "low", "intermediate", or "high" grade
lymphoma.
However, this protocol uses the former terminology.] Prior/Concurrent Therapy:
Biologic therapy: Chemotherapy: - At least 4 weeks since prior chemotherapy
Endocrine therapy: Radiotherapy: - No prior radiotherapy involving more than 25% of bone
marrow
- At least 4 weeks since prior external beam
radiotherapy
Surgery: Patient Characteristics:
Age: Performance status: Life expectancy: Hematopoietic: - Absolute neutrophil count at least 1,500/mm3
- Platelet count at least 130,000/mm3
Hepatic: - Bilirubin no greater than 1.5 mg/dL
- AST no greater than 84 U/L
Renal: - Creatinine less than 1.5 mg/dL
OR - Creatinine clearance at least 50 mL/min
Cardiovascular: Pulmonary: - FEV1 at least 60% of predicted
- FVC at least 60% of predicted
- Corrected DLCO at least 50%
Other: - No other malignancy within the past 5 years except for
non- melanoma skin cancer
- HIV negative
- No AIDS
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective contraception
Expected Enrollment A maximum of 40 patients will be accrued for this study within 36 months. Outline This is an open-label, dose escalation study of yttrium Y 90 monoclonal
antibody Lym-1 (Y90 MOAB Lym-1). Patients are assigned to one of four
cohorts. - Cohort I: Patients receive filgrastim (G-CSF) subcutaneously (SC)
beginning 4 days prior to peripheral blood stem cell (PBSC) mobilization and
continuing until adequate PBSC are collected. Patients receive unlabeled
monoclonal antibody (MOAB) Lym-1 IV followed by a tracer dose of indium In 111
MOAB Lym-1 (In111 MOAB Lym-1) IV on day 0 and unlabeled MOAB Lym-1 IV followed
by Y90 MOAB Lym-1 IV on day 7. Patients also receive oral cyclosporine every
12 hours on days -2 to 14. Patients may undergo autologous PBSC
transplantation, if necessary, no earlier than day 17 and receive G-CSF SC
beginning at the completion of PBSC re-infusion and continuing until blood
counts recover.
- Cohort II: Patients undergo PBSC mobilization and receive treatment as
in cohort I. Patients also receive paclitaxel IV over 3 hours on day 9.
- Cohort III: Patients undergo PBSC mobilization and receive unlabeled
MOAB Lym-1, In111 MOAB Lym-1, Y90 MOAB Lym-1, and cyclosporine as in cohort I
and paclitaxel as in cohort II. Patients undergo autologous PBSC
transplantation no earlier than day 17. Patients receive G-CSF after
transplantation as in cohort I.
- Cohort IV: Patients undergo PBSC mobilization and receive treatment as
in cohort III. Treatment repeats every 6 weeks for 2 courses in the absence
of disease progression or unacceptable toxicity.
Cohorts of 1 to 3 patients receive escalating doses of Y90 MOAB Lym-1
until the maximum tolerated dose (MTD) is determined. The MTD is defined as
the dose at which 1 of 3 patients require PBSC transplantation, or the dose
preceding that at which 2 of 3 patients experience dose-limiting
toxicity. Patients are followed monthly for 3 months, every 3 months for 1 year,
every 6 months for 1 year, and then annually thereafter.
Trial Contact Information
Trial Lead Organizations University of California Davis Cancer Center | | | Gerald DeNardo, MD, Protocol chair | | | |
Registry Information | | Official Title | | A Phase I Study of 90Y-DOTA-Peptide-Lym-1 With Peripheral Blood Stem Cell Support, Paclitaxel And Cyclosporin A In Patients With Non-Hodgkin's Lymphoma | | Trial Start Date | | 2001-02-14 | | Registered in ClinicalTrials.gov | | NCT00008021 | | Date Submitted to PDQ | | 2000-11-09 | | Information Last Verified | | 2002-12-06 |
Note: The purpose of most clinical trials listed in this database is to test new cancer treatments, or new methods of diagnosing, screening, or preventing cancer. Because all potentially harmful side effects are not known before a trial is conducted, dose and schedule modifications may be required for participants if they develop side effects from the treatment or test. The therapy or test described in this clinical trial is intended for use by clinical oncologists in carefully structured settings, and may not prove to be more effective than standard treatment. A responsible investigator associated with this clinical trial should be consulted before using this protocol. Back to Top |
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