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Bortezomib and Vorinostat in Treating Patients With Recurrent Mantle Cell Lymphoma or Recurrent and/or Refractory Diffuse Large B-Cell Lymphoma
This study is currently recruiting participants.
Verified by National Cancer Institute (NCI), December 2008
Sponsors and Collaborators: H. Lee Moffitt Cancer Center and Research Institute
National Cancer Institute (NCI)
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00703664
  Purpose

RATIONALE: Bortezomib and vorinostat may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth. Giving bortezomib together with vorinostat may kill more cancer cells.

PURPOSE: This phase II trial is studying how well giving bortezomib together with vorinostat works in treating patients with recurrent mantle cell lymphoma or recurrent and/or refractory diffuse large B-cell lymphoma.


Condition Intervention Phase
Lymphoma
Drug: bortezomib
Drug: vorinostat
Procedure: immunohistochemistry staining method
Procedure: laboratory biomarker analysis
Phase II

MedlinePlus related topics: Cancer Lymphoma
Drug Information available for: Suberoylanilide hydroxamic acid Bortezomib
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Open Label
Official Title: Phase II Trial of Bortezomib and Vorinostat in Mantle Cell and Diffuse Large B-Cell Lymphomas

Further study details as provided by National Cancer Institute (NCI):

Primary Outcome Measures:
  • Response rates [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Safety and tolerability of vorinostat and bortezomib combination therapy as assessed by NCI CTCAE v3.0 [ Designated as safety issue: Yes ]
  • Progression-free survival [ Designated as safety issue: No ]
  • Response duration [ Designated as safety issue: No ]
  • Relationship between pretreatment lymphoma cell nuclear relA and response [ Designated as safety issue: No ]

Estimated Enrollment: 116
Study Start Date: July 2008
Estimated Primary Completion Date: January 2011 (Final data collection date for primary outcome measure)
Detailed Description:

OBJECTIVES:

Primary

  • To estimate the response rates of patients with recurrent mantle cell lymphoma or recurrent and/or refractory diffuse large B-cell lymphoma treated with combination therapy comprising bortezomib and vorinostat.

Secondary

  • To assess the safety and tolerability of this regimen in these patients.
  • To observe progression-free survival and response duration in patients treated with this regimen.
  • To observe the relationship between pretreatment lymphoma cell nuclear relA and response in these patients.

OUTLINE: This is a multicenter study. Patients are stratified according to prior autologous stem cell transplantation (yes vs no). Patients are assigned to 1 of 3 treatment cohorts.

  • Cohort 1 (mantle cell lymphoma and no prior bortezomib): Patients receive oral vorinostat once daily on days 1-5 and 8-12. Patients also receive bortezomib IV on days 1, 4, 8, and 11. Treatment repeats every 3 weeks in the absence of disease progression, unacceptable toxicity, or requirement for palliative irradiation.
  • Cohort 2 (mantle cell lymphoma and prior bortezomib): Patients receive vorinostat and bortezomib as in cohort 1. Treatment repeats every 3 weeks in the absence of disease progression, unacceptable toxicity, or requirement for palliative irradiation.
  • Cohort 3 (diffuse large B-cell lymphoma and no prior bortezomib): Patients receive vorinostat and bortezomib as in cohort 1. Treatment repeats every 3 weeks in the absence of disease progression, unacceptable toxicity, or requirement for palliative irradiation.

Patients who experience a complete or partial response after at least 1 year of study therapy may discontinue treatment while remaining on study and then resume treatment at the time of disease progression.

Archival or recent biopsy tissue specimens are obtained at baseline for laboratory correlative studies. Samples are analyzed by IHC for expression of Rel A protein as a predictive marker of response.

After completion of study therapy, patients are followed periodically.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

DISEASE CHARACTERISTICS:

  • Histologically confirmed diagnosis of 1 of the following:

    • Mantle cell lymphoma meeting the following criteria:

      • At least 1 prior systemic therapy
    • Diffuse large B-cell lymphoma meeting the following criteria:

      • At least 1 prior systemic therapy AND meets 1 of the following criteria:

        • Previously treated recurrent disease refractory to standard salvage therapy
        • Unsuitable for further aggressive salvage therapy after progression during or after initial standard adriamycin-based therapy
        • Eligible for stem cell transplantation (SCT) and achieved a complete response to salvage therapy patient must refuse SCT as an option prior to consideration for this study
      • No prior bortezomib
  • Measurable disease, defined as ≥ 1 lesion > 1.0 cm in diameter in both the long and short axis, according to Revised Response Criteria for Malignant Lymphoma, as measured by spiral CT scan or physical exam
  • Must have histological material available for pathologic review and correlative studies, including either of the following:

    • Archival specimens from previous biopsies
    • Specimens from repeat biopsy for histological confirmation in patients with lymphoma that has undergone histological transformation in the past
  • No history of brain metastasis, including leptomeningeal metastasis

PATIENT CHARACTERISTICS:

  • ECOG performance status 0-2
  • Life expectancy > 3 months
  • ANC ≥ 1.5 x 10^9/L
  • CD4 count ≥ 0.5 x 10^9/L (must be specifically assayed only in patients with known HIV infection)
  • Platelet count ≥ 75 x 10^9/L
  • Total bilirubin ≤ 2 mg/dL
  • AST and ALT ≤ 2.5 times upper limit of normal
  • Creatinine normal OR creatinine clearance ≥ 60 mL/min
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception prior to and during study treatment
  • Able to tolerate loperamide or other anti-diarrheal medications
  • Able to take oral medications
  • No neuropathy ≥ grade 2
  • No history of allergic reactions attributed to compounds of similar chemical or biological composition to bortezomib or vorinostat
  • No medical or other condition (e.g., uncontrolled infection) that would represent an inappropriate risk to the patient or likely would compromise achievement of the primary study objective
  • No QTc interval > 470 msec

    • Discontinuation of QTc-prolonging medications to eliminate this exclusion may be considered if medically appropriate
  • Able to understand and willing to sign a written informed consent document

PRIOR CONCURRENT THERAPY:

  • See Disease Characteristics
  • Recovered from prior treatment
  • No prior histone deactylase inhibitor as cancer treatment
  • No prior bortezomib
  • No prior allogeneic stem cell transplantation
  • More than 3 weeks since prior chemotherapy or large field radiotherapy
  • No plan for other concurrent cancer treatment
  • No concurrent investigational agent
  • No concurrent treatment (e.g., marrow suppressive agents such as zidovidine) that would represent an inappropriate risk to the patient or likely would compromise achievement of the primary study objective
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00703664

Locations
United States, Florida
H. Lee Moffitt Cancer Center and Research Institute at University of South Florida Recruiting
Tampa, Florida, United States, 33612-9497
Contact: Clinical Trials Office - H. Lee Moffitt Cancer Center and Rese     800-456-7121     canceranswers@moffitt.org    
United States, Georgia
Winship Cancer Institute of Emory University Recruiting
Atlanta, Georgia, United States, 30322
Contact: Mary Jo Lechowicz, MD     404-778-3908     mary_jo_lechowicz@emoryhealthcare.org    
United States, North Carolina
Lineberger Comprehensive Cancer Center at University of North Carolina - Chapel Hill Recruiting
Chapel Hill, North Carolina, United States, 27599-7295
Contact: Clinical Trials Office - Lineberger Comprehensive Cancer Cente     877-668-0683; 919-966-4432        
United States, Tennessee
Vanderbilt-Ingram Cancer Center Recruiting
Nashville, Tennessee, United States, 37232-6838
Contact: Clinical Trials Office - Vanderbilt-Ingram Cancer Center     800-811-8480        
United States, Virginia
Virginia Commonwealth University Massey Cancer Center Recruiting
Richmond, Virginia, United States, 23298-0037
Contact: Clinical Trials Office -Virginia Commonwealth University Masse     804-628-1939        
Sponsors and Collaborators
H. Lee Moffitt Cancer Center and Research Institute
Investigators
Study Chair: Lubomir Sokol, MD, PhD H. Lee Moffitt Cancer Center and Research Institute
  More Information

Clinical trial summary from the National Cancer Institute's PDQ® database  This link exits the ClinicalTrials.gov site

Study ID Numbers: CDR0000598308, MCC-15428, 8064
Study First Received: June 20, 2008
Last Updated: December 9, 2008
ClinicalTrials.gov Identifier: NCT00703664  
Health Authority: Unspecified

Keywords provided by National Cancer Institute (NCI):
recurrent mantle cell lymphoma
recurrent adult diffuse large cell lymphoma

Study placed in the following topic categories:
Lymphoma, Large B-Cell, Diffuse
Immunoproliferative Disorders
Lymphoma, Mantle-Cell
Bortezomib
Vorinostat
Mantle cell lymphoma
Recurrence
Lymphoma, B-Cell
Lymphoma, large-cell
Lymphatic Diseases
B-cell lymphomas
Lymphoproliferative Disorders
Lymphoma, Non-Hodgkin
Lymphoma

Additional relevant MeSH terms:
Anticarcinogenic Agents
Anti-Inflammatory Agents
Neoplasms by Histologic Type
Molecular Mechanisms of Pharmacological Action
Immune System Diseases
Antineoplastic Agents
Physiological Effects of Drugs
Enzyme Inhibitors
Protective Agents
Pharmacologic Actions
Protease Inhibitors
Neoplasms
Analgesics, Non-Narcotic
Sensory System Agents
Therapeutic Uses
Anti-Inflammatory Agents, Non-Steroidal
Analgesics
Peripheral Nervous System Agents
Antirheumatic Agents
Central Nervous System Agents

ClinicalTrials.gov processed this record on January 15, 2009