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A Phase I/II Study of the Novel Proteasome Inhibitor Bortezomib in Combination With Rituxamib, Cyclophosphamide and Prednisone in Patients With Relapsed/Refractory Indolent B-Cell Lymphoproliferative Disorders and Mantle Cell Lymphoma (MCL)
This study is currently recruiting participants.
Verified by Columbia University, March 2009
First Received: March 9, 2009   No Changes Posted
Sponsored by: Columbia University
Information provided by: Columbia University
ClinicalTrials.gov Identifier: NCT00859443
  Purpose

The proteasome inhibitor Bortezomib in combination with Rituximab, Cyclophosphamide and Prednisone will increase progression free survival, event free survival and overall survival of patients in with relapsed/refractory indolent B cell lymphoproliferative disorders and Mantle Cell Lymphoma (MCL).


Condition Intervention Phase
Follicular Lymphoma (Grade I, II, III)
B-Cell Small Lymphocytic Lymphoma
Chronic Lymphocytic Leukemia
Marginal Zone Lymphoma
Waldenstrom's Macroglobulinemia
Mantle Cell Lymphoma
Drug: Bortezomib
Phase I
Phase II

Genetics Home Reference related topics: aceruloplasminemia hemophilia
MedlinePlus related topics: Leukemia, Adult Acute Leukemia, Adult Chronic Lymphoma
Drug Information available for: Cyclophosphamide Prednisone Bortezomib
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Non-Randomized, Open Label, Single Group Assignment, Safety/Efficacy Study
Official Title: A Phase I/II Study of the Novel Proteasome Inhibitor Bortezomib in Combination With Rituxamib, Cyclophosphamide and Prednisone in Patients With Relapsed/Refractory Indolent B-Cell Lymphoproliferative Disorders and Mantle Cell Lymphoma (MCL)

Further study details as provided by Columbia University:

Primary Outcome Measures:
  • Phase I: Maximum Tolerated Dose [ Time Frame: 3 months ] [ Designated as safety issue: Yes ]
  • Phase II: To determine the frequency and duration of complete and partial responses [ Time Frame: 4 months ] [ Designated as safety issue: Yes ]

Estimated Enrollment: 91
Study Start Date: September 2007
Estimated Study Completion Date: December 2013
Estimated Primary Completion Date: December 2012 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Bortezomib: Experimental
Bortezomib in combination with rituximab, cyclophosphamide, and prednisone
Drug: Bortezomib

Cohort 1: Weekly dosing, the planned dose escalation will begin with bortezomib at 1.3 mg/m2 and 750 mg/m2 of cyclophosphamide and not exceed 1.8 mg/m2 of bortezomib and 1000 mg/m2 of cyclophosphamide. Rituxamib, 375 mg/m2 and prednisone 100 mg/day remain constant.

Cohort 2: Twice weekly dosing: the planned dose escalation will begin with 1.0 mg/m2 bortezomib and 750 mg/m2 cyclophosphamide and not exceed 1.5 mg/m2 bortezomib and 1000 mg/m2 cyclophosphamide. Rituxamib 375 mg/m2 and prednisone 100 mg/day remain constant.


Detailed Description:

This is a Phase I/II study to evaluate the safety and efficacy of bortezomib for patients with indolent and mantle cell lymphomas. The primary objective in Phase I is to determine the maximum tolerated dose (MTD) of bortezomib when given in combination with rituximab, cyclophosphamide, and prednisone (RCP). The primary objective in Phase II is to determine the frequency and duration of complete and partial responses in patients treated with bortezomib

  • RCP (RCB or P) administered every 21 days for a total of 68 cycles.
  Eligibility

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

Inclusion Criteria:

  • Patients must have histologically confirmed (using the WHO Classification): chronic lymphocytic leukemia/B cell small lymphocytic lymphoma, any marginal zone lymphoma, follicular lymphoma, grade I, II, III, Waldenstrom's macroglobulinemia (all in cohort 1 of the phase II portion of the study), or mantle cell lymphoma (cohort 2 of the phase II portion of the study). Patients with transformed indolent lymphomas will be enrolled on the phase I portion, but not the phase II portion of the study.
  • For the phase I portion of this study, all patients must have assessable disease. For the phase II portion all NHL patients (except SLL/CLL and Waldenstrom's macroglobulinemia, discussed below) must have measurable disease defined as at least one lesion that can be accurately measured in at least one dimension (longest diameter to be recorded as >2 cm with conventional techniques or as >1 cm with spiral CT scan). Lymph nodes measuring < 1 cm in the short axis are considered normal. For chronic lymphocytic leukemia, patients must have an absolute lymphocytosis > 5 x 109/L with a B cell phenotype (CD19 or CD20 co expression with CD5, CD 23 +/), with > 30% bone marrow lymphocytes. Staging will be made according to the modified Rai as outlined.
  • Patients must have received at least one but no more than three prior regimens of conventional cytotoxic therapy, and must be off all cytotoxic chemotherapy for at least four weeks prior to study enrollment (6 weeks for BCNU or mitomycin C, 12 weeks with recovery to baseline counts for radioimmunotherapy). Patients are allowed to have received one course of prior radioimmunotherapy (RIT: either tositumomab or ibritumomab). Prior recipients of stem cell transplantation will be included, with the preparative cytoreductive and high dose therapies counted collectively as one prior therapy.
  • Patients must not have received any therapeutic monoclonal antibodies (e.g. rituximab, tositumomab, ibritumomab alemtuzumab, etc.) within 3 months of enrollment (except for patients enrolled on the phase I portion, who may have received rituximab up to 7 days prior to enrollment). Patients who have been treated with monoclonal antibodies within 3 months may be enrolled if they show progression of disease on this therapy, as long as they have not received the treatment within 7 days of enrollment.
  • Age greater than or equal to 18 years. Because no dosing or adverse event data are currently available on the use of bortezomib in patients <18 years of age, children are excluded from this study but will be eligible for future pediatric single agent trials, if applicable.

Exclusion Criteria:

  • Patients who have had chemotherapy or radiotherapy within 4 weeks (6 weeks for nitrosoureas or mitomycin C, 12 weeks or lack of recovery to baseline counts for RIT) prior to entering the study or those who have not recovered from adverse events due to agents administered more than 4 weeks earlier. Patients who have received a therapeutic monoclonal antibody within 3 months (except those with objective evidence of PD).
  • Patients may not be receiving any other investigational agents.
  • Patients with known brain metastases or meningeal disease will be excluded from this clinical trial because of their poor prognosis and because they often develop progressive neurologic dysfunction that would confound the evaluation of neurologic and other adverse events.
  • Patients who have had any major surgery within four weeks of study entry.
  • Patients with uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, cerebrovascular accident (CVA) or transient ischemic attack within 6 months of study enrollment, unstable angina pectoris, cardiac arrhythmia, EKG evidence of acute ischemia, or psychiatric illness/social situations that would limit compliance with study requirements.
  • Pregnant women are excluded from this study because bortezomib is a novel agent that may have the potential for teratogenic or abortifacient effects. Because there is an unknown but potential risk for adverse events in nursing infants secondary to treatment of the mother with bortezomib, breastfeeding should be discontinued if the mother is treated with this agent.
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00859443

Contacts
Contact: Celeste Rojas 212-342-3095 cr2393@columbia.edu
Contact: Danielle Wright 212-342-3482 dw2316@columbia.edu

Locations
United States, New York
Columbia University Medical Center Recruiting
New York, New York, United States, 10032
Contact: Celeste Rojas     212-342-3095     cr2393@columbia.edu    
Contact: Danielle Wright     212-342-3482     dw2316@columbia.edu    
Sponsors and Collaborators
Columbia University
Investigators
Principal Investigator: Owen A O'Connor, MD, PhD Columbia University Medical Center
  More Information

No publications provided

Responsible Party: Columbia University Medical Center ( Owen A. O'Connor, MD, PhD )
Study ID Numbers: PILS-2, AAAC4297
Study First Received: March 9, 2009
Last Updated: March 9, 2009
ClinicalTrials.gov Identifier: NCT00859443     History of Changes
Health Authority: United States: Institutional Review Board

Study placed in the following topic categories:
Anti-Inflammatory Agents
Prednisone
Leukemia, Lymphoid
Immunologic Factors
Blood Protein Disorders
Hormone Antagonists
Lymphoma, Mantle-Cell
Hormones, Hormone Substitutes, and Hormone Antagonists
Lymphoma, Follicular
Paraproteinemias
Mantle Cell Lymphoma
Cyclophosphamide
Hemostatic Disorders
Hormones
Follicular Lymphoma
Leukemia
Hemorrhagic Disorders
Leukemia, Lymphocytic, Chronic, B-Cell
Leukemia, B-cell, Chronic
Alkylating Agents
Lymphoma
Immunoproliferative Disorders
Antineoplastic Agents, Hormonal
Hematologic Diseases
Blood Coagulation Disorders
Bortezomib
Vascular Diseases
Glucocorticoids
Immunosuppressive Agents
Protease Inhibitors

Additional relevant MeSH terms:
Anti-Inflammatory Agents
Prednisone
Leukemia, Lymphoid
Molecular Mechanisms of Pharmacological Action
Immunologic Factors
Antineoplastic Agents
Blood Protein Disorders
Lymphoma, Mantle-Cell
Physiological Effects of Drugs
Hormones, Hormone Substitutes, and Hormone Antagonists
Lymphoma, Follicular
Paraproteinemias
Cyclophosphamide
Hemostatic Disorders
Hormones
Leukemia
Hemorrhagic Disorders
Leukemia, Lymphocytic, Chronic, B-Cell
Therapeutic Uses
Cardiovascular Diseases
Alkylating Agents
Lymphoma
Immunoproliferative Disorders
Neoplasms by Histologic Type
Antineoplastic Agents, Hormonal
Immune System Diseases
Hematologic Diseases
Bortezomib
Vascular Diseases
Enzyme Inhibitors

ClinicalTrials.gov processed this record on May 06, 2009