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Bryostatin 1 Plus Vincristine in Treating Patients With Recurrent or Refractory HIV-Related Lymphoma
This study has been completed.
First Received: August 10, 2001   Last Updated: August 23, 2008   History of Changes
Sponsors and Collaborators: AIDS Associated Malignancies Clinical Trials Consortium
National Cancer Institute (NCI)
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00022555
  Purpose

RATIONALE: Drugs used in chemotherapy use different ways to stop cancer cells from dividing so they stop growing or die. Bryostatin 1 may help vincristine kill more cancer cells by making them more sensitive to the drug.

PURPOSE: Phase I trial to study the effectiveness of bryostatin 1 plus vincristine in treating patients who have recurrent or refractory lymphoma.


Condition Intervention Phase
Lymphoma
Drug: bryostatin 1
Drug: vincristine sulfate
Phase I

MedlinePlus related topics: AIDS Cancer Lymphoma
Drug Information available for: Vincristine Bryostatin 1 Vincristine sulfate
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment
Official Title: A Phase I Trial of Combination Bryostatin-1 and Vincristine in HIV-Related B-Cell Neoplasms

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

Study Start Date: August 2001
Detailed Description:

OBJECTIVES:

  • Determine the maximum tolerated dose of bryostatin 1 when administered with vincristine in patients with recurrent or refractory HIV-related B-cell lymphoma.
  • Determine the toxicity profile of this regimen in these patients.
  • Determine the objective response and survival of these patients treated with this regimen.
  • Determine the immunomodulatory effects of this regimen on interleukin-2 (IL-2), IL-2 receptor, and IL-6 cytokine levels in these patients.
  • Determine the effect of this regimen on CD4+ lymphocyte count and HIV load in these patients.
  • Determine the effect of this regimen on the human herpes virus-8 load in these patients with body cavity-based lymphoma.

OUTLINE: This is a multicenter, dose-escalation study of bryostatin 1.

Patients receive bryostatin 1 IV continuously on days 1 and 15 and vincristine IV over 5 minutes on days 2 and 16. Treatment continues every 4 weeks for a minimum of 2 courses in the absence of disease progression or unacceptable toxicity.

Cohorts of 3-6 patients receive escalating doses of bryostatin 1 until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 6 patients experience dose-limiting toxicity.

PROJECTED ACCRUAL: A total of 9-12 patients will be accrued for this study.

  Eligibility

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

DISEASE CHARACTERISTICS:

  • Histologically confirmed B-cell lymphoma

    • Eligible subtypes:

      • Intermediate or high-grade non-Hodgkin's lymphoma (NHL), defined as follicular large cell, mantle cell, diffuse mixed cell, diffuse large cell and variants, Burkitt or Burkitt-like, or unclassifiable aggressive histologies
      • Body cavity-based lymphoma or primary effusion lymphoma
  • Evidence of HIV infection
  • Received at least 1 prior systemic chemotherapy regimen with failure to respond or relapse after completion of first-line therapy, including one of the following doxorubicin-based combinations:

    • Cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP)
    • Infusional cyclophosphamide, doxorubicin, and etoposide (CDE)
    • Etoposide, prednisone, vincristine, cyclophosphamide, and doxorubicin (EPOCH)
  • Evaluable disease outside of prior radiation port
  • No CNS parenchymal or leptomeningeal involvement
  • No primary CNS NHL
  • No HTLV-1-associated leukemia or lymphoma 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 terminology of "low", "intermediate", or "high" grade lymphoma.

However,this protocol uses the former terminology.

PATIENT CHARACTERISTICS:

Age:

  • 18 and over

Performance status:

  • Karnofsky 70-100%

Life expectancy:

  • At least 12 weeks

Hematopoietic:

  • Absolute granulocyte count at least 1,000/mm3
  • Platelet count at least 75,000/mm3
  • Hemoglobin at least 8.0 g/dL

Hepatic:

  • Bilirubin no greater than 1.5 mg/dL (unless concurrently on indinavir)
  • SGOT and SGPT less than 3 times upper limit of normal

Renal:

  • Creatinine no greater than 1.5 mg/dL OR
  • Creatinine clearance at least 50 mL/min

Cardiovascular:

  • No history of cardiac disease
  • LVEF at least 45% by radionuclide ventriculography
  • No symptomatic congestive heart failure
  • No active angina pectoris
  • No uncontrolled hypertension

Pulmonary:

  • No history of symptomatic pulmonary disease
  • Corrected DLCO more than 50% predicted
  • No severe chronic obstructive lung disease
  • No symptomatic restrictive lung disease

Other:

  • Recurrent controllable infection (e.g., thrush) on chronic suppressive therapy allowed
  • No active uncontrolled infection
  • No active significant opportunistic infection (e.g., acute Pneumocystis pneumonia, cytomegalovirus retinitis on induction or maintenance therapy, acute toxoplasmosis)
  • No grade 2 or greater peripheral neuropathy
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective barrier contraception

PRIOR CONCURRENT THERAPY:

Biologic therapy:

  • At least 24 hours since prior transfusion
  • At least 24 hours since prior colony-stimulating factor therapy
  • No concurrent prophylactic filgrastim (G-CSF)

Chemotherapy:

  • See Disease Characteristics
  • No concurrent hydroxyurea

Endocrine therapy:

  • Not specified

Radiotherapy:

  • See Disease Characteristics
  • At least 4 weeks since prior large-field radiotherapy

Surgery:

  • Not specified

Other:

  • At least 3 weeks since prior anticancer therapy and recovered
  • Must be receiving stable antiretroviral regimen of at least 4 weeks duration
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00022555

Locations
United States, Michigan
Henry Ford Hospital
Detroit, Michigan, United States, 48202
United States, New York
Herbert Irving Comprehensive Cancer Center
New York, New York, United States, 10032
United States, Ohio
Ireland Cancer Center
Cleveland, Ohio, United States, 44106-5065
Sponsors and Collaborators
AIDS Associated Malignancies Clinical Trials Consortium
Investigators
Study Chair: Scot C. Remick, MD Case Comprehensive Cancer Center
  More Information

Additional Information:
No publications provided

Study ID Numbers: CDR0000068830, AMC-029
Study First Received: August 10, 2001
Last Updated: August 23, 2008
ClinicalTrials.gov Identifier: NCT00022555     History of Changes
Health Authority: United States: Federal Government

Keywords provided by National Cancer Institute (NCI):
AIDS-related peripheral/systemic lymphoma
AIDS-related diffuse large cell lymphoma
AIDS-related small noncleaved cell lymphoma
AIDS-related diffuse mixed cell lymphoma

Study placed in the following topic categories:
Lymphoma, AIDS-related
Lymphoma, Large B-Cell, Diffuse
Immunoproliferative Disorders
Immunologic Factors
Acquired Immunodeficiency Syndrome
Adjuvants, Immunologic
Vincristine
Antimitotic Agents
Bryostatin 1
Small Non-cleaved Cell Lymphoma
Recurrence
Lymphoma, B-Cell
Lymphatic Diseases
B-cell Lymphomas
Lymphoma, AIDS-Related
HIV Infections
Tubulin Modulators
Lymphoproliferative Disorders
Lymphoma, Non-Hodgkin
Lymphoma, Large-cell
Antineoplastic Agents, Phytogenic
Lymphoma

Additional relevant MeSH terms:
Neoplasms by Histologic Type
Immunoproliferative Disorders
Immunologic Factors
Molecular Mechanisms of Pharmacological Action
Immune System Diseases
Antineoplastic Agents
Physiological Effects of Drugs
Mitosis Modulators
Adjuvants, Immunologic
Vincristine
Antimitotic Agents
Bryostatin 1
Pharmacologic Actions
Lymphoma, B-Cell
Lymphatic Diseases
Neoplasms
Lymphoma, AIDS-Related
Therapeutic Uses
Tubulin Modulators
Lymphoproliferative Disorders
Lymphoma, Non-Hodgkin
Antineoplastic Agents, Phytogenic
Lymphoma

ClinicalTrials.gov processed this record on May 06, 2009