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Vorinostat, Rituximab, Ifosfamide, Carboplatin, and Etoposide in Treating Patients With Relapsed or Primary Refractory Lymphoma or Previously Untreated T-Cell Non-Hodgkin Lymphoma or Mantle Cell Lymphoma
This study is currently recruiting participants.
Verified by National Cancer Institute (NCI), April 2009
First Received: January 24, 2008   Last Updated: April 23, 2009   History of Changes
Sponsors and Collaborators: Puget Sound Oncology Consortium at Fred Hutchinson Cancer Research Center
National Cancer Institute (NCI)
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00601718
  Purpose

RATIONALE: Vorinostat may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth. Monoclonal antibodies, such as rituximab, can block cancer growth in different ways. Some block the ability of cancer cells to grow and spread. Others find cancer cells and help kill them or carry cancer-killing substances to them. Drugs used in chemotherapy, such as ifosfamide, carboplatin, and etoposide, work in different ways to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Giving vorinostat together with rituximab and combination chemotherapy may kill more cancer cells.

PURPOSE: This phase I/II trial is studying the side effects and best dose of vorinostat when given together with rituximab, ifosfamide, carboplatin, and etoposide and to see how well they work in treating patients with relapsed or primary refractory lymphoma or previously untreated T-cell non-Hodgkin lymphoma or mantle cell lymphoma.


Condition Intervention Phase
Lymphoma
Biological: filgrastim
Biological: pegfilgrastim
Biological: rituximab
Drug: carboplatin
Drug: etoposide
Drug: ifosfamide
Drug: vorinostat
Phase I
Phase II

MedlinePlus related topics: Cancer Lymphoma
Drug Information available for: Etoposide Carboplatin Etoposide phosphate Filgrastim Suberoylanilide hydroxamic acid Rituximab Pegfilgrastim Ifosfamide
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment
Official Title: A Phase I/II Study of Vorinostat Plus Rituximab, Ifosphamide, Carboplatin, and Etoposide for Patients With Relapsed or Refractory Lymphoid Malignancies or Untreated T- or Mantle Cell Lymphoma

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

Primary Outcome Measures:
  • Maximum tolerated dose of vorinostat [ Designated as safety issue: Yes ]
  • Safety and toxicity [ Designated as safety issue: Yes ]
  • Efficacy [ Designated as safety issue: No ]
  • Ability to proceed to peripheral blood stem cell collection following treatment [ Designated as safety issue: No ]
  • Impact of treatment on stem cell reserve [ Designated as safety issue: No ]

Estimated Enrollment: 21
Study Start Date: March 2008
Estimated Primary Completion Date: January 2015 (Final data collection date for primary outcome measure)
Detailed Description:

OBJECTIVES:

  • To determine the maximum tolerated dose of vorinostat when administered in combination with rituximab, ifosfamide, carboplatin, and etoposide in patients with relapsed or primary refractory lymphoid malignancies or previously untreated T-cell non-Hodgkin lymphoma or mantle cell lymphoma.
  • To determine the safety and toxicity of this regimen.
  • To gain a preliminary assessment of the efficacy of this regimen.
  • To determine the ability to proceed to peripheral blood stem cell collection following treatment with this regimen.
  • To determine the impact of this regimen on stem cell reserve

OUTLINE: This is a dose-escalation study of vorinostat.

Patients receive oral vorinostat once daily on days 1-5, ifosfamide IV continuously over 24 hours and carboplatin IV over 1 hour on day 4, and etoposide IV over 1 hour on days 3-5. Patients also receive pegfilgrastim subcutaneously (SC) once on day 6 or 7 OR filgrastim (G-CSF) SC once daily beginning on day 6 or 7 and continuing until blood counts recover. Patients who are CD20+ also receive rituximab IV once on day 3, 4, or 5. Treatment repeats every 21 days for 2 courses in the absence of disease progression or unacceptable toxicity.

After completion of study treatment, patients are followed every 3 months for 1 year and then every 6 months for 4 years.

  Eligibility

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

DISEASE CHARACTERISTICS:

  • Diagnosis of previously untreated T-cell non-Hodgkin lymphoma or mantle cell lymphoma OR relapsed or primary refractory lymphoid malignancy, including the following types:

    • B-cell lymphoma
    • T-cell lymphoma
    • Hodgkin lymphoma
  • Patients with other lymphomas that have not received any prior therapy AND are not candidates for anthracycline-based therapies are eligible with Principle Investigator review and approval
  • Measurable disease, defined as any of the following:

    • Lesions that can be accurately measured in two dimensions by CT scan, MRI, medical photograph (skin or oral lesion), plain x-ray, or other conventional technique AND a greatest transverse diameter of ≥ 1 cm
    • Palpable lesions with both diameters ≥ 2 cm
  • No disease refractory (i.e., not responded or progressed within the past 6 months) to a carboplatin-, cisplatin-, ifosfamide-, or etoposide-based regimen
  • Patients with evidence of adenopathy in the neck must have a CT scan of the neck
  • Must be able to complete at least 2 courses of chemotherapy
  • No active CNS lymphoma

PATIENT CHARACTERISTICS:

  • SWOG performance status 0-2
  • ANC ≥ 1,500/mm³
  • Platelets ≥ 100,000/mm³ (without transfusion)
  • Serum creatinine < 1.5 mg/dL OR creatinine clearance > 60 mL/min
  • Total bilirubin < 1.5 times upper limit of normal (ULN)
  • AST < 5 times ULN
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception
  • No known HIV positivity
  • No other prior malignancies except for adequately treated basal cell carcinoma, squamous cell carcinoma of the skin, carcinoma in situ of the cervix, or other cancer from which the patient has been disease-free for ≥ 5 years unless approved by the protocol Chair or Co-Chair
  • No other medical condition that would contraindicate treatment with aggressive chemotherapy, including any of the following:

    • Active infection
    • Uncontrolled hypertension
    • Congestive heart failure
    • Unstable angina pectoris
    • Myocardial infarction within the past 6 months
    • Uncontrolled arrhythmia
  • No history of impaired cardiac status, including any of the following:

    • Severe coronary artery disease
    • Cardiomyopathy
    • Congestive heart failure
    • Arrhythmia
  • No arrhythmias on EKG (sinus arrhythmia or infrequent premature ventricular contractions allowed)
  • LVEF ≥ 50% by MUGA or ECHO

PRIOR CONCURRENT THERAPY:

  • See Disease Characteristics
  • More than 28 days since prior anticancer therapy
  • More than 12 months since prior autologous or allogeneic stem cell transplantation
  • More than 6 months since prior radioimmunotherapy
  • More than 2 weeks since prior and no concurrent valproic acid
  • No other prior or concurrent histone deacetylase inhibitors
  • No other concurrent therapy intended to treat the primary cancer including chemotherapy, investigational agents, biologic agents, or other antitumor agents
  • No concurrent radiotherapy
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00601718

Locations
United States, Washington
Seattle Cancer Care Alliance Recruiting
Seattle, Washington, United States, 98109-1023
Contact: Clinical Trials Office - Seattle Cancer Care Alliance     800-804-8824        
Sponsors and Collaborators
Puget Sound Oncology Consortium at Fred Hutchinson Cancer Research Center
Investigators
Principal Investigator: Elizabeth Pan Seattle Cancer Care Alliance
Investigator: Ajay K. Gopal, MD Seattle Cancer Care Alliance
Investigator: John Pagel, MD, PhD Fred Hutchinson Cancer Research Center
  More Information

Additional Information:
No publications provided

Responsible Party: Seattle Cancer Care Alliance ( Elizabeth Pan )
Study ID Numbers: CDR0000584894, PSOC-2302, FHCRC-IR-6632
Study First Received: January 24, 2008
Last Updated: April 23, 2009
ClinicalTrials.gov Identifier: NCT00601718     History of Changes
Health Authority: Unspecified

Keywords provided by National Cancer Institute (NCI):
recurrent grade 1 follicular lymphoma
recurrent grade 2 follicular lymphoma
recurrent grade 3 follicular lymphoma
recurrent adult Hodgkin lymphoma
recurrent adult T-cell leukemia/lymphoma
anaplastic large cell lymphoma
angioimmunoblastic T-cell lymphoma
cutaneous B-cell non-Hodgkin lymphoma
recurrent cutaneous T-cell non-Hodgkin lymphoma
recurrent mycosis fungoides/Sezary syndrome
recurrent adult grade III lymphomatoid granulomatosis
adult nasal type extranodal NK/T-cell lymphoma
Waldenstrom macroglobulinemia
recurrent adult Burkitt lymphoma
recurrent adult diffuse large cell lymphoma
recurrent adult diffuse mixed cell lymphoma
recurrent adult diffuse small cleaved cell lymphoma
recurrent adult immunoblastic large cell lymphoma
recurrent adult lymphoblastic lymphoma
recurrent mantle cell lymphoma
extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue
nodal marginal zone B-cell lymphoma
recurrent marginal zone lymphoma
splenic marginal zone lymphoma
recurrent small lymphocytic lymphoma
contiguous stage II mantle cell lymphoma
noncontiguous stage II mantle cell lymphoma
stage I mantle cell lymphoma
stage II mantle cell lymphoma
stage III mantle cell lymphoma

Study placed in the following topic categories:
Anticarcinogenic Agents
Anti-Inflammatory Agents
Lymphoma, Mantle-Cell
Mantle Cell Lymphoma
Follicular Lymphoma
Mycoses
Leukemia, Lymphocytic, Chronic, B-Cell
Lymphoma, Large-Cell, Anaplastic
Hodgkin Disease
Etoposide
Lymphoma, Large B-Cell, Diffuse
Immunoproliferative Disorders
Rituximab
Carboplatin
Waldenstrom Macroglobulinemia
B-cell Lymphomas
Leukemia, T-Cell
Lymphoma, Non-Hodgkin
Antineoplastic Agents, Phytogenic
Lymphoma, T-Cell, Cutaneous
Immunologic Factors
Lymphoma, Follicular
Lymphoma, B-Cell, Marginal Zone
Sezary Syndrome
Mycosis Fungoides
Lymphoblastic Lymphoma
Etoposide phosphate
Lymphoma, Large-cell, Immunoblastic
Lymphoma, B-Cell
Lymphoma, Small Cleaved-cell, Diffuse

Additional relevant MeSH terms:
Anticarcinogenic Agents
Anti-Inflammatory Agents
Molecular Mechanisms of Pharmacological Action
Immunologic Factors
Antineoplastic Agents
Lymphoma, Mantle-Cell
Physiological Effects of Drugs
Etoposide phosphate
Sensory System Agents
Lymphoma, T-Cell
Therapeutic Uses
Anti-Inflammatory Agents, Non-Steroidal
Analgesics
Etoposide
Lymphoma
Alkylating Agents
Immunoproliferative Disorders
Neoplasms by Histologic Type
Immune System Diseases
Rituximab
Vorinostat
Enzyme Inhibitors
Carboplatin
Protective Agents
Pharmacologic Actions
Lymphatic Diseases
Neoplasms
Ifosfamide
Analgesics, Non-Narcotic
Peripheral Nervous System Agents

ClinicalTrials.gov processed this record on May 06, 2009