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Sunitinib in Treating Patients With Relapsed or Refractory Diffuse or Mediastinal Large B-Cell Lymphoma
This study is ongoing, but not recruiting participants.
First Received: October 25, 2006   Last Updated: April 14, 2009   History of Changes
Sponsors and Collaborators: National Cancer Institute of Canada
National Cancer Institute (NCI)
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00392496
  Purpose

RATIONALE: Sunitinib may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth and by blocking blood flow to the cancer.

PURPOSE: This phase II trial is studying how well sunitinib works in treating patients with relapsed or refractory diffuse or mediastinal large B-cell lymphoma.


Condition Intervention Phase
Lymphoma
Drug: sunitinib malate
Phase II

MedlinePlus related topics: Cancer Lymphoma
Drug Information available for: Sunitinib malate Sunitinib
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Non-Randomized
Official Title: A Phase II Study of Sunitinib (SU11248; NSC 736511; IND 74019), an Oral Multi-Targeted Tyrosine Kinase Inhibitor, in Patients With Relapsed or Refractory Diffuse Large B-Cell Lymphoma

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

Primary Outcome Measures:
  • Objective tumor response [ Designated as safety issue: No ]

Estimated Enrollment: 25
Study Start Date: November 2006
Estimated Primary Completion Date: August 2009 (Final data collection date for primary outcome measure)
Detailed Description:

OBJECTIVES:

  • Determine the response rate in patients with relapsed or refractory, diffuse or mediastinal, large B-cell lymphoma treated with sunitinib malate.
  • Determine the toxicity of this drug in these patients.
  • Determine the effects of this drug on peripheral blood biomarkers, circulating endothelial cells, and their precursors in these patients.

OUTLINE: This is a non-randomized, open-label, multicenter study. Patients receive sunitinib malate orally once daily on days 1-28. Treatment repeats every 4 weeks for a maximum of 12 courses in the absence of disease progression or unacceptable toxicity.

After completion of study treatment, patients are followed at 4 weeks and then every 3 months thereafter.

PROJECTED ACCRUAL: A total of 25 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 diffuse or mediastinal large B-cell lymphoma*, meeting the following criteria:

    • Advanced or metastatic disease
    • Incurable by standard therapies
    • Relapsed or refractory disease NOTE: *Patients with diffuse large B-cell lymphoma whose disease has transformed from an earlier diagnosis of low grade lymphoma (i.e., an indolent histology) are eligible
  • Bidimensionally measurable disease** by CT scan, MRI, or physical exam, with ≥ 1 disease site meeting 1 of the following criteria:

    • Lymph nodes ≥ 1.5 cm x 1.5 cm by spiral CT scan
    • Non-nodal regions ≥ 1 cm x 1 cm by MRI, CT scan, or physical exam NOTE: **Bone lesions are not considered bidimensionally measurable disease
  • Received 1-2 prior chemotherapy regimens that included doxorubicin hydrochloride

    • Prior stem cell transplantation and high-dose chemotherapy is considered one regimen
    • One prior nonchemotherapy regimen in the form of radiation allowed

      • Measurable disease must be outside the previously irradiated area
      • No sole site of disease in a previously irradiated area unless progressive disease or new lesions are documented
      • Low-dose palliative radiotherapy may be allowed
  • No known brain metastases

PATIENT CHARACTERISTICS:

  • Life expectancy ≥ 12 weeks
  • ECOG performance status 0-1
  • Absolute granulocyte count ≥ 1,500/mm³
  • Platelet count ≥ 100,000/mm³
  • AST and ALT ≤ 2.5 times upper limit of normal (ULN)
  • Bilirubin normal
  • Calcium ≤ 3 mmol/L
  • Creatinine ≤ 1.25 times ULN OR creatinine clearance ≥ 60 mL/min
  • LVEF normal by MUGA
  • None of the following in the past 12 months:

    • Cardiac arrhythmia
    • Cerebrovascular accident (CVA)
    • Coronary/peripheral artery bypass graft or stenting
    • Myocardial infarction
    • Stable or unstable angina
    • Symptomatic congestive heart failure
    • Transient ischemic attack
    • Pulmonary embolism
  • No uncontrolled hypertension (systolic blood pressure ≥ 140 mm Hg or diastolic blood pressure ≥ 90 mm Hg)
  • No New York Heart Association (NYHA) class III or IV heart disease
  • No QTc prolongation (QTc interval ≥ 500 msec) or other significant ECG abnormalities
  • No other prior malignancies except nonmelanoma skin cancer, in situ cervical cancer, or other solid tumors curatively treated with no evidence of disease for ≥ 5 years
  • No history of allergic reaction to compounds of similar chemical or biological composition to sunitinib malate
  • No other serious illness or medical condition that would preclude study participation, including, but not limited to, the following:

    • Active, uncontrolled infection
    • Serious or nonhealing wound, ulcer, or bone fracture
    • History of significant neurologic or psychiatric disorder that would impair the ability to obtain consent or limit compliance
    • Other medical condition that might be aggravated by treatment
  • No abdominal fistula, gastrointestinal perforation, or intra-abdominal abscess within the past 28 days
  • No bowel obstruction
  • No condition that would impair the ability to swallow and retain sunitinib malate tablets, including any of the following:

    • Gastrointestinal tract disease resulting in inability to take oral medication or a requirement for IV alimentation
    • Prior surgical procedures affecting absorption
    • Active peptic ulcer disease
  • No pre-existing hypothyroidism unless euthyroid on medication
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception

PRIOR CONCURRENT THERAPY:

  • See Disease Characteristics
  • At least 28 days since prior chemotherapy
  • At least 28 days since prior radiotherapy and recovered

    • Radiotherapy must have involved < 30% of functioning bone marrow
  • At least 28 days since prior major surgery and recovered
  • At least 12 days since prior and no concurrent CYP3A4 inducers, including any of the following:

    • Rifampin
    • Phenytoin
    • Rifabutin
    • Hypericum perforatum (St. John's wort)
    • Carbamazepine
    • Efavirenz
    • Phenobarbital
    • Tipranavir
  • At least 7 days since prior and concurrent CYP3A4 inhibitors, including any of the following:

    • Azole antifungals (e.g., ketoconazole, itraconazole)
    • Verapamil
    • Clarithromycin
    • HIV protease inhibitors (e.g., indinavir, saquinavir, ritonavir, atazanavir, nelfinavir)
    • Erythromycin
    • Delavirdine
    • Diltiazem
  • No prior therapy with other antiangiogenic agents or multitargeted tyrosine kinase inhibitors, including any of the following:

    • Bevacizumab
    • Sorafenib tosylate
    • Pazopanib
    • Thalidomide
    • AZD2171
    • Vandetanib
    • AMG 706
    • Vatalanib
    • VEGF Trap
  • No concurrent therapeutic doses of coumarin-derivative anticoagulants (e.g., warfarin)

    • Concurrent dosing of ≤ 2 mg of warfarin daily for prophylaxis of thrombosis is allowed
    • Concurrent low molecular weight heparin is allowed provided INR is ≤ 1.5
  • No other concurrent anticancer treatments, including investigational agents
  • No concurrent agents with proarrhythmic potential, including any of the following:

    • Terfenadine
    • Quinidine
    • Procainamide
    • Disopyramide
    • Sotalol
    • Probucol
    • Bepridil
    • Haloperidol
    • Risperidone
    • Indapamide
    • Flecainide
  • No concurrent combination antiretroviral therapy for HIV-positive patients
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00392496

Locations
Canada, Alberta
Cross Cancer Institute at University of Alberta
Edmonton, Alberta, Canada, T6G 1Z2
Canada, British Columbia
BCCA - Fraser Valley Cancer Centre
Surrey, British Columbia, Canada, V3V 1Z2
British Columbia Cancer Agency - Centre for the Southern Interior
Kelowna, British Columbia, Canada, V1Y 5L3
Canada, Nova Scotia
Nova Scotia Cancer Centre
Halifax, Nova Scotia, Canada, B3H 1V7
Canada, Ontario
Edmond Odette Cancer Centre at Sunnybrook
Toronto, Ontario, Canada, M4N 3M5
Princess Margaret Hospital
Toronto, Ontario, Canada, M5G 2M9
Canada, Saskatchewan
Allan Blair Cancer Centre at Pasqua Hospital
Regina, Saskatchewan, Canada, S4T 7T1
Sponsors and Collaborators
National Cancer Institute of Canada
Investigators
Study Chair: Rena Buckstein, MD Edmond Odette Cancer Centre at Sunnybrook
  More Information

Additional Information:
No publications provided

Responsible Party: Cancer Research Institute at Queen's University ( Ralph M. Meyer )
Study ID Numbers: CDR0000509173, CAN-NCIC-IND182
Study First Received: October 25, 2006
Last Updated: April 14, 2009
ClinicalTrials.gov Identifier: NCT00392496     History of Changes
Health Authority: United States: Food and Drug Administration

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

Study placed in the following topic categories:
Lymphoma, B-Cell
Lymphatic Diseases
Lymphoma, Large B-Cell, Diffuse
Immunoproliferative Disorders
B-cell Lymphomas
Sunitinib
Lymphoma, Large-cell
Lymphoma, Non-Hodgkin
Lymphoproliferative Disorders
Angiogenesis Inhibitors
Lymphoma
Recurrence

Additional relevant MeSH terms:
Neoplasms by Histologic Type
Immunoproliferative Disorders
Immune System Diseases
Antineoplastic Agents
Growth Substances
Physiological Effects of Drugs
Angiogenesis Inhibitors
Pharmacologic Actions
Lymphoma, B-Cell
Lymphatic Diseases
Neoplasms
Sunitinib
Therapeutic Uses
Growth Inhibitors
Angiogenesis Modulating Agents
Lymphoproliferative Disorders
Lymphoma, Non-Hodgkin
Lymphoma

ClinicalTrials.gov processed this record on May 07, 2009