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Phase I Study of Alefacept in Patients With Relapsed or Refractory Cutaneous T-Cell Lymphoma or
Peripheral T-Cell Non-Hodgkin's Lymphoma
Alternate Title Basic Trial Information Objectives Entry Criteria Expected Enrollment Outcomes Outline Trial Contact Information Registry Information
Alternate Title
Alefacept in Treating Patients With Relapsed or Refractory Cutaneous T-Cell Lymphoma or Peripheral T-Cell Non-Hodgkin's Lymphoma
Basic Trial Information
Phase | Type | Status | Age | Protocol IDs |
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Phase I | Biomarker/Laboratory analysis, Treatment | Active | 18 and over | MAYO-LS058C MAYO-06-002246, NCT00438802 |
Special Category:
SPORE trial Objectives Primary - Determine the maximum tolerated dose or the optimal immunologic
dose of alefacept in patients with relapsed or refractory cutaneous T-cell lymphoma or peripheral T-cell non-Hodgkin's lymphoma.
Secondary - Determine if antitumor activity of this drug exists in these patients.
Entry Criteria Disease Characteristics:
- Histologically confirmed cutaneous T-cell lymphoma (CTCL) or peripheral T-cell non-Hodgkin's lymphoma
- Diagnostic biopsies must have been obtained within the past 6 months
- Relapsed or refractory disease
- Patients with CTCL must have failed ≥ 2 skin-directed therapies
- No limit on the number of prior therapies
- Measurable disease, defined as at least 1 bidimensionally measurable lesion >
2 cm by CT scan, MRI, physical exam, or photograph with appended
ruler
- At least 2 bidimensionally measurable target lesions required
for patients with skin lesions only
- No CNS lymphoma
Prior/Concurrent Therapy:
- See Disease Characteristics
- More than 3 weeks since prior cytotoxic chemotherapy
- More than 3 weeks since prior denileukin diftitox
- More than 3 weeks since prior radiotherapy (less than 3 weeks if the acute side effects
of this therapy are resolved)
- More than 2 weeks since prior oral corticosteroids (unless being used to treat
adrenal insufficiency)
- More than 2 weeks since prior phototherapy, including ultraviolet B and psoralen with ultraviolet A
- More than 1 week since prior biologic therapy
- No concurrent chemotherapy, other immunotherapy, or radiotherapy
- No other concurrent investigational agents
Patient Characteristics:
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ECOG performance status 0-2
- Absolute neutrophil count ≥ 1,000/mm3
- Platelet count ≥ 75,000/mm3
- Hemoglobin ≥ 9 g/dL
- Total bilirubin ≤ 2 times upper limit of normal (ULN) OR direct bilirubin ≤ 1.5 times ULN
- AST ≤ 3 times ULN (≤ 5 times ULN if liver involvement)
- Creatinine ≤ 2 times ULN
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective contraception
- Willing to provide all research blood samples as required by the protocol
- Willing to undergo repeat biopsy of either an accessible skin lesion or lymph
node, if there are no circulating sezary cells, for the purpose of research
studies (patients without easily accessible lesions are not required to have a
repeat biopsy solely for research purposes but must be willing to provide a
portion of the on-study biopsy or a previous lymphoma biopsy, if available)
- No known congenital or acquired immunodeficiency syndromes, including HIV
- No known active viral hepatitis or tuberculosis infection
- No uncontrolled infection
- No other uncontrolled serious medical condition unrelated to lymphoma (e.g.,
cardiac arrhythmia or diabetes)
- No other active malignancies
- No history of serious allergic reaction to citrate or glycine
Expected Enrollment 24A total of 24 patients will be accrued for this study. Outcomes Primary Outcome(s)Tolerability Immunostimulation
Secondary Outcome(s)Clinical response
Outline This is a multicenter, dose-escalation study. - Induction therapy: Patients receive alefacept IV over 2-5 minutes once weekly for up to 8 weeks in the absence of disease progression or unacceptable toxicity. Patients with stable disease or complete or partial response after induction therapy proceed to maintenance therapy.
Cohorts of 6 patients receive escalating doses of alefacept 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. The optimal immunologic dose is defined as the dose that does not exceed the MTD, has the highest alefacept level, and achieves saturation of CD2 receptors.
- Maintenance therapy: Patients receive alefacept IV on day 1. Treatment repeats every 4 weeks for 10-12 courses in the absence of disease progression or unacceptable toxicity.
Patients who experience disease progression during maintenance therapy may receive reinduction therapy* comprising 4 weekly doses of alefacept. The patient then proceeds to a second maintenance phase in the absence of disease progression. [Note: *Only 1 reinduction allowed.]
Patients undergo blood and tissue collection periodically for pharmacological studies. Blood serum is analyzed for alefacept concentration, cytokine concentration, CD16 polymorphisms, and CD2 saturation via flow cytometry. After completion of study treatment, patients are followed every 3 months for up to 3 years and then periodically thereafter.
Trial Contact Information
Trial Lead Organizations Mayo Clinic Cancer Center | | | Thomas Witzig, MD, Protocol chair | | | | Mark Pittelkow, MD, Protocol co-chair | | | | Brian Link, MD, Protocol co-chair | | | | Yvette Kasamon, MD, Protocol co-chair | | | | Jasmine Zain, MD, Protocol co-chair | | | | Trial Sites
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U.S.A. |
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California |
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Duarte |
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| | | | | | | | City of Hope Comprehensive Cancer Center |
| | Clinical Trials Office - City of Hope Comprehensive Cancer Center | |
| Email:
becomingapatient@coh.org |
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Iowa |
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Iowa City |
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| | | Holden Comprehensive Cancer Center at University of Iowa |
| | Cancer Information Service | |
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Minnesota |
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Rochester |
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| | | Mayo Clinic Cancer Center |
| | Clinical Trials Office - All Mayo Clinic Locations | |
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Registry Information | | Official Title | | A Phase I Study of Alefacept (AmeviveTM) in the Treatment of Cutaneous T-cell Lymphoma and
Peripheral T-cell NHL | | Trial Start Date | | 2006-03-13 | | Trial Completion Date | | 2009-12-31 (estimated) | | Registered in ClinicalTrials.gov | | NCT00438802 | | Date Submitted to PDQ | | 2007-01-04 | | Information Last Verified | | 2009-02-17 | | NCI Grant/Contract Number | | CA097274, CA15083 |
Note: The purpose of most clinical trials listed in this database is to test new cancer treatments, or new methods of diagnosing, screening, or preventing cancer. Because all potentially harmful side effects are not known before a trial is conducted, dose and schedule modifications may be required for participants if they develop side effects from the treatment or test. The therapy or test described in this clinical trial is intended for use by clinical oncologists in carefully structured settings, and may not prove to be more effective than standard treatment. A responsible investigator associated with this clinical trial should be consulted before using this protocol. Back to Top |
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