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Phase II Study of "VIPER" Chemotherapy in Rel/Ref DLBCL
This study is currently recruiting participants.
Verified by Weill Medical College of Cornell University, June 2009
First Received: July 19, 2007   Last Updated: June 9, 2009   History of Changes
Sponsors and Collaborators: Weill Medical College of Cornell University
Millennium Pharmaceuticals, Inc.
Information provided by: Weill Medical College of Cornell University
ClinicalTrials.gov Identifier: NCT00504751
  Purpose

Objectives

The primary objective of this study is to:

  • determine the complete and partial response rates and the toxicity profile of bortezomib (VELCADE, formerly PS-341) when administered in combination with DICE chemotherapy plus rituximab (i.e. VIPER) to patients with relapsed or refractory diffuse large B-cell non-Hodgkin's lymphoma

The secondary objectives of this study are to:

  • assess event free survival and overall survival
  • assess conversion of chemo-resistant to chemo-sensitive disease
  • assess the ability to collect stem cells from patients treated with salvage VIPER who then undergo autologous stem cell transplantation
  • perform correlative studies on pre-treatment tumor biopsy specimens; analyses will include the assessment of immunohistochemical expression patterns (germinal center B cell vs. activated B cell) and NF-κB activity

Condition Intervention Phase
Non-Hodgkin's Lymphoma
Drug: bortezomib, dexamethasone, ifosfamide
Drug: mesna, cisplatin, etoposide, rituximab
Phase II

Study Type: Interventional
Study Design: Treatment, Non-Randomized, Open Label, Uncontrolled, Single Group Assignment, Safety/Efficacy Study
Official Title: Phase II Trial of "VIPER" Chemotherapy in Relapsed and Refractory Diffuse Large B-Cell Lymphoma (NHL)

Resource links provided by NLM:


Further study details as provided by Weill Medical College of Cornell University:

Primary Outcome Measures:
  • determine rate of response to chemotherapy [ Time Frame: duration of study ] [ Designated as safety issue: No ]

Estimated Enrollment: 30
Study Start Date: May 2007
Estimated Study Completion Date: December 2010
Estimated Primary Completion Date: December 2010 (Final data collection date for primary outcome measure)
Intervention Details:
    Drug: bortezomib, dexamethasone, ifosfamide

    VIPER chemotherapy will be administered every 28 days at the following doses:

    • Dexamethasone 40 mg IV days 1-4
    • Ifosfamide 1.0 gram/m2 CIVI over 24 hours days 1-4
    • Mesna 1.0 gram/m2 CIVI over 24 hours days 1-4 (mix solution with ifosfamide)
    • Cisplatin 25 mg IV days 1-4
    • Etoposide 100 mg/m2 CIVI over 24 hours days 1-4
    • Rituximab 500 mg/m2 IV day 1 prior to start of DICE (375 mg/m2 for subsequent cycles)
    • VELCADE 1.5 mg/m2 on days 2 and 5
    Drug: mesna, cisplatin, etoposide, rituximab

    VIPER chemotherapy will be administered every 28 days at the following doses:

    • Dexamethasone 40 mg IV days 1-4
    • Ifosfamide 1.0 gram/m2 CIVI over 24 hours days 1-4
    • Mesna 1.0 gram/m2 CIVI over 24 hours days 1-4 (mix solution with ifosfamide)
    • Cisplatin 25 mg IV days 1-4
    • Etoposide 100 mg/m2 CIVI over 24 hours days 1-4
    • Rituximab 500 mg/m2 IV day 1 prior to start of DICE (375 mg/m2 for subsequent cycles)
    • VELCADE 1.5 mg/m2 on days 2 and 5
Detailed Description:

Single arm phase II trial of combination therapy bortezomib, DICE, and Rituximab in patients with relapsed and refractory diffuse large B-cell non-Hodgkin's lymphoma (NHL)

VIPER chemotherapy will be administered every 28 days at the following doses:

  • Dexamethasone 40 mg IV days 1-4
  • Ifosfamide 1.0 gram/m2 CIVI over 24 hours days 1-4
  • Mesna 1.0 gram/m2 CIVI over 24 hours days 1-4 (mix solution with ifosfamide)
  • Cisplatin 25 mg IV days 1-4
  • Etoposide 100 mg/m2 CIVI over 24 hours days 1-4
  • Rituximab 500 mg/m2 IV day 1 prior to start of DICE (375 mg/m2 for subsequent cycles)
  • VELCADE 1.5 mg/m2 on days 2 and 5
  Eligibility

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

Inclusion Criteria:

  • Histologically confirmed diagnosis of CD20 positive, diffuse large B-cell NHL; de novo or transformed histologies are acceptable
  • Patient must have relapsed after or not responded to at least one standard, upfront multi-agent chemotherapy for DLBCL
  • Measurable PET positive disease, as defined by tumor mass > 1.5 cm in one dimension
  • Stage II, III, or IV disease
  • Age > 18 years
  • Adequate liver and kidney function (total bilirubin < 2 x ULN and creatinine < 2.0 mg/dl, unless abnormalities are related to lymphoma or Gilbert's disease
  • Adequate bone marrow reserves (absolute neutrophil count >1500 cells/mm3 and platelet count > 100,000, unless cytopenias are the result of marrow infiltration by lymphoma
  • ECOG performance status < 2
  • Life expectancy of at least 3 months
  • Bortezomib-naive
  • Voluntary written informed consent before performance of any study-related procedure not part of normal medical care, with the understanding that consent may be withdrawn by the subject at any time without prejudice to future medical care
  • Female subject is either post-menopausal or surgically sterilized or willing to use an acceptable method of birth control (i.e., a hormonal contraceptive, intrauterine device, diaphragm with spermicide, condom with spermicide, or abstinence) for the duration of the study.
  • Male subject agrees to use an acceptable method for contraception for the duration of the study.

Exclusion Criteria:

  • Patient has ≥ Grade 2 peripheral neuropathy within 14 days before enrollment.
  • Myocardial infarction within 6 months prior to enrollment or has New York Heart Association (NYHA) Class III or IV heart failure (see section 8.4), uncontrolled angina, severe uncontrolled ventricular arrhythmias, or electrocardiographic evidence of acute ischemia or active conduction system abnormalities. Prior to study entry, any ECG abnormality at Screening has to be documented by the investigator as not medically relevant.
  • Patient has hypersensitivity to boron or mannitol
  • Female subject is pregnant or breast-feeding. Confirmation that the subject is not pregnant must be established by a negative serum β-human chorionic gonadotropin (β-hCG) pregnancy test result obtained during screening. (Pregnancy testing is not required for post-menopausal or surgically sterilized women)
  • Patient has received other investigational drugs or cytotoxic chemotherapy within 14 days of enrollment
  • Serious medical or psychiatric illness likely to interfere with participation in this clinical study
  • Known HIV infection
  • Active Hepatitis B or C as defined by positive Hepatitis B surface antigen or hepatitis C RNA
  • Known CNS disease
  • Pregnant or nursing women
  • Concurrent treatment with other chemotherapy or anti-lymphoma therapy, including corticosteroids, unless on a stable dose of corticosteroids less than the equivalent of 20 mg of prednisone each day for treatment of disease not related to lymphoma
  • Concomitant malignancies or previous malignancies within the last five years, with the exception of adequately treated basal or squamous cell carcinoma of the skin or carcinoma in situ of the cervix.
  • Any condition that, in the opinion of the investigator, would prevent the subject from being fully compliant with the protocol.
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00504751

Contacts
Contact: Trish Glynn, RN 212-746-6738 pwg2002@med.cornell.edu

Locations
United States, New York
Weill Cornell Medical College Recruiting
New York, New York, United States, 10021
Contact: Trish Glynn, RN     212-746-6738        
Principal Investigator: Richard Furman, MD            
Sponsors and Collaborators
Weill Medical College of Cornell University
Millennium Pharmaceuticals, Inc.
Investigators
Principal Investigator: Richard Furman, MD Weill Cornell Medical College
  More Information

Additional Information:
No publications provided

Responsible Party: Weill Cornell Medical College ( Dr. Richard Furman )
Study ID Numbers: 0701008963
Study First Received: July 19, 2007
Last Updated: June 9, 2009
ClinicalTrials.gov Identifier: NCT00504751     History of Changes
Health Authority: United States: Institutional Review Board

Keywords provided by Weill Medical College of Cornell University:
diffuse large b cell

Study placed in the following topic categories:
Anti-Inflammatory Agents
Dexamethasone
Immunologic Factors
Hormone Antagonists
Hormones, Hormone Substitutes, and Hormone Antagonists
Antiemetics
Hormones
Etoposide phosphate
Lymphoma, Small Cleaved-cell, Diffuse
Lymphoma, B-Cell
Cisplatin
Lymphoma, Large-cell
Alkylating Agents
Lymphoma
Etoposide
Dexamethasone acetate
Lymphoma, Large B-Cell, Diffuse
Immunoproliferative Disorders
Antineoplastic Agents, Hormonal
Rituximab
Bortezomib
Glucocorticoids
Lymphatic Diseases
Ifosfamide
B-cell Lymphomas
Radiation-Sensitizing Agents
Mechlorethamine
Antineoplastic Agents, Alkylating
Peripheral Nervous System Agents
Antirheumatic Agents

Additional relevant MeSH terms:
Anti-Inflammatory Agents
Dexamethasone
Immunologic Factors
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents
Physiological Effects of Drugs
Hormones, Hormone Substitutes, and Hormone Antagonists
Antiemetics
Hormones
Cisplatin
Therapeutic Uses
Alkylating Agents
Etoposide
Lymphoma
Dexamethasone acetate
Immunoproliferative Disorders
Neoplasms by Histologic Type
Antineoplastic Agents, Hormonal
Immune System Diseases
Rituximab
Gastrointestinal Agents
Glucocorticoids
Pharmacologic Actions
Lymphatic Diseases
Neoplasms
Ifosfamide
Radiation-Sensitizing Agents
Autonomic Agents
Antineoplastic Agents, Alkylating
Peripheral Nervous System Agents

ClinicalTrials.gov processed this record on September 11, 2009