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MDX-010 in Treating Patients With Recurrent or Refractory Lymphoma
This study is ongoing, but not recruiting participants.
Sponsors and Collaborators: Mayo Clinic
National Cancer Institute (NCI)
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00089076
  Purpose

RATIONALE: Biological therapies, such as MDX-010, work in different ways to stimulate the immune system and stop cancer cells from growing.

PURPOSE: This phase I/II trial is studying the side effects and best dose of MDX-010 and to see how well it works in treating patients with recurrent or refractory B-cell non-Hodgkin's lymphoma.


Condition Intervention Phase
Lymphoma
Drug: ipilimumab
Phase I
Phase II

MedlinePlus related topics: Cancer Lymphoma
Drug Information available for: Immunoglobulins Globulin, Immune Ipilimumab Cytotoxic T-lymphocyte antigen 4
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Open Label
Official Title: Phase I/II Study Of Anti CTLA-4 Monoclonal Antibody (MDX-010) In B-Cell Non-Hodgkin's Lymphoma

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

Primary Outcome Measures:
  • Proportion of overall confirmed responses during month 7 of treatment [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Time to progression [ Designated as safety issue: No ]
  • Overall survival [ Designated as safety issue: No ]
  • Duration of response [ Designated as safety issue: No ]
  • Immunologic studies [ Designated as safety issue: No ]

Estimated Enrollment: 36
Study Start Date: July 2004
Estimated Primary Completion Date: January 2006 (Final data collection date for primary outcome measure)
Detailed Description:

OBJECTIVES:

Primary

  • Determine the safety of anti-cytotoxic T-lymphocyte-associated antigen-4 monoclonal antibody (MDX-010) in patients with recurrent or refractory B-cell non-Hodgkin's lymphoma.
  • Determine a tolerable, immunologically active dose of this drug in these patients.
  • Determine the clinical response rate in patients treated with this drug.

Secondary

  • Determine the time to progression in patients treated with this drug.
  • Determine the duration of response in patients treated with this drug.

OUTLINE: This is a multicenter, open-label, phase I, dose-escalation study followed by a phase II study. Patients are grouped according to prior treatment with a vaccine therapy for lymphoma (yes vs no).

  • Phase I: Patients receive anti-cytotoxic T-lymphocyte-associated antigen-4 monoclonal antibody (MDX-010) IV over 90 minutes on day 1. Treatment repeats every 28 days for a total of 4 courses in the absence of disease progression or unacceptable toxicity.

Cohorts of 6 patients from each group receive escalating doses of MDX-010 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.

  • Phase II: Patients receive MDX-010 as in phase I at the MTD. Patients are followed at 1 and 4 months and then every 6 months for up to 2 years.

PROJECTED ACCRUAL: A total of 12-36 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

    • Any B-cell non-Hodgkin's lymphoma except small lymphocytic lymphoma and/or chronic lymphocytic lymphoma
  • Recurrent or refractory disease after ≥ 1 prior conventional therapy, including chemotherapy or monoclonal antibody therapy

    • No more than 3 prior chemotherapy regimens
    • Prior monoclonal antibody therapy or radiotherapy to a single site allowed (not considered a prior chemotherapy regimen)
    • Tumor vaccine therapy is not considered a prior therapy regimen
  • Measurable disease

    • At least 1 pathologic node measuring 2.0 X 2.0 cm by CT scan OR 2 nodes measuring > 1.5 X 1.5 cm each after collection of tumor for immunologic analyses
  • No potentially curative or life-extending standard therapy exists
  • No clinical evidence of CNS involvement by lymphoma

PATIENT CHARACTERISTICS:

Age

  • 18 and over

Performance status

  • ECOG 0-1

Life expectancy

  • At least 24 weeks

Hematopoietic

  • Absolute neutrophil count ≥ 1,000/mm^3
  • Platelet count ≥ 75,000/mm^3
  • Hemoglobin ≥ 8.0 g/dL

Hepatic

  • Bilirubin ≤ 1.5 times upper limit of normal (ULN)
  • AST ≤ 3 times ULN
  • Hepatitis B surface antigen negative
  • Hepatitis C virus negative OR hepatitis C virus RNA-negative by polymerase chain reaction

Renal

  • Creatinine ≤ 1.5 times ULN

Cardiovascular

  • No New York Heart Association class III or IV heart disease
  • No history of angina pectoris requiring active treatment

Immunologic

  • Antinuclear antibody titer or rheumatoid factor titer ≤ 3 times ULN
  • No uncontrolled infection
  • No known immune deficiency
  • No history of autoimmune disease requiring systemic therapy with immunosuppressive drugs, including, but not limited to, any of the following:

    • Rheumatoid arthritis
    • Inflammatory bowel disease
    • Systemic lupus erythematosus
    • Multiple sclerosis
    • Psoriasis
  • HIV negative

Other

  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception

PRIOR CONCURRENT THERAPY:

Biologic therapy

  • See Disease Characteristics
  • No prior anti-cytotoxic T-lymphocyte-associated antigen-4 monoclonal antibody therapy (MDX-010)
  • No other concurrent immunotherapy

Chemotherapy

  • See Disease Characteristics
  • Recovered from prior chemotherapy
  • More than 1 year since prior fludarabine or cladribine
  • No concurrent chemotherapy

Endocrine therapy

  • No concurrent steroid therapy, including inhaled steroids for asthma

Radiotherapy

  • See Disease Characteristics
  • No concurrent radiotherapy

Surgery

  • Not specified

Other

  • No other concurrent investigational therapy
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00089076

Locations
United States, California
Jonsson Comprehensive Cancer Center at UCLA
Los Angeles, California, United States, 90095-1781
United States, Minnesota
Mayo Clinic Cancer Center
Rochester, Minnesota, United States, 55905
Sponsors and Collaborators
Mayo Clinic
Investigators
Study Chair: Stephen M. Ansell, MD, PhD Mayo Clinic
  More Information

Clinical trial summary from the National Cancer Institute's PDQ® database  This link exits the ClinicalTrials.gov site

Study ID Numbers: CDR0000378036, MAYO-MC0312, NCI-6359, UCLA-0406055-01
Study First Received: August 4, 2004
Last Updated: January 6, 2009
ClinicalTrials.gov Identifier: NCT00089076  
Health Authority: United States: Food and Drug Administration

Keywords provided by National Cancer Institute (NCI):
recurrent grade 1 follicular lymphoma
recurrent grade 2 follicular lymphoma
stage IV grade 1 follicular lymphoma
stage IV grade 2 follicular lymphoma
recurrent adult diffuse large cell lymphoma
recurrent adult diffuse mixed cell lymphoma
recurrent adult diffuse small cleaved cell lymphoma
recurrent mantle cell lymphoma
recurrent marginal zone lymphoma
stage IV adult diffuse large cell lymphoma
stage IV adult diffuse mixed cell lymphoma
stage IV adult diffuse small cleaved cell lymphoma
stage IV grade 3 follicular lymphoma
stage IV mantle cell lymphoma
stage IV marginal zone lymphoma
recurrent grade 3 follicular lymphoma
recurrent adult immunoblastic large cell lymphoma
stage IV adult immunoblastic large cell lymphoma
recurrent adult lymphoblastic lymphoma
stage IV adult lymphoblastic lymphoma

Study placed in the following topic categories:
Lymphoma, Large B-Cell, Diffuse
Immunoproliferative Disorders
Lymphoma, Mantle-Cell
Lymphoma, Follicular
Lymphoma, small cleaved-cell, diffuse
Lymphoblastic lymphoma
Mantle cell lymphoma
Cytotoxic T-lymphocyte antigen 4
Lymphoma, large-cell, immunoblastic
Recurrence
Antibodies, Monoclonal
Lymphoma, large-cell
Lymphoma, B-Cell
Lymphatic Diseases
Antibodies
B-cell lymphomas
Lymphoma, Large-Cell, Immunoblastic
Lymphoma, Non-Hodgkin
Lymphoproliferative Disorders
Lymphoma
Follicular lymphoma
Immunoglobulins

Additional relevant MeSH terms:
Neoplasms
Neoplasms by Histologic Type
Immune System Diseases

ClinicalTrials.gov processed this record on January 14, 2009