Safety and Efficacy of Iodine-131 Anti-B1 Antibody for Non Hodgkin's Lymphoma (NHL) Patients With Greater Than 25% Bone Marrow Involvement
Information source: GlaxoSmithKline
ClinicalTrials.gov processed this data on August 23, 2015 Link to the current ClinicalTrials.gov record.
Condition(s) targeted: Lymphoma, Non-Hodgkin
Intervention: Iodine-131 Anti-B1 Antibody (Biological)
Phase: Phase 1
Status: Completed
Sponsored by: GlaxoSmithKline Official(s) and/or principal investigator(s): GSK Clinical Trials, Study Director, Affiliation: GlaxoSmithKline
Summary
This is a phase I, dose escalation, open-label, multicenter study of iodine-131 Anti-B1
Antibody for patients with non-Hodgkin's lymphoma (NHL) who have more than 25% bone marrow
involvement with NHL. Prior studies with Iodine-131 Anti B1 Antibody for the treatment of
NHL have excluded patients with more than 25% bone marrow involvement with NHL. To be
eligible, patients must have been previously treated and failed to achieve an objective
response on or relapse during or following their last treatment.
Patients will undergo two dosing phases while on study. In the first phase, termed the
"dosimetric dose", patients will receive 450 mg unlabeled Anti-B1 Antibody infused over 1
hour or longer followed by 35 mg of Anti-B1 Antibody of which 1-2 mg has been labeled with 5
mCi of Iodine-131 infused over 20 minutes. Whole body camera scans will be obtained on Day
0, Day 2, 3, or 4, and Day 6 or 7 following the dosimetric dose. Using dosimetric data from
three imaging time points, a patient-specific dose of Iodine-131 Anti-B1 Antibody to deliver
the desired total body dose of radiotherapy will be calculated. In the second phase, termed
the "therapeutic dose", 450 mg Anti-B1 Antibody will be infused over 1 hour or longer
followed by 35 mg of Anti-B1 Antibody labeled with the subject-specific dose of Iodine-131
to deliver the desired total body radiation, infused over 20 minutes. The dose escalation
will be initiated at 45 cGy and will be increased in 10 cGy increments until the maximum
tolerated dose (MTD) is reached.
Patients will be treated with either saturated potassium iodide, Lugol's solution, or
potassium iodide tablets starting at least 24 hours prior to the infusion of the dosimetric
dose and continuing for 14 days following the last infusion of the therapeutic dose.
The primary endpoint is to determine the maximum tolerated dose of Iodine-131 Anti B-1
Antibody in patients with previously treated NHL having more than 25% bone marrow
involvement with lymphoma. Secondary endpoints include assessment of response rate,
duration of response, relapse-free survival, time to treatment failure, safety, and
survival.
Clinical Details
Official title: Phase I, Dose-Escalation Study of Iodine-131 Anti-B1 Antibody for Patients With Previously Treated Non Hodgkin's Lymphoma With More Than 25% Bone Marrow Involvement
Study design: Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
Primary outcome: The maximum tolerated dose of Iodine-131 Anti B-1 Antibody in patients with previously treated NHL having more than 25% bone marrow involvement with lymphoma.
Secondary outcome: response rateduration of response relapse-free survival time to treatment failure Safety as measured by adverse events, severity of hematologic toxicity, the use of supportive care and the percentage of human anti-murine antibody positivity
Eligibility
Minimum age: 18 Years.
Maximum age: N/A.
Gender(s): Both.
Criteria:
Inclusion Criteria:
- Patients must have a histologically confirmed initial diagnosis of low-grade
non-Hodgkin's B-cell lymphoma according to International Working Formulation (i. e.,
small lymphocytic [with or without plasmacytoid differentiation]; follicular small
cleaved, or follicular, mixed small cleaved and large cell), or low-grade lymphoma
that has transformed to a higher grade histology, or de novo follicular large cell
lymphoma.
- Patients must have Ann Arbor Stage IV disease and greater than an average of 25% of
the intratrabecular marrow space involved by NHL in bilateral bone marrow biopsy
specimens as assessed microscopically at study entry. A unilateral bone marrow biopsy
demonstrating greater than 50% involvement with NHL is also adequate for study entry.
- Patients must have been previously treated with chemotherapy and progressed on,
failed to achieve an objective response on, or progressed after completion of their
last chemotherapy.
- Patients must have evidence that their tumor tissue expresses the CD20 antigen.
- Patients must have a performance status of at least 60% on the Karnofsky Performance
Scale and an anticipated survival of at least 3 months.
- Patients must have an ANC greater than 1500 cells/mm3 and a platelet count greater
than or equal to 150,000 cells/mm3 within 14 days of study entry. These blood counts
must be sustained without support of hematopoietic cytokines or transfusion of blood
products.
- Patients must have adequate renal function (defined as serum creatinine less than 1. 5
times the upper limit of normal) and hepatic function (defined as total bilirubin
less than 1. 5 times the upper limit of normal and AST less than 5 times the upper
limit of normal) within 14 days of study entry.
- Patients must have bi-dimensionally measurable disease. At least one lesion must be
greater than or equal to 2 x 2 cm.
Exclusion Criteria:
- Patients with active obstructive hydronephrosis.
- Patients with New York Heart Association class III or IV heart disease or other
serious illness that would preclude evaluation.
- Patients with prior malignancy other than lymphoma, except for adequately treated
skin cancer, in situ cervical cancer, or other cancer for which the patient has been
disease-free for 5 years. Patients who have been disease-free of another cancer for
greater than 5 years must be carefully assessed at the time of study entry to rule
out recurrent disease.
- Patients with known HIV infection.
- Patients who are HAMA positive.
- Patients with known brain or leptomeningeal metastases.
- Patients who have undergone therapy with either stem cell or bone marrow transplant.
- Patients who have received cytotoxic chemotherapy, immunosuppressants, or cytokine
therapy within 4 weeks prior to study entry (6 weeks for nitrosourea compounds). The
use of systemic steroids must be discontinued at least 1 week prior to study entry.
- Patients who are pregnant or breastfeeding. Patients of childbearing potential must
undergo a serum pregnancy test within 7 days prior to study entry. Males and females
must agree to use effective contraception for 6 months following the
radioimmunotherapy dose.
- Patients with progressive disease within 1 year of irradiation arising in a field
that has been previously irradiated with more than 3500 cGy.
- Patients who are concurrently receiving either approved or non-approved (through
another protocol) anti-cancer drugs or biologics.
- Patients with active infection requiring IV anti-infectives at the time of study
entry.
- Patients who have previously received radioimmunotherapy.
- Patients with de novo intermediate- or high-grade NHL, except for intermediate
subtype of follicular large cell NHL.
Locations and Contacts
Additional Information
Starting date: May 1999
Last updated: October 18, 2012
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