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Biological Therapy After Chemotherapy in Treating Patients With Relapsed or Refractory Non-Hodgkin's Lymphoma
This study is ongoing, but not recruiting participants.
Study NCT00012207   Information provided by National Cancer Institute (NCI)
First Received: March 3, 2001   Last Updated: February 7, 2009   History of Changes

March 3, 2001
February 7, 2009
September 2000
December 2011   (final data collection date for primary outcome measure)
Safety and toxicity by NCI CTC toxicity scale in patients w/ recurr. or refract. CD20+ follicular lymphoma who are not candidates for high dose chemoradiotx and stem cell transplant during each infusion, weekly for 4 wks and then monthly for a yr [ Designated as safety issue: Yes ]
Safety and toxicity by NCI CTC toxicity scale in patients w/ recurr. or refract. CD20+ follicular lymphoma who are not candidates for high dose chemoradiotx and stem cell transplant during each infusion, weekly for 4 wks and then monthly for a yr
Complete list of historical versions of study NCT00012207 on ClinicalTrials.gov Archive Site
  • Duration of in vivo persistence of adoptively transferred CD20-specific CD8+ T cell clones by flow cytometry and quantitative polymerase chain reaction (qPCR) during each infusion, weekly for 4 weeks, and then monthly for a year [ Designated as safety issue: No ]
  • Trafficking of CD8+ CD20-specific T cell clones to lymph nodes by Gamma camera imaging during each infusion, weekly for 4 weeks, and then monthly for a year [ Designated as safety issue: No ]
  • Development of host anti-scFvFc:zeta (and anti-NeoR) immune responses by ELISA and chromium release assays during each infusion, weekly for 4 weeks, and then monthly for a year [ Designated as safety issue: No ]
  • Tumor responses to cyclophosphamide, vincristine, and prednisone (CVP) and to cytotoxic T-lymphocyte (CTL) infusions by Cheson criteria during each infusion, weekly for 4 weeks, and then monthly for a year [ Designated as safety issue: Yes ]
  • Duration of in vivo persistence of adoptively transferred CD20-specific CD8+ T cell clones by flow cytometry and quantitative polymerase chain reaction (qPCR) during each infusion, weekly for 4 weeks, and then monthly for a year
  • Trafficking of CD8+ CD20-specific T cell clones to lymph nodes by Gamma camera imaging during each infusion, weekly for 4 weeks, and then monthly for a year
  • Development of host anti-scFvFc:zeta (and anti-NeoR) immune responses by ELISA and chromium release assays during each infusion, weekly for 4 weeks, and then monthly for a year
  • Tumor responses to cyclophosphamide, vincristine, and prednisone (CVP) and to cytotoxic T-lymphocyte (CTL) infusions by Cheson criteria during each infusion, weekly for 4 weeks, and then monthly for a year
 
Biological Therapy After Chemotherapy in Treating Patients With Relapsed or Refractory Non-Hodgkin's Lymphoma
A Phase I Study To Evaluate The Safety Of Cellular Immunotherapy Using Genetically Modified Autologous Cd20-Specific Cd8+ T Cell Clones For Patients With Relapsed Cd20+ Indolent Lymphomas

RATIONALE: Biological therapies use different ways to stimulate the immune system and stop cancer cells from growing. Drugs used in chemotherapy use different ways to stop cancer cells from dividing so they stop growing or die. Combining biological therapy with chemotherapy may kill more cancer cells.

PURPOSE: Phase I trial to study the effectiveness of biological therapy after chemotherapy in treating patients who have relapsed or refractory non-Hodgkin's lymphoma.

OBJECTIVES:

Primary

  • Determine the safety and toxicity of cellular immunotherapy with autologous CD8+ cytotoxic T-lymphocyte clones after chemotherapy comprising cyclophosphamide, vincristine, and prednisone in patients with relapsed or refractory CD20+ indolent lymphomas or mantle cell lymphoma.

Secondary

  • Determine the duration of in vivo persistence of adoptively transferred CD20-specific CD8+ cytotoxic T-lymphocyte clones in the absence and presence of subcutaneous interleukin-2 in these patients.
  • Assess the trafficking of CD8+ cytotoxic T-lymphocyte clones to lymph nodes in these patients treated with this regimen.
  • Determine immune response and tumor response in patients treated with this regimen.

OUTLINE: This is an open-label, pilot study.

  • Leukapheresis: Patients undergo leukapheresis. Selected CD20-specific CD8+ cells are cultured to expand the cytotoxic T lymphocytes (CTL), which are then cloned.
  • Chemotherapy:

Patients receive oral cyclophosphamide and oral prednisone on days 1-5 and vincristine IV on day 1. Courses repeat every 3-4 weeks for a total of 6 courses.

  • Immune cell infusion:

Beginning 4 weeks after the last course of chemotherapy (and lymph nodes ≤ 5 cm diameter or ≤ 5,000 circulating CD20+ lymphocytes/mm^3), patients receive autologous CD8+ CTL clones IV over 30 minutes. Courses repeat every 2-5 days for a total of 3 courses in the absence of disease progression or unacceptable toxicity. The last 6 patients receive interleukin-2 subcutaneously every 12 hours for 14 days, beginning 2 hours after the last infusion of CD8+ CTL clones.

After course 2 or 3 of immune cells, all patients undergo surgical lymph node biopsy to determine if immune cells are moving to the lymph nodes.

Patients are followed monthly for 1 year and then annually for 2 years.

PROJECTED ACCRUAL: A total of 12 patients will be accrued for this study within 4 years.

Phase I
Interventional
Treatment, Open Label
  • Leukemia
  • Lymphoma
  • Biological: aldesleukin
  • Biological: therapeutic autologous lymphocytes
  • Drug: cyclophosphamide
  • Drug: prednisone
  • Drug: vincristine sulfate
  • Procedure: adjuvant therapy
 
Till BG, Jensen MC, Wang J, Chen EY, Wood BL, Greisman HA, Qian X, James SE, Raubitschek A, Forman SJ, Gopal AK, Pagel JM, Lindgren CG, Greenberg PD, Riddell SR, Press OW. Adoptive immunotherapy for indolent non-Hodgkin lymphoma and mantle cell lymphoma using genetically modified autologous CD20-specific T cells. Blood. 2008 Sep 15;112(6):2261-71. Epub 2008 May 28.

*   Includes publications given by the data provider as well as publications identified by National Clinical Trials Identifier (NCT ID) in Medline.
 
Active, not recruiting
12
 
December 2011   (final data collection date for primary outcome measure)

DISEASE CHARACTERISTICS:

  • Immunohistopathologically documented relapsed or refractory CD20+ indolent lymphomas or mantle cell lymphoma

    • Indolent B-cell lymphomas including any of the following subtypes:

      • Follicular lymphoma (grade I, II, or III)
      • Small lymphocytic lymphoma or chronic lymphocytic leukemia
      • Marginal zone lymphoma (splenic, nodal, and extra-nodal)
      • Lymphoplasmacytoid lymphoma
  • Ineligible for or unwilling to participate in other FHCRC/UWMC protocols
  • Serological evidence of prior exposure to Epstein-Barr virus
  • Must agree to undergo peripheral blood drawing, bone marrow biopsy, lymph node biopsy, and nuclear medicine imaging
  • Must agree to cytoreductive chemotherapy if necessary to reduce lymph nodes to < 5 cm in diameter or circulating B lymphocyte counts to < 5,000/mm^3
  • No pulmonary involvement
  • No CNS involvement

PATIENT CHARACTERISTICS:

Age:

  • Any age

Performance status:

  • Not specified

Life expectancy:

  • At least 90 days

Hematopoietic:

  • Not specified

Hepatic:

  • No active hepatitis B infection

Renal:

  • Not specified

Other:

  • No HIV positivity
  • Not pregnant or nursing
  • Fertile patients must use effective contraception
  • No history of hypersensitivity reactions to murine proteins

PRIOR CONCURRENT THERAPY:

Biologic therapy:

  • At least 4 months since prior rituximab, tositumomab, or ibritumomab
  • No prior allogeneic stem cell transplantation
  • No other concurrent immunotherapy (e.g., interferons, vaccines, or other cellular products)

Chemotherapy:

  • At least 2 years since prior fludarabine or cladribine
  • At least 4 weeks since prior chemotherapy and recovered

Endocrine therapy:

  • No concurrent systemic corticosteroids except to treat toxicity from chemotherapy or cellular immunotherapy

Radiotherapy:

  • Not specified

Surgery:

  • Not specified

Other:

  • At least 4 weeks since prior immunosuppressive therapy and recovered
  • No concurrent pentoxifylline
  • No other concurrent investigational agents
Both
 
No
Contact information is only displayed when the study is recruiting subjects
United States
 
NCT00012207
 
CDR0000068494, FHCRC-1503.00, NCI-G01-1921
Fred Hutchinson Cancer Research Center
National Cancer Institute (NCI)
Study Chair: Oliver W. Press, MD, PhD Fred Hutchinson Cancer Research Center
National Cancer Institute (NCI)
February 2009

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP