Rituximab, Cyclophosphamide, Bortezomib, and Prednisone in Treating Patients With Stage III or Stage IV Follicular Lymphoma or Marginal Zone Lymphoma
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Purpose
RATIONALE: Monoclonal antibodies, such as rituximab, can block cancer growth in different ways. Some block the ability of cancer cells to grow and spread. Others find cancer cells and help kill them or carry cancer-killing substances to them. Drugs used in chemotherapy, such as cyclophosphamide and prednisone, work in different ways to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Bortezomib may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth and by blocking blood flow to the tumor. Giving rituximab together with cyclophosphamide, bortezomib, and prednisone may kill more cancer cells.
PURPOSE: This clinical trial is studying how well giving rituximab together with cyclophosphamide, bortezomib, and prednisone works as first-line therapy in treating patients with stage III or stage IV follicular lymphoma or marginal zone lymphoma.
| Condition | Intervention |
|---|---|
|
Lymphoma |
Drug: Rituximab Drug: Bortezomib Drug: Cyclophosphamide Drug: Prednisone |
| Study Type: | Interventional |
| Study Design: | Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Pilot Study of RCVELP as First Line Therapy for Follicular Lymphoma (FL) and Marginal Zone Lymphoma (MZL) |
- Overall Response Rate, According to the International Workshop Criteria (IWC) [ Time Frame: 5 years ] [ Designated as safety issue: No ]
- Progression-free Survival as Assessed by RECIST Criteria [ Time Frame: 5 years ] [ Designated as safety issue: No ]
- Overall Survival [ Time Frame: 5 years ] [ Designated as safety issue: No ]
- Safety and Tolerance to Rituximab, Cyclophosphamide, Bortezomib, and Prednisone [ Time Frame: 5 years ] [ Designated as safety issue: Yes ]
| Enrollment: | 3 |
| Study Start Date: | September 2008 |
| Study Completion Date: | February 2011 |
| Primary Completion Date: | February 2011 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
| Experimental: RCVELP |
Drug: Rituximab
375 mg/m2 IV infusion at 50 mg/hr on Day 1 of every 21 days cycle for 8 cycles
Other Name: Rituxan
Drug: Bortezomib
1.6 mg/m2 IV push over 3-5 seconds on Days 1 and 8 of every 21 days cycle for 8 cycles
Other Name: Velcade
Drug: Cyclophosphamide
750 mg/m2 IVPB over 30 minuntes on Day 1 of every 21 day cycle for 8 cycles
Other Name: Cytoxan
Drug: Prednisone
100 mg PO daily on Days 1-5 of every 21 day cycle for 8 cycles
|
Detailed Description:
OBJECTIVES:
Primary
- To determine the overall response rate, in terms of complete response (CR), unconfirmed CR, and partial response, in patients with follicular lymphoma or marginal zone lymphoma treated with rituximab, cyclophosphamide, bortezomib, and prednisone (R-CVelP) as first line of treatment.
Secondary
- To determine progression-free survival of patients treated with this regimen.
- To determine overall survival of patients treated with this regimen.
- To determine the safety and tolerance to R-CVelP in these patients.
OUTLINE:
- Induction therapy: Patients receive rituximab IV and cyclophosphamide IV over 30 minutes on day 1, bortezomib IV on days 1 and 8, and oral prednisone once daily on days 1-5. Treatment repeats every 21 days for up to 8 courses in the absence of disease progression or unacceptable toxicity. Patients then proceed to maintenance therapy.
- Maintenance therapy: Patients receive rituximab IV on days 1, 8, 15, and 22. Treatment repeats every 6 months for up to 4 courses in the absence of disease progression or unacceptable toxicity.
After completion of study therapy, patients are followed every 4 months for 1 year, every 6 months for 2 years, and then annually thereafter.
Eligibility| Ages Eligible for Study: | 17 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
DISEASE CHARACTERISTICS:
Histologically confirmed grade 1 or 2 follicular lymphoma (FL) or marginal zone lymphoma (MZL)
- Stage III or IV disease
- Measurable or evaluable disease
- Previously untreated disease
PATIENT CHARACTERISTICS:
- ECOG performance status 1-3
- ANC > 1,000/mm³
- Platelet count > 100,000/mm³ (unless due to lymphoma)
- Bilirubin < 2.0 mg/dL
- Creatinine < 2 mg/dL (unless due to lymphoma)
- AST, ALT, and alkaline phosphatase < 3 times upper limit of normal
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective contraception
- No myocardial infarction within the past 6 months
- No NYHA class III-IV heart failure
- No uncontrolled angina
- No severe uncontrolled ventricular arrhythmias
- No ECG evidence of acute ischemia or active conductive system abnormalities
- No hypersensitivity to boron or mannitol
- No serious medical or psychiatric illness likely to interfere with participation in this clinical study
- No history of HIV infection
- No concurrent or previous malignancy with poor prognosis (< 90% probability of survival at 5 years) or actively treated for a second malignancy
- No peripheral neuropathy ≥ grade 2 within the past 14 days
PRIOR CONCURRENT THERAPY:
- No prior therapy for this disease including chemotherapy, single-agent rituximab, or radiotherapy
- No other concurrent anticancer therapy including chemotherapy, radiation, hormonal treatment, or immunotherapy
- At least 14 days since prior and no other concurrent investigational drugs
- No concurrent participation in another clinical study
Contacts and Locations| United States, Florida | |
| University of Miami Sylvester Comprehensive Cancer Center - Miami | |
| Miami, Florida, United States, 33136 | |
| Study Chair: | Denise Pereira, MD | University of Miami Sylvester Comprehensive Cancer Center |
More Information
Additional Information:
No publications provided
| Responsible Party: | University of Miami Sylvester Comprehensive Cancer Center |
| ClinicalTrials.gov Identifier: | NCT00772668 History of Changes |
| Other Study ID Numbers: | EPROST-20070963, SCCC-2006120 |
| Study First Received: | October 12, 2008 |
| Results First Received: | January 18, 2013 |
| Last Updated: | February 20, 2013 |
| Health Authority: | United States: Food and Drug Administration |
Keywords provided by University of Miami Sylvester Comprehensive Cancer Center:
|
stage III grade 1 follicular lymphoma stage IV grade 1 follicular lymphoma stage III grade 2 follicular lymphoma |
stage IV grade 2 follicular lymphoma stage III marginal zone lymphoma stage IV marginal zone lymphoma |
Additional relevant MeSH terms:
|
Lymphoma Lymphoma, Follicular Lymphoma, B-Cell, Marginal Zone Neoplasms by Histologic Type Neoplasms Lymphoproliferative Disorders Lymphatic Diseases Immunoproliferative Disorders Immune System Diseases Lymphoma, Non-Hodgkin Lymphoma, B-Cell Cyclophosphamide Rituximab Bortezomib Prednisone |
Immunosuppressive Agents Immunologic Factors Physiological Effects of Drugs Pharmacologic Actions Antirheumatic Agents Therapeutic Uses Antineoplastic Agents, Alkylating Alkylating Agents Molecular Mechanisms of Pharmacological Action Antineoplastic Agents Myeloablative Agonists Glucocorticoids Hormones Hormones, Hormone Substitutes, and Hormone Antagonists Antineoplastic Agents, Hormonal |
ClinicalTrials.gov processed this record on June 17, 2013