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Pegfilgrastim and Rituximab in Treating Patients With Untreated, Relapsed, or Refractory Follicular Lymphoma, Small Lymphocytic Lymphoma, or Marginal Zone Lymphoma

This study is ongoing, but not recruiting participants.
Sponsor:
Collaborator:
Information provided by (Responsible Party):
Roswell Park Cancer Institute
ClinicalTrials.gov Identifier:
NCT01682044
First received: September 5, 2012
Last updated: January 10, 2014
Last verified: January 2014

September 5, 2012
January 10, 2014
April 2007
July 2013   (final data collection date for primary outcome measure)
  • Overall response rate (ORR) [ Time Frame: Up to 43 weeks ] [ Designated as safety issue: No ]
    Two-sided 95% exact confidence intervals around the estimates will be calculated. Overall performance on study (weight loss, change in Karnofsky Scores) will be measured. Radiologic evaluation of the extent of disease following therapy will be used to assess response according to the standard World Health Organization (WHO) response criteria.
  • Complete response (CR) [ Time Frame: Up to 43 weeks ] [ Designated as safety issue: No ]
    Two-sided 95% exact confidence intervals around the estimates will be calculated. Summarized overall for the intent-to-treat and the evaluable populations. Overall performance on study (weight loss, change in Karnofsky Scores) will be measured. Radiologic evaluation of the extent of disease following therapy will be used to assess response according to the standard WHO response criteria.
  • Partial response (PR) rates [ Time Frame: Up to 43 weeks ] [ Designated as safety issue: No ]
    Two-sided 95% exact confidence intervals around the estimates will be calculated. Summarized overall for the intent-to-treat and the evaluable populations. Overall performance on study (weight loss, change in Karnofsky Scores) will be measured. Radiologic evaluation of the extent of disease following therapy will be used to assess response according to the standard WHO response criteria.
Same as current
Complete list of historical versions of study NCT01682044 on ClinicalTrials.gov Archive Site
  • Time to disease progression, defined as date of progression/death/last contact to the date treatment started [ Time Frame: At 2 years ] [ Designated as safety issue: No ]
    Descriptive statistics such as median, minimum, and maximum values will be used to summarize the time to event data. Kaplan-Meier estimates will be used.
  • Time to disease progression, defined as date of progression/death/last contact to the date treatment started [ Time Frame: At 4 years ] [ Designated as safety issue: No ]
    Descriptive statistics such as median, minimum, and maximum values will be used to summarize the time to event data. Kaplan-Meier estimates will be used.
  • Survival, defined as date of death/last contact to the date treatment started [ Time Frame: At 2 years ] [ Designated as safety issue: No ]
    Descriptive statistics such as median, minimum, and maximum values will be used to summarize the time to event data. Kaplan-Meier estimates will be used. Overall performance on study (weight loss, change in Karnofsky Scores) will be measured.
  • Survival, defined as date of death/last contact to the date treatment started [ Time Frame: At 4 years ] [ Designated as safety issue: No ]
    Descriptive statistics such as median, minimum, and maximum values will be used to summarize the time to event data. Kaplan-Meier estimates will be used. Overall performance on study (weight loss, change in Karnofsky Scores) will be measured.
Same as current
Not Provided
Not Provided
 
Pegfilgrastim and Rituximab in Treating Patients With Untreated, Relapsed, or Refractory Follicular Lymphoma, Small Lymphocytic Lymphoma, or Marginal Zone Lymphoma
Phase II Clinical Trial of Rituximab in Combination With Pegfilgrastim in Patients With Indolent B-Cell (CD-20-Positive) Lymphoma

This phase II trial studies the side effects and how well giving pegfilgrastim together with rituximab works in treating patients with untreated, relapsed, or refractory follicular lymphoma, small lymphocytic lymphoma (SLL), or marginal zone lymphoma (MZL). Colony-stimulating factors, such as pegfilgrastim, may increase the number of immune cells found in bone marrow or peripheral blood and may help the immune system recover from the side effects of therapy. Monoclonal antibodies, such as rituximab, can block cancer growth in different ways. Some block the ability of cancer to grow and spread. Others find cancer cells and help kill them or tumor cancer-killing substances to them. Giving pegfilgrastim together with rituximab may kill more cancer cells

PRIMARY OBJECTIVES:

I. To evaluate the safety of Pegfilgrastim in combination with rituximab in patients with untreated or relapsed/refractory follicular, SLL or MZL.

SECONDARY OBJECTIVES:

I. To evaluate the efficacy (including overall response rate and durability of objective responses) of Pegfilgrastim in combination with rituximab in patients with untreated or relapsed/refractory follicular, SLL or MZL.

II. To evaluate functional and phenotypic characteristics of host neutrophils undergoing treatment with Pegfilgrastim and rituximab.

III. To evaluate changes in cluster of differentiation (CD)20 antigen expression and density of expression in patients receiving Pegfilgrastim and rituximab.

IV. To evaluate changes in serum levels of tumor necrosis factor (TNF), interferon alpha (INFalpha) and free radical levels in patients undergoing treatment with Pegfilgrastim and rituximab.

OUTLINE:

Patients receive pegfilgrastim subcutaneously (SC) followed by rituximab intravenously (IV) 3 days later in weeks 1, 3, 5, 7, 15, 23, 31, and 39. Treatment continues in the absence of disease progression or unacceptable toxicity.

After completion of study treatment, patients are followed up every 4 months for 1 year, every 6 months for 2 years, and then yearly for 1 year.

Interventional
Phase 2
Endpoint Classification: Safety Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
  • Contiguous Stage II Grade 1 Follicular Lymphoma
  • Contiguous Stage II Grade 2 Follicular Lymphoma
  • Contiguous Stage II Grade 3 Follicular Lymphoma
  • Contiguous Stage II Marginal Zone Lymphoma
  • Contiguous Stage II Small Lymphocytic Lymphoma
  • Extranodal Marginal Zone B-cell Lymphoma of Mucosa-associated Lymphoid Tissue
  • Nodal Marginal Zone B-cell Lymphoma
  • Noncontiguous Stage II Grade 1 Follicular Lymphoma
  • Noncontiguous Stage II Grade 2 Follicular Lymphoma
  • Noncontiguous Stage II Grade 3 Follicular Lymphoma
  • Noncontiguous Stage II Marginal Zone Lymphoma
  • Noncontiguous Stage II Small Lymphocytic Lymphoma
  • Recurrent Grade 1 Follicular Lymphoma
  • Recurrent Grade 2 Follicular Lymphoma
  • Recurrent Grade 3 Follicular Lymphoma
  • Recurrent Marginal Zone Lymphoma
  • Recurrent Small Lymphocytic Lymphoma
  • Splenic Marginal Zone Lymphoma
  • Stage I Grade 1 Follicular Lymphoma
  • Stage I Grade 2 Follicular Lymphoma
  • Stage I Grade 3 Follicular Lymphoma
  • Stage I Marginal Zone Lymphoma
  • Stage I Small Lymphocytic Lymphoma
  • Stage III Grade 1 Follicular Lymphoma
  • Stage III Grade 2 Follicular Lymphoma
  • Stage III Grade 3 Follicular Lymphoma
  • Stage III Marginal Zone Lymphoma
  • Stage III Small Lymphocytic Lymphoma
  • Stage IV Grade 1 Follicular Lymphoma
  • Stage IV Grade 2 Follicular Lymphoma
  • Stage IV Grade 3 Follicular Lymphoma
  • Stage IV Marginal Zone Lymphoma
  • Stage IV Small Lymphocytic Lymphoma
  • Biological: pegfilgrastim
    Given SC
    Other Names:
    • Filgrastim SD-01
    • GCSF-SD01
    • Neulasta
    • SD-01 sustained duration G-CSF
  • Biological: rituximab
    Given IV
    Other Names:
    • IDEC-C2B8
    • IDEC-C2B8 monoclonal antibody
    • Mabthera
    • MOAB IDEC-C2B8
    • Rituxan
  • Other: flow cytometry
    Correlative studies
  • Procedure: biopsy
    Correlative studies
    Other Name: biopsies
  • Other: immunohistochemistry staining method
    Correlative studies
    Other Name: immunohistochemistry
  • Genetic: western blotting
    Correlative studies
    Other Names:
    • Blotting, Western
    • Western Blot
Experimental: Treatment (colony-stimulating factor and monoclonal antibody)
Patients receive pegfilgrastim SC followed by rituximab IV 3 days later in weeks 1, 3, 5, 7, 15, 23, 31, and 39. Treatment continues in the absence of disease progression or unacceptable toxicity.
Interventions:
  • Biological: pegfilgrastim
  • Biological: rituximab
  • Other: flow cytometry
  • Procedure: biopsy
  • Other: immunohistochemistry staining method
  • Genetic: western blotting
Not Provided

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Active, not recruiting
20
Not Provided
July 2013   (final data collection date for primary outcome measure)

Inclusion Criteria:

  • Untreated or relapsed/refractory follicular, SLL or MZL (i.e. no limit to number of prior treatments as long as patients meet other study criteria)
  • Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1
  • Measurable tumor size (at least one node measuring 4 cm^2 in bidimensional measurement)
  • Expected survival of > 6 months
  • Prior rituximab or other monoclonal immunotherapy permitted and eligible for rituximab monotherapy
  • Full recovery from any significant toxicity associated with prior surgery, radiation therapy, chemotherapy, or immunotherapy
  • Absolute neutrophil count > 1.0 x 10^9/L
  • Platelets > 50 x 10^9/L
  • Patients may receive erythropoietin growth factors to maintain adequate hemoglobin levels (>= 8.0 mg/dl)
  • Creatinine < 1.5 x upper normal levels (UNL)
  • Total bilirubin < 1.5 mg/dL (> 25.65 umol/L)
  • Aspartate aminotransferase < 5 x UNL
  • Alkaline phosphatase < 5 x UNL
  • Informed consent approved in institutional review board (lRB)
  • CD20+ B-cell lymphoma

Exclusion Criteria:

  • Prior history of human immunodeficiency virus (HIV)-positivity (routine HIV testing is required pretreatment)
  • Serious non-malignant disease (e.g. active uncontrolled bacterial, viral, or fungal infections) or other conditions which, in the opinion of the principal investigator would compromise other protocol objectives
  • Presence of central nervous system (CNS) lymphoma
  • Chemotherapy within 4 weeks of the first scheduled study treatment
  • Another primary malignancy (other than squamous or basal cell carcinoma of the skin or in-situ carcinoma of the cervix) for which the patient has not been disease-free for at least five years
  • Major surgery, other than diagnostic surgery, within four weeks
  • Patients with non-Hodgkin lymphoma (NHL) other than relapsed/refractory follicular, MZL or SLL
  • Patients must not have a history of cardiac disease, defined as New York Heart Association Class II or greater or clinical evidence of congestive heart failure
  • Concurrent use of other investigational agents
  • Pregnant or breast feeding
  • Subjects of reproductive potential who are not using adequate contraceptive precautions, in the judgment of the investigator
  • Known hypersensitivity to any recombinant E coli-derived product, murine proteins, or any components of the study medications
  • Concerns for the subject's compliance with the protocol
  • Any premalignant myeloid condition or any malignancy with myeloid characteristics (e.g. myelodysplastic syndromes, acute or chronic myelogenous leukemia)
  • Patient is currently enrolled in, or has not yet completed at least 30 days since ending another investigational device or drug trial
Both
19 Years and older
No
Contact information is only displayed when the study is recruiting subjects
United States
 
NCT01682044
I 83106, NCI-2011-00134
Yes
Roswell Park Cancer Institute
Roswell Park Cancer Institute
National Cancer Institute (NCI)
Principal Investigator: Francisco Hernandez-ILizaliturri Roswell Park Cancer Institute
Roswell Park Cancer Institute
January 2014

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