ClinicalTrials.gov
 Home    Search    Study Topics    Glossary  
 

  Full Text View  
  Tabular View  
  Contacts and Locations  
  Related Studies  
Biological Therapy After Chemotherapy in Treating Patients With Relapsed or Refractory Non-Hodgkin's Lymphoma

This study is currently recruiting participants.
Verified by National Cancer Institute (NCI), April 2008

Sponsors and Collaborators: Fred Hutchinson Cancer Research Center
National Cancer Institute (NCI)
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00012207
  Purpose

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.


Condition Intervention Phase
Leukemia
Lymphoma
Drug: aldesleukin
Drug: cyclophosphamide
Drug: prednisone
Drug: therapeutic autologous lymphocytes
Drug: vincristine
Procedure: adjuvant therapy
Procedure: chemotherapy
Procedure: interleukin therapy
Procedure: peripheral blood lymphocyte therapy
Phase I

MedlinePlus related topics:   Leukemia, Adult Acute   Leukemia, Adult Chronic   Leukemia, Childhood   Lymphoma  

ChemIDplus related topics:   Cyclophosphamide   Prednisone   Vincristine   Aldesleukin   Vincristine sulfate  

U.S. FDA Resources

Study Type:   Interventional
Study Design:   Treatment, Open Label
Official Title:   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

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

Primary Outcome Measures:
  • 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 ]

Secondary Outcome Measures:
  • 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 ]

Estimated Enrollment:   12
Study Start Date:   September 2000
Estimated Primary Completion Date:   December 2011 (Final data collection date for primary outcome measure)

Detailed Description:

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.

  Eligibility
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No

Criteria

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
  Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00012207

Locations
United States, California
City of Hope Comprehensive Cancer Center     Recruiting
      Duarte, California, United States, 91010-3000
      Contact: Clinical Trials Office - City of Hope Comprehensive Cancer Cen     800-826-4673     becomingapatient@coh.org    
United States, Washington
Fred Hutchinson Cancer Research Center     Recruiting
      Seattle, Washington, United States, 98109-1024
      Contact: Oliver W. Press, MD, PhD     206-667-1872     press@u.washington.edu    
University of Washington School of Medicine     Recruiting
      Seattle, Washington, United States, 98195
      Contact: Clinical Trials Office - University of Washington School of Me     206-616-8289        

Sponsors and Collaborators
Fred Hutchinson Cancer Research Center
National Cancer Institute (NCI)

Investigators
Study Chair:     Oliver W. Press, MD, PhD     Fred Hutchinson Cancer Research Center    
  More Information

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

Study ID Numbers:   CDR0000068494, FHCRC-1503.00, NCI-G01-1921
First Received:   March 3, 2001
Last Updated:   April 9, 2008
ClinicalTrials.gov Identifier:   NCT00012207
Health Authority:   Unspecified

Keywords provided by National Cancer Institute (NCI):
recurrent grade 1 follicular lymphoma  
recurrent grade 2 follicular lymphoma  
recurrent grade 3 follicular lymphoma  
recurrent mantle cell lymphoma  
recurrent marginal zone lymphoma
recurrent small lymphocytic lymphoma
refractory chronic lymphocytic leukemia

Study placed in the following topic categories:
Chronic lymphocytic leukemia
Prednisone
Leukemia, Lymphoid
Immunoproliferative Disorders
Leukemia, B-cell, chronic
Lymphoma, Mantle-Cell
Lymphoma, Follicular
Lymphoma, small cleaved-cell, diffuse
Vincristine
Cyclophosphamide
Mantle cell lymphoma
Recurrence
Leukemia
Lymphatic Diseases
Aldesleukin
Lymphoma, Non-Hodgkin
Leukemia, B-Cell
Lymphoproliferative Disorders
Lymphoma
Follicular lymphoma

Additional relevant MeSH terms:
Anti-Inflammatory Agents
Anti-Infective Agents
Hemic and Lymphatic Diseases
Molecular Mechanisms of Pharmacological Action
Immunologic Factors
Antineoplastic Agents
Physiological Effects of Drugs
Hormones, Hormone Substitutes, and Hormone Antagonists
Hormones
Anti-Retroviral Agents
Therapeutic Uses
Alkylating Agents
Neoplasms by Histologic Type
Anti-HIV Agents
Immune System Diseases
Antineoplastic Agents, Hormonal
Mitosis Modulators
Antimitotic Agents
Antiviral Agents
Immunosuppressive Agents

ClinicalTrials.gov processed this record on May 08, 2008