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Flavopiridol, Fludarabine, and Rituximab in Treating Patients With Lymphoproliferative Disorders or Mantle Cell Lymphoma
This study has been completed.
First Received: April 7, 2003   Last Updated: March 5, 2009   History of Changes
Sponsors and Collaborators: Arthur G. James Cancer Hospital & Richard J. Solove Research Institute
National Cancer Institute (NCI)
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00058227
  Purpose

RATIONALE: Monoclonal antibodies such as rituximab can locate cancer cells and either kill them or deliver cancer-killing substances to them without harming normal cells. Drugs used in chemotherapy such as flavopiridol and fludarabine use different ways to stop cancer cells from dividing so they stop growing or die. Combining monoclonal antibody therapy with chemotherapy may kill more cancer cells.

PURPOSE: This phase I trial is studying the side effects, best way to give, and the best dose of flavopiridol when given together with fludarabine and rituximab in treating patients with previously untreated or relapsed lymphoproliferative disorders or mantle cell lymphoma.


Condition Intervention Phase
Leukemia
Lymphoma
Biological: rituximab
Drug: alvocidib
Drug: fludarabine phosphate
Phase I

Study Type: Interventional
Study Design: Treatment
Official Title: A Phase I Study of Flavopiridol, Fludarabine and Rituximab in Indolent B-Cell Lymphoproliferative Disorders and Mantle Cell Lymphoma

Resource links provided by NLM:


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

Estimated Enrollment: 37
Study Start Date: April 2003
Primary Completion Date: February 2009 (Final data collection date for primary outcome measure)
Detailed Description:

OBJECTIVES:

Primary

  • Determine the maximum tolerated dose of flavopiridol in combination with standard-dose rituximab and fludarabine in patients with indolent B-cell lymphoproliferative disorders or mantle cell lymphoma.
  • Determine the toxicity of this regimen in these patients.
  • Determine the safety, toxicity, and efficacy of administering flavopiridol as a 30-minute bolus followed by a 4-hour infusion in patients treated with this regimen.

Secondary

  • Determine the pharmacokinetics and pharmacodynamics of this regimen in these patients.

OUTLINE: This is a dose-escalation study of flavopiridol.

Patients receive fludarabine IV over 15-30 minutes on days 1-5 and rituximab IV over 3-4 hours on day 1. Flavopiridol is administered IV over 60 minutes on day 1 in cohort 1; on days 1 and 2 in cohort 2; and on days 1, 2, and 3 in cohort 3. In cohorts 4 and 5, patients receive fludarabine and rituximab as above and flavopiridol IV over 30 minutes and then IV over 4 hours on day 1 of courses 2-6. Treatment repeats every 28 days for up to 6 courses in the absence of disease progression or unacceptable toxicity.

A total of 10-12 patients are treated with flavopiridol at the maximum tolerated dose.

PROJECTED ACCRUAL: A total of 37 patients will be accrued for this study.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

DISEASE CHARACTERISTICS:

  • Histologically confirmed mantle cell lymphoma OR indolent B-cell lymphoproliferative disorders of any of the following types:

    • Chronic lymphocytic leukemia
    • Small lymphocytic lymphoma
    • Follicular center cell non-Hodgkin's lymphoma (grade I or II)
    • Marginal zone lymphoma
    • Waldenstrom's macroglobulinemia
    • Hairy cell leukemia
  • Previously untreated or relapsed/refractory disease
  • No evidence of histological transformation to an intermediate-grade or aggressive lymphoma
  • CD20 positive by immunoperoxidase or flow cytometry
  • Evaluable disease with presence of 1 of the following criteria:

    • Absolute lymphocyte count greater than 5,000/mm^3
    • At least 1 measurable node greater than 2 cm by CT scan OR measurable disease in a lymphoid structure (spleen)
    • Bone marrow involvement (greater than 20% of marrow cellularity)

PATIENT CHARACTERISTICS:

Age

  • 18 and over

Performance status

  • ECOG 0-2

Life expectancy

  • Not specified

Hematopoietic

  • See Disease Characteristics
  • Absolute neutrophil count at least 1,500/mm^3*
  • Platelet count at least 100,000/mm^3*
  • Hemoglobin at least 9.0 g/dL* NOTE: *Unless due to hematologic malignancy

Hepatic

  • Bilirubin no greater than 2 times normal
  • AST no greater than 2 times normal

Renal

  • Creatinine no greater than 2.0 mg/dL OR
  • Creatinine clearance at least 50 mL/min
  • No renal dysfunction that would impair tolerance or compliance with study therapy

Cardiovascular

  • No cardiac dysfunction that would impair tolerance or compliance with study therapy

Pulmonary

  • No pulmonary dysfunction that would impair tolerance or compliance with study therapy

Other

  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception
  • No chronic gastrointestinal disease (e.g., Crohn's disease, ulcerative colitis, short gut syndrome) that would impair tolerability of compliance with therapy
  • No neurological or psychiatric dysfunction that would impair tolerability of or compliance with study therapy

PRIOR CONCURRENT THERAPY:

Biologic therapy

  • Not specified

Chemotherapy

  • At least 6 weeks since prior nitrosourea or mitomycin
  • No more than 6 prior courses of fludarabine

Endocrine therapy

  • No concurrent corticosteroids as antiemetics

Radiotherapy

  • Not specified

Surgery

  • Not specified

Other

  • At least 4 weeks since prior therapy for disease
  • No more than 3 prior treatments for disease (not including steroids alone)
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00058227

Locations
United States, Ohio
Arthur G. James Cancer Hospital and Solove Research Institute at Ohio State University
Columbus, Ohio, United States, 43210-1240
Sponsors and Collaborators
Arthur G. James Cancer Hospital & Richard J. Solove Research Institute
Investigators
Study Chair: Thomas S. Lin, MD, PhD Arthur G. James Cancer Hospital & Richard J. Solove Research Institute
  More Information

Additional Information:
No publications provided

Study ID Numbers: CDR0000287196, OSU-02H0281, OSU-0211, NCI-5745
Study First Received: April 7, 2003
Last Updated: March 5, 2009
ClinicalTrials.gov Identifier: NCT00058227     History of Changes
Health Authority: United States: Food and Drug Administration

Keywords provided by National Cancer Institute (NCI):
B-cell chronic lymphocytic leukemia
stage 0 chronic lymphocytic leukemia
stage I chronic lymphocytic leukemia
stage II chronic lymphocytic leukemia
stage III chronic lymphocytic leukemia
stage IV chronic lymphocytic leukemia
refractory chronic lymphocytic leukemia
untreated hairy cell leukemia
Waldenstrom macroglobulinemia
progressive hairy cell leukemia, initial treatment
refractory hairy cell leukemia
contiguous stage II mantle cell lymphoma
noncontiguous stage II mantle cell lymphoma
stage I mantle cell lymphoma
stage III mantle cell lymphoma
stage IV mantle cell lymphoma
recurrent mantle cell lymphoma
recurrent grade 1 follicular lymphoma
recurrent grade 2 follicular lymphoma
stage I grade 1 follicular lymphoma
stage I grade 2 follicular lymphoma
contiguous stage II grade 1 follicular lymphoma
contiguous stage II grade 2 follicular lymphoma
noncontiguous stage II grade 1 follicular lymphoma
noncontiguous stage II grade 2 follicular lymphoma
stage III grade 1 follicular lymphoma
stage III grade 2 follicular lymphoma
stage IV grade 1 follicular lymphoma
stage IV grade 2 follicular lymphoma
contiguous stage II small lymphocytic lymphoma

Study placed in the following topic categories:
Antimetabolites
Leukemia, Lymphoid
Immunologic Factors
Lymphoma, Mantle-Cell
Lymphoma, Follicular
Lymphoma, B-Cell, Marginal Zone
Mantle Cell Lymphoma
Protein Kinase Inhibitors
Follicular Lymphoma
Lymphoma, B-Cell
Leukemia
Leukemia, Lymphocytic, Chronic, B-Cell
Leukemia, B-cell, Chronic
Lymphoma
Immunoproliferative Disorders
Rituximab
Hairy Cell Leukemia
Fludarabine monophosphate
Immunosuppressive Agents
Recurrence
Lymphatic Diseases
Flavopiridol
Leukemia, Hairy Cell
Waldenstrom Macroglobulinemia
Chronic Lymphocytic Leukemia
B-cell Lymphomas
Fludarabine
Antirheumatic Agents
Lymphoproliferative Disorders
Lymphoma, Non-Hodgkin

Additional relevant MeSH terms:
Antimetabolites
Antimetabolites, Antineoplastic
Immunologic Factors
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents
Lymphoma, Mantle-Cell
Physiological Effects of Drugs
Protein Kinase Inhibitors
Leukemia
Therapeutic Uses
Growth Inhibitors
Lymphoma
Immunoproliferative Disorders
Neoplasms by Histologic Type
Immune System Diseases
Rituximab
Growth Substances
Enzyme Inhibitors
Fludarabine monophosphate
Immunosuppressive Agents
Pharmacologic Actions
Flavopiridol
Lymphatic Diseases
Neoplasms
Fludarabine
Antirheumatic Agents
Lymphoma, Non-Hodgkin
Lymphoproliferative Disorders

ClinicalTrials.gov processed this record on July 02, 2009