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Siplizumab in Treating Patients With Lymphoproliferative Disorder
This study is ongoing, but not recruiting participants.
First Received: January 9, 2004   Last Updated: November 25, 2009   History of Changes
Sponsor: National Cancer Institute (NCI)
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00075361
  Purpose

RATIONALE: Monoclonal antibodies such as siplizumab can locate cancer cells and either kill them or deliver cancer-killing substances to them without harming normal cells.

PURPOSE: This phase I trial is studying the side effects, best way to give, and best dose of siplizumab in treating patients with lymphoproliferative disorders.


Condition Intervention Phase
Leukemia
Lymphoma
Biological: siplizumab
Phase I

Study Type: Interventional
Study Design: Treatment, Open Label
Official Title: Phase I Trial Of Medi-507 In CD2-Positive Lymphoproliferative Disease

Resource links provided by NLM:


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

Primary Outcome Measures:
  • Safety and maximum tolerated dose at study completion then every 3 months for 1 year [ Designated as safety issue: Yes ]

Estimated Enrollment: 88
Study Start Date: November 2003
Detailed Description:

OBJECTIVES:

Primary

  • Determine the maximum tolerated dose of siplizumab (MEDI-507) in patients with CD2-positive lymphoproliferative disorders.
  • Determine the safety and tolerability of this drug in these patients.

Secondary

  • Determine the time to MEDI-507 saturation of CD2-binding sites in peripheral blood and tumor aspirates of these patients.
  • Determine the serum pharmacokinetics of this drug in these patients.
  • Determine the time to T-cell and natural killer cell depletion and recovery in patients after treatment with this drug.
  • Determine the antitumor activity of this drug, in terms of response rate, time to progression, and overall survival, in these patients.

OUTLINE: This is an open-label, dose-escalation study.

Patients receive siplizumab (MEDI-507) IV over 4 hours on days 1 and 2 every 2 weeks for 16 weeks OR on days 1-3 every 2 weeks for 16 weeks OR on days 1 and 14, then weekly for 16 weeks in the absence of disease progression or unacceptable toxicity. Patients with a positive treatment response (e.g., stable disease, minor response, partial response, or complete response) after 16 weeks of treatment may continue to receive MEDI-507 as above in the absence of disease progression or unaccebtable toxicity.

Cohorts of 3-6 patients receive escalating doses of MEDI-507 until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity.

After completion of treatment, patients are followed at 30 days and then every 3 months for 1 year.

PROJECTED ACCRUAL: A total of 88 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 lymphoproliferative disorder, including the following types:

    • Adult T-cell leukemia

      • No smoldering leukemia
    • Cutaneous T-cell lymphoma

      • All stages, excluding stage Ia
      • Patients with stage Ib, II, or III disease must have failed at least 1 prior standard therapy regimen
    • Peripheral T-cell lymphoma

      • Stage I-IV
      • Disease progression after standard chemotherapy
    • Large granular lymphocyte leukemia meeting the following criteria:

      • Must have 1 of the following:

        • Myelosuppression based on at least 1 of the following laboratory values:

          • Granulocyte count no greater than 1,500/mm^3
          • Platelet count no greater than 75,000/mm^3
          • Hemoglobin no greater than 10 g/dL
        • Requirement for hematopoietic support (e.g., transfusion or colony-stimulating factors, including filgrastim [G-CSF], interleukin-11, or epoetin alfa) to maintain blood levels or control systemic symptoms (e.g., fever, night sweats, or weight loss)
      • Disease unresponsive to 1 prior therapy regimen
      • Monoclonal and polyclonal forms of disease allowed
  • CD2-positive by immunohistochemistry

    • At least 30% of tumor cells must express CD2
  • Measurable or evaluable disease
  • No history of CNS disease

PATIENT CHARACTERISTICS:

Age

  • 18 and over

Performance status

  • Karnofsky 70-100%

Life expectancy

  • More than 2 months

Hematopoietic

  • See Disease Characteristics
  • Granulocyte count at least 1,000/mm^3*
  • Platelet count at least 50,000/mm^3* NOTE: *Requirement waived for patients with large granular lymphocyte leukemia

Hepatic

  • SGOT and SGPT ≤ 2.0 times upper limit of normal (ULN) (5 times ULN for patients with Gilbert's syndrome)
  • Bilirubin ≤ 2.0 mg/dL (3.5 times ULN for patients with Gilbert's syndrome)
  • Hepatitis B surface antigen negative
  • No positive antibodies to hepatitis C virus

Renal

  • Creatinine ≤ 1.5 mg/dL OR
  • Creatinine clearance > 60 mL/ min by 24-hour urine collection

Cardiovascular

  • No myocardial infarction within the past 6 months
  • No uncontrolled hypertension within the past 6 months
  • No stroke or transient ischemic attack within the past 6 months

Pulmonary

  • Oxygen saturation level at least 90% by pulse oximetry
  • No respiratory insufficiency requiring oxygen therapy

Other

  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception
  • HIV negative
  • Symptomatic cytomegalovirus (CMV) negative or CMV PCR ≤ 1000 copies
  • No history of significant adverse events related to previously administered monoclonal antibody
  • No active infection requiring systemic anti-infective therapy
  • No physical or general medical illness that would increase risk to the patient
  • No psychological or behavioral condition that would increase risk to the patient or preclude study participation

PRIOR CONCURRENT THERAPY:

Biologic therapy

  • At least 30 days since prior monoclonal antibody therapy
  • No prior siplizumab (MEDI-507)
  • No other concurrent monoclonal antibody therapies
  • No other concurrent biologic response modifier therapy
  • No concurrent gamma globulin
  • Concurrent G-CSF, epoetin alfa, and interleukin-11 allowed for large granular lymphocyte leukemia

Chemotherapy

  • See Disease Characteristics
  • At least 3 weeks since prior cytotoxic chemotherapy and recovered
  • No concurrent FDA-approved or investigational cancer chemotherapeutic agents

Endocrine therapy

  • At least 3 weeks since prior prolonged cytolytic steroid therapy and recovered
  • No concurrent steroids

Radiotherapy

  • Not specified

Surgery

  • At least 3 weeks since prior surgery and recovered

Other

  • At least 30 days since other prior investigational anticancer drugs
  • No other concurrent investigational anticancer drugs
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00075361

Locations
United States, Maryland
Warren Grant Magnuson Clinical Center - NCI Clinical Trials Referral Office
Bethesda, Maryland, United States, 20892-1182
Sponsors and Collaborators
Investigators
Principal Investigator: John E. Janik, MD NCI - Metabolism Branch;MET
  More Information

Additional Information:
Publications:
Study ID Numbers: CDR0000344422, NCI-04-C-0031, MEDIMMUNE-MI-CP094
Study First Received: January 9, 2004
Last Updated: November 25, 2009
ClinicalTrials.gov Identifier: NCT00075361     History of Changes
Health Authority: United States: Food and Drug Administration

Keywords provided by National Cancer Institute (NCI):
recurrent cutaneous T-cell non-Hodgkin lymphoma
stage I cutaneous T-cell non-Hodgkin lymphoma
stage II cutaneous T-cell non-Hodgkin lymphoma
stage III cutaneous T-cell non-Hodgkin lymphoma
recurrent mycosis fungoides/Sezary syndrome
stage I mycosis fungoides/Sezary syndrome
stage II mycosis fungoides/Sezary syndrome
stage III mycosis fungoides/Sezary syndrome
recurrent adult T-cell leukemia/lymphoma
stage I adult T-cell leukemia/lymphoma
stage II adult T-cell leukemia/lymphoma
stage III adult T-cell leukemia/lymphoma
stage IV adult T-cell leukemia/lymphoma
T-cell large granular lymphocyte leukemia
stage IV cutaneous T-cell non-Hodgkin lymphoma
stage IV mycosis fungoides/Sezary syndrome
anaplastic large cell lymphoma
angioimmunoblastic T-cell lymphoma

Additional relevant MeSH terms:
Lymphatic Diseases
Leukemia
Neoplasms
Immunoproliferative Disorders
Neoplasms by Histologic Type
Immune System Diseases
Lymphoproliferative Disorders
Lymphoma

ClinicalTrials.gov processed this record on November 27, 2009