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Biological Therapy Plus Monoclonal Antibody Therapy in Treating Patients With Relapsed or Refractory Non-Hodgkin's Lymphoma

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00040950
Recruitment Status : Completed
First Posted : January 27, 2003
Last Update Posted : December 19, 2013
National Cancer Institute (NCI)
Information provided by:
National Cancer Institute (NCI)

Brief Summary:

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. Biological therapies such as CpG 7909 use different ways to stimulate the immune system and stop cancer cells from growing. Combining CpG 7909 with rituximab may kill more cancer cells.

PURPOSE: Phase I trial to study the effectiveness of CpG 7909 plus rituximab in treating patients who have relapsed or refractory non-Hodgkin's lymphoma.

Condition or disease Intervention/treatment Phase
Lymphoma Biological: rituximab Drug: agatolimod sodium Phase 1

Detailed Description:


  • Determine the maximum tolerated dose of subcutaneous and IV CpG 7909 when administered with rituximab in patients with relapsed or refractory B-cell non-Hodgkin's lymphoma.
  • Determine the safety and tolerability of this regimen in these patients.
  • Determine the disease response in patients treated with this regimen.

OUTLINE: This is a multicenter, dose-escalation study of CpG 7909. Patients are sequentially assigned to 1 of 2 treatment groups.

  • Group A: Patients receive rituximab IV over 4-5 hours followed by CpG 7909 IV over 2 hours on day 1. Courses repeat weekly for 4 weeks.
  • Group B: Patients receive rituximab as above followed by CpG 7909 subcutaneously on day 1. Courses repeat weekly for 4 weeks.

Cohorts of 3-6 patients receive escalating doses of CpG 7909 until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which at least 2 of 3 or 2 of 6 patients experience dose-limiting toxicity.

Patients are followed at 4 weeks.

PROJECTED ACCRUAL: A total of 6-48 patients (3-24 per treatment group) will be accrued for this study.

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Study Type : Interventional  (Clinical Trial)
Primary Purpose: Treatment
Official Title: A Multi-Center, Phase I, Open Label, Two Arm, Non-Randomized, Dose-Escalation, Study Of The Safety And Tolerability Of CPG 7909 In Patients Receiving Rituxan For Relapsed Or Refractory B-Cell Non-Hodgkin's Lymphoma
Study Start Date : March 2002
Actual Study Completion Date : October 2007

Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No


  • Histologically confirmed CD20+ B-cell non-Hodgkin's lymphoma (NHL)

    • CD20 positive by immunohistochemistry or flow cytometry
  • Relapsed or refractory disease
  • Bidimensionally measurable disease

    • Sole site of measurable disease within a previously irradiated field allowed provided there was disease progression at that site
  • No pre-existing ascites or pleural effusions
  • No known CNS involvement by NHL



  • 18 and over

Performance status:

  • ECOG 0-2

Life expectancy:

  • More than 3 months


  • Neutrophil count at least 1,000/mm3
  • Platelet count at least 50,000/mm3


  • Bilirubin less than 2 mg/dL
  • Transaminase less than 2 times upper limit of normal
  • No hepatitis B or C


  • Creatinine less than 2 mg/dL


  • No significant cardiovascular disease
  • No New York Heart Association class III congestive heart failure
  • No myocardial infarction within the past 6 months
  • No unstable angina
  • No uncontrolled atrial or ventricular cardiac arrhythmias


  • No concurrent significant pulmonary disease


  • HIV negative
  • No acute infection requiring antibiotics
  • No fever over 38.2 degrees C within the past 3 days
  • No other malignancy within the past 5 years except basal cell or noninvasive squamous cell skin cancer or carcinoma in situ of the cervix
  • No pre-existing autoimmune disease or antibody-mediated disease, including:

    • Systemic lupus erythematosus
    • Rheumatoid arthritis
    • Multiple sclerosis
    • Sjogren's syndrome
    • Autoimmune thrombocytopenia
  • Controlled thyroid disease allowed
  • Concurrent autoantibodies without clinical autoimmune disease allowed
  • No history of allergic reactions attributed to compounds of similar composition to study drugs
  • No other medical history, including laboratory results, that would preclude study
  • No suspected or confirmed poor compliance or mental instability that would preclude study
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception


Biologic therapy:

  • No prior allogeneic transplantation
  • More than 30 days since prior hematopoietic growth factors (e.g., filgrastim (G-CSF) or epoetin alfa)
  • More than 30 days since prior immunotherapy
  • More than 90 days since prior monoclonal antibodies as monotherapy for patients who were unresponsive to treatment (30 days for patients who responded to treatment and subsequently relapsed)
  • No other concurrent biological agents
  • No concurrent hematopoietic growth factors (e.g., G-CSF or epoetin alfa)


  • More than 30 days since prior chemotherapy
  • No concurrent chemotherapy

Endocrine therapy:

  • More than 30 days since prior systemic corticosteroids
  • No concurrent systemic corticosteroids


  • See Disease Characteristics
  • More than 30 days since prior radiotherapy
  • No concurrent radiotherapy


  • Not specified


  • Recovered from prior therapy
  • At least 6 months since prior coronary angioplasty
  • More than 30 days since prior immunosuppressants
  • More than 30 days since prior participation in an investigational drug study
  • No concurrent immunosuppressants
  • No concurrent anticoagulants except aspirin at doses no greater than 325 mg/day
  • No other concurrent anticancer therapy
  • No other concurrent investigational agents

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT00040950

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United States, California
Jonsson Comprehensive Cancer Center, UCLA
Los Angeles, California, United States, 90095-1781
Sponsors and Collaborators
Jonsson Comprehensive Cancer Center
National Cancer Institute (NCI)
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Study Chair: Christos E. Emmanouilides, MD Jonsson Comprehensive Cancer Center
Publications of Results:
Layout table for additonal information Identifier: NCT00040950    
Other Study ID Numbers: CDR0000069423
First Posted: January 27, 2003    Key Record Dates
Last Update Posted: December 19, 2013
Last Verified: July 2003
Keywords provided by National Cancer Institute (NCI):
recurrent grade 1 follicular lymphoma
recurrent grade 2 follicular lymphoma
recurrent grade 3 follicular lymphoma
recurrent adult diffuse small cleaved cell lymphoma
recurrent adult diffuse mixed cell lymphoma
recurrent adult diffuse large cell lymphoma
recurrent adult immunoblastic large cell lymphoma
recurrent adult lymphoblastic lymphoma
recurrent adult Burkitt lymphoma
recurrent mantle cell lymphoma
recurrent marginal zone lymphoma
recurrent small lymphocytic lymphoma
extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue
nodal marginal zone B-cell lymphoma
splenic marginal zone lymphoma
Additional relevant MeSH terms:
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Lymphoma, Non-Hodgkin
Neoplasms by Histologic Type
Lymphoproliferative Disorders
Lymphatic Diseases
Immunoproliferative Disorders
Immune System Diseases
Antineoplastic Agents, Immunological
Antineoplastic Agents
Immunologic Factors
Physiological Effects of Drugs
Antirheumatic Agents