Combination Bortezomib and Rituximab in Patients With Waldenstrom's Macroglobulinemia - Full Text View

Purpose

In this study, we are trying to find out if the combination of these two drugs is effective in treating Waldenstrom's macroglobulinemia (WM). The combination of these two drugs has not been studied for patients with relapsed or refractory macroglobulinemia. The U.S. Food and Drug Administration (FDA) has approved bortezomib for the treatment of multiple myeloma, a cancer that is closely related to Waldenstrom's macroglobulinemia.

Condition	Intervention	Phase
Waldenstrom's Macroglobulinemia	Drug: Bortezomib Drug: Rituximab	Phase 2


Study Type:	Interventional
Study Design:	Endpoint Classification: Efficacy Study Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Treatment
Official Title:	Phase II Study of Combination Bortezomib (Velcade PS-341) and Rituximab in Patients With Previously Untreated and Relapsed/Refractory Waldenstrom's Macroglobulinemia

Resource links provided by NLM:

Drug Information available for: Rituximab Bortezomib

Genetic and Rare Diseases Information Center resources: Waldenstrom Macroglobulinemia

U.S. FDA Resources

Further study details as provided by Dana-Farber Cancer Institute:

Primary Outcome Measures:

Assess the response rate of bortezomib and rituximab (VR) in patients with relapsed or refractory WM. [ Time Frame: 2 Years ] [ Designated as safety issue: No ]

Secondary Outcome Measures:

Evaluate the toxicity of VR in patients with WM [ Time Frame: 2 Years ] [ Designated as safety issue: Yes ]
evaluate the time to progression in patients with WM [ Time Frame: Years ] [ Designated as safety issue: No ]
Study the effect of bortezomib and rituximab on tumor cells in this patient population. [ Time Frame: 2 Years ] [ Designated as safety issue: No ]


Estimated Enrollment:	45
Study Start Date:	September 2006
Estimated Study Completion Date:	April 2016
Estimated Primary Completion Date:	April 2015 (Final data collection date for primary outcome measure)

Arms	Assigned Interventions
Experimental: bortezomib and rituximab bortezomib and rituximab	Drug: Bortezomib Once weekly for 3 weeks Drug: Rituximab Intravenously once a week for the first and fourth weeks of a cycle

Detailed Description:

Participants will receive 6 cycles of the study treatment with bortezomib and rituximab. Each cycle is 28 days long (4 weeks).
Participants will receive Rituximab intravenously once a week for the first and fourth cycles only. Participants will receive bortezomib once a week for three weeks on and one week off every cycle, for a total of 6 cycles.
During the rituximab infusion, the participants blood pressure and pulse will be monitored frequently. The rate of infusion may be decreased depending upon the side effects that are experienced.
Blood samples will be collected before the first dose and on follow up with every cycle. Blood counts will also be performed every week.
Routine physical exams will be performed at each evaluation. A PET/CAT scan of the chest, abdomen and pelvis at the end of treatment. This scan is required to assess the response of the participants disease.
In order to learn more on how bortezomib and rituximab affect WM, a bone marrow biopsy will be performed.
We anticipate that participants will complete the active therapy over a period of 6 cycles provided that they are benefiting from therapy and have not had any serious side effects. The participant will be followed every three months for 2 years for office visits and laboratory tests.

Eligibility


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

Criteria

Inclusion Criteria:

18 years of age or older
Patients with previously untreated WM and those who have received prior therapy are eligible
Must have received prior therapy for their WM and have relapsed or refractory WM.
CD20 positive disease based on any previous bone marrow immuno-histochemistry or flow cytometric analysis performed up to 3 months prior to enrollment.
Measurable disease
ECOG Performance Status 0,1, or 2
Total bilirubin < 2.0 mg/dl
AST < 3 x ULN
Life expectancy of greater than 12 weeks

Exclusion Criteria:

Uncontrolled infection
Other active malignancies
Cytotoxic chemotherapy less than 3 weeks, or biologic therapy less than 2 weeks, or corticosteroids less than 2 weeks, prior to registration.
Other concurrent chemotherapy, immunotherapy, radiotherapy, or any ancillary therapy considered investigational
Known to be HIV positive or HEP B positive
Radiation therapy less than 2 weeks prior to registration
Grade 2 or greater peripheral neuropathy
Myocardial infarction within 6 months rior to enrollment or has NYHA Class III or IV heart failure, uncontrolled angina, severe uncontrolled ventricular arrhythmias, or electrocardiographic evidence of acute ischemia or active conduction system abnormalities.
Hypersensitivity to bortezomib, boron, or mannitol
Pregnant or breast feeding women
Other investigational drugs within 14 days of enrollment
Serious medical or psychiatric illness likely to interfere with participation

Contacts and Locations

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, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00422799

Locations


United States, Massachusetts
Dana-Farber Cancer Institute
Boston, Massachusetts, United States, 02115

Sponsors and Collaborators

Dana-Farber Cancer Institute

Millennium Pharmaceuticals, Inc.

Investigators


Principal Investigator:	Irene Ghobrial, MD	Dana-Farber Cancer Institute

More Information

Publications:

Ghobrial IM, Hong F, Padmanabhan S, Badros A, Rourke M, Leduc R, Chuma S, Kunsman J, Warren D, Harris B, Sam A, Anderson KC, Richardson PG, Treon SP, Weller E, Matous J. Phase II trial of weekly bortezomib in combination with rituximab in relapsed or relapsed and refractory Waldenstrom macroglobulinemia. J Clin Oncol. 2010 Mar 10;28(8):1422-8. doi: 10.1200/JCO.2009.25.3237. Epub 2010 Feb 8.


Responsible Party:	Irene Ghobrial, MD, Principal Investigator, Dana-Farber Cancer Institute
ClinicalTrials.gov Identifier:	NCT00422799 History of Changes
Other Study ID Numbers:	06-008
Study First Received:	January 12, 2007
Last Updated:	December 1, 2014
Health Authority:	United States: Institutional Review Board

Keywords provided by Dana-Farber Cancer Institute:


relapsed Waldenstrom's macroglobulinemia refractory Waldenstrom's macroglobulinemia Velcade WM

Additional relevant MeSH terms:


Waldenstrom Macroglobulinemia Blood Protein Disorders Cardiovascular Diseases Hematologic Diseases Hemorrhagic Disorders Hemostatic Disorders Immune System Diseases Immunoproliferative Disorders Lymphatic Diseases Lymphoproliferative Disorders Neoplasms Neoplasms by Histologic Type	Neoplasms, Plasma Cell Paraproteinemias Vascular Diseases Bortezomib Rituximab Antineoplastic Agents Antirheumatic Agents Immunologic Factors Pharmacologic Actions Physiological Effects of Drugs Therapeutic Uses

ClinicalTrials.gov processed this record on February 27, 2015