Rituxan Plus FavId (Idiotype Vaccine) for Low-grade Non-Hodgkin's Lymphoma

NCT ID: NCT00041730

Last Updated: 2009-09-30

Basic Information

• Recruitment Status: UNKNOWN
• Clinical Phase: PHASE2
• Total Enrollment: 90 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2002-07-31

Brief Summary

The purpose of this study is to evaluate the ability of patients treated with Rituxan® plus FavId™ and GM-CSF to mount an immune response (humoral and/or cellular) to KLH and their idiotype.

Detailed Description

The purpose of this study is to evaluate the ability of patients treated with Rituxan® plus FavId™ and GM-CSF to mount an immune response (humoral and/or cellular) to KLH and their idiotype. Secondary objectives are the determination of overall objective response rate, duration of response and time to progression. B-cell malignancies express a unique antigen, the immunoglobulin idiotype (Id), on their surface. Each B-cell harbors a unique genetic sequence used in production of unique Id protein. No normal B-cells possess that Id on their cell surface. Hence, Id protein should serve as an ideal target for individualized active immune therapy of NHL. Many of the antigens expressed by tumors (including Id) are only weak immunogens. To augment the immune response against Id, the Id protein must be chemically coupled to a strongly immunogenic protein. keyhole limpet hemocyanin (KLH) is a commonly used protein carrier capable of augmenting the body's immune reaction against Id protein. For vaccines which produce primarily an antibody response, there is a concern that combining immunotherapy with Rituxan®, which produces a rapid and sustained (up to 6 to 9 months post-treatment in 83% of patients) depletion of circulating and tissue-based B-cells, would blunt any antibody response. For vaccines that induce strong T-cell responses like Id-KLH plus GM-CSF, there is evidence in mice that depleting the host of B-cells could actually increase the T-cell response to the vaccine. GM-CSF is a hematopoietic growth factor that stimulates T-cell proliferation. T-cell response to both the patient's Idiotype and KLH will be measured during this trial.

Conditions

Non-Hodgkin's Lymphoma

Keywords

lymphoma; vaccine; idiotype; KLH; GM-CSF; FavId

Study Design

• Allocation Method: NON_RANDOMIZED
• Intervention Model: SINGLE_GROUP
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Interventions

Id-KLH

Intervention Type: BIOLOGICAL

Eligibility Criteria

Inclusion Criteria

• 18 years of age or older
• Patients that are treatment naive OR
• Relapsed or refractory following chemotherapy OR
• Relapsed following a prior response to Rituxan(R) Note: Rituxan (R) may have been given as second-line therapy following an initial response to chemotherapy or in combination with chemotherapy for initial therapy of their disease.
• Tumor accessible for biopsy or previously existing recent biopsy material
• Measurable disease after node biopsy
• Histologically confirmed grade 1 or 2 follicular B-cell lymphoma (WHO classification)
• Performance status (ECOG) of 0, 1 or 2
• Absolute Granulocyte count > 1,000/mm3
• Platelets > 100,000/mm3
• Total Bilirubin <2 mg/dL
• AST and ALT <2x Upper Limit of Normal
• Creatinine < 1.5 mg/dL

Exclusion Criteria

• Patients who are refractory to Rituxan(R) Note: Patients who did not attain a CR or PR are considered to be refractory
• More than 2 prior treatment regimens (e.g. CHOP plus Rituxan(R) is one treatment regimen; CHOP followed by Rituxan(R) at initial relapse equals two treatment regimens)
• Treatment w/Fludarabine within 9 months of study entry
• Patients with > 5,000 lymphocytes
• Prior tumor-specific idiotype immunotherapy using the identical idiotype (patients whose idiotype has changed are eligible for retreatment with new idiotype)
• Concurrent immunosuppressive therapy (high-dose steroids; ect.)
• Known history of CNS lymphoma or meningeal lymphomatosis
• HIV positive
• Serious non-malignant disease (e.g., psychiatric disorders, compromised pulmonary function (e.g. active asthma, COPD, pneumonitis, bronchiolitis obliterans), congestive heart failure, or active uncontrolled bacterial, viral or fungal infections), or other conditions which, in the opinion of the investigator would compromise protocol objectives
• Prior malignancy (excluding non-melanoma carcinomas of the skin and in situ cervical carcinomas) unless in remission for >2 years
• Treatment with an investigational drug within 8 weeks prior to study entry
• Pregnant or nursing women NOTE: Women of childbearing potential should be advised to avoid becoming pregnant while receiving study treatment.

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Favrille

INDUSTRY

Sponsor Role: lead

Locations

University of California, San Diego

La Jolla, California, United States

Tower Hematology Oncology Medical Group

Los Angeles, California, United States

Oncology Associates of San Diego

San Diego, California, United States

University California, San Francisco

San Francisco, California, United States

University of Florida, Jacksonville

Jacksonville, Florida, United States

H. Lee Moffitt Cancer Center

Tampa, Florida, United States

Northwestern University

Chicago, Illinois, United States

Ochsner Clinical Foundation

New Orleans, Louisiana, United States

Henry Ford Hospital

Detroit, Michigan, United States

New York Medical College - Our Lady of Mercy Medical Center, Comprehensive Cancer Center

The Bronx, New York, United States

Oncology/Hematology Care Clinical Cancer Institute

Cincinnati, Ohio, United States

University Hospitals of Cleveland Case Western, Ireland Cancer Center

Cleveland, Ohio, United States

The Ohio State University

Columbus, Ohio, United States

The Sarah Cannon Cancer Center

Nashville, Tennessee, United States

University of Virginia

Charlottesville, Virginia, United States

Countries

United States

Other Identifiers

FavId-04

Identifier Type: -

Identifier Source: org_study_id

NCT00060164

Identifier Type: -

Identifier Source: nct_alias