Clofarabine for Relapsed or Refractory T-Cell or B-Cell Non-Hodgkin Lymphoma (NHL)

NCT ID: NCT00156013

Last Updated: 2017-11-29

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: PHASE1/PHASE2
• Total Enrollment: 33 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2005-09-30
• Study Completion Date: 2010-04-30

Brief Summary

This research is being done to develop new treatment for non-hodgkin's lymphoma in subjects whose cancer has returned or resisted treatment with chemotherapy. The investigational drug clofarabine is being used in this study. An investigational drug is one that has not been approved by the United States Food and Drug Administration (FDA).

Detailed Description

The safety profile of clofarabine appears acceptable within the target populations studied to date in the clinical studies, with numerous responses observed in heavily pre-treated patients with relapsed/refractory ALL or AML. Dose escalation of clofarabine in patients with solid tumors and lymphoproliferative disorders has been limited because grade 3 and 4 myelosuppression was considered acceptable in patients with acute leukemia, provided that hematologic recovery occurred within 6 weeks of therapy , and dose escalation has proceeded as high as 40 mg/m2 in this patient population. Furthermore, no responses were observed in a recent trial in which patients with relapsed CLL were treated with clofarabine 2 mg/m2, an indolent B-cell lymphoproliferative disorder indicating that low doses are likely to be ineffective in patients with aggressive NHL. (Personal Communication with ILEX Products, INC.)

This Phase I/II study will evaluate escalating doses of clofarabine in patients with relapsed and refractory diffuse large cell B-cell NHL starting at a dose of 4 mg/m2/day for 5 consecutive days and repeated every 28 days for a maximum of 6 cycles. This dosing regimen should be evaluated in this patient population because there is no standard therapy at relapse and grade 3 and 4 myelosuppression is frequently observed with traditional NHL salvage. Additionally, patients will receive granulocyte colony stimulating factors at the discretion of the investigator. Antifungal and antibacterial prophylaxis will be administered to minimize the risk of infection.

Conditions

Lymphoma, B-Cell; Lymphoma, Non-Hodgkin

Keywords

B-Cell NHL

Study Design

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

Study Groups

1

Clofarabine 4 mg/m\^2 days 1-5 of every cycle for a maximum of 6 cycles.

Group Type: EXPERIMENTAL

CLOFARABINE

Intervention Type: DRUG

4 mg/m\^2 days 1-5 of every cycle for a maximum of 6 cycles

Interventions

CLOFARABINE

4 mg/m\^2 days 1-5 of every cycle for a maximum of 6 cycles

Intervention Type: DRUG

Other Intervention Names

Clolar®

Eligibility Criteria

Inclusion Criteria

• Adult patients who are at least 18 years old with histology confirmed diffuse large cell B-cell NHL who have failed prior systemic chemotherapy with or without monoclonal antibody-based therapies.
• Measurable disease determined by Ct or PET scans or bone marrow involvement, defined as lesions that can be accurately measured in two dimensions by CT or PET scan with the longest diameter accurately as greater than or equal to 1.0 cm or palpable lesions with both diameters greater than or equal to 2.0 cm. PET scan measurable disease is defined based on SUV value as determined by nuclear medicine evaluation.
• Eastern Cooperative Oncology Group (ECOG) performance status of 0,1,or 2.
• Life expectancy greater than 12 weeks.
• Laboratory values obtained less than or equal to 14 days prior to registration:

• Absolute neutrophil count (ANC) greater than or equal to 1500.
• White blood cell (WBC) count greater than 3.0.
• Platelets greater than or equal to 100.
• Hemoglobin (HG) greater than 9.0 g/dL.
• Total bilirubin less than or equal to 2.0 mg/dL.
• Aspartate transaminase (AST)/alanine transaminase (ALT) less than or equal to 3 times the upper limit of normal (ULN). Higher values are acceptable if it is deemed that they are related to liver involvement with NHL.
• Serum creatinine less than or equal to 2.0 mg/dL.
• Cardiac function on pretreatment MUGA scan or echocardiogram that is considered normal by institutional standards.
• Capable of understanding the investigational nature, potential risks and benefits of the study, and able to provide valid informed consent.
• Female patients of childbearing potential must have a negative serum pregnancy test within 2 weeks prior to enrollment.
• Male and female patients must use an effective contraceptive method during the study and for a minium of 6 months after study treatment.

Exclusion Criteria

• Previously untreated NHL.
• Received previous treatment with clofarabine.
• History of T-cell lymphoma.
• Bulky disease (ie, any single mass greater than 10 cm or circulating malignant cells greater than or equal to 24,000 cells/ul.
• Patients with known AIDS-related or HIV-positive lymphoma.
• Autologous bone marrow or stem cell transplant within 3 months of study entry.
• History of allogeneic bone marrow transplant or organ transplant.
• Prior radiotherapy to the only site of measurable disease.
• Any medical condition that requires chronic use of oral high-dose corticosteroids. ( in excess of 1 mg/kg/day).
• Autoimmune thrombocytopenia.
• Use if investigational agents within 30 days or any anticancer therapy within 3 weeks before study entry. The patient must have recovered from all acute toxicities from any previous therapy.
• Patients with an active, uncontrolled systemic infection considered to be opportunistic, life threatening, or clinically significant at the time of treatment or with a known or suspected fungal infection (ie, patients of parenteral antifungal therapy).
• HIV-positive status.
• Active secondary malignancy.
• Pregnant or lactating patients.
• Any significant concurrent disease, illness , or psychiatric disorder that would compromise patient safety or compliance, interfere with consent, study participation, follow-up, or interpretation of study results.
• Patients with active or untreated central nervous lymphoma (CNS) lymphoma.

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

Sponsors

Genzyme, a Sanofi Company

INDUSTRY

Sponsor Role: collaborator

Oncology Specialists, S.C.

OTHER

Sponsor Role: lead

Responsible Party

Dr. Sigrun Hallmeyer

Principal Investigator

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Chadi Nabhan, MD

Role: PRINCIPAL_INVESTIGATOR

Oncology Specialists,SC

Locations

Oncology Specialists, SC

Park Ridge, Illinois, United States

Countries

United States

References

Nabhan C, Davis N, Bitran JD, Galvez A, Fried W, Tolzien K, Foss S, Dewey WM, Venugopal P. Efficacy and safety of clofarabine in relapsed and/or refractory non-Hodgkin lymphoma, including rituximab-refractory patients. Cancer. 2011 Apr 1;117(7):1490-7. doi: 10.1002/cncr.25603. Epub 2010 Nov 8.

Reference Type: DERIVED

PMID: 21425150 (View on PubMed)

Other Identifiers

1066306 (0408)

Identifier Type: -

Identifier Source: org_study_id

NCT00305721

Identifier Type: -

Identifier Source: nct_alias