Pegfilgrastim and Rituximab in Treating Patients With Untreated, Relapsed, or Refractory Follicular Lymphoma, Small Lymphocytic Lymphoma, or Marginal Zone Lymphoma

NCT ID: NCT01682044

Last Updated: 2017-10-09

Study Results

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE2

Total Enrollment

20 participants

Study Classification

INTERVENTIONAL

Study Start Date

2007-04-17

Study Completion Date

2016-12-22

Brief Summary

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This phase II trial studies the side effects and how well giving pegfilgrastim together with rituximab works in treating patients with untreated, relapsed, or refractory follicular lymphoma, small lymphocytic lymphoma (SLL), or marginal zone lymphoma (MZL). Colony-stimulating factors, such as pegfilgrastim, may increase the number of immune cells found in bone marrow or peripheral blood and may help the immune system recover from the side effects of therapy. Monoclonal antibodies, such as rituximab, can block cancer growth in different ways. Some block the ability of cancer to grow and spread. Others find cancer cells and help kill them or tumor cancer-killing substances to them. Giving pegfilgrastim together with rituximab may kill more cancer cells

Detailed Description

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PRIMARY OBJECTIVES:

I. To evaluate the safety of Pegfilgrastim in combination with rituximab in patients with untreated or relapsed/refractory follicular, SLL or MZL.

SECONDARY OBJECTIVES:

I. To evaluate the efficacy (including overall response rate and durability of objective responses) of Pegfilgrastim in combination with rituximab in patients with untreated or relapsed/refractory follicular, SLL or MZL.

II. To evaluate functional and phenotypic characteristics of host neutrophils undergoing treatment with Pegfilgrastim and rituximab.

III. To evaluate changes in cluster of differentiation (CD)20 antigen expression and density of expression in patients receiving Pegfilgrastim and rituximab.

IV. To evaluate changes in serum levels of tumor necrosis factor (TNF), interferon alpha (INFalpha) and free radical levels in patients undergoing treatment with Pegfilgrastim and rituximab.

OUTLINE:

Patients receive pegfilgrastim subcutaneously (SC) followed by rituximab intravenously (IV) 3 days later in weeks 1, 3, 5, 7, 15, 23, 31, and 39. Treatment continues in the absence of disease progression or unacceptable toxicity.

After completion of study treatment, patients are followed up every 4 months for 1 year, every 6 months for 2 years, and then yearly for 1 year.

Conditions

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Contiguous Stage II Grade 1 Follicular Lymphoma Contiguous Stage II Grade 2 Follicular Lymphoma Contiguous Stage II Grade 3 Follicular Lymphoma Contiguous Stage II Marginal Zone Lymphoma Contiguous Stage II Small Lymphocytic Lymphoma Extranodal Marginal Zone B-cell Lymphoma of Mucosa-associated Lymphoid Tissue Nodal Marginal Zone B-cell Lymphoma Noncontiguous Stage II Grade 1 Follicular Lymphoma Noncontiguous Stage II Grade 2 Follicular Lymphoma Noncontiguous Stage II Grade 3 Follicular Lymphoma Noncontiguous Stage II Marginal Zone Lymphoma Noncontiguous Stage II Small Lymphocytic Lymphoma Recurrent Grade 1 Follicular Lymphoma Recurrent Grade 2 Follicular Lymphoma Recurrent Grade 3 Follicular Lymphoma Recurrent Marginal Zone Lymphoma Recurrent Small Lymphocytic Lymphoma Splenic Marginal Zone Lymphoma Stage I Grade 1 Follicular Lymphoma Stage I Grade 2 Follicular Lymphoma Stage I Grade 3 Follicular Lymphoma Stage I Marginal Zone Lymphoma Stage I Small Lymphocytic Lymphoma Stage III Grade 1 Follicular Lymphoma Stage III Grade 2 Follicular Lymphoma Stage III Grade 3 Follicular Lymphoma Stage III Marginal Zone Lymphoma Stage III Small Lymphocytic Lymphoma Stage IV Grade 1 Follicular Lymphoma Stage IV Grade 2 Follicular Lymphoma Stage IV Grade 3 Follicular Lymphoma Stage IV Marginal Zone Lymphoma Stage IV Small Lymphocytic Lymphoma

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Treatment (colony-stimulating factor and monoclonal antibody)

Patients receive pegfilgrastim SC followed by rituximab IV 3 days later in weeks 1, 3, 5, 7, 15, 23, 31, and 39. Treatment continues in the absence of disease progression or unacceptable toxicity.

Group Type EXPERIMENTAL

pegfilgrastim

Intervention Type BIOLOGICAL

Given SC

rituximab

Intervention Type BIOLOGICAL

Given IV

flow cytometry

Intervention Type OTHER

Correlative studies

biopsy

Intervention Type PROCEDURE

Correlative studies

immunohistochemistry staining method

Intervention Type OTHER

Correlative studies

western blotting

Intervention Type GENETIC

Correlative studies

Interventions

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pegfilgrastim

Given SC

Intervention Type BIOLOGICAL

rituximab

Given IV

Intervention Type BIOLOGICAL

flow cytometry

Correlative studies

Intervention Type OTHER

biopsy

Correlative studies

Intervention Type PROCEDURE

immunohistochemistry staining method

Correlative studies

Intervention Type OTHER

western blotting

Correlative studies

Intervention Type GENETIC

Other Intervention Names

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Filgrastim SD-01 GCSF-SD01 Neulasta SD-01 sustained duration G-CSF IDEC-C2B8 IDEC-C2B8 monoclonal antibody Mabthera MOAB IDEC-C2B8 Rituxan biopsies immunohistochemistry Blotting, Western Western Blot

Eligibility Criteria

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Inclusion Criteria

* Untreated or relapsed/refractory follicular, SLL or MZL (i.e. no limit to number of prior treatments as long as patients meet other study criteria)
* Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1
* Measurable tumor size (at least one node measuring 4 cm\^2 in bidimensional measurement)
* Expected survival of \> 6 months
* Prior rituximab or other monoclonal immunotherapy permitted and eligible for rituximab monotherapy
* Full recovery from any significant toxicity associated with prior surgery, radiation therapy, chemotherapy, or immunotherapy
* Absolute neutrophil count \> 1.0 x 10\^9/L
* Platelets \> 50 x 10\^9/L
* Patients may receive erythropoietin growth factors to maintain adequate hemoglobin levels (\>= 8.0 mg/dl)
* Creatinine \< 1.5 x upper normal levels (UNL)
* Total bilirubin \< 1.5 mg/dL (\> 25.65 umol/L)
* Aspartate aminotransferase \< 5 x UNL
* Alkaline phosphatase \< 5 x UNL
* Informed consent approved in institutional review board (lRB)
* CD20+ B-cell lymphoma

Exclusion Criteria

* Prior history of human immunodeficiency virus (HIV)-positivity (routine HIV testing is required pretreatment)
* Serious non-malignant disease (e.g. active uncontrolled bacterial, viral, or fungal infections) or other conditions which, in the opinion of the principal investigator would compromise other protocol objectives
* Presence of central nervous system (CNS) lymphoma
* Chemotherapy within 4 weeks of the first scheduled study treatment
* Another primary malignancy (other than squamous or basal cell carcinoma of the skin or in-situ carcinoma of the cervix) for which the patient has not been disease-free for at least five years
* Major surgery, other than diagnostic surgery, within four weeks
* Patients with non-Hodgkin lymphoma (NHL) other than relapsed/refractory follicular, MZL or SLL
* Patients must not have a history of cardiac disease, defined as New York Heart Association Class II or greater or clinical evidence of congestive heart failure
* Concurrent use of other investigational agents
* Pregnant or breast feeding
* Subjects of reproductive potential who are not using adequate contraceptive precautions, in the judgment of the investigator
* Known hypersensitivity to any recombinant E coli-derived product, murine proteins, or any components of the study medications
* Concerns for the subject's compliance with the protocol
* Any premalignant myeloid condition or any malignancy with myeloid characteristics (e.g. myelodysplastic syndromes, acute or chronic myelogenous leukemia)
* Patient is currently enrolled in, or has not yet completed at least 30 days since ending another investigational device or drug trial
Minimum Eligible Age

19 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Cancer Institute (NCI)

NIH

Sponsor Role collaborator

Roswell Park Cancer Institute

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Francisco Hernandez-ILizaliturri

Role: PRINCIPAL_INVESTIGATOR

Roswell Park Cancer Institute

Locations

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Roswell Park Cancer Institute

Buffalo, New York, United States

Site Status

Countries

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United States

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Other Identifiers

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NCI-2011-00134

Identifier Type: REGISTRY

Identifier Source: secondary_id

I 83106

Identifier Type: -

Identifier Source: org_study_id

NCT00524628

Identifier Type: -

Identifier Source: nct_alias