Phase 2 Study of Atorvastatin Safety and Antitumor Effects in Non-Hodgkin's Lymphoma

Leukemia Clinical Trial

Official title:

A Phase II Study of Atorvastatin in Patients With Low Grade or Refractory Non-Hodgkin's Lymphoma

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT00185731
• Other study ID #: IRB-13683
• Secondary ID: 4328-0795140LYMN
• Status: Completed
• Phase: Phase 2
• First received: September 12, 2005
• Last updated: October 25, 2017
• Start date: April 2005
• Est. completion date: November 2012

Study information

• Verified date: October 2017
• Source: Stanford University
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

This is an approach which can inflict significant toxicity. An alternative is to block expression of oncogenes which are over-expressed only in cancer cells, a therapeutic approach which could reduce toxicity to the host while maximizing destruction of the oncogene-dependent malignant cells.

Description:

Atorvastatin has been shown to decrease levels of active oncogenes in preclinical studies with murine and human lymphoma cell lines, and administration of statins leads to shrinkage of lymphoma in murine models. Therefore, it may be possible for atorvastatin to decrease levels of active oncogenes in human lymphomas. Further, upon decrease in levels of active oncogenes, human lymphomas may regress. Atorvastatin is a commonly prescribed drug for hypercholesterolemia: targeting the 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase enzyme may also be a way to decrease activation of oncogenes in human lymphoma, with minimal toxicity. For human low grade non-Hodgkin lymphoma, no curative treatment is available; therefore new, non-toxic and targeted therapies are sought for this disease.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 25
• Est. completion date: November 2012
• Est. primary completion date: November 2012
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• > 18 years old

• Disease criteria: Confirmed by Stanford Pathology to be one of the following Non-Hodgkin's Lymphoma (NHL) subtypes:

• Chronic lymphocytic leukemia /small lymphocytic lymphoma (CLL/SLL)

• Extranodal marginal zone B-cell lymphoma

• Nodal marginal zone B-cell lymphoma

• Splenic marginal zone B-cell lymphoma

• Treatment criteria

• Untreated: watchful waiting currently appropriate (includes CLL stage 0) o OR

• Prior treatment: watchful waiting currently appropriate o OR

• Refractory disease

• Staging within 4 weeks prior to enrollment (SLL, marginal zone lymphoma)

• CT chest (date)

• CT abdomen (date)

• CT pelvis (date) OR

• Staging within 4 weeks prior to enrollment (CLL: CT not required)

• Total white blood cell count (WBC) (Value) (date)

• Absolute lymphoma cell count (ALC) (Value) (date)

• Measurable disease (Site) (Size) OR

• CLL (only): elevated absolute lymphoma cell count

• Disease amenable to biopsy (must check at least one):

• Circulating tumor cells

• Positive bone marrow

• Palpable involved site (such as lymph node) measuring > 1.5 cm

• Eastern Cooperative Oncology Group performance status <2 (Karnofsky >60)

• Life expectancy of greater than 3 months

• Patients must have adequate organ and marrow function

• Absolute neutrophil count > 1,000/uL

• Platelets > 30,000/uL

• Total bilirubin within normal institutional limits

• Aspartate aminotransferase (AST) / alanine aminotransferase (ALT) ratio < 2.5 x institutional upper limit of normal

• Creatinine within normal institutional limits OR creatinine clearance > 60 mL/min/1.73 m² for patients with creatinine levels above institutional normal.

• Women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry and for the duration of study participation. Women of child-bearing potential must have negative BetaHCG at enrollment

Exclusion Criteria:

• Chemotherapy or radiotherapy within 4 weeks (6 weeks for nitrosoureas or mitomycin C) prior to entering the study

• Not recovered from adverse events due to agents administered more than four weeks earlier

• Has stable low grade lymphoma has had rituximab within 3 months Patient with relapsed or refractory disease has had rituximab within 1 month

• Not recovered from adverse events due to surgery performed 4 weeks earlier

• Receiving any other investigational agent. Known brain metastases

• Taken any statin within the past 6 months prior to enrollment in the trial

• Currently abuses alcohol

• Currently takes cyclosporin or gemfibrozil Patient has a prior history of rhabdomyolysis

• Has uncontrolled intercurrent illness including, but not limited to ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements.

• Pregnant: Patients are not excluded if they are breastfeeding at the time of enrollment, but breastfeeding should be discontinued if the mother is treated with atorvastatin.

• HIV-positive patients receiving combination anti-retroviral therapy

Related Conditions & MeSH terms

• Leukemia
• Lymphoma
• Lymphoma, Non-Hodgkin

Intervention

Drug:
• Atorvastatin
80 mg orally once daily

Locations

Country	Name	City	State
United States	Stanford University School of Medicine	Stanford	California

Sponsors (4)

Lead Sponsor	Collaborator
Dean Felsher	Burroughs Wellcome, Damon Runyon Cancer Research Foundation, The Leukemia and Lymphoma Society

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Tumor Apoptosis	Expressed as the number of participants whose tumor cells showed an increase in apoptosis during atorvastatin treatment	1 year
Secondary	Correlation of Tumor Apoptosis to Clinical Response	The validity of tumor apoptosis as a biologic endpoint was assessed by correlation to clinical response. A correlation substantially less than 1 is interpreted as a poor correlation, while a correlation near +1 or -1 is interpreted as a strong correlation.	1 year
Secondary	Atorvastatin Toxicity	Assessed as the number of study participants with atorvastatin-related serious adverse events (SAEs).	1 year