Neoplasms Clinical Trial
Official title:
Phase I Study of HeFi-1 in Refractory CD30-Positive Malignancy
Background:
- Some cancers, such as Hodgkin's disease, anaplastic large cell lymphoma and others, have
a protein on the surface of the cancer cell called CD30.
- HeFi-1 is an antibody that binds to the CD30 protein and sends signals to the cancer
cells that can cause them to die.
Objectives:
- To determine the highest dose of HeFi-1 that can safely be given to patients with tumors
that have the CD30 protein.
- To determine the response of the tumor to treatment with HeFi-1.
Eligibility:
- Patients 18 years of age and older with Hodgkin's disease, anaplastic large cell
lymphoma, cutaneous T cell lymphoma and adult T cell leukemia or lymphoma who have signs
of tumor growth or recurrence following standard treatment
- Patients' tumor cells must have the CD30 protein.
Design:
- Groups of three patients are treated with increasingly higher doses of HeFi-1 (ranging
from 0.5 to 5 mg/kg) to determine the highest safe dose.
- HeFi-1 is infused through a vein on 4 days, followed by 2 days of rest over a 10-day
period. Patients may receive up to 2 treatment courses if they show some response and do
not have severe side effects.
- Blood samples are collected several times during the study to determine safety. A lymph
node biopsy is done at the beginning of the study to test the effect of HeFi-1 on cancer
cells in the test tube, and a bone marrow biopsy may be done at the end of treatment if
the bone marrow was positive for tumor cells at the beginning of treatment.
BACKGROUND:
The scientific basis for this study is the observation that antibodies directed at the
ligand-binding site of CD30 induce apoptosis in vitro and cure animals bearing CD30-positive
tumors.
HeFi-1, a murine monoclonal antibody developed at the NCI, specifically binds human CD30, a
member of the tumor necrosis receptor superfamily, at the ligand-binding site.
CD30 is expressed on activated T-cells, Reed-Sternberg cells, anaplastic large cell lymphoma,
and some AIDS-related lymphoma cells.
Tumor cells from patients with anaplastic large cell lymphoma are sensitive to the effects of
HeFi-1 but Hodgkin's disease cell lines show variable responsiveness due to the presence of
mutations in I B kinase which result in constitutive activation of NF- B.
OBJECTIVE:
The primary objective of this study is to determine the toxicity and maximum tolerated dose
of HeFi-1 in patients with CD30-positive malignancy.
This study will explore the pharmacokinetics, dose required to saturate CD30 binding sites in
tumor aspirates, and the frequency and time course of onset of development of human
anti-mouse antibody (HAMA).
These studies will allow us to monitor in a preliminary fashion the clinical tumor response,
measured by reduction in tumor lesions and by following the tumor marker serum soluble
interleukin 2 receptor.
ELIGIBILITY:
Patients with measurable or evaluable CD30-positive lymphoma who have become refractory to
standard therapy, including Hodgkin's disease, systemic anaplastic large cell lymphoma,
cutaneous T cell lymphoma and adult T cell leukemia/lymphoma are eligible for treatment.
DESIGN:
This is a phase I dose-escalation trial in which cohorts of three patients will be treated
with HeFi-1 ranging from 0.5 to 5 mg/kg/dose (total dose of 2 to 20 mg/kg per treatment
course).
Four doses will be given on an every three days schedule over a 10-day period for each cycle.
Two cycles of therapy will be administered provided the patient has had a partial or complete
response and has not developed dose-limiting toxicity or HAMA.
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