Study of Velcade and Temsirolimus for Relapsed or Refractory Non-Hodgkin Lymphoma

Non-Hodgkins Lymphoma Clinical Trial

Official title:

A Phase II Study of Velcade and Temsirolimus for Relapsed or Refractory B-cell Non-Hodgkin Lymphoma

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT01281917
• Other study ID #: HO10407
• Secondary ID: H-2010-0393NCI-2
• Status: Completed
• Phase: Phase 2
• Start date: February 2011
• Est. completion date: June 2014

Study information

• Verified date: July 2017
• Source: University of Wisconsin, Madison
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The investigators want to find out if the drugs Velcade and temsirolimus given together are effective in treating cancer. Velcade and temsirolimus are each FDA approved individually for certain types of cancer (Velcade for multiple myeloma and mantle cell lymphoma, and temsirolimus for renal cell carcinoma) but are not currently approved in combination for B-cell non-Hodgkin lymphoma. The investigators are trying to find out if giving these 2 drugs together will improve the period of time that the patient's cancer is stopped or slowed from growing and causing symptoms.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 40
• Est. completion date: June 2014
• Est. primary completion date: October 2013
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• Relapsed or refractory B-cell non-Hodgkin lymphoma which includes: diffuse large B-cell lymphoma; primary mediastinal large B-cell lymphoma; follicular lymphoma (grade 1, 2 or 3); mantle cell lymphoma; small lymphocytic lymphoma; marginal zone lymphoma; lymphoplasmacytic lymphoma; B-cell lymphoblastic lymphoma; or Burkitt lymphoma. "Grey-zone" lymphomas must be approved by the Wisconsin Oncology Network (WON) Study Chair or Principal Investigator prior to enrollment.

• At least one measurable tumor mass (>1.5 cm in the long axis and > 1.0 cm in the short axis) that has not been previously irradiated, or has grown since previous irradiation.

• Documented relapse or progression following prior antineoplastic therapy.

• No clinical or documented radiographic evidence of central nervous system lymphoma.

• Eastern Cooperative Oncology Group [ECOG] performance status of 0-2.

• The following clinical laboratory values within 14 days prior to enrollment:

• Absolute neutrophil count (ANC) = 1.5 x 109 cells / L

• Platelets = 100 x 109 cells / L

• Alanine transaminase (ALT) and Aspartate transaminase (AST) = 3X the upper limit of normal (ULN)

• Total bilirubin = 2X the upper limit of normal (ULN).

• Calculated creatinine clearance =40 mL/min (using the Cockcroft-Gault equation).

• Female subjects must be either post-menopausal for at least 1 year or surgically sterilized, agree to practice 2 effective methods of contraception from the time of signing the informed consent form through 30 days after the last dose of Velcade, or agree to completely abstain from heterosexual intercourse.

• Male subjects, even if surgically sterilized (ie, status postvasectomy) must agree to 1 of the following: practice effective barrier contraception during the entire study treatment period and through a minimum of 30 days after the last dose of study drug, or completely abstain from heterosexual intercourse.

Exclusions:

• Antineoplastic, experimental, or radiation therapy within 14 days prior to enrollment, or 21 days prior to Day 1 of Cycle 1.

• Radioimmunoconjugates within 10 weeks of Day 1 of Cycle 1.

• Autologous stem cell transplant within 3 months before Day 1 of Cycle 1, or any prior history of allogeneic stem cell transplant.

• Platelet transfusion within 7 days of Day 1 of Cycle 1.

• Ongoing therapy with glucocorticoids. Prednisone =15 mg per day or its equivalent is allowed.

• Patient has Grade 2 or greater peripheral neuropathy within 14 days before enrollment.

• Myocardial infarction within 6 months prior to enrollment or has New York Heart Association (NYHA) Class III or IV heart failure (see section 8.4), uncontrolled angina, severe uncontrolled ventricular arrhythmias, or electrocardiographic evidence of acute ischemia or active conduction system abnormalities.

• Patient has hypersensitivity to Velcade, boron or mannitol.

• Female subjects that are pregnant or breast-feeding.

• Serious medical or psychiatric illness that is likely to interfere with participation

• Diagnosed or treated for another malignancy within 2 years of enrollment, with the exception of complete resection of basal cell carcinoma or squamous cell carcinoma of the skin, an in situ malignancy, or low-risk prostate cancer after curative therapy.

• Prior therapy with both Velcade and temsirolimus. Patients who have previously been treated with either Velcade or temsirolimus (but not both) are eligible.

• Radiation therapy within 3 weeks before randomization.

• Patients must not be taking the following strong CyP3A inducers at study entry:

phenytoin, phenobarbital, rifampin, carbamazepin, rifabutin, rifampicin, a one week washout period is required.

Related Conditions & MeSH terms

• Lymphoma
• Lymphoma, Non-Hodgkin
• Non-Hodgkins Lymphoma

Intervention

Drug:
• Velcade
Velcade, 1.6 mg/m2 weekly (days 1, 8, 15, and 22)
• Temsirolimus
Temsirolimus 25mg IV weekly (days 1, 8, 15, 22, and 29)

Locations

Country	Name	City	State
United States	Aurora Baycare Medical Center-GreenBay	Green Bay	Wisconsin
United States	Bellin Memorial Hospital, Inc	Green Bay	Wisconsin
United States	St Vincent Regional Cancer Center CCOP	Green Bay	Wisconsin
United States	Gunderson Lutheran Health System	La Crosse	Wisconsin
United States	University Of Wisconsin Cancer Center	Madison	Wisconsin
United States	UW Health Oncology- 1 S Park	Madison	Wisconsin
United States	Aurora BayCare Medical Center	Marinette	Wisconsin
United States	Marshfield Clinic	Marshfield	Wisconsin
United States	Columbia St Mary's, Inc	Milwaukee	Wisconsin
United States	Medical College of Wisconsin	Milwaukee	Wisconsin
United States	Rapid City Regional Hospital John T. Vucurevich Cancer Care Institute	Rapid City	South Dakota
United States	Aurora Sheboygan Memorial Medical Center	Sheboygan	Wisconsin
United States	Aurora Medical Center in Summit	Summit	Wisconsin
United States	Aurora Medical Center in Two Rivers	Two Rivers	Wisconsin
United States	Waukesha Memorial Hospital	Waukesha	Wisconsin
United States	Aspirus Wausau Hospital	Wausau	Wisconsin
United States	Aurora Health Care Metro, Inc.	Wauwatosa	Wisconsin
United States	UW Cancer Center-Riverview	Wisconsin Rapids	Wisconsin

Sponsors (4)

Lead Sponsor	Collaborator
University of Wisconsin, Madison	Millennium Pharmaceuticals, Inc., National Cancer Institute (NCI), Pfizer

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Overall Response Rate	The primary objective of this study is to determine whether Velcade in combination with temsirolimus provides benefit to subjects with relapsed or refractory B-cell non-Hodgkin lymphoma as assessed by overall response rate (ORR) to therapy. ORR is the sum of patients with a Complete Response and Partial Response to therapy. Per Response Evaluation Criteria in Solid Tumors Criteria (RECIST v1.0) for target lesions and assessed by MRI: Complete REsponse (CR), Disappearance of all target lesions; Partial Response (PR), >=30% decrease in the sum of the longest diameter of target lesions; Overall Response (OR) = CR + PR.	Up to 60 months
Primary	Progression Free Survival	The primary objective of this study is to determine whether Velcade in combination with temsirolimus provides benefit to subjects with relapsed or refractory B-cell non-Hodgkin lymphoma as assessed by progression-free survival (PFS).	Up to 60 months
Secondary	Safety of This Regimen	Safety of the regimen will be measured by frequency and severity of adverse events.	Up to 36 months
Secondary	Complete Response Rate	The complete response rate (CR) to therapy as defined by International Lymphoma Response Criteria.	Up to 60 months
Secondary	Tolerability of the Regimen	Tolerability of the regimen is measured by the number of subjects able to complete the therapy as planned.	Up to 36 months
Secondary	Duration of Response	Duration of Response is how long a response to therapy is held before a subject has progressive disease.	Up to 60 months
Secondary	Overall Survival	Length of time from enrollment until death.	Up to 60 months