Refractory Classic Hodgkin Lymphoma Clinical Trial
Official title:
A Randomized Phase II Study of Bortezomib Plus ICE (BICE) Versus Standard ICE for Patients With Relapsed/Refractory Classical Hodgkin Lymphoma
This phase II trial studies how well combination chemotherapy with or without bortezomib works in treating patients with classical Hodgkin lymphoma that has come back or does not respond to prior treatment. Drugs used in chemotherapy, such as ifosfamide, carboplatin, and etoposide, work in different ways to stop the growth of cancer cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Bortezomib is designed to block a protein that plays a role in cell function and growth. Bortezomib may cause cancer cells to die. It is not yet known if combination chemotherapy with or without bortezomib may work better in treating patients with classical Hodgkin lymphoma.
PRIMARY OBJECTIVES:
I. To determine the objective response rate (ORR), partial remissions (PR), and complete
remissions (CR) after 3 cycles of bortezomib plus ifosfamide, carboplatin, and etoposide
(ICE) (BICE) versus ICE in patients with relapsed/refractory classical Hodgkin lymphoma
(cHL).
II. To evaluate 2-year progression-free survival (PFS) in patients treated with 3 cycles of
BICE versus ICE.
SECONDARY OBJECTIVES:
I. To compare positron emission tomography (PET) scan response after 3 cycles of BICE versus
ICE chemotherapy.
II. To compare serum levels of tumor necrosis factor (TNF) proteins (a proliferation-inducing
ligand [APRIL], B lymphocyte stimulator [BLyS], soluble [s]CD30, and CD40L) and CC thymus and
activation-related cytokine (TARC) at baseline and after 3 cycles of BICE versus ICE
chemotherapy.
III. To correlate baseline cytokine/chemokine levels with response to therapy.
OUTLINE: Patients are randomized to 1 of 2 arms.
ARM A: Patients receive bortezomib intravenously (IV) over 5 seconds on days 1 and 4,
ifosfamide IV continuously over 24 hours on day 1, carboplatin IV over 1 hour on day 1, and
etoposide IV over 2 hours on days 1-3. Treatment repeats every 14 days for up to 6 courses in
the absence of disease progression or unacceptable toxicity.
ARM B: Patients receive ifosfamide, carboplatin and etoposide as in Arm A. Treatment repeats
every 14 days for up to 6 courses in the absence of disease progression or unacceptable
toxicity.
After completion of study treatment, patients are followed up every 4 months for 2 years.
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