A Phase I/II Study of G3139 (Genasense) in Combination With RICE Chemotherapy in Relapsed B-Cell Non-Hodgkin's Lymphoma
oblimersen sodium
+ rituximab
+ ifosfamide
Maladies du Système Immunitaire+11
+ Troubles immunoprolifératifs
+ Lymphome
Étude thérapeutique
Résumé
Date de début de l'étude : 1 mai 2004
Date à laquelle le premier participant a commencé l'étude.PRIMARY OBJECTIVES: I. Determine the maximum tolerated dose of oblimersen when given in combination with rituximab, ifosfamide, carboplatin, and etoposide in patients with relapsed or refractory aggressive B-cell non-Hodgkin's lymphoma. II. Determine the safety and toxicity of this regimen in these patients. III. Determine the complete and partial response rate in patients treated with this regimen. SECONDARY OBJECTIVES: I. Determine the duration of response, overall survival, and time to progression in patients treated with this regimen. II. Determine the effect of this regimen on hematopoietic stem cell kinetics and yield from these patients. OUTLINE: This is a multicenter, phase I, dose-escalation study of oblimersen followed by a phase II study. Phase I: Patients receive GRICE comprising oblimersen IV continuously on days 1-5, rituximab IV, ifosfamide IV continuously over 24 hours, and carboplatin IV over 1 hour on day 4, and etoposide IV over 30 minutes once daily on days 4-6. Treatment repeats every 14 days for 3 courses. Patients also receive filgrastim (G-CSF) subcutaneously (SC) once daily beginning on day 7 and continuing until blood counts recover OR one dose of pegfilgrastim SC on day 7 of courses 1 and 2. For course 3, all patients receive G-CSF SC twice daily beginning on day 7 and continuing until stem cell collection is complete. Patients with responding disease who are not eligible for autologous SCT may receive up to 8 total courses of GRICE or 2 additional courses beyond maximal response. Patients with responding disease to GRICE who are eligible for autologous SCT are removed from the study and undergo autologous SCT off study. Cohorts of 3-6 patients receive escalating doses of oblimersen until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity. Phase II: Patients receive oblimersen at the MTD determined in phase I and rituximab, ifosfamide, carboplatin, and etoposide followed by G-CSF or pegfilgrastim as in phase I. In both phases, treatment continues in the absence of disease progression, unacceptable toxicity, or the patient becomes a candidate for autologous SCT. Patients are followed for survival.
Protocole
Cette section fournit des détails sur le plan de l'étude, y compris la manière dont l'étude est conçue et ce qu'elle évalue.25 participants à inclure
Nombre total de participants que l'essai clinique vise à recruter.Traitement
Éligibilité
Les chercheurs recherchent des patients correspondant à une certaine description appelée critères d'éligibilité : état de santé général ou traitements antérieurs du patient.Tout sexe
Le sexe biologique des participants éligibles à s'inscrire.À partir de 18 ans
Tranche d'âge des participants éligibles à participer.Volontaires sains non autorisés
Indique si les individus en bonne santé et ne présentant pas la condition étudiée peuvent participer.Conditions
Pathologie
Critères
Inclusion Criteria: * Histologically confirmed aggressive B-cell non-Hodgkin's lymphoma * Any 1 one of the following histological subtypes for phase I: * Grade 3 follicular center lymphoma * Diffuse large B-cell lymphoma * Transformed follicular lymphoma * Mantle cell lymphoma * Primary mediastinal B-cell lymphoma * Any 1 of the following histological subtypes for phase II: * Diffuse large B-cell lymphoma * Transformed follicular lymphoma * Primary mediastinal B-cell lymphoma * Measurable disease * At least 1 bidimensionally measurable lesion ≥ 10 mm in longest diameter by CT scan, MRI, x-ray, or clinical exam * Relapsed disease after 1, and only 1, prior anthracycline-based chemotherapy regimen * No known brain metastases * Performance status - ECOG 0-2 * Performance status - Karnofsky 60-100% * More than 3 months * Absolute neutrophil count ≥ 1,000/mm\^3\* * Platelet count ≥ 100,000/mm\^3\* * Bilirubin normal\*\* * AST and ALT ≤ 2.5 times upper limit of normal * PT and PTT normal * Creatinine normal * Creatinine clearance ≥ 60 mL/min * No symptomatic congestive heart failure * No unstable angina pectoris * No cardiac arrhythmia * Not pregnant or nursing * Negative pregnancy test * Fertile patients must use effective contraception * No history of allergic reactions attributed to compounds of similar chemical or biological composition to oblimersen or other study drugs * No currently active second malignancy except nonmelanoma skin cancer or carcinoma in situ of the cervix * Must have completed any prior therapy for a second malignancy and is considered to be at \< 30% risk of relapse * No ongoing or active infection * No psychiatric illness or social situation that would preclude study compliance * No other concurrent uncontrolled illness * Prior rituximab allowed * No other concurrent immunotherapy * See Disease Characteristics * At least 4 weeks since prior cytotoxic chemotherapy (6 weeks for nitrosoureas or mitomycin) and recovered * No other concurrent chemotherapy * No concurrent hormonal therapy * At least 4 weeks since prior radiotherapy and recovered * No concurrent therapeutic radiotherapy * At least 4 weeks since prior surgery * No prior oblimersen or other antisense oligonucleotide therapy * No other concurrent anticancer agents or therapies * No concurrent combination antiretroviral therapy for HIV-positive patients * No other concurrent investigational agents
Plan de l'étude
Découvrez tous les traitements administrés dans cette étude, leur description détaillée et ce qu'ils impliquent.Un seul groupe d'intervention est désigné dans cette étude
Cette étude ne comporte pas de groupe placebo.
Groupes de traitement
Groupe I
ExpérimentalObjectifs de l'étude
Objectifs principaux
Objectifs secondaires
Centres d'étude
Ce sont les hôpitaux, cliniques ou centres de recherche où l'essai est conduit. Vous pouvez trouver le site le plus proche de vous ainsi que son statut.Cette étude comporte 1 site