Phase II Study of UCN-01 in Relapsed or Refractory Systemic Anaplastic Large Cell and Mature T-Cell Lymphomas
UCN-01 (7-hydroxystaurosporine)
Hemic and Lymphatic Diseases+8
+ Immune System Diseases
+ Immunoproliferative Disorders
Treatment Study
Summary
Study start date: April 5, 2004
Actual date on which the first participant was enrolled.Background: * UCN-01 (7-hydroxystaurosporine), a non-specific protein kinase C (PKC) inhibitor appears to have several mechanisms of action including protein kinase C (PKC) isoenzyme inhibition and cyclin dependent kinase activation and inhibition. * We have demonstrated that cell lines derived from T-cell lymphomas, including those with the t (2; 5) translocation, are very sensitive to UCN-01. The t (2; 5) translocation, associated with three quarters of cases of anaplastic large cell lymphomas (ALCL), is an oncogenic fusion protein - nucleophosmin-anaplastic lymphoma kinase (NPM-ALK). * Anaplastic lymphoma receptor tyrosine kinase (ALK) is one potential target for UCN-01 action, and anaplastic large cell lymphoma (ALCL) derived SUDHL-1 cells containing the NPM-ALK protein have been shown to be very sensitive to UCN-01. Objectives: * To assess the clinical response to UCN-01 and progression-free and overall survival in patients with relapsed or refractory systemic Anaplastic Large Cell and other mature T-cell Lymphomas. * To assess the effect of UCN-01 on ALK expression in ALCL cells. * To assess the effect of UCN-01 on soluble tetrameric antibody complexes (TAC) (CD25). * To evaluate mature T-cell lymphoma malignant cells by complimentary deoxyribonucleic acid (cDNA) microarray. Eligibility: * Relapsed or refractory systemic Anaplastic Large Cell Lymphoma (ALCL) with T or Null phenotype or relapsed or refractory mature T-cell lymphomas. * All patients should have evaluable or measurable disease on entry to study. * Requires systemic therapy * Performance Status Eastern Cooperative Oncology Group (ECOG) less than or equal to 2 * Age 7 years or older * Human immunodeficiency virus (HIV) negative * Patients should not have received systemic cytotoxic chemotherapy within 3 weeks of study entry. Design: * The study will be a Phase II study. * Patients will receive the first cycle of UCN-01 over 72 hours on days 1-3 and subsequent cycles over 36 hours. Patients with stable disease may receive UCN-01 for up to 1 year beyond achieving maximum response or stable disease, and restaging will be done every 2 cycles for the first 6 cycles and every 4 cycles thereafter. * Two sequential biopsies will be performed to investigate complimentary deoxyribonucleic acid (cDNA) expression by microarray. Soluble Tac (CD25) will be serially followed in patients. * For each of the two histologies, this study will be conducted using a Simon two-stage optimal design. Up to 37 patients will be treated.
Protocol
This section provides details of the study plan, including how the study is designed and what the study is measuring.20 patients to be enrolled
Total number of participants that the clinical trial aims to recruit.Treatment Study
Eligibility
Researchers look for people who fit a certain description, called eligibility criteria: person's general health condition or prior treatments.Any sex
Biological sex of participants that are eligible to enroll.Over 12 Years
Range of ages for which participants are eligible to join.Healthy volunteers not allowed
If individuals who are healthy and do not have the condition being studied can participate.Conditions
Pathology
Criteria
* INCLUSION CRITERIA: Relapsed or refractory systemic Anaplastic Large Cell Lymphoma (ALCL). Relapsed or refractory mature T-cell lymphoma to include peripheral T-cell lymphoma unspecified and the following "specified" mature T-cell lymphomas: Adult T-cell lymphoma; Extranodal natural killer (NK)/T-cell lymphoma, nasal type; Enteropathy-type T-cell lymphoma; Hepatosplenic T-cell lymphoma; Subcutaneous panniculitis-like T-cell lymphoma; Angioimmunoblastic T-cell lymphoma. All patients should have evaluable or measurable disease on entry to study. Histology confirmed by Laboratory of Pathology, National Cancer Institute (NCI). Performance Status Eastern Cooperative Oncology Group (ECOG) less than or equal to 2. Age 7 years or older. Creatinine less than or equal to 1.5 mg/dl or creatinine clearance greater than 50 ml/min for patients at least 18 years. Pediatric patients should have maximum serum creatinine by age as follows: * Less than age 7 and less than or equal to age 10 may have a Maximum Serum Creatinine of 1.0 mg/dl * Less than age10 and less than or equal to age 15 may have a Maximum Serum Creatinine of 1.2 mg/dl * Age 15 years or older may have a Maximum Serum Creatinine of 1.5 mg/dl Alternatively, pediatric patients should have a creatinine clearance of greater than 50 m1/min/1.73m\^2. Total bilirubin less than 1.5 x upper limit of normal (ULN) (patients with elevation of total bilirubin consistent with Gilbert's disease are eligible providing they have a normal direct bilirubin); aspartate aminotransferase (AST) less than or equal to 2.5 x ULN; absolute neutrophil count (ANC) greater than 500/mm\^3; and platelet greater than or equal to 50,000/mm\^3; unless hematological impairment due to organ involvement by lymphoma. Provides signed informed consent. Not pregnant or nursing. This drug has unknown effects in pregnancy and on young infants/children. Human immunodeficiency virus (HIV) negative. Willing to use contraception and continue for at least 8 weeks following the last treatment. No active central nervous system (CNS) lymphoma. Patients should not have received systemic cytotoxic chemotherapy within 3 weeks of study entry. Have recovered from the toxic effects of prior therapy to a grade less than or equal to 1. No history of diabetes mellitus requiring insulin treatment. No symptomatic pulmonary disease. No evidence of symptomatic cardiac disease (e.g. symptomatic congestive heart failure, unstable angina pectoris, exertional angina pectoris, cardiac arrhythmia). Patients may not be concurrently receiving any other investigational agents. Not a candidate for potentially curative (i.e. transplant) treatment at the time of study entry or the patient has a window of opportunity to receive UCN-01 before a transplant. Patients are required to have considered a transplant. If, having done this, they refuse it, decide against it or decide to wait, they would be eligible for this study.
Study Plan
Find out more about all the medication administered in this study, their detailed description and what they involve.2 intervention groups are designated in this study
This study does not include a placebo group
Treatment Groups
Group I
ExperimentalGroup II
ExperimentalStudy Objectives
Primary Objectives
Secondary Objectives
Study Centers
These are the hospitals, clinics, or research facilities where the trial is being conducted. You can find the location closest to you and its status.This study has 1 location
National Institutes of Health Clinical Center, 9000 Rockville Pike
Bethesda, United StatesOpen National Institutes of Health Clinical Center, 9000 Rockville Pike in Google Maps