PXD101 in Treating Patients With Relapsed or Refractory Aggressive B-Cell Non-Hodgkin's Lymphoma

National Cancer Institute (NCI)

Status and phase: Completed; Phase 2

Conditions: Recurrent Adult Burkitt Lymphoma; Recurrent Adult Diffuse Large Cell Lymphoma

Treatments: Drug: belinostat

Study type: Interventional

Funder types: NIH

Identifiers

NCT00303953

CDR0000462614

S0520 (Other Identifier)

NCI-2009-01096 (Registry Identifier)

U10CA032102 (U.S. NIH Grant/Contract)

Details and patient eligibility

About

This phase II trial is studying how well PXD101 works in treating patients with relapsed or refractory aggressive B-cell non-Hodgkin's lymphoma. PXD101 may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth and by blocking blood flow to the cancer.

Full description

PRIMARY OBJECTIVES:

I. Evaluate response rate in patients with relapsed or refractory aggressive B-cell non-Hodgkin's lymphoma treated with PXD101.

SECONDARY OBJECTIVES:

I. Determine the toxicity of this drug in these patients. II. Estimate the 6-month progression-free survival rate in patients treated with this drug.

TERTIARY OBJECTIVES:

I. Determine the major histocompatability complex of class II proteins (HLA-DR, -DP, -DQ), TUNEL, and CD8 infiltration status, by immunochemistry on paired pre- and post-treatment tumor samples, in the first 20 patients enrolled.

II. Measure CIITA and HLA-DR mRNA expression using quantitative reverse transcriptase-polymerase chain reaction and determine, preliminarily, the associations of these markers with progression-free survival.

III. Evaluate paired pre- and post-treatment peripheral blood mononuclear cells from patients for histone acetylation status and determine correlation with findings from duplicate experiments on pre- and post-needle core biopsies.

OUTLINE: This is a multicenter study.

Patients receive PXD101 IV over 30 minutes on days 1-5. Treatment repeats every 21 days for up to 2 years in the absence of disease progression or unacceptable toxicity.

Needle core biopsies and peripheral blood mononuclear cells are obtained from the first 20 patients pre- and post-treatment for biomarker correlative studies.

After completion of study treatment, patients are followed every 3-6 months for up to 3 years.

Enrollment: 22 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion and exclusion criteria

Inclusion Criteria:

• Biopsy-proven (no needle aspirations or cytologies) aggressive B-cell non-Hodgkin's lymphoma (NHL), including 1 of the following histology subtypes:

  • Diffuse large cell NHL
  • Burkitt's or Burkitt-like NHL
  • Primary mediastinal NHL

• Relapsed or refractory disease

• Bidimensionally measurable disease

• Transformed NHL allowed

• Not eligible for stem cell transplantation (for patients registered to study at first relapse)

• No active CNS involvement by lymphoma

• Zubrod performance status 0-2

• No history of allergic reactions attributed to compounds of similar chemical or biologic composition to PXD101

• Absolute neutrophil count >= 1,500/mm^3

• Platelet count>=100,000/mm^3

• WBC >= 3,000/mm^3

• Creatinine < 2 times upper limit of normal (ULN) OR creatinine clearance >= 60 mL/min

• No significant EKG abnormalities

• Bilirubin normal

• SGOT/SGPT < 2.5 times ULN (=< 5 times ULN if liver involvement)

• No long QT syndrome or marked baseline prolongation of QT/QTc interval (e.g., repeated demonstration of QTc interval > 500 msec)

• No other significant cardiovascular disease, including any of the following:

  • Unstable angina pectoris
  • Uncontrolled hypertension
  • Congestive heart failure related to primary cardiac disease
  • Any condition requiring anti-arrhythmic therapy
  • Ischemic or severe valvular heart disease
  • Myocardial infarction within the past 6 months

• No major surgery within 28 days prior to study entry

• No concurrent combination antiretroviral therapy for HIV-positive patients

• No concurrent medication that may cause Torsades de Pointes (i.e., prolongation of the QT interval > 500 msec)

• At least 14 days since prior radiotherapy

• At least 2 weeks since prior valproic acid or any other histone deacetylase inhibitor

• No clinical evidence of any of the following:

  • Severe peripheral vascular disease
  • Diabetic ulcers or venous stasis ulcers
  • History of deep venous or arterial thrombosis within the past 3 months

• Radioimmunotherapy is considered a chemotherapy regimen

• Single-agent rituximab is not considered a chemotherapy regimen

• Standard salvage chemotherapy followed by autologous stem cell transplantation is considered 1 regimen

• No known AIDS or HIV-associated complex

• Not pregnant or nursing

• Fertile patients must use effective contraception

• No other malignancy within the past 5 years except adequately treated basal cell or squamous cell skin cancer or in situ carcinoma of the cervix

• At least 2 weeks since prior therapy and recovered

• No more than 5 prior chemotherapy regimens

Trial design

Primary purpose: Treatment

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

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22 participants in 1 patient group

Arm I

Experimental group

Description:

Patients will receive an infusion of PXD101 once a day for 5 days. Treatment may repeat every 3 weeks for up to 2 years. Some patients will also undergo core biopsy and blood collection for laboratory studies before and after treatment. After finishing treatment, patients will be evaluated every 3-6 months for up to 3 years.

Treatment:

Drug: belinostat