Radiolabeled Monoclonal Antibody in Treating Patients With Previously Treated Large Cell Lymphoma

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Case Comprehensive Cancer Center (Case CCC)

Status and phase

Completed
Phase 1

Conditions

Lymphoma

Treatments

Radiation: iodine I 131 monoclonal antibody Lym-1

Study type

Interventional

Funder types

Other
NIH

Identifiers

NCT00028613
NCI-G01-2038
CWRU-090036
BRLX-303680
CWRU-BRLX-1400
BRLX1400

Details and patient eligibility

About

RATIONALE: Radiolabeled monoclonal antibodies can locate tumor cells and deliver tumor-killing substances such as radioactive iodine to them without harming normal cells. PURPOSE: Phase I trial to study the effectiveness of radiolabeled monoclonal antibodies in treating patients who have large cell lymphoma that has been previously treated.

Full description

OBJECTIVES: Determine the maximum tolerated dose of iodine I 131 monoclonal antibody Lym-1 in patients with previously treated diffuse large cell lymphoma. Determine the safety of this drug in these patients. Determine the response of patients to this drug. OUTLINE: This is a dose-escalation, multicenter study. Patients receive unlabeled monoclonal antibody Lym-1 IV over 40 minutes followed 15-30 minutes later by iodine I 131 monoclonal antibody Lym-1 IV over 2 minutes. Cohorts of 3-6 patients receive escalating doses of iodine I 131 monoclonal antibody Lym-1 until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which at least 2 of 3 or 2 of 6 patients experience dose-limiting toxicity. Patients are followed weekly for 8 weeks and then every 3 months for 1 year. PROJECTED ACCRUAL: A total of 8-36 patients will be accrued for this study.

Enrollment

2 patients

Sex

All

Ages

18+ years old

Volunteers

No Healthy Volunteers

Inclusion and exclusion criteria

Inclusion Criteria

  • Histologic diagnosis of B-cell diffuse large cell lymphoma (REAL classification system) confirmed by an independent central pathology reviewer.
  • The tumor's B-cell phenotype will be confirmed by positive L-26 (CD20).
  • Previous treatment with 2 common combination chemotherapy regimens. Patients previously treated with unlabeled monoclonal antibody therapy are eligible.
  • Men or women at least 18 years of age.
  • Karnofsky Performance Score (KPS) estimated to be > 60 at the time of the scheduled therapeutic dose of 131I-Lym-1.
  • Life expectancy estimated to be at least 3 months from the time of the therapeutic dose of 131I Lym-1.
  • Measurable disease demonstrable by physical examination or computerized tomography (CT).
  • CT scan evidence of at least one indicator lesion with at least one diameter that measures > 2 cm. (The CT scan should be done within 2 weeks of the imaging study.)

Exclusion Criteria

Inability or unwillingness to comply with the following:

  • Bone marrow biopsy
  • Return for follow-up visits
  • Remaining motionless for extended periods of time for imaging procedures
  • Serial blood/urine sampling (for dosimetry patients only)
  • Pregnancy (Women of childbearing potential must be practicing an effective method of contraception.)
  • Presence of a second malignancy except for basal cell skin carcinoma or carcinoma in-situ of the cervix
  • Presence of active lymphomatous meningitis or other CNS involvement with lymphoma.
  • HIV positive patients.
  • Prior total body irradiation, or a course of prior radiation > 3,000 cGy delivered to > 20% of the central marrow or the lumbar vertebrae within 6 months of screening.
  • Serum creatinine or total bilirubin > 2 x the upper limit of normal.
  • Aspartate aminotransferase (AST), alanine aminotransferase (ALT) or alkaline phosphatase > 3 x the upper limit of normal.

Significant marrow lymphoma (defined as lymphoma cells constituting greater than 20% of the hematopoietic marrow elements from an iliac crest biopsy). A prior bone marrow biopsy is acceptable if it meets the following criteria:

  • If there is prior bone marrow involvement, the biopsy must be performed within 45 days of screening.
  • If there is no prior bone marrow involvement, the biopsy must be performed within 90 days of screening
  • WBC count < 3,500/mm3, granulocyte count < 1,500/mm3, or platelet count < 125,000/mm3.
  • Positive human anti-mouse antibodies (HAMA) serum values, defined as > 74 ng/mL at screening.
  • Patients who have not recovered from toxicities of most recent anti-lymphoma therapy.

Treatment with:

  • Colony stimulating factor G-CSF or GM-CSF within 120 hours of screening laboratory assessment.
  • Erythropoietin (EPO) within a month of screening laboratory assessment
  • Whole blood or platelet transfusion within 120 hours of screening laboratory assessment
  • History or electrocardiographic (ECG) evidence of Q-wave myocardial infarction within 6 months of screening or congestive heart failure (CHF; NYHA Stage III or IV).
  • Known hypersensitivity to iodine or iodine-containing organic substances.
  • Patients who require therapy with anticoagulants or antiplatelet drugs which cannot be discontinued during the study.
  • Patients who are known to have antiplatelet antibodies.

Trial contacts and locations

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Data sourced from clinicaltrials.gov

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