LymphomaPhase 1NCT00787969
Rituximab, Cladribine, and Temsirolimus in Treating Patients With Newly Diagnosed Mantle Cell Lymphoma
A Phase 1 study testing rituximab, cladribine and temsirolimus in people with Lymphoma, run by Alliance for Clinical Trials in Oncology at 144 sites in United States.
Trial summary
This phase I/II trial studies the side effects and best dose of temsirolimus when given together with cladribine and rituximab and to see how well it works in treating patients with newly diagnosed mantle cell lymphoma. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Lymphoma
- What is being tested?
- rituximab, cladribine and temsirolimus
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 74 participants
- Where
- 144 sitesUnited States
- Study dates
- Apr 2009to 15 Jun 2017
- Phase
- Phase 1
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Histologically confirmed mantle cell lymphoma (MCL); the diagnosis must be confirmed by NCCTG pre-registration pathology review by Dr. Paul Kurtin or his designate; it is recommended that the biopsy be an excisional biopsy, but adequate core-needle biopsies will be accepted as long as they are considered adequate for registration by Dr. Kurtin or his designate; the tumor must be cyclin D-1 positive by immunohistochemistry or have evidence of a t(11;14) translocation by fluorescence based in situ hybridization (FISH) or cytogenetics
- Measurable or assessable disease, defined as at least one of the following:
- A lymph node or tumor mass that is >= 2.0 cm in at least one dimension by positron emission tomography (PET)/computed tomography (CT), CT, magnetic resonance imaging (MRI), or plain radiograph imaging
- Splenic enlargement may be used as a measurable parameter if the spleen is palpable >= 3 cm below the left costal margin
- Diffuse infiltration of an organ such as the stomach, bone marrow, peripheral blood, liver, lungs, or bowel by lymphoma without a discrete mass would constitute assessable, but not measurable, disease
- Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 0, 1, 2, or 3
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- Life expectancy >= 12 weeks
- Absolute neutrophil count (ANC) >= 1,500/mm³
- Platelet count (PLT) >= 100,000/mm³
- Serum creatinine =< 2.0 mg/dL
- Serum total bilirubin (or direct bilirubin if total is abnormal) =< institutional upper limit of normal (ULN) with or without secondary liver involvement
- Serum glutamic oxaloacetic transaminase (SGOT) =< 3 x institutional ULN (exception: if there is liver involvement, SGOT must be =< 5 x institutional ULN)
- Negative pregnancy test done =< 7 days prior to registration, for women of childbearing potential only
- Willingness to return to NCCTG enrolling institution for follow-up
- Willingness to provide the blood specimens as required by the protocol
- Willingness to provide tissue specimens as required by the protocol
- Willing to return to NCCTG enrolling institution for follow-up
- Willing to provide blood and tissue specimens as required by the protocol
- Willing to abstain from eating grapefruit or drinking grapefruit juice
- Willingness to abstain from eating grapefruit or drinking grapefruit juice for the duration of the study
Who cannot join
- Any prior therapy for mantle cell non-Hodgkin lymphoma including radiation therapy; exception: patient may have undergone a splenectomy for diagnosis, cytopenia, or systematic splenomegaly
- Active or uncontrolled infection
- Any of the following cardiac conditions:
- Uncontrolled high blood pressure
- Unstable angina
- Active congestive heart failure
Show all 21Show fewer
- Myocardial infarction =< 6 months
- Serious uncontrolled cardiac arrhythmia
- Known central nervous system (CNS) involvement
- Any of the following:
- Pregnant women or women of reproductive ability who are unwilling to use effective contraception while taking the drug and for 12 months after stopping treatment
- Nursing women
- Men who are unwilling to use a condom (even if they have undergone a prior vasectomy) while having intercourse with any woman, while taking the drug and for 12 months after stopping treatment
- Medical or psychiatric conditions which, in the opinion of the investigator, make the patient a poor risk for participation
- Known to be human immunodeficiency virus (HIV) positive; HIV testing is not required but should be done if clinically indicated; HIV-positive patients receiving combination anti-retroviral therapy are excluded from the study
- Concurrent malignancy =< 5 years ago; exceptions: carcinoma in situ of the cervix, resected basal cell or squamous cell carcinomas of the skin, or prostate cancer that is in remission following a radical retropubic prostatectomy or radiation therapy; if there is a history of prior malignancy, they must not be receiving other specific treatment (other than hormonal therapy) for their cancer
- Known hypersensitivity to rituximab or its components, or to murine proteins
- Receiving any other investigational agent which would be considered as a treatment for the primary neoplasm
- Prior treatment with an mTOR inhibitor
- Autologous or allogeneic stem cell transplant planned as part of initial therapy
- Receiving enzyme-inducing antiepileptic drugs (enzyme inducing anti-epileptic drugs [EIAEDs]; e.g., phenytoin, fosphenytoin, carbamazepine, oxcarbazepine, phenobarbital, or primidone); any other potent cytochrome P450, family 3, subfamily A, polypeptide 4 (CYP3A4) inducer such as rifampin, glucocorticoids at greater than adrenal replacement levels, or St. John's wort; or receiving strong CYP3A4 inhibitors * Note: if these agents are discontinued, temsirolimus therapy can begin >= 7 days after discontinuation of such agent
Trial locations and contacts
144 sites in 1 country.
144 sites in 1 country
United States144 sites
McFarland Clinic, PC
Ames, Iowa, 50010
Battle Creek Health System Cancer Care Center
Battle Creek, Michigan, 49017
Mecosta County Medical Center
Big Rapids, Michigan, 49307
CCOP - Montana Cancer Consortium
Billings, Montana, 59101
St. Vincent Healthcare Cancer Care Services
Billings, Montana, 59101
Hematology-Oncology Centers of the Northern Rockies - Billings
Billings, Montana, 59102
Billings Clinic - Downtown
Billings, Montana, 59107-7000
Bismarck Cancer Center
Bismarck, North Dakota, 58501
Medcenter One Hospital Cancer Care Center
Bismarck, North Dakota, 58501
Mid Dakota Clinic, PC
Bismarck, North Dakota, 58501
St. Alexius Medical Center Cancer Center
Bismarck, North Dakota, 58502
Illinois CancerCare - Bloomington
Bloomington, Illinois, 61701
St. Joseph Medical Center
Bloomington, Illinois, 61701
Bozeman Deaconess Cancer Center
Bozeman, Montana, 59715
Fairview Ridges Hospital
Burnsville, Minnesota, 55337
St. James Healthcare Cancer Care
Butte, Montana, 59701
Graham Hospital
Canton, Illinois, 61520
Illinois CancerCare - Canton
Canton, Illinois, 61520
Illinois CancerCare - Carthage
Carthage, Illinois, 62321
Memorial Hospital
Carthage, Illinois, 62321
Cedar Rapids Oncology Associates
Cedar Rapids, Iowa, 52403
Mercy Regional Cancer Center at Mercy Medical Center
Cedar Rapids, Iowa, 52403
Cancer Center of Kansas, PA - Chanute
Chanute, Kansas, 66720
Medical Oncology and Hematology Associates - West Des Moines
Clive, Iowa, 50325
Mercy and Unity Cancer Center at Mercy Hospital
Coon Rapids, Minnesota, 55433
CCOP - Iowa Oncology Research Association
Des Moines, Iowa, 50309
John Stoddard Cancer Center at Iowa Methodist Medical Center
Des Moines, Iowa, 50309
Medical Oncology and Hematology Associates at John Stoddard Cancer Center
Des Moines, Iowa, 50309
Medical Oncology and Hematology Associates at Mercy Cancer Center
Des Moines, Iowa, 50314
Mercy Cancer Center at Mercy Medical Center - Des Moines
Des Moines, Iowa, 50314
John Stoddard Cancer Center at Iowa Lutheran Hospital
Des Moines, Iowa, 50316
Cancer Center of Kansas, PA - Dodge City
Dodge City, Kansas, 67801
Duluth Clinic Cancer Center - Duluth
Duluth, Minnesota, 55805-1983
CCOP - Duluth
Duluth, Minnesota, 55805
Miller - Dwan Medical Center
Duluth, Minnesota, 55805
Fairview Southdale Hospital
Edina, Minnesota, 55435
Cancer Center of Kansas, PA - El Dorado
El Dorado, Kansas, 67042
Elkhart Clinic, LLC
Elkhart, Indiana, 46514-2098
Michiana Hematology-Oncology, PC - Elkhart
Elkhart, Indiana, 46514
Elkhart General Hospital
Elkhart, Indiana, 46515
Green Bay Oncology, Limited - Escanaba
Escanaba, Michigan, 49431
Eureka Community Hospital
Eureka, Illinois, 61530
Illinois CancerCare - Eureka
Eureka, Illinois, 61530
Cancer Center of Kansas - Fort Scott
Fort Scott, Kansas, 66701
Mercy and Unity Cancer Center at Unity Hospital
Fridley, Minnesota, 55432
Galesburg Clinic, PC
Galesburg, Illinois, 61401
Illinois CancerCare - Galesburg
Galesburg, Illinois, 61401
Butterworth Hospital at Spectrum Health
Grand Rapids, Michigan, 49503
CCOP - Grand Rapids
Grand Rapids, Michigan, 49503
Lacks Cancer Center at Saint Mary's Health Care
Grand Rapids, Michigan, 49503
Great Falls Clinic - Main Facility
Great Falls, Montana, 59405
Sletten Cancer Institute at Benefis Healthcare
Great Falls, Montana, 59405
Green Bay Oncology, Limited at St. Vincent Hospital Regional Cancer Center
Green Bay, Wisconsin, 54301-3526
Green Bay Oncology, Limited at St. Mary's Hospital
Green Bay, Wisconsin, 54303
St. Mary's Hospital Medical Center - Green Bay
Green Bay, Wisconsin, 54303
St. Vincent Hospital Regional Cancer Center
Green Bay, Wisconsin, 54307-3508
Illinois CancerCare - Havana
Havana, Illinois, 62644
Mason District Hospital
Havana, Illinois, 62644
Northern Montana Hospital
Havre, Montana, 59501
St. Peter's Hospital
Helena, Montana, 59601
Hutchinson Area Health Care
Hutchinson, Minnesota, 55350
Cancer Center of Kansas-Independence
Independence, Kansas, 67301
Dickinson County Healthcare System
Iron Mountain, Michigan, 49801
Glacier Oncology, PLLC
Kalispell, Montana, 59901
Kalispell Medical Oncology at KRMC
Kalispell, Montana, 59901
Kalispell Regional Medical Center
Kalispell, Montana, 59901
Illinois CancerCare - Kewanee Clinic
Kewanee, Illinois, 61443
Cancer Center of Kansas, PA - Kingman
Kingman, Kansas, 67068
Howard Community Hospital
Kokomo, Indiana, 46904
Center for Cancer Therapy at LaPorte Hospital and Health Services
La Porte, Indiana, 46350
Lawrence Memorial Hospital
Lawrence, Kansas, 66044
Cancer Center of Kansas, PA - Liberal
Liberal, Kansas, 67901
Illinois CancerCare - Macomb
Macomb, Illinois, 61455
McDonough District Hospital
Macomb, Illinois, 61455
Holy Family Memorial Medical Center Cancer Care Center
Manitowoc, Wisconsin, 54221-1450
HealthEast Cancer Care at St. John's Hospital
Maplewood, Minnesota, 55109
Minnesota Oncology Hematology, PA - Maplewood
Maplewood, Minnesota, 55109
Bay Area Cancer Care Center at Bay Area Medical Center
Marinette, Wisconsin, 54143
Mercy Cancer Center at Mercy Medical Center - North Iowa
Mason City, Iowa, 50401
Virginia Piper Cancer Institute at Abbott - Northwestern Hospital
Minneapolis, Minnesota, 55407
Hennepin County Medical Center - Minneapolis
Minneapolis, Minnesota, 55415
Michiana Hematology-Oncology, PC - South Bend
Mishawaka, Indiana, 46545-1470
Saint Joseph Regional Medical Center
Mishawaka, Indiana, 46545-1470
Montana Cancer Center at St. Patrick Hospital and Health Sciences Center
Missoula, Montana, 59807
Illinois CancerCare - Monmouth
Monmouth, Illinois, 61462
OSF Holy Family Medical Center
Monmouth, Illinois, 61462
Mercy General Health Partners
Muskegon, Michigan, 49443
Cancer Center of Kansas, PA - Newton
Newton, Kansas, 67114
Michiana Hematology Oncology PC - Niles
Niles, Michigan, 49120
BroMenn Regional Medical Center
Normal, Illinois, 61761
Community Cancer Center
Normal, Illinois, 61761
Illinois CancerCare - Community Cancer Center
Normal, Illinois, 61761
Green Bay Oncology, Limited - Oconto Falls
Oconto Falls, Wisconsin, 54154
Community Hospital of Ottawa
Ottawa, Illinois, 61350
Oncology Hematology Associates of Central Illinois, PC - Ottawa
Ottawa, Illinois, 61350
Cancer Center of Kansas, PA - Parsons
Parsons, Kansas, 67357
Cancer Treatment Center at Pekin Hospital
Pekin, Illinois, 61554
Illinois CancerCare - Pekin
Pekin, Illinois, 61603
Proctor Hospital
Peoria, Illinois, 61614
CCOP - Illinois Oncology Research Association
Peoria, Illinois, 61615
Oncology Hematology Associates of Central Illinois, PC - Peoria
Peoria, Illinois, 61615
Methodist Medical Center of Illinois
Peoria, Illinois, 61636
OSF St. Francis Medical Center
Peoria, Illinois, 61637
Illinois CancerCare - Peru
Peru, Illinois, 61354
Illinois Valley Community Hospital
Peru, Illinois, 61354
Michiana Hematology Oncology PC - Plymouth
Plymouth, Indiana, 46563
Cancer Center of Kansas, PA - Pratt
Pratt, Kansas, 67124
Illinois CancerCare - Princeton
Princeton, Illinois, 61356
Perry Memorial Hospital
Princeton, Illinois, 61356
Rapid City Regional Hospital
Rapid City, South Dakota, 57701
Humphrey Cancer Center at North Memorial Outpatient Center
Robbinsdale, Minnesota, 55422-2900
Mayo Clinic Cancer Center
Rochester, Minnesota, 55905
Lakeland Regional Cancer Care Center - St. Joseph
Saint Joseph, Michigan, 49085
Lakeside Cancer Specialists, PLLC
Saint Joseph, Michigan, 49085
CCOP - Metro-Minnesota
Saint Louis Park, Minnesota, 55416
Park Nicollet Cancer Center
Saint Louis Park, Minnesota, 55416
Regions Hospital Cancer Care Center
Saint Paul, Minnesota, 55101
United Hospital
Saint Paul, Minnesota, 55102
Cancer Center of Kansas, PA - Salina
Salina, Kansas, 67401
Mayo Clinic Scottsdale
Scottsdale, Arizona, 85259-5499
St. Francis Cancer Center at St. Francis Medical Center
Shakopee, Minnesota, 55379
St. Nicholas Hospital
Sheboygan, Wisconsin, 53081
Welch Cancer Center at Sheridan Memorial Hospital
Sheridan, Wyoming, 82801
Siouxland Hematology-Oncology Associates, LLP
Sioux City, Iowa, 51101
Mercy Medical Center - Sioux City
Sioux City, Iowa, 51102
St. Luke's Regional Medical Center
Sioux City, Iowa, 51104
CCOP - Northern Indiana CR Consortium
South Bend, Indiana, 46601
Memorial Hospital of South Bend
South Bend, Indiana, 46601
Illinois CancerCare - Spring Valley
Spring Valley, Illinois, 61362
Lakeview Hospital
Stillwater, Minnesota, 55082
Green Bay Oncology, Limited - Sturgeon Bay
Sturgeon Bay, Wisconsin, 54235
Munson Medical Center
Traverse City, Michigan, 49684
Ridgeview Medical Center
Waconia, Minnesota, 55387
Cancer Center of Kansas, PA - Wellington
Wellington, Kansas, 67152
Michiana Hematology Oncology PC - La Porte
Westville, Indiana, 46391
Associates in Womens Health, PA - North Review
Wichita, Kansas, 67208
Cancer Center of Kansas, PA - Medical Arts Tower
Wichita, Kansas, 67208
Cancer Center of Kansas, PA - Wichita
Wichita, Kansas, 67214
CCOP - Wichita
Wichita, Kansas, 67214
Via Christi Cancer Center at Via Christi Regional Medical Center
Wichita, Kansas, 67214
Willmar Cancer Center at Rice Memorial Hospital
Willmar, Minnesota, 56201
Cancer Center of Kansas, PA - Winfield
Winfield, Kansas, 67156
Minnesota Oncology Hematology, PA - Woodbury
Woodbury, Minnesota, 55125
Metro Health Hospital
Wyoming, Michigan, 49519
About this study
Official title: Phase I/II Trial of Rituximab, Cladribine, and Temsirolimus (RCT) Therapy in Newly Diagnosed Mantle Cell Lymphoma (MCL)
This phase I/II trial studies the side effects and best dose of temsirolimus when given together with cladribine and rituximab and to see how well it works in treating patients with newly diagnosed mantle cell lymphoma. Monoclonal antibodies, such as rituximab, may interfere with the ability of cancer cells to grow and spread. Drugs used in chemotherapy, such as cladribine, 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. Temsirolimus may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth. Giving temsirolimus together with cladribine and rituximab may kill more cancer cells.
Read the detailed description
PRIMARY OBJECTIVES:
- To assess the efficacy and safety of the combination of rituximab, cladribine, and temsirolimus for newly diagnosed mantle cell lymphoma.
II. To determine the maximum tolerated dose (MTD) of temsirolimus combined with a fixed dose and schedule of rituximab and cladribine. (Phase I) III. To assess the efficacy of the combination of rituximab, cladribine, and temsirolimus for newly diagnosed mantle cell lymphoma with the proportion of complete responses as the primary endpoint. (Phase II)
SECONDARY OBJECTIVES:
- To assess other measures of efficacy of the regimen including progression free survival, duration of response, and overall survival.
II. To assess the toxicity profile of the combination of rituximab, cladribine, and temsirolimus.
III. To assess efficacy using traditional lymphoma parameters and absolute lymphocyte count.
IV. To assess metabolic markers (hyperglycemia, hyperlipidemia) as markers of mammalian target of rapamycin (mTOR) inhibition using the glucose and lipid measurements being performed in the clinical laboratory as part of routine care.
- To correlate response with serum free light chains, single nucleotide polymorphisms (SNPs) in host immune genes, vitamin D metabolites, and phosphatidylinositide 3-kinase (PI3K) pathway member expression.
VI. As part of ongoing research for North Central Cancer Treatment Group (NCCTG) lymphoma studies, paraffin-embedded tissue blocks/slides and blood products will be banked for future studies.
OUTLINE: This is a phase I, dose-escalation study of temsirolimus followed by a phase II study.
Patients receive rituximab intravenously (IV) on day 1 and cladribine IV over 2 hours on days 1-5. Patients then receive temsirolimus IV over 30 minutes on days 1, 8, 15, and 22. Patients also receive filgrastim subcutaneously (SC) on days 6-15 or pegfilgrastim SC on day 6. Treatment repeats every 28 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 3 months for 2 years and then every 4 months for 3 years.
- Conditions
- Lymphoma
- Being tested
- rituximab, cladribine, temsirolimus, Filgrastim, Pegfilgrastim
- Keywords
- stage I mantle cell lymphoma, Stage II Contiguous Mantle Cell Lymphoma, Stage II Non-Contiguous Mantle Cell Lymphoma, Stage III Mantle Cell Lymphoma, Stage IV Mantle Cell Lymphoma
- Medical subject headings
- Lymphoma, Lymphoma, Mantle-Cell
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
rituximabBiological
Give IV
cladribineDrug
Give IV
temsirolimusDrug
Give IV
FilgrastimBiological
Give SC
PegfilgrastimBiological
| Study group | Role | What they receive |
|---|---|---|
| Treatment (rituximab, cladribine, temsirolimus) | Experimental | Patients receive rituximab IV on day 1 and cladribine IV over 2 hours on days 1-5. Patients then receive temsirolimus IV over 30 minutes on days 1, 8, 15, and 22. Patients also receive filgrastim SC on days 6-15 or pegfilgrastim SC on day 6. Treatment repeats every 28 days for up to 6 courses in the absence of disease progression or unacceptable toxicity. Receives: Biological: rituximab; Drug: cladribine; Drug: temsirolimus; Biological: Filgrastim; Biological: Pegfilgrastim |
What is being measured
The primary outcome is the main question the study is designed to answer.
Number of dose limiting toxicity incidents as per National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) version (v) 3.0 (Phase I)
Measured: 28 days
Proportion of complete tumor responses defined as complete remission (CR) as the objective status (Phase II)
Measured: Up to 5 years
Secondary outcomes (6)
Overall survival
Measured: up to 5 years
Progression-free survival (PFS)
Measured: up to 5 years
Time to disease progression
Measured: up to 5 years
Duration of response, defined as date at which the patient's objective status is first noted to be either a CR or partial remission to the date progression is documented
Measured: Up to 5 years
Survival time
Measured: Up to 5 years
Frequency and severity of adverse events assessed by CTCAE v3.0
Measured: Up to 5 years
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted10 Nov 2008 (estimated)
- Study startApr 2009
- Primary completionApr 2012
- Study completion15 Jun 2017
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for LymphomaStudies of the same condition, open and under way.
- More trials run by Alliance for Clinical Trials in OncologyThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 1
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Enrolment
- 74 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Alliance for Clinical Trials in Oncology
- Sponsor type
- University, hospital or other
- Collaborators
- National Cancer Institute (NCI)
- Responsible party
- Sponsor
- Investigators
- David J. Inwards, MD, Study chair, Mayo Clinic
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT00787969
- Sponsor's protocol ID
- NCCTG-N078D
- Other IDs
- NCI-2009-00669, CDR0000619329
- Status last verified
- Jan 2018
- First submitted
- 7 Nov 2008
- Last updated
- 9 Jan 2018
- Results posted
- No
- Data monitoring committee
- Yes
Publications
Inwards DJ, Fishkin PA, LaPlant BR, Drake MT, Kurtin PJ, Nikcevich DA, Wender DB, Lair BS, Witzig TE. Phase I trial of rituximab, cladribine, and temsirolimus (RCT) for initial therapy of mantle cell lymphoma. Ann Oncol. 2014 Oct;25(10):2020-2024. doi: 10.1093/annonc/mdu273. Epub 2014 Jul 23.
PubMed 25057177
Study at a glance
From the registry record, last updated by the sponsor on 9 Jan 2018. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Phase I/II Trial of Rituximab, Cladribine, and Temsirolimus (RCT) Therapy in Newly Diagnosed Mantle Cell Lymphoma (MCL)
- ClinicalTrials.gov ID
- NCT00787969
- Acronym / sponsor ID
- NCCTG-N078D
- Conditions
- Lymphoma
- Keywords
- stage I mantle cell lymphoma, Stage II Contiguous Mantle Cell Lymphoma, Stage II Non-Contiguous Mantle Cell Lymphoma, Stage III Mantle Cell Lymphoma, Stage IV Mantle Cell Lymphoma
- Phase
- Phase 1
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 74 participants (estimated)
- Lead sponsor
- Alliance for Clinical Trials in OncologyUniversity, hospital or other
- Collaborators
- National Cancer Institute (NCI)
- Study start
- Apr 2009 (actual)
- Primary completion
- Apr 2012 (actual)
- Study completion
- 15 Jun 2017 (actual)
- First posted
- 10 Nov 2008 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This phase I/II trial studies the side effects and best dose of temsirolimus when given together with cladribine and rituximab and to see how well it works in treating patients with newly diagnosed mantle cell lymphoma. Monoclonal antibodies, such as rituximab, may interfere with the ability of cancer cells to grow and spread. Drugs used in chemotherapy, such as cladribine, 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. Temsirolimus may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth. Giving temsirolimus together with cladribine and rituximab may kill more cancer cells.
Detailed description
PRIMARY OBJECTIVES:
- To assess the efficacy and safety of the combination of rituximab, cladribine, and temsirolimus for newly diagnosed mantle cell lymphoma.
II. To determine the maximum tolerated dose (MTD) of temsirolimus combined with a fixed dose and schedule of rituximab and cladribine. (Phase I) III. To assess the efficacy of the combination of rituximab, cladribine, and temsirolimus for newly diagnosed mantle cell lymphoma with the proportion of complete responses as the primary endpoint. (Phase II)
SECONDARY OBJECTIVES:
- To assess other measures of efficacy of the regimen including progression free survival, duration of response, and overall survival.
II. To assess the toxicity profile of the combination of rituximab, cladribine, and temsirolimus.
III. To assess efficacy using traditional lymphoma parameters and absolute lymphocyte count.
IV. To assess metabolic markers (hyperglycemia, hyperlipidemia) as markers of mammalian target of rapamycin (mTOR) inhibition using the glucose and lipid measurements being performed in the clinical laboratory as part of routine care.
- To correlate response with serum free light chains, single nucleotide polymorphisms (SNPs) in host immune genes, vitamin D metabolites, and phosphatidylinositide 3-kinase (PI3K) pathway member expression.
VI. As part of ongoing research for North Central Cancer Treatment Group (NCCTG) lymphoma studies, paraffin-embedded tissue blocks/slides and blood products will be banked for future studies.
OUTLINE: This is a phase I, dose-escalation study of temsirolimus followed by a phase II study.
Patients receive rituximab intravenously (IV) on day 1 and cladribine IV over 2 hours on days 1-5. Patients then receive temsirolimus IV over 30 minutes on days 1, 8, 15, and 22. Patients also receive filgrastim subcutaneously (SC) on days 6-15 or pegfilgrastim SC on day 6. Treatment repeats every 28 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 3 months for 2 years and then every 4 months for 3 years.
Study design
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| Treatment (rituximab, cladribine, temsirolimus) | Experimental | Biological: rituximab, Drug: cladribine, Drug: temsirolimus, Biological: Filgrastim, Biological: PegfilgrastimPatients receive rituximab IV on day 1 and cladribine IV over 2 hours on days 1-5. Patients then receive temsirolimus IV over 30 minutes on days 1, 8, 15, and 22. Patients also receive filgrastim SC on days 6-15 or pegfilgrastim SC on day 6. Treatment repeats every 28 days for up to 6 courses in the absence of disease progression or unacceptable toxicity. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (20 listed)
- Histologically confirmed mantle cell lymphoma (MCL); the diagnosis must be confirmed by NCCTG pre-registration pathology review by Dr. Paul Kurtin or his designate; it is recommended that the biopsy be an excisional biopsy, but adequate core-needle biopsies will be accepted as long as they are considered adequate for registration by Dr. Kurtin or his designate; the tumor must be cyclin D-1 positive by immunohistochemistry or have evidence of a t(11;14) translocation by fluorescence based in situ hybridization (FISH) or cytogenetics
- Measurable or assessable disease, defined as at least one of the following:
- Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 0, 1, 2, or 3
- Life expectancy >= 12 weeks
- Absolute neutrophil count (ANC) >= 1,500/mm³
Key exclusion criteria (21 listed)
- Any prior therapy for mantle cell non-Hodgkin lymphoma including radiation therapy; exception: patient may have undergone a splenectomy for diagnosis, cytopenia, or systematic splenomegaly
- Active or uncontrolled infection
- Any of the following cardiac conditions:
- Known central nervous system (CNS) involvement
- Any of the following:
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| rituximabGive IV | Biological | Treatment (rituximab, cladribine, temsirolimus) |
| cladribineGive IV | Drug | Treatment (rituximab, cladribine, temsirolimus) |
| temsirolimusGive IV | Drug | Treatment (rituximab, cladribine, temsirolimus) |
| FilgrastimGive SC | Biological | Treatment (rituximab, cladribine, temsirolimus) |
| Pegfilgrastim | Biological | Treatment (rituximab, cladribine, temsirolimus) |
Primary outcome
Number of dose limiting toxicity incidents as per National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) version (v) 3.0 (Phase I)
Time frame: 28 days
Proportion of complete tumor responses defined as complete remission (CR) as the objective status (Phase II)
Time frame: Up to 5 years
6 secondary outcomes
Overall survival
Time frame: up to 5 years
Progression-free survival (PFS)
Time frame: up to 5 years
Time to disease progression
Time frame: up to 5 years
Duration of response, defined as date at which the patient's objective status is first noted to be either a CR or partial remission to the date progression is documented
Time frame: Up to 5 years
Survival time
Time frame: Up to 5 years
Frequency and severity of adverse events assessed by CTCAE v3.0
Time frame: Up to 5 years
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 9 Jan 2018.
- Derived from this study: PubMed 25057177Inwards DJ, Fishkin PA, LaPlant BR, Drake MT, Kurtin PJ, Nikcevich DA, Wender DB, Lair BS, Witzig TE. Phase I trial of rituximab, cladribine, and temsirolimus (RCT) for initial therapy of mantle cell lymphoma. Ann Oncol. 2014 Oct;25(10):2020-2024. doi: 10.1093/annonc/mdu273. Epub 2014 Jul 23.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
David J. Inwards, MD study chair
Mayo Clinic
144 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 1 study testing rituximab, cladribine and temsirolimus in people with Lymphoma, run by Alliance for Clinical Trials in Oncology at 144 sites in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 20 inclusion and 21 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 9 Jan 2018. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 144 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Number of dose limiting toxicity incidents as per National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) version (v) 3.0 (Phase I) (time frame: 28 days). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT00787969, which also lists 1 linked publication.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 9 Jan 2018.