A Phase I Study Evaluating Escalating Doses of 90Y-BC8-DOTA (Anti-CD45) Antibody Followed by Autologous Stem Cell Transplantation for Relapsed or Refractory Lymphoid Malignancies
Overview
- Phase
- Phase 1
- Intervention
- Not specified
- Conditions
- Adult Nasal Type Extranodal NK/T-cell Lymphoma
- Sponsor
- Fred Hutchinson Cancer Center
- Enrollment
- 2
- Locations
- 1
- Primary Endpoint
- Percentage of Participants With Dose Limiting Toxicities (DLT) of Yttrium-90 Anti-CD45
- Status
- Terminated
- Last Updated
- 5 years ago
Overview
Brief Summary
This phase I trial studies the side effects and best dose of monoclonal antibody therapy before stem cell transplant in treating patients with relapsed or refractory lymphoid malignancies. Radiolabeled monoclonal antibodies, such as yttrium-90 anti-CD45 monoclonal antibody BC8, can find cancer cells and carry cancer-killing substances to them without harming normal cells. When the healthy stem cells from a donor are infused into the patient they may help the patient's bone marrow make stem cells, red blood cells, white blood cells, and platelets. Giving radiolabeled monoclonal antibody before a stem cell transplant may be an effective treatment for relapsed or refractory lymphoid malignancies.
Detailed Description
PRIMARY OBJECTIVES: I. To estimate the maximally tolerated dose (MTD) of 90Y-BC8-DOTA (anti-cluster of differentiation \[CD\]45) (yttrium-90 anti-CD45 monoclonal antibody BC8) that can be delivered prior to autologous stem cell transplantation for patients with relapsed/refractory B-cell non-Hodgkin lymphoma (B-NHL), T-cell NHL (T-NHL), and Hodgkin lymphoma (HL). SECONDARY OBJECTIVES: I. To optimize the protein dose (antibody \[Ab\]) to deliver a favorable biodistribution in the majority of patients. II. To describe the impact of rituximab concentrations, B-cell depletion, and disease burden on CD20 and CD45 targeting. III. To describe response rates and remission durations in relapsed B-NHL, T-NHL, and HL following administration of myeloablative doses of 90Y-BC8-DOTA prior to autologous stem cell transplant (ASCT). IV. To assess the correlation of lymphoma biomarkers with outcomes. OUTLINE: This is a dose-escalation study of yttrium-90 anti-CD45 monoclonal antibody BC8. Patients receive indium-111 anti-CD45 monoclonal antibody BC8 intravenously (IV) on day -28 and (if necessary) day -21 to evaluate the antibody's biodistribution. Patients then receive yttrium-90 anti-CD45 monoclonal antibody BC8 IV on day -14. Patients then undergo autologous peripheral blood stem cell transplantation on day 0. After completion of study treatment, patients are followed up at 3, 6, and 12 months and then annually thereafter.
Investigators
Ajay Gopal
Principal Investigator
Fred Hutchinson Cancer Center
Eligibility Criteria
Inclusion Criteria
- •Patients must have a histologically confirmed diagnosis of B-NHL, T-NHL, or HL; only patients with classical HL must have documented histologic demonstration of CD45+ cells adjacent to the Reed Sternberg cells; patients must have received at least one prior standard systemic therapy with documented recurrent or refractory disease; patients with mantle cell lymphoma (MCL), T-NHL, or other high-risk malignancies may be enrolled/transplanted in complete remission (CR)/first partial remission (PR1)
- •Creatinine \< 2.0
- •Bilirubin \< 1.5 mg/dL
- •All patients eligible for therapeutic study must have a minimum of \>= 2 x 10\^6 CD34/kg autologous hematopoietic stem cells harvested and cryopreserved
- •Patients must have an expected survival of \> 60 days and must be free of major infection
- •Patients are preferred to have either a tumor mass amenable to core needle biopsy during the dosimetry phase, or a measurable tumor mass with at least one site of involvement measuring 2.5 cm in largest dimension on computed tomography (CT) imaging for purposes of planar and/or single-photon emission computed tomography (SPECT)/CT tumor dosimetry
Exclusion Criteria
- •Circulating human anti-mouse antibody (HAMA), to be determined before each infusion
- •Systemic anti-lymphoma therapy given in the previous 30 days before the scheduled therapy dose with the exception of rituximab
- •Inability to understand or give an informed consent
- •Lymphoma involving the central nervous system
- •Other serious medical conditions considered to represent contraindications to ASCT (e.g., abnormally decreased cardiac ejection fraction, diffusion capacity of the lung for carbon monoxide \[DLCO\] \< 50% predicted, acquired immune deficiency syndrome \[AIDS\], etc.)
- •Known human immunodeficiency virus (HIV) seropositivity
- •Pregnancy or breast feeding
- •Prior allogeneic bone marrow or stem cell transplant
- •Prior autologous bone marrow or stem cell transplant within 1 year of enrollment
- •Prior radiation therapy (RT) \> 20 Gray (Gy) to a critical organ within 1 year of enrollment
Outcomes
Primary Outcomes
Percentage of Participants With Dose Limiting Toxicities (DLT) of Yttrium-90 Anti-CD45
Time Frame: Up to 30 days after receiving study drug
A DLT (dose limiting toxicity) is defined as a therapy-related grade III or IV Bearman (transplant) toxicity within 30 days of transplant.
Secondary Outcomes
- Tumor to Normal Organ Ratios(Up to 6 years)
- Overall Response Rate(Up to 6 years)
- Overall Survival(Up to 6 years)
- Progression-free Survival(Up to 6 years)