Intratumoral Injection of an Immunostimulatory CpG, SD-101, Combined With Local Radiation for the Treatment of Recurrent or Progressive Lymphoma After Allogeneic Hematopoietic Cell Transplantation
试验速览
- 阶段
- 1 期
- 状态
- 终止
- 发起方
- 入组人数
- 6
- 试验地点
- 1
- 主要终点
- Determination of the maximum tolerated dose based on dose limiting toxicity defined as any new grade 3-4 toxicity after the first SD-101 administration
研究概览
简要总结
For patients with lymphoma that recurs after chemotherapy, bone marrow transplantation using cells from a healthy donor represents potentially curative treatment. In these individuals, cure is possible because transplantation of healthy donor immune cells can fight the lymphoma in the patient. The goal of this work is to test a strategy that activates the healthy donor immune cells so that they more effectively fight lymphoma and can result in an increased cure rate for these patients. Our group has previously studied CpG, an immune activating medication, in patients with lymphoma and demonstrated modest anti-tumor responses. We now have a more potent form of CpG which we intend to test to see if it will better activate the donor immune cells and result in shrinkage of tumor throughout the entire body, not just at the injected site.
详细描述
Patients will receive low dose radiation to all bulky or symptomatic lymph nodes on days -2 and -1. SD-101 will be administered intratumorally to the single largest palpable node within 24 hours after completion of radiation, on day 0. Two additional intratumoral SD-101 injections will be performed on days 7 (+/- 2 days) and 14 (+/- 2 days). This is a dose ranging study using a 3+3 design with a definition of maximum tolerated dose (MTD) which our group has found acceptable in the past. The first cohort of patients will receive a SD-101 dose of 0.3 mg per injection. The dose will be escalated to 1 mg and 3 mg based on dose limiting toxicity (DLT).
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Biopsy-confirmed relapsed, refractory, or progressive NHL or HL (Refer to Section 3.2.1 for excluded subtypes)
- •At least 3 sites of disease
- •One for diagnosis (lymph node or bone marrow biopsy)
- •One palpable for treatment
- •One measurable radiographically
- •> 60 days after RIC allogeneic transplant for lymphoma
- •18 years of age or older
- •Mixed (5-95%) or complete (>95%) chimerism
- •Eastern Oncology Cooperative Group (ECOG) performance status ≤ 2
- •ANC >1000/mm3, platelets >50,000/mm3
- •Total bilirubin ≤ 2.5 mg/dL, AST and ALT < 3 times upper limit of normal
- •Serum creatinine ≤ 3 mg/dL
- •No chemotherapy, RT, DLI or biologic therapy for lymphoma at least 4 weeks prior to scheduled treatment
- •Minimal immunosuppression (defined as monotherapy with ≤ 10 mg prednisone daily, ≤ 200 mg cyclosporine daily, or ≤ 2 mg tacrolimus daily) at least 2 weeks prior to scheduled treatment
排除标准
- •HIV associated lymphoma
- •Acute GVHD at time of enrollment (history of treated and resolved GVHD is permitted)
- •Active infection within 14 days prior to scheduled treatment
- •Active Cytomegalovirus (CMV) disease at the time of enrollment
- •Pre-existing autoimmune or antibody mediated disease (including systemic lupus erythematosus, rheumatoid arthritis, multiple sclerosis, Sjogren's syndrome, and autoimmune thrombocytopenia)
研究组 & 干预措施
SD-101 + Combined with Local Radiation
干预措施: SD-101 (Drug)
SD-101 + Combined with Local Radiation
干预措施: Local Radiation (Radiation)
结局指标
主要结局
Determination of the maximum tolerated dose based on dose limiting toxicity defined as any new grade 3-4 toxicity after the first SD-101 administration
时间窗: 60 Days
次要结局
- Measure cytotoxic T-cell activity changes pre- and post-treatment of tumor infiltrating lymphocytes and peripheral blood lymphocytes using ELISA and Immunohistochemistry.(2, 3, 8 weeks after treatment)
- Measure tumor response by PET-CT scan imaging(8 weeks after treatment)
- Measure level of donor specific tumor infiltrating lymphocytes by flow cytometry and Immunofluorescence(2, 3, 8 weeks after treatment)
研究者
Robert Lowsky
Associate Professor of Medicine
Stanford University