A Phase II Study of the Novel Proteasome Inhibitor Bortezomib in Combination With Rituximab, Cyclophosphamide and Prednisone in Patients With Relapsed/Refractory Indolent B-Cell Lymphoproliferative Disorders and Mantle Cell Lymphoma (MCL)
OBJECTIVES:
Primary
- Determine the maximum tolerated dose of bortezomib when given in combination with
rituximab, cyclophosphamide, and prednisone (R-CP) in patients with relapsed or
refractory indolent B-cell lymphoproliferative disorders or mantle cell lymphoma.
(phase I)
- Determine the frequency and duration of complete and partial responses in patients
treated with two different treatment regimes. (phase II)
Secondary
- Evaluate the progression-free survival, event-free survival, and overall survival of
patients treated with this regimen. (phase II)
- Evaluate the toxicity profile of this regimen.
OUTLINE: This is a phase I dose-escalation study of bortezomib followed by a phase II
randomized, multicenter study. Patients in phase II are stratified according to disease
(mantle cell lymphoma vs indolent B-cell lymphoproliferative disorder vs transformed
lymphoma).
- Phase I: Patients receive cyclophosphamide IV and rituximab IV on day 1, oral
prednisone on days 2-6, and bortezomib IV on days 2 and 7. Treatment repeats every 21
days for 8 courses in the absence of disease progression or unacceptable toxicity.
Cohorts of 3-6 patients receive escalating doses of bortezomib until the maximum tolerated
dose (MTD) is determined. The MTD is defined as the dose preceding that at which 1 of 3 or 2
of 6 patients experience dose-limiting toxicity.
- Phase II: Patients are randomized to 1 of 2 treatment arms.
- Arm I: Patients receive cyclophosphamide IV and rituximab IV on day 1, oral
prednisone on days 2-6, and bortezomib IV (at the MTD determined in phase I) on
days 2, 5, 9, and 12. Treatment repeats every 21 days for up to 8 courses in the
absence of disease progression or unacceptable toxicity.
- Arm II: Patients receive cyclophosphamide IV and rituximab IV on day 1, oral
prednisone on days 2-6, and bortezomib IV (at the MTD determined in phase I) on
days 2 and 8. Treatment repeats every 21 days for up to 8 courses in the absence
of disease progression or unacceptable toxicity.
After completion of study treatment, patients are followed at 1 month, every 4 months for 2
years, and then every 6 months thereafter.
Interventional
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
Maximum tolerated dose
2 years
Yes
John F. Gerecitano, MD, PhD
Study Chair
Memorial Sloan-Kettering Cancer Center
United States: Institutional Review Board
05-103
NCT00295932
December 2005
September 2014
Name | Location |
---|---|
Memorial Sloan-Kettering Cancer Center | New York, New York 10021 |
Winship Cancer Institute of Emory University | Atlanta, Georgia 30322 |
Cancer Institute of New Jersey at UMDNJ - Robert Wood Johnson Medical School | New Brunswick, New Jersey 08903 |
Herbert Irving Comprehensive Cancer Center at Columbia University Medical Center | New York, New York 10032 |
Memorial Sloan-Kettering at Basking Ridge | Basking Ridge, New Jersey 07920 |
Memorial Sloan-Kettering Cancer Center @ Suffolk | Commack, New York 11725 |
Memorial Sloan-Kettering at Mercy Medical Center | Rockville Centre, New York |
Memoral Sloan Kettering Cancer Center@Phelps | Sleepy Hollow, New York |