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A Phase II, Multicenter, Open-Label Trial Evaluating the Activity and Tolerability of Romidepsin (Depsipeptide, FK228) in Progressive or Relapsed Peripheral T-cell Lymphoma Following Prior Systemic Therapy


Phase 2
18 Years
N/A
Open (Enrolling)
Both
Peripheral T-cell Lymphoma

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Trial Information

A Phase II, Multicenter, Open-Label Trial Evaluating the Activity and Tolerability of Romidepsin (Depsipeptide, FK228) in Progressive or Relapsed Peripheral T-cell Lymphoma Following Prior Systemic Therapy


Inclusion Criteria:



Patients must fulfill all of the following criteria to be eligible for study participation
and have:

- Histologically confirmed PTCL not otherwise specified, angioimmunoblastic T-cell
lymphoma, extranodal natural killer (NK)/T-cell lymphoma nasal type, enteropathy-
type T-cell lymphoma, subcutaneous panniculitis-like T-cell lymphoma, cutaneous γδ
T-cell lymphoma (excludes mycosis fungoides or Sezary syndrome), transformed mycosis
fungoides, hepatosplenic T-cell lymphoma, anaplastic large cell lymphoma (ALCL;
anaplastic lymphoma kinase [ALK]-1 negative), or patients with ALK 1 expressing ALCL
(ALK-1 positive) who have relapsed disease after autologous stem cell transplant
(ASCT);

- Age ≥18 years;

- Written informed consent;

- Progressive disease following at least one systemic therapy or refractory to at least
one prior systemic therapy;

- Measurable disease according to the International Workshop Response (IWC) criteria
and/or measurable cutaneous disease;

- Eastern Cooperative Oncology Group (ECOG) performance status of 0-2;

- Serum potassium ≥3.8 mmol/L and magnesium ≥0.85 mmol/L (electrolyte abnormalities can
be corrected with supplementation to meet inclusion criteria);

- Negative urine or serum pregnancy test on females of childbearing potential; and

- All women of childbearing potential must use an effective barrier method of
contraception (either an intrauterine contraceptive device [IUCD] or double barrier
method using condoms or a diaphragm plus spermicide) during the treatment period and
for at least 1 month thereafter. Male patients should use a barrier method of
contraception during the treatment period and for at least 1 month thereafter.
Hormonal methods of contraception such as the contraceptive pill or patch
(particularly those containing ethinyl-estradiol) should be avoided due to a
potential drug interaction.

Exclusion Criteria:

Patients are ineligible for entry if any of the following criteria are met:

- Known central nervous system (CNS) lymphoma [computed tomography (CT) or magnetic
resonance imaging (MRI) scans are required only if brain metastasis is suspected
clinically];

- Chemotherapy or immunotherapy within 4 weeks of study entry (6 weeks if nitrosoureas
given);

- Initiation of corticosteroids during study (defined as 7 days prior to Cycle 1 Day
1[C1D1] until study drug discontinuation)

- Patients treated with a pulse of steroids were to discontinue steroid use 7 days
prior to C1D1 and have a repeat CT scan and disease assessment after
discontinuation of corticosteroids and before starting romidepsin;

- Concomitant use of any other anti-cancer therapy;

- Concomitant use of any investigational agent;

- Use of any investigational agent within 4 weeks of study entry;

- Any known cardiac abnormalities such as:

- Congenital long QT syndrome;

- QTc interval >480 milliseconds (msec);

- A myocardial infarction within 6 months of C1D1. Patients with a history of
myocardial infraction between 6 and 12 months prior to C1D1 who are asymptomatic
and have had a negative cardiac risk assessment (treadmill stress test, nuclear
medicine stress test, or stress echocardiogram) since the event may participate;

- Other significant electrocardiogram (ECG) abnormalities including 2nd degree
atrio-ventricular (AV) block type II, 3rd degree AV block, or bradycardia
(ventricular rate less than 50 beats/min).

- Symptomatic coronary artery disease (CAD), e.g., angina Canadian Class II-IV.
In any patient in whom there is doubt, the patient should be referred to a
cardiologist for evaluation;

- An ECG recorded at screening showing significant ST depression (ST depression of
≥2 mm, measured from isoelectric line to the ST segment at a point 60 msec at
the end of the QRS complex). If in any doubt, the patient should have a stress
imaging study and, if abnormal, angiography to define whether or not CAD is
present;

- Congestive heart failure (CHF) that meets New York Heart Association (NYHA)
Class II to IV definitions and/or ejection fraction <40% by MUGA scan or <50% by
echocardiogram and/or MRI;

- A known history of sustained ventricular tachycardia (VT), ventricular
fibrillation (VF), Torsade de Pointes, or cardiac arrest unless currently
addressed with an automatic implantable cardioverter defibrillator (AICD);

- Hypertrophic cardiomyopathy or restrictive cardiomyopathy from prior treatment
or other causes (if in doubt, see ejection fraction criteria above);

- Uncontrolled hypertension, i.e., blood pressure (BP) of ≥160/95; patients who
have a history of hypertension controlled by medication must be on a stable dose
(for at least one month) and meet all other inclusion criteria;

- Any cardiac arrhythmia requiring anti-arrhythmic medication;

- Serum potassium <3.8 mmol/L or serum magnesium <0.85 mmol/L (electrolyte
abnormalities can be corrected with supplementation to meet inclusion criteria);

- Concomitant use of drugs that may cause a significant prolongation of the QTc;

- Concomitant use of CYP3A4 significant or moderate inhibitors;

- Concomitant use of therapeutic warfarin or another anticoagulant due to a potential
drug interaction. Use of a small dose of a anticoagulant to maintain patency of
venous access port and cannulas is permitted;

- Clinically significant active infection;

- Known infection with human immunodeficiency virus (HIV), hepatitis B, or hepatitis C;

- Previous extensive radiotherapy involving ≥30% of bone marrow (e.g., whole pelvis,
half spine), excluding patients who have had total body irradiation as part of a
conditioning regimen for ASCT;

- Major surgery within 2 weeks of study entry;

- Previous allogeneic stem cell transplant;

- Inadequate bone marrow or other organ function as evidenced by:

- Hemoglobin <9 g/dL (transfusions and/or erythropoietin are permitted);

- Absolute neutrophil count (ANC) ≤1.0 × 10^9 cells/L [patients with neutropenia
(ANC 1-1.5 10^9 cells/L) as a function of their disease may be supported with
granulocyte-colony stimulating factor (G-CSF)];

- Platelet count <100 × 10^9 cells/L or platelet count <75 × 10^9 cells/L if bone
marrow disease involvement is documented;

- Total bilirubin >2.0 × upper limit of normal (ULN) or >3.0 × ULN in the presence
of demonstrable liver metastases;

- Aspartate transaminase/serum glutamic oxaloacetic transaminase (AST/SGOT) and
alanine transaminase/serum glutamic pyruvic transaminase (ALT/SGPT) >2.0 × ULN
or >3.0 × ULN in the presence of demonstrable liver metastases; or

- Serum creatinine >2.0 × ULN;

- Patients who are pregnant or breast-feeding;

- Coexistent second malignancy or history of prior solid organ malignancy within
previous 3 years (excluding basal or squamous cell carcinoma of the skin, and in situ
carcinoma of the cervix (CIN 1) that has been treated curatively);

- Any prior history of a hematologic malignancy (other than T-cell lymphoma);

- Any significant medical or psychiatric condition that might prevent the patient from
complying with all study procedures; or

- Prior exposure to romidepsin (other histone deacetylase inhibitors are allowed).

Type of Study:

Interventional

Study Design:

Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment

Outcome Measure:

Percentage of Participants With a Complete Response According to the International Workshop Response Criteria (IWC) for Non-Hodgkin's Lymphomas (NHL) Assessed by an Independent Review Committee

Outcome Description:

Complete Response (CR): >75% decrease in size aggregate of nodal index lesions (large and small), complete disappearance of extranodal and non-index lesions; total disappearance of clinical disease including skin involvement; disease-related signs and symptoms, normalization of biochemical abnormalities and reduction in size of spleen or liver so no longer palpable. Unconfirmed CR: all above criteria except all nodal index lesions must have regressed >75% in the sum of the product diameters (SPD) from baseline. Individual nodes previously confluent must have regressed by >75% in their SPD.

Outcome Time Frame:

Response was assessed after every 2 cycles of treatment and at completion of therapy, up until 31 October 2010 (maximum duration on study was 1086 days).

Safety Issue:

No

Principal Investigator

Jean Nichols, Ph.D.

Investigator Role:

Study Director

Investigator Affiliation:

Celgene Corporation

Authority:

United States: Food and Drug Administration

Study ID:

GPI-06-0002

NCT ID:

NCT00426764

Start Date:

June 2007

Completion Date:

December 2012

Related Keywords:

  • Peripheral T-cell Lymphoma
  • peripheral T-cell lymphoma
  • T-cell lymphoma
  • romidepsin
  • Lymphoma
  • Lymphoma, T-Cell
  • Lymphoma, T-Cell, Peripheral

Name

Location

Memorial Sloan Kettering Cancer Center New York, New York  10021
Fred Hutchinson Cancer Research Center Seattle, Washington  98109
University of Texas Health Science Center at San Antonio San Antonio, Texas  78284-7811
Georgetown University Washington, District of Columbia  20007-2197
Northwest Cancer Specialists Vancouver, Washington  98664
Yale University New Haven, Connecticut  06520
Augusta Oncology Associates Augusta, Georgia  30901
H. Lee Moffitt Cancer Center & Research Institute Tampa, Florida  33612
Cancer Centers of Florida Orlando, Florida  32806
U.T. M.D. Anderson Cancer Center Houston, Texas  77030
Tufts Medical Center Boston, Massachusetts  02111
Arch Medical Services, INC. St. Louis, Missouri  63142
El Paso Cancer Treatment Center El Paso, Texas  79915
Columbia University Medical Center New York, New York  10032
Cancer Care & Hematology Specialists of Chicagoland Niles, Illinois  60714
Weill Cornell Medical College New York, New York  10021
Northwest Cancer Specialists Portland, Oregon  97225
Rush University Chicago, Illinois  60612
UT Southwestern Medical Center, Simmons Comprehensive Cancer Center Dallas, Texas  
University of California at San Diego - Moore Cancer institute La Jolla, California  92093
UCLA Medical Center Division for Oncology and Hematology Los Angeles, California  90095
Rocky Mountain Cancer Center-12 locations in CO Denver, Boulder, Aurora, Colorado Springs, etc., Colorado  80909
Winship Cancer Institute - Emory University Atlanta, Georgia  30322
Central Georgia Cancer Care Macon, Georgia  31201
St Agnes Hospital Baltimore, Maryland  21229
Centers for Cancer and Blood Disorders Bethesda, Maryland  20817
Center for Cancer Research National Cancer Institute Bethesda, Maryland  20892
Nebraska Methodist Hospital, Eastbrook Cancer Center Omaha, Nebraska  68114
Hackensack University, The Cancer Center at HUMC Hackensack, New Jersey  07601