A Phase I/II Study of VELCADE in Combination With Gemcitabine in Relapsed B-Cell Non-Hodgkin's Lymphoma
Inclusion Criteria:
- Patients must have histologically or cytologically confirmed intermediate or high
grade B-cell Non-Hodgkin lymphoma with primary progressive or relapsed disease
- Patients may have had up to 4 prior chemo-and-or radiation therapy regiments,
including one autologous transplant based protocol; any prior therapy (chemotherapy
or radiation) must have been completed at least 4 weeks prior to start of this
protocol; for prior high-dose chemotherapy with stem cell transplant, a 6-week
interval is required; all side effects must have resolved
- Karnofsky performance status >= 60%
- Life expectancy of greater than 3 months
- Absolute neutrophil count >= 1,500 mm^3
- Platelets >= 50,000 mm^3
- Total bilirubin =< 1.5 mg/dl
- Aspartate aminotransferase (AST) (serum glutamic oxaloacetic transaminase [SGOT]) =<
2.5 x institutional upper limit of normal
- Creatinine within normal institutional limits OR creatinine clearance >= 50 mL/min
for creatinine levels above institutional normal (calculated or measured)
- Cardiac ejection fraction of > 40% by echocardiogram or multi gated acquisition
(MUGA) scan
- Have no serious or intercurrent medical illness
- Voluntary written informed consent before performance of any study-related procedure
not part of normal medical care, with the understanding that consent may be withdrawn
by the subject at any time without prejudice to future medical care
- Female subject is either post-menopausal or surgically sterilized or willing to use
an acceptable method of birth control (i.e., a hormonal contraceptive, intra-uterine
device, diaphragm with spermicide, condom with spermicide, or abstinence) for the
duration of the study
- Male subject agrees to use an acceptable method for contraception for the duration of
the study
Exclusion Criteria:
- Patient has a platelet count of < 20 x 10^9/L with 7 days before enrollment
- Patient has an absolute neutrophil count of < 1.0 x 10^9/L within 7 days before
enrollment
- Patient has a calculated or measured creatinine clearance of < 30 ml/min with 14 days
before enrollment
- Patient has >= Grade 2 peripheral neuropathy within 14 days before enrollment
- Patient has hypersensitivity to bortezomib, boron, or mannitol
- Female subject is pregnant or breastfeeding; confirmation that the subject is not
pregnant must be established by a negative serum beta-human chorionic gonadotropin
(beta-hCG) pregnancy test result obtained during screening; pregnancy testing is not
required for postmenopausal or surgically sterilized women
- Patient has received other investigational drugs with 14 days before enrollment
- Serious medical or psychiatric illness likely to interfere with participation in this
clinical study
- Patients who have had more than 4 prior different chemotherapy regimens will be
excluded; patients who have had chemotherapy or radiotherapy within 4 weeks (6 weeks
for autologous transplant regimens) prior to entering the study or those who have not
recovered from adverse events due to agents administered more than 4 weeks earlier
- Patients may not have previously received VELCADE or gemcitabine
- Patients with active central nervous system (CNS) involvement are not eligible
- Human immunodeficiency virus (HIV)-positive patients receiving combination
anti-retroviral therapy
- Uncontrolled intercurrent illness including, but not limited to, ongoing or active
infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac
arrhythmia, or psychiatric illness/social situations that would limit compliance with
study requirements