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Last Modified: 11/1/2006     First Published: 3/24/2003  
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Phase I Study of Flavopiridol, Fludarabine, and Rituximab in Patients With Indolent B-Cell Lymphoproliferative Disorders or Mantle Cell Lymphoma

Alternate Title
Basic Trial Information
Objectives
Entry Criteria
Expected Enrollment
Outline
Trial Contact Information
Registry Information

Alternate Title

Flavopiridol, Fludarabine, and Rituximab in Treating Patients With Lymphoproliferative Disorders or Mantle Cell Lymphoma

Basic Trial Information

Phase
Type
Status
Age
Sponsor
Protocol IDs

Phase I


Treatment


Closed


18 and over


NCI


OSU-02H0281
OSU-0211, NCI-5745, NCT00058227, 5745

Objectives

Primary

  1. Determine the maximum tolerated dose of flavopiridol in combination with standard-dose rituximab and fludarabine in patients with indolent B-cell lymphoproliferative disorders or mantle cell lymphoma.
  2. Determine the toxicity of this regimen in these patients.
  3. Determine the safety, toxicity, and efficacy of administering flavopiridol as a 30-minute bolus followed by a 4-hour infusion in patients treated with this regimen.

Secondary

  1. Determine the pharmacokinetics and pharmacodynamics of this regimen in these patients.

Entry Criteria

Disease Characteristics:

  • Histologically confirmed mantle cell lymphoma OR indolent B-cell lymphoproliferative disorders of any of the following types:
    • Chronic lymphocytic leukemia
    • Small lymphocytic lymphoma
    • Follicular center cell non-Hodgkin's lymphoma (grade I or II)
    • Marginal zone lymphoma
    • Waldenstrom's macroglobulinemia
    • Hairy cell leukemia


  • Previously untreated or relapsed/refractory disease


  • No evidence of histological transformation to an intermediate-grade or aggressive lymphoma


  • CD20 positive by immunoperoxidase or flow cytometry


  • Evaluable disease with presence of 1 of the following criteria:
    • Absolute lymphocyte count greater than 5,000/mm3
    • At least 1 measurable node greater than 2 cm by CT scan OR measurable disease in a lymphoid structure (spleen)
    • Bone marrow involvement (greater than 20% of marrow cellularity)


Prior/Concurrent Therapy:

Biologic therapy

  • Not specified

Chemotherapy

  • At least 6 weeks since prior nitrosourea or mitomycin
  • No more than 6 prior courses of fludarabine

Endocrine therapy

  • No concurrent corticosteroids as antiemetics

Radiotherapy

  • Not specified

Surgery

  • Not specified

Other

  • At least 4 weeks since prior therapy for disease
  • No more than 3 prior treatments for disease (not including steroids alone)

Patient Characteristics:

Age

  • 18 and over

Performance status

  • ECOG 0-2

Life expectancy

  • Not specified

Hematopoietic

  • See Disease Characteristics
  • Absolute neutrophil count at least 1,500/mm3*
  • Platelet count at least 100,000/mm3*
  • Hemoglobin at least 9.0 g/dL*

 [Note: *Unless due to hematologic malignancy]

Hepatic

  • Bilirubin no greater than 2 times normal
  • AST no greater than 2 times normal

Renal

  • Creatinine no greater than 2.0 mg/dL

    OR

  • Creatinine clearance at least 50 mL/min
  • No renal dysfunction that would impair tolerance or compliance with study therapy

Cardiovascular

  • No cardiac dysfunction that would impair tolerance or compliance with study therapy

Pulmonary

  • No pulmonary dysfunction that would impair tolerance or compliance with study therapy

Other

  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception
  • No chronic gastrointestinal disease (e.g., Crohn's disease, ulcerative colitis, short gut syndrome) that would impair tolerability of compliance with therapy
  • No neurological or psychiatric dysfunction that would impair tolerability of or compliance with study therapy

Expected Enrollment

37

A total of 37 patients will be accrued for this study.

Outline

This is a dose-escalation study of flavopiridol.

Patients receive fludarabine IV over 15-30 minutes on days 1-5 and rituximab IV over 3-4 hours on day 1. Flavopiridol is administered IV over 60 minutes on day 1 in cohort 1; on days 1 and 2 in cohort 2; and on days 1, 2, and 3 in cohort 3. In cohorts 4 and 5, patients receive fludarabine and rituximab as above and flavopiridol IV over 30 minutes and then IV over 4 hours on day 1 of courses 2-6. Treatment repeats every 28 days for up to 6 courses in the absence of disease progression or unacceptable toxicity.

A total of 10-12 patients are treated with flavopiridol at the maximum tolerated dose.

Trial Contact Information

Trial Lead Organizations

Arthur G. James Cancer Hospital and Solove Research Institute at Ohio State University Medical Center

Thomas Lin, MD, PhD, Protocol chair
Ph: 614-293-5655
Email: thomas.lin@osumc.edu

Registry Information
Official Title A Phase I Study of Flavopiridol, Fludarabine and Rituximab in Indolent B-Cell Lymphoproliferative Disorders and Mantle Cell Lymphoma
Trial Start Date 2003-04-21
Registered in ClinicalTrials.gov NCT00058227
Date Submitted to PDQ 2003-02-25
Information Last Verified 2006-10-24
NCI Grant/Contract Number CA76576, CA16058

Note: The purpose of most clinical trials listed in this database is to test new cancer treatments, or new methods of diagnosing, screening, or preventing cancer. Because all potentially harmful side effects are not known before a trial is conducted, dose and schedule modifications may be required for participants if they develop side effects from the treatment or test. The therapy or test described in this clinical trial is intended for use by clinical oncologists in carefully structured settings, and may not prove to be more effective than standard treatment. A responsible investigator associated with this clinical trial should be consulted before using this protocol.

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