SAHA + CHOP in Untreated T-cell Non-Hodgkin's Lymphoma

NCT00787527 | Completed Phase 1 Results

• 1 other identifier: 2008-0484
• Study Type: interventional
• Target: 14
• Locations: 1 country
• Sites: 1

Brief Summary

The goal of this clinical research study is to find out how well the drug Zolinza (vorinostat) works in combination with the drug combination called CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) to treat patients with untreated T-cell Non-Hodgkin's Lymphoma (NHL). The safety of these drugs in combination and the best dose of vorinostat when given in combination with CHOP will also be studied.

Conditions

Lymphoma

Keywords

Lymphoma; Non-Hodgkin's Lymphoma; SAHA; Vorinostat; Suberoylanilide Hydroxamic Acid; MSK-390; CHOP; Cyclophosphamide; Doxorubicin; AD; Hydroxydaunomycin hydrochloride; Cytoxan; Neosar; Vincristine; Prednisone; Untreated T-cell; T-cell NHL; Peripheral T-cell lymphoma; PTCL; CD 30; Anaplastic large cell lymphoma; Angioimmunoblastic T-cell lymphoma; Intestinal T-cell lymphoma; Subcutaneous panniculitic T-cell lymphoma

Outcome Measures

Primary Outcomes (3)

• Phase I Maximum Tolerated Dose (MTD) of Vorinostat

  MTD of Vorinostat when administered in combination with Cyclophosphamide, Doxorubicin, Vincristine, Prednisone (CHOP) defined as highest dose level in which 6 patients have been treated with less than 2 instances of dose limiting toxicity (DLT). Continual reassessment during each 21-day cycle to assess dose limiting toxicity. Two schedules of Vorinostat were investigated: Phase I A) daily doses on days 5 to 14, or Phase II B) three times a day on days -2 to 3 of standard CHOP every 21 days. Vorinostat was administered orally on days 5 to 14 (Schedule A), first at 300 mg orally once daily (total doses of 3000 mg over 10 days per cycle), and next at 200 mg orally twice daily (total doses of 4000 mg over 10 days per cycle); and for Phase II Schedule B Vorinostat administered orally 300 mg orally three times daily from days -2 to 3 (4500 mg over 5 days per cycle).

  21 Days

• Number of Participants With Dose Limiting Toxicity for Determination Phase I (Schedule A) MTD of Vorinostat

  MTD of Vorinostat defined as highest dose level in which 6 patients have been treated with less than 2 instances of DLT. Continual reassessment during each 21-day cycle to assess DLT. Vorinostat was administered orally on days 5 to 14 (Schedule A), first at 300 mg orally once daily (total doses of 3000 mg over 10 days per cycle), and next at 200 mg orally twice daily (total doses of 4000 mg over 10 days per cycle. The dose of Vorinostat escalated in successive 3+3 cohorts of participants to determine the MTD.

  21 Days

• Phase II MTD of Vorinostat

  MTD of Vorinostat when administered in combination with Cyclophosphamide, Doxorubicin, Vincristine, Prednisone (CHOP) defined as highest dose level in which 6 patients have been treated with less than 2 instances of dose limiting toxicity (DLT). Continual reassessment during each 21-day cycle to assess dose limiting toxicity. Two schedules of Vorinostat were investigated: Phase I A) daily doses on days 5 to 14, or Phase II B) three times a day on days -2 to 3 of standard CHOP every 21 days. Vorinostat was administered orally on days 5 to 14 (Schedule A), first at 300 mg orally once daily (total doses of 3000 mg over 10 days per cycle), and next at 200 mg orally twice daily (total doses of 4000 mg over 10 days per cycle); Schedule B Vorinostat administered orally 300 mg orally three times daily from days -2 to 3 (4500 mg over 5 days per cycle).

  21 Days

Study Arms (1)

Zolinza + CHOP

EXPERIMENTAL

Zolinza (vorinostat) + CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone)

Drug: Zolinza (vorinostat); Drug: Cyclophosphamide; Drug: Doxorubicin; Drug: Vincristine; Drug: Prednisone

Interventions

Zolinza (vorinostat) DRUG

Up to two 100 mg capsules of Vorinostat (dosage will vary from 100 mg orally (PO) twice daily (BID), 300 mg PO every evening and 200 mg PO BID with the starting dose at 300 mg PO every evening for the phase I trial) are to be administered orally twice daily (once in the morning and once in the evening, or if in the daily dosing cohort once in the evening) in repeated 21-day cycles consisting of 10 days dosing starting on days 5 through 14 followed by a 7-day rest period, during which no vorinostat will be administered.

Also known as: vorinostat, SAHA, Suberoylanilide Hydroxamic Acid, MSK-390

Zolinza + CHOP

Cyclophosphamide DRUG

750 mg/m\^2 by vein over 1 hour on Day 1 of 21 day cycle

Also known as: Cytoxan, Neosar

Zolinza + CHOP

Doxorubicin DRUG

50 mg/m\^2 by vein over 15 minutes on Day 1 of 21 day cycle

Also known as: AD, Hydroxydaunomycin hydrochloride

Zolinza + CHOP

Vincristine DRUG

1.4 mg/m\^2 by vein over 15 minutes on Day 1 of 21 day cycle

Zolinza + CHOP

Prednisone DRUG

100 mg tablets by mouth once a day on Days 1-5 of 21 day cycle

Zolinza + CHOP

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Patients must have a new diagnosis of T-cell NHL eligible histologies include:Peripheral T-cell lymphoma (unspecified), CD 30 + anaplastic large cell lymphoma (ALK) (ALK-1 positive and ALK-1 negative), angioimmunoblastic T-cell lymphoma, intestinal T-cell lymphoma, subcutaneous panniculitic T-cell lymphoma.
• Patients who are eligible for blood and marrow transplant can receive this treatment to maximal reduction of tumor bulk. A minimum of four cycles of therapy will be given before evaluation for to hematopoetic stem cell transplant.
• Patients must have biopsy proven disease which can include bone marrow and/or lymph node (cutaneous only disease is excluded)
• Patient must have an Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 2.
• Patients must be age 18 years old and above.There is no dosing or adverse event data are currently available on the use of vorinostat in patients \<18 years of age, children are excluded from this study but may be eligible for future pediatric phase 2 combination trials.
• There is Patients are required to have adequate bone marrow reserve as indicated: Absolute neutrophil count (ANC) \>/= 1000/mm\^3, Platelets \>/= 50,000/mm3, Hemoglobin \>/= 8g/dL. If there is bone marrow involvement by lymphoma then there is no minimum level of counts required.
• Patients must have adequate liver function as indicated by: Bilirubin \</= 1.5 times the upper limit of normal (ULN), Alanine transaminase (ALT) \</=2 times the (ULN) or aspartate transaminase (AST) \</= 2 times the ULN. These values must be obtained within two weeks before protocol entry.
• Patients are required to have adequate renal function as indicated by a serum creatinine \</= 2.5 mg/dL. This value must be obtained within two weeks before protocol entry.
• Left ventricular ejection fraction must be evaluated by nuclear medicine scan or echocardiography and measure \>/= 50%.
• Concomitant steroids may continue provided they are being used for symptom management and not for treatment of lymphoma.
• Male patients must agree to use a barrier method of contraception or agree to abstain from heterosexual activity for the duration of the study
• Female patients must be willing to use two adequate barrier methods of contraception to prevent pregnancy or agree to abstain from heterosexual activity throughout the study or be post menopausal (free from menses \> two years or surgically sterilized).
• Female patients of childbearing potential must have a negative serum pregnancy test (Beta human chorionic gonadotropin (hCG)) within 72 hours of receiving the first dose of vorinostat.
• Patients must have the ability able to give informed consent.

You may not qualify if:

• \. Patients with a) T-cell lymphoma with skin involvement only are excluded if they have no evidence of systemic disease b)T-cell prolymphocytic leukemia (T-PLL) c) T-cell large granular lymphocytic leukemia d) Primary cutaneous CD30+ disorders: anaplastic large cell lymphoma and lymphomatoid papulosis e) Angiocentric/nasal type T/Natural Killer (NK)-cell lymphoma f) Hepatosplenic gamma-delta T-cell lymphoma
• Patients with active Hepatitis B and/or Hepatitis C infection.
• Patients with known HIV infection are excluded. a) These patients are excluded secondary to potential to target activated T-cells, in a population of patients already at risk for T-cell depletion, would be a contraindication to therapy.
• Patients with active infections requiring specific anti-infective therapy are not eligible until all signs of infections are resolved.
• Patients with pre-existing cardiovascular disease requiring ongoing treatment. This includes:a) Congestive heart failure, b) Severe CAD, c) Cardiomyopathy, d) Uncontrolled cardiac arrhythmia, e) Unstable angina pectoris, f) Recent MI (within 6 months).
• Patients with prior exposure to either vorinostat (including other histone deacetylase (HDAC) inhibitors except valproic acid) or anthracyclines: a) Patients who have received valproic acid (VPA) for the treatment of seizures may be enrolled on this study, but must not have received VPA within 30 days of study enrollment.
• Patients who are pregnant or breast-feeding. a)Effects of this treatment on the fetus and young children are unknown at this time.
• Patients who have had an invasive solid tumor malignancy in the past five years except non-melanoma skin cancers or cervical carcinoma in situ or ductal/lobular carcinoma in situ of the breast who is currently without evidence of disease.
• Patients undergoing anti-neoplastic chemotherapy, radiation, hormonal (excluding contraceptives) or immunotherapy, or investigational medications within the past four weeks.
• Patients with deep vein thrombosis within three months.
• Patient with concurrent use of complementary or alternative medicines.
• Patients with psychiatric illness and/or social situations that would limit compliance with the study medication and requirements.
• Patients with grade 2 or more neuropathy.
• Patients with known central nervous system (CNS) lymphoma.

Sponsors & Collaborators

• M.D. Anderson Cancer Center: lead
• Merck Sharp & Dohme LLC: collaborator

Study Sites (1)

UT MD Anderson Cancer Center

Houston, Texas, 77030, United States

Location

Related Links

• The University of Texas (UT) MD Anderson Cancer Center official website

MeSH Terms

Conditions

Lymphoma; Lymphoma, Non-Hodgkin; Lymphoma, T-Cell, Peripheral; Lymphoma, Large-Cell, Anaplastic; Immunoblastic Lymphadenopathy; Enteropathy-Associated T-Cell Lymphoma; Subcutaneous panniculitis-like T-cell lymphoma

Interventions

Vorinostat; Cyclophosphamide; Doxorubicin; Vincristine; Prednisone

Condition Hierarchy (Ancestors)

Neoplasms by Histologic Type; Neoplasms; Lymphoproliferative Disorders; Lymphatic Diseases; Hemic and Lymphatic Diseases; Immunoproliferative Disorders; Immune System Diseases; Lymphoma, T-Cell; Lymphadenopathy

Intervention Hierarchy (Ancestors)

Anilides; Amides; Organic Chemicals; Aniline Compounds; Amines; Hydroxamic Acids; Hydroxylamines; Hydroxy Acids; Carboxylic Acids; Phosphoramide Mustards; Nitrogen Mustard Compounds; Mustard Compounds; Hydrocarbons, Halogenated; Hydrocarbons; Phosphoramides; Organophosphorus Compounds; Daunorubicin; Anthracyclines; Naphthacenes; Polycyclic Aromatic Hydrocarbons; Hydrocarbons, Aromatic; Hydrocarbons, Cyclic; Polycyclic Compounds; Aminoglycosides; Glycosides; Carbohydrates; Vinca Alkaloids; Secologanin Tryptamine Alkaloids; Indole Alkaloids; Alkaloids; Heterocyclic Compounds; Indoles; Heterocyclic Compounds, 2-Ring; Heterocyclic Compounds, Fused-Ring; Indolizidines; Indolizines; Pregnadienediols; Pregnadienes; Pregnanes; Steroids; Fused-Ring Compounds

Results Point of Contact

• Title: Yasuhiro Oki, MD/ Associate Professor
• Organization: University of Texas MD Anderson Cancer Center

yoki@mdanderson.org

713-792-2860

Study Officials

• Yasuhiro Oki, MD

  UT MD Anderson Cancer Center

  PRINCIPAL INVESTIGATOR

Publication Agreements

• PI is Sponsor Employee: Yes
• Restrictive Agreement: No

Study Design

• Study Type: interventional
• Phase: phase 1
• Allocation: NA
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: November 6, 2008
• First Posted: November 7, 2008
• Study Start: November 1, 2008
• Primary Completion: December 1, 2012
• Study Completion: December 1, 2012
• Last Updated: September 9, 2014
• Results First Posted: September 9, 2014

Record last verified: 2014-09

Locations

US (1)