Phase 2
N=41
Study of Iodine 131 Anti B1 Antibody for 1st or 2nd Relapsed Indolent B-Cell Lymphomas or B-Cell Lymphomas That Have Transformed to a More Aggressive Histology
Lymphoma, Non-Hodgkin
Bottom Line
View on ClinicalTrials.gov: NCT00950755 ↗Enrolled (actual)
41
Serious AEs
31.7%
Results posted
Aug 2012
Primary outcome: Primary: Number of Participants (Par.) With Response as Assessed by the Investigator — 31 participants
Study Design & Population
- Study type
- Interventional
- Phase
- Phase 2
- Interventions
- tositumomab and Iodine I 131 tositumomab (anti-B1 antibody) (Biological)
- Age
- Adult, Older Adult · 18+ yrs
- Sex
- All
- Sponsor
- GlaxoSmithKline
- Primary completion
- Apr 2011
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Number of Participants (Par.) With Response as Assessed by the Investigator |
31 | — |
| PRIMARY Number of Participants With Confirmed Response as Assessed by the Investigator |
22 | — |
| PRIMARY Number of Participants With Confirmed Complete Response (CR) as Assessed by the Investigator |
14 | — |
| PRIMARY Number of Participants With Confirmed Complete Response Plus Clinical Complete Response (CR + CCR) as Assessed by the Investigator |
17 | — |
| PRIMARY Number of Participants With Confirmed Partial Response (PR) as Assessed by the Investigator |
4 | — |
| SECONDARY Duration of Response for All Confirmed Responders (CR, CCR, or PR) as Assessed by the Investigator |
46.4 | — |
| SECONDARY Time to Progression of Disease or Death as Assessed by the Investigator |
12.6 | — |
| SECONDARY Time to Treatment Failure as Assessed by the Investigator |
9.5 | — |
| SECONDARY Overall Survival |
74.5 | — |
| SECONDARY Number of Participants With the Indicated Adverse Events (AE) Possibly or Probably Related to Study Drug and Experienced by at Least 5% of Participants |
18; 14; 15; 3; 12; 3 | — |
| SECONDARY Number of Participants With the Indicated Serious Adverse Events (SAE) Related to Study Drug |
6; 6; 2; 1; 1; 2 | — |
| SECONDARY Number of Participants With the Indicated Type of Infection |
21; 20; 0; 0; 3; 1 | — |
| SECONDARY Number of Participants With an Infection for Which Anti-infectives Were Administered |
18; 3 | — |
| SECONDARY Duration of the Indicated Grade 3 or Grade 4 Hematologic Toxicities |
16; 25; 28; 23 | — |
| SECONDARY Time to Nadir and Time to Recovery to Baseline in Hematologic Laboratory Evaluations |
42.5; 47; 32; 42.5; 61; 61 | — |
| SECONDARY Nadir Values for Hematologic Parameters ANC, Platelets, and WBC Count |
1.2; 78; 2.3 | — |
| SECONDARY Nadir Values for Hemoglobin, a Hematologic Parameter |
11.3 | — |
| SECONDARY Number of Participants Who Became Positive or Negative for Human Anti-murine Antibody (HAMA) After Study Treatment |
4; 37 | — |
| SECONDARY Time to HAMA Positivity From First Dosimetric Dose |
112 | — |
| SECONDARY Number of Participants in the Indicated Categories of Thyroid Function Assessment |
9; 3 | — |
| SECONDARY Number of Days Each Participant Took to Reach Hypothyroidism After the First Dosimetric Dose |
192; 475; 671 | — |
Summary
This is a single-arm, open-label study of Iodine 131 Anti B1 Antibody for the treatment of 1st or 2nd relapsed indolent B cell lymphomas or B cell lymphomas that have transformed to a more aggressive histology. The primary endpoint of the study is to determine the response rate. Secondary endpoints of the study is to determine the duration of response, time to progression, time-to-treatment failure, safety, and survival.
Forty patients will receive therapy on this study at the 2 clinical sites. Patients will undergo 2 phases of the study. In the first phase, termed the "dosimetric dose", patients will receive an infusion of unlabeled Anti B1 Antibody (450 mg) over 70 minutes (including a 10 minute flush) immediately followed by a 30 minute infusion (including a 10 minute flush) of Anti B1 Antibody (35 mg) which has been trace-labeled with 5 mCi of Iodine 131. Whole body gamma camera scans will be obtained on 1) Day 0; 2) Day 2, 3, or 4; and 3) Day 6 or 7 following the dosimetric dose. Using the dosimetric data from the 3 imaging timepoints, a patient-specific dose of Iodine 131 Anti B1 Antibody to deliver the desired total body dose of radiotherapy will be calculated. In the second phase, termed the "radioimmunotherapeutic dose", patients will receive a 70 minute infusion (including a 10 minute flush) of unlabeled Anti B1 Antibody (450 mg) immediately followed by a 30 minute infusion (including a 10 minute flush) of 35 mg Anti B1 Antibody labeled with the patient-specific dose of Iodine 131 to deliver a whole body dose of 75 cGy to patients with no hematologic risk factors. Patients who have platelet counts of 100,001-149,999 cells/mm3 will receive 65 cGy and patients who are obese will be dosed based upon 137% of their lean body mass (see Appendix A). Patients will be treated with either saturated solution potassium iodide (SSKI), Lugol's solution, or potassium iodide tablets starting at least 24 hours prior to the first infusion of the Iodine 131 Anti B1 Antibody and continuing for 14 days following the last infusion of Iodine 131 Anti B1 Antibody (i.e., therapeutic dose).
Eligibility Criteria
Inclusion Criteria
- Patients must have a histologically-confirmed diagnosis of B-cell CLL/PLL/SLL; lymphoplasmacytic - immunocytoma; follicle center, follicular, grade I; or follicle center, follicular, grade II NHLs or one of these B-cell lymphomas which has transformed to a more aggressive histology (37).
- Patients must have evidence that their tumor tissue expresses the CD20 antigen. Immunoperoxidase stains of paraffin-embedded tissue showing positive reactivity with L26 antibody or immunoperoxidase stains of frozen tissue showing positive reactivity with Anti B1 Antibody (>50% of tumor cells are positive) or evidence of CD20 positivity by flow cytometry (>50% of tumor cells are positive) are acceptable evidence of CD20 positivity. Testing of tumor tissue from any time in the course of the patient's disease is acceptable.
- Patients must have received 1 or 2 prior chemotherapy regimens and have progressed following their last regimen. Patients who have received >2 prior chemotherapy regimens are excluded. Prior therapy with radiation, immunosuppressants, or steroids are not counted as chemotherapy regimens.
- Patients must have a performance status of at least 60% on the Karnofsky Scale (see Appendix B) and an anticipated survival of at least 3 months.
- Patients must have an absolute granulocyte count >1,500 x 109/l and a platelet count >100,000 x 109/l within 14 days of study entry. These blood counts must be sustained without support of hematopoietic cytokines or transfusion of blood products.
- Patients must have adequate renal function (defined as serum creatinine /=2cm x 2 cm (by CT scan).
- Patients must be at least 18 years of age.
- Patients must give written informed consent and sign an EC-approved informed consent form prior to study entry.
Exclusion Criteria
- Patients with more than an average of 25% of the intratrabecular marrow space involved by lymphoma in bone marrow biopsy specimens as assessed microscopically within 42 days of study entry. Bilateral posterior iliac crest core biopsies are required if the percentage of intratrabecular space involved exceeds 10% on a unilateral biopsy. The mean of bilateral biopsies must be no more than 25%. The procedure for bilateral bone marrow biopsy analysis of marrow involvement is included in Appendix C.
- Patients who have received cytotoxic chemotherapy, radiation therapy, or cytokine treatment within 4 weeks prior to study entry (6 weeks for nitrosourea compounds) or who exhibit persistent clinical evidence of toxicity. The use of systemic steroids must be discontinued one week prior to study entry.
- Patients with prior hematopoietic stem cell transplant following high-dose chemotherapy or chemo/radiotherapy.
- Patients with active obstructive hydronephrosis.
- Patients with evidence of active infection requiring IV antibiotics at the time of study entry.
- Patients with New York Heart Association class III or IV heart disease (see Appendix D) or other serious illness that would preclude evaluation.
- Patients with prior malignancy other than lymphoma, except for adequately-treated skin cancer, in situ cervical cancer, or other cancer for which the patient has been disease-free for 5 years. Patients who have been disease-free of another cancer for greater than 5 years must be carefully assessed at the time of study entry to rule out recurrent disease.
- Patients with known HIV infection.
- Patients with known brain or leptomeningeal metastases.
- Patients who are pregnant or breast-feeding. Patients of child-bearing potential must undergo a serum pregnancy test within 7 days prior to study entry and radiolabeled antibody is not to be administered until a negative result is obtained. Males and females must agree to use effective contraception for 6 months following treatment.
- Patients with previous allergic reactions to iodine. This does not include reacting to IV iodine-containing contrast materials.
- Patients who were previously given any monoclonal or
Data sourced from ClinicalTrials.gov (NCT00950755). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.