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| ID | Type | Description | Link |
|---|---|---|---|
| 06-C-0240 | |||
| NCI-P6761 | |||
| NCI-7835 | |||
| CDR0000508789 |
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| Name | Class |
|---|---|
| National Cancer Institute (NCI) | NIH |
RATIONALE: Drugs used in chemotherapy, such as fludarabine and cyclophosphamide, work in different ways to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. LMB-2 immunotoxin can find cancer cells and kill them without harming normal cells. Giving fludarabine and cyclophosphamide followed by LMB-2 immunotoxin may kill more cancer cells.
PURPOSE: This clinical trial is studying how well giving fludarabine and cyclophosphamide followed by LMB-2 immunotoxin works in treating patients with Hodgkin's lymphoma.
OBJECTIVES:
Primary
Secondary
OUTLINE: This is a nonrandomized, pilot study.
Patients receive fludarabine phosphate IV over 30 minutes and cyclophosphamide IV over 60 minutes on days 1-4 and filgrastim (G-CSF) subcutaneously once daily beginning on day 5 and continuing until blood counts recover.
Beginning 4 weeks after completion of chemotherapy, patients receive LMB-2 immunotoxin IV over 30 minutes on days 1, 3, and 5. Treatment repeats every 28 days for up to 6 courses in the absence of disease progression.
Blood is obtained prior to and after chemotherapy and then periodically during LMB-2 immunotoxin therapy for pharmacokinetic studies to measure lymphocyte subsets.
PROJECTED ACCRUAL: A total of 30 patients will be accrued for this study.
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| LMB-2 immunotoxin | Biological | |||
| cyclophosphamide | Drug | |||
| fludarabine phosphate | Drug | |||
| pharmacological study | Other |
| Measure | Description | Time Frame |
|---|---|---|
| Feasibility of using fludarabine phosphate and cyclophosphamide to decrease neutralizing antibodies |
| Measure | Description | Time Frame |
|---|---|---|
| Response rate | ||
| Response duration | ||
| Correlation of serum levels of LMB-2 immunotoxin with toxicity and response |
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DISEASE CHARACTERISTICS:
Histopathologically confirmed CD25+ Hodgkin's lymphoma
Meets the following criteria:
Measurable disease
No patient whose serum neutralizes LMB-2 immunotoxin in tissue culture, due either to antitoxin or antimouse-IgG antibodies
No patient whose serum neutralizes > 75% of the activity of 1 µg/mL of LMB-2 immunotoxin
PATIENT CHARACTERISTICS:
ECOG performance status 0-2
Absolute neutrophil count ≥ 1,000/mm³
Platelet count ≥ 50,000/mm³
Not pregnant or nursing
Negative pregnancy test
Fertile patients must use effective contraception
ALT and AST ≤ 2.5 times upper limit of normal
Albumin ≥ 3.0 g/dL
Bilirubin ≤ 2.2 mg/dL (< 5 mg/dL if Gilbert's syndrome is present)
Creatinine ≤ 1.4 mg/dL OR creatinine clearance ≥ 50 mL/min
No uncontrolled intercurrent illness including, but not limited to, any of the following:
No HIV or hepatitis C positivity
LVEF ≥ 45%
DLCO ≥ 50% of normal OR FEV_1 ≥ 60% of normal
No active second malignancy requiring treatment
PRIOR CONCURRENT THERAPY:
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| Name | Affiliation | Role |
|---|---|---|
| Robert Kreitman, MD | National Cancer Institute (NCI) | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Warren Grant Magnuson Clinical Center - NCI Clinical Trials Referral Office | Bethesda | Maryland | 20892-1182 | United States |
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| Development of neutralizing antibodies and its effect on blood level of LMB-2 immunotoxin and toxicity |
| Correlation of soluble Tac-peptide with treatment response |
| ID | Term |
|---|---|
| D008223 | Lymphoma |
| D006689 | Hodgkin Disease |
| ID | Term |
|---|---|
| D009370 | Neoplasms by Histologic Type |
| D009369 | Neoplasms |
| D008232 | Lymphoproliferative Disorders |
| D008206 | Lymphatic Diseases |
| D006425 | Hemic and Lymphatic Diseases |
| D007160 | Immunoproliferative Disorders |
| D007154 | Immune System Diseases |
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| ID | Term |
|---|---|
| C077707 | B3(Fv)-PE38KDEL recombinant immunotoxin |
| D003520 | Cyclophosphamide |
| C042382 | fludarabine phosphate |
| ID | Term |
|---|---|
| D010752 | Phosphoramide Mustards |
| D009588 | Nitrogen Mustard Compounds |
| D009150 | Mustard Compounds |
| D006846 | Hydrocarbons, Halogenated |
| D006838 | Hydrocarbons |
| D009930 | Organic Chemicals |
| D063088 | Phosphoramides |
| D009943 | Organophosphorus Compounds |
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