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RATIONALE: The CAT-8015 immunotoxin can bind tumor cells and kill them without harming normal cells. This may be an effective treatment for hairy cell leukemia(HCL) that has not responded to chemotherapy, surgery or radiation therapy.
PURPOSE: Phase I dose escalation study to determine the maximum tolerated dose of CAT-8015 immunotoxin in treating patients who have hairy cell leukemia (HCL) that has not responded to treatment.
OUTLINE: Patients receive CAT-8015 IV over 30 minutes on days 1, 3, and 5 followed by rest. Treatment repeats every 4 weeks for up to a total of 10 courses in the absence of dose limiting toxicity, complete response or disease progression. Patients are followed at 1, 3, 6,12,15,18, 21, 24 months following the start of the last treatment cycle.
Cohorts of 3-6 patients each will receive escalating doses of recombinant CAT-8015 until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose proceeding that at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity. Once the MTD is determined, between16 to 25 new patients will be added to the MTD cohort depending on how well the CAT-8015 is tolerated.
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Immunotoxin therapy | Drug | |||
| CAT-8015 Immunotoxin | Drug | |||
| Biological therapy | Procedure |
| Measure | Description | Time Frame |
|---|---|---|
| Estimate the maximum dose that can be safely administered to a patient | ||
| Characterize the toxicity profile of CAT-8015 | ||
| Study the clinical pharmacology of CAT-8015 | ||
| Observe anti-tumor activity, if any. |
| Measure | Description | Time Frame |
|---|---|---|
| To assess the immunogenic potential of CAT-8015 to induce antibodies | ||
| To investigate the potential of biomarkers to predict any therapeutic or toxic response. |
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INCLUSION CRITERIA:
DISEASE CHARACTERISTICS:
At least one of the following indications for treatment:
PATIENT CHARACTERISTICS:
Performance status • ECOG 0-2
Life expectancy
• Life expectancy of greater than 6 months, as assessed by the principal investigator
Other
EXCLUSION CRITERIA:
Hepatic function: serum transaminases (either ALT or AST) or bilirubin:
• ≥ Grade 2, unless bilirubin is due to Gilbert's disease
Renal function: serum creatinine clearance ≤60mL/min as estimated by Cockroft-Gault formula
Hematologic function:
Pulmonary function:
• Patients with < 50% of predicted forced expiratory volume (FEV1) or <50% of predicted diffusing capacity for carbon monoxide (DLCO), corrected for hemoglobin concentration and alveolar volume. Note: Patients with no prior history of pulmonary illness are not required to have PFTs. FEV1 will be assessed following bronchodilator therapy.
Recent prior therapy:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Stanford University School of Medicine | Not yet recruiting | Stanford | California | 94305 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 16061911 | Background | Kreitman RJ, Squires DR, Stetler-Stevenson M, Noel P, FitzGerald DJ, Wilson WH, Pastan I. Phase I trial of recombinant immunotoxin RFB4(dsFv)-PE38 (BL22) in patients with B-cell malignancies. J Clin Oncol. 2005 Sep 20;23(27):6719-29. doi: 10.1200/JCO.2005.11.437. Epub 2005 Aug 1. | |
| 18596230 | Derived | Matsushita K, Margulies I, Onda M, Nagata S, Stetler-Stevenson M, Kreitman RJ. Soluble CD22 as a tumor marker for hairy cell leukemia. Blood. 2008 Sep 15;112(6):2272-7. doi: 10.1182/blood-2008-01-131987. Epub 2008 Jul 2. |
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| ID | Term |
|---|---|
| D007938 | Leukemia |
| D007943 | Leukemia, Hairy Cell |
| D012008 | Recurrence |
| ID | Term |
|---|---|
| D009370 | Neoplasms by Histologic Type |
| D009369 | Neoplasms |
| D006402 | Hematologic Diseases |
| D006425 | Hemic and Lymphatic Diseases |
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| ID | Term |
|---|---|
| C541974 | immunotoxin HA22 |
| D001691 | Biological Therapy |
| ID | Term |
|---|---|
| D013812 | Therapeutics |
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| Cancer Center of Northwestern University | Not yet recruiting | Chicago | Illinois | 60611 | United States |
|
| Warren Grant Megnuson Clinical Center - NCI Clinical Trials Referral Office | Recruiting | Bethesda | Maryland | 20892 | United States |
|
| Klinika Hamtologii Uniwersytetu Medycznego (Medical University of Lodz) | Not yet recruiting | Lodz | Poland |
|
| Royal Marsden Hospital and Institute of Cancer Research | Not yet recruiting | Surrey | United Kingdom |
|
| D008232 | Lymphoproliferative Disorders |
| D008206 | Lymphatic Diseases |
| D007160 | Immunoproliferative Disorders |
| D007154 | Immune System Diseases |
| D020969 | Disease Attributes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |