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| Name | Class |
|---|---|
| National Comprehensive Cancer Network | NETWORK |
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This research study is evaluating a drug called carfilzomib used in combination with another drug called belinostat with participants who have relapsed or refractory non-Hodgkin lymphoma (NHL).
The investigators are looking for the highest dose of the study drug that can be administered safely without severe or unmanageable side effects in participants that have NHL, not everyone who participates in this research study will receive the same dose of the study drug. The dose the each participant gets will depend on the number of participants who have been enrolled in the study prior and how the dose was tolerated.
Study Drug(s): Both carfilzomib and belinostat will be given through a vein in the participant's arm (IV infusion). Each treatment cycle lasts 28 days (4 weeks).
Clinical Exams: During all cycles the participant will have a physical exam and will be asked questions about their general health and specific questions about any problems any medications you may be taking.
Pharmacokinetic (PK) blood tests: One of the main reasons for this study is to find the highest dose of the study drug combination that can be used safely without experiencing severe side effects to use for future studies. Once this dose is found (the maximum tolerated dose, or MTD), additional blood samples will be drawn from a small set of participants (about 5 participants total) to learn more about the activity of the study drugs in the body over a period of time, including the ways the study drugs are absorbed, distributed, and then released from the body. If participating in this group (the participant will be informed from the Investigator) these pharmacokinetic (PK) samples will be drawn repeatedly over a period of 24 hours on certain days: Blood samples will be drawn at 0, 15, 30, 60, 90 minutes, and 2, 4, 6, 8 and 24 hours after the study drug dosing on Days 1-2, 4-5, and 9 of Cycle 1.
Scans (or Imaging tests): Tumor assessment by CT or PET CT scans once every 8 weeks (every other cycle).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Carfilzomib/ Belinostat | Experimental | Carfilzomib and Belinostat will be administered on a 28-day schedule.
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Carfilzomib | Drug |
|
| |
| Belinostat |
| Measure | Description | Time Frame |
|---|---|---|
| Maximum tolerated doses of carfilzomib and belinostat in combination | Baseline, 28 days |
| Measure | Description | Time Frame |
|---|---|---|
| Number of Participants with Serious Adverse Events | 28 days | |
| Plasma Concentration Time Profiles | Limited PK assessment to characterize the plasma concentration time profiles at times when the two compounds are given together and alone during the first cycle of therapy in a group of 5 patients treated with the MTD of the combination |
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Inclusion Criteria:
Subjects must have histologically confirmed relapsed or refractory non-Hodgkin lymphoma that is not a candidate for standard curative therapy. NHL subtypes include: Diffuse large B-cell lymphoma (DLBCL), Mantle cell lymphoma, Marginal zone lymphoma, Lymphoplasmacytic lymphoma, Peripheral T-cell lymphomas, and Follicular lymphoma of any grade.
Patients must have received at least one prior systemic therapy for lymphoma. A washout period of at least 3 weeks is required from the most recent prior therapy.
Age ≥18 years
ECOG performance status ≤ 2 (Karnofsky ≥ 60%, see Appendix A)
Participants must have organ and marrow function as defined below:
absolute neutrophil count ≥1,000/mcL
platelets ≥75,000/mcL
total bilirubin ≤ 2 × institutional upper limit of normal
AST(SGOT)/ALT(SGPT) ≤ 3 × institutional upper limit of normal
creatinine ≤1.5 × institutional upper limit of normal
--- OR
creatinine clearance ≥45 mL/min/1.73 m2 for participants with creatinine levels above institutional normal.
Participants may have either measurable or non-measurable disease, but in all cases eligible patients must have disease that can be clinically evaluated for improvement or progression.
Patients must have fully recovered from major surgery and from the acute toxic effects of prior chemotherapy and radiotherapy (residual grade 1 toxicity, e.g., grade 1 peripheral neuropathy, and residual alopecia are allowed).
The effects of carfilzomib and belinostat on the developing human fetus are unknown. For this reason, women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry and for the duration of study participation. Should a woman become pregnant or suspect she is pregnant while she or her partner is participating in this study, she should inform her treating physician immediately. Men treated or enrolled on this protocol must also agree to use adequate contraception prior to the study, for the duration of study participation, and 4 months after completion of study drug administration.
Ability to understand and the willingness to sign a written informed consent document
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Jeremy Abramson, MD | Massachusetts General Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Massachusetts General Hospital | Boston | Massachusetts | 02114 | United States | ||
| Beth-Israel Deaconess Medical Center |
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| ID | Term |
|---|---|
| D008228 | Lymphoma, Non-Hodgkin |
| D016403 | Lymphoma, Large B-Cell, Diffuse |
| D020522 | Lymphoma, Mantle-Cell |
| D008224 | Lymphoma, Follicular |
| D016411 | Lymphoma, T-Cell, Peripheral |
| D018442 | Lymphoma, B-Cell, Marginal Zone |
| D008258 | Waldenstrom Macroglobulinemia |
| ID | Term |
|---|---|
| D008223 | Lymphoma |
| D009370 | Neoplasms by Histologic Type |
| D009369 | Neoplasms |
| D008232 | Lymphoproliferative Disorders |
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| ID | Term |
|---|---|
| C524865 | carfilzomib |
| C487081 | belinostat |
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| Drug |
|
|
| 0, 5, 15, 30, 60, 90 min and 2, 4, 6, 8, and 24 hours |
| Objective response rate | Preliminary assessment of efficacy of carfilzomib and belinostat based on objective response rate For the purposes of this study, participants with measurable disease should be re-evaluated every 8 weeks. Participants with low-grade histologies will be staged and re-staged with CT scans of the chest, abdomen, and pelvis. Participants with high-grade histologies will be staged and re-staged with PET/CT scans. | 8 Weeks |
| Boston |
| Massachusetts |
| 02115 |
| United States |
| Dana Farber Cancer Institute | Boston | Massachusetts | 02215 | United States |
| D008206 |
| Lymphatic Diseases |
| D006425 | Hemic and Lymphatic Diseases |
| D007160 | Immunoproliferative Disorders |
| D007154 | Immune System Diseases |
| D016393 | Lymphoma, B-Cell |
| D016399 | Lymphoma, T-Cell |
| D054219 | Neoplasms, Plasma Cell |
| D020141 | Hemostatic Disorders |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
| D010265 | Paraproteinemias |
| D001796 | Blood Protein Disorders |
| D006402 | Hematologic Diseases |
| D006474 | Hemorrhagic Disorders |