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NCT03269552 · REGISTRY CONDITION SEARCH

Carfilzomib With or Without Rituximab in the Treatment of Waldenstrom Macroglobulinemia or Marginal Zone Lymphoma

Found through the registry condition index, not selected as a treatment recommendation. This discovery collection was restricted to studies with posted results.

Phase
PHASE2
Status at capture
TERMINATED
Registry last update
2020-01-18

This phase II trial studies how well carfilzomib with or without rituximab work in treating patients with Waldenstrom macroglobulinemia or marginal zone lymphoma that is previously untreated, has come back, or does not respond to treatment. Carfilzomib may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth. Immunotherapy with monoclonal antibodies, such as rituximab, may induce changes in body's immune system and may interfere with the ability of tumor cells to grow and spread. Giving carfilzomib alone when disease is responding or with rituximab when disease is not responding may work better in treating patients with Waldenstrom macroglobulinemia or marginal zone lymphoma.

Open the original ClinicalTrials.gov record → · Download preserved record

What did the study report?

Outcomes, safety and baseline populations are separate source sections. Quality-of-life measures appear under their original outcome titles.

flow

Participant flow

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baseline

Baseline characteristics

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outcome · POSTED

Overall Response Rate

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outcome · POSTED

Overall Survival

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outcome · POSTED

Time to Best Response

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outcome · POSTED

Time to Progression

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adverse events

Adverse events

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more info

Limitations, agreements, and source contact

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Who could take part
eligibility Criteria
Inclusion Criteria: * Waldenstrom's macroglobulinemia (WM) or marginal zone lymphoma (MZL) based on institutional pathology review; patients may have either previously untreated or relapsed/refractory disease * Measurable disease: for WM presence of monoclonal IgM immunoglobulin concentration on serum electrophoresis, with lymphoplasmacytic marrow infiltrate; for MZL: measurable nodal disease measuring at least 1.5 cm in longest dimension, or splenomegaly * Indication for initiation of therapy * Absolute neutrophil count (ANC) \> 1,000/uL unless disease-related (due to marrow infiltration or splenomegaly) * Platelet count \> 75,000/uL unless disease-related (due to marrow infiltration or splenomegaly) * Serum creatinine \< 2.5 mg/dL or creatinine clearance \> 30 cc/min * Bilirubin \< 2 x upper limit of normal (ULN) * Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) \< 3 x ULN * All patients must be informed of the investigational nature of this study and have given written consent in accordance with institutional and federal guidelines * Expected survival of \> 90 days * Females of childbearing potential (FCBP) must agree to pregnancy testing and to practice contraception * Male subjects must agree to practice contraception Exclusion Criteria: * Known human immunodeficiency virus (HIV), hepatitis C, or hepatitis B positivity (subjects with hepatitis B surface antigen \[SAg\] or core antibody positivity, who are receiving and responding to antiviral therapy directed at hepatitis B or are negative for hepatitis B virus \[HBV\] deoxyribonucleic acid \[DNA\], are allowed) * Candidate for potentially curative antibiotic therapy for gastric mucosa-associated lymphoid tissue (MALT); (gastric MALT lymphoma patients with stage I/II helicobacter \[H.\] pylori positive lymphoma must fail therapy with H.-pylori directed therapy before being considered for this study) * Eastern Cooperative Oncology Group (ECOG) performance status 3 or higher * Known active central nervous system (CNS) involvement * Pregnant or lactating females * Inadequate cardiac function, as measured by left ventricular ejection fraction (LVEF) that is less than or equal to 40%, or the presence of New York Heart Association (NYHA) classification of greater than stage II congestive heart failure * Significant neuropathy (grades 3-4, or grade 2 with pain) within 14 days prior to screening * Uncontrolled inter-current illness including, but not limited to, unstable angina, recent myocardial infarction within 6 months of screening and uncontrolled cardiac arrhythmias, psychiatric illness, or psychosocial difficulty that would limit compliance with study requirements * Non-hematologic malignancy within the past 3 years with the exception of a) adequately treated basal cell carcinoma, squamous cell skin cancer, or thyroid cancer; b) carcinoma in situ of the cervix or breast; c) prostate cancer of Gleason grade 6 or less with stable prostate-specific antigen levels; or d) cancer considered cured by surgical resection or unlikely to impact survival during the duration of the study
healthy Volunteers
false
minimum Age
18 Years
sex
ALL
std Ages
  1. ADULT
  2. OLDER_ADULT
Treatment arms and interventions
arm Groups
  1. description
    Patients receive carfilzomib IV over 30 minutes on days 1, 8, and 15. Treatment repeats every 28 days for up to 6 courses in the absence of disease progression or unacceptable toxicity. Patients who fail to achieve at least 25% M-protein reduction for Waldenstrom's macroglobulinemia or partial response for marginal zone lymphoma after 2 courses of carfilzomib, receive rituximab IV weekly on days 1, 8, 15, and 22 of course 3 and then monthly on day 1 of courses 4-6 in the absence of disease progression or unacceptable toxicity.
    intervention Names
    1. Drug: Carfilzomib
    2. Other: Laboratory Biomarker Analysis
    3. Biological: Rituximab
    label
    Treatment (carfilzomib, rituximab)
    type
    EXPERIMENTAL
interventions
  1. arm Group Labels
    1. Treatment (carfilzomib, rituximab)
    description
    Given IV
    name
    Carfilzomib
    other Names
    1. Kyprolis
    2. PR-171
    type
    DRUG
  2. arm Group Labels
    1. Treatment (carfilzomib, rituximab)
    description
    Correlative studies
    name
    Laboratory Biomarker Analysis
    type
    OTHER
  3. arm Group Labels
    1. Treatment (carfilzomib, rituximab)
    description
    Given IV
    name
    Rituximab
    other Names
    1. ABP 798
    2. BI 695500
    3. C2B8 Monoclonal Antibody
    4. Chimeric Anti-CD20 Antibody
    5. CT-P10
    6. IDEC-102
    7. IDEC-C2B8
    8. IDEC-C2B8 Monoclonal Antibody
    9. MabThera
    10. Monoclonal Antibody IDEC-C2B8
    11. PF-05280586
    12. Rituxan
    type
    BIOLOGICAL
Study design
allocation
NA
intervention Model
SINGLE_GROUP
masking Info
masking
NONE
primary Purpose
TREATMENT
Enrollment
count
4
type
ACTUAL
Registered outcome plans (not posted results)
primary Outcomes
  1. description
    Descriptive statistics will be used for baseline characteristics, and responses to treatment.
    measure
    Overall Response Rate
    time Frame
    Up to 1 year
secondary Outcomes
  1. description
    Estimated using Kaplan-Meier analysis.
    measure
    Overall Survival
    time Frame
    Up to 1 year
  2. description
    Estimated using Kaplan-Meier analysis.
    measure
    Time to Best Response
    time Frame
    Up to 1 year
  3. description
    Estimated using Kaplan-Meier analysis.
    measure
    Time to Progression
    time Frame
    Up to 1 year
Full study description
brief Summary
This phase II trial studies how well carfilzomib with or without rituximab work in treating patients with Waldenstrom macroglobulinemia or marginal zone lymphoma that is previously untreated, has come back, or does not respond to treatment. Carfilzomib may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth. Immunotherapy with monoclonal antibodies, such as rituximab, may induce changes in body's immune system and may interfere with the ability of tumor cells to grow and spread. Giving carfilzomib alone when disease is responding or with rituximab when disease is not responding may work better in treating patients with Waldenstrom macroglobulinemia or marginal zone lymphoma.
detailed Description
PRIMARY OBJECTIVES: I. Determine the overall response rate of single-agent weekly carfilzomib (CFZ), measured after 2 cycles of therapy, in Waldenstrom's macroglobulinemia (WM) and marginal zone lymphoma (MZL). SECONDARY OBJECTIVES: I. Assess safety and tolerability of single agent, weekly CFZ in patients with WM and MZL, and determine the tolerability of weekly CFZ+rituximab for applicable patients. II. Estimate the time to best response, response duration, and survival with weekly CFZ for WM and MZL. III. Evaluate the overall response rate associated with weekly CFZ in a subset of patients with rituximab refractory WM or MZL. OUTLINE: Patients receive carfilzomib intravenously (IV) over 30 minutes on days 1, 8, and 15. Treatment repeats every 28 days for up to 6 courses in the absence of disease progression or unacceptable toxicity. Patients who fail to achieve at least 25% M-protein reduction for Waldenstrom's macroglobulinemia or partial response for marginal zone lymphoma after 2 courses of carfilzomib, receive rituximab IV weekly on days 1, 8, 15, and 22 of course 3 and then monthly on day 1 of courses 4-6 in the absence of disease progression or unacceptable toxicity. After completion of study treatment, patients are followed up every 3 months for up to 1 year.
Source references
Source notices and limitations
    Discovery and provenance
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    Preserved source evidence · Not medical advice