Phase 1 Trial of Siplizumab and Dose-Adjusted EPOCH-Rituximab in T- and NK-Cell Lymphomas
Status:
Completed
Trial end date:
2020-10-22
Target enrollment:
Participant gender:
Summary
Studies conducted at the National Cancer Institute suggest that certain chemotherapy drugs
may be more effective if given by continuous infusion into the vein rather than by the
standard method of rapid intravenous injection. One such combination of six chemotherapy
drugs, known as Etoposide, Prednisone, Vincristine, Cyclophosphamide, Doxorubicin, Rituximab
(EPOCH-R), has had a high degree of effectiveness in people with certain kinds of cancer.
Recent evidence also indicates that the effects of chemotherapy may be improved by combining
the treatment with monoclonal antibodies, which are purified proteins that are specially made
to attach to foreign substances such as cancer cells. This protocol is specifically for
adults with the types of cancer known as T-cell and Naturel Killer (NK)-cell lymphomas, who
have never received chemotherapy previously. The additional monoclonal antibody in the study,
called siplizumab, has been manufactured to attach to the cluster of differentiation 2 (CD2)
protein contained in these types of tumors.
Study volunteers will need to undergo an initial period of evaluation that may take up to 3
weeks and may be done on an outpatient basis. Evaluation may include some or all of the
following tests: blood and urine tests, tests of lung and heart function, lumbar punctures to
take samples of cerebrospinal fluid, magnetic resonance imaging (MRI) or computerized
tomography (CT) scans, full-body positron emission tomography (PET) scans, bone marrow
biopsies, and biopsies of suspected tumor areas.
During the study, patients will receive EPOCH-R chemotherapy, which includes the following
drugs: etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin, and rituximab. The
additional drug, siplizumab, will be given by IV infusion on the first day of treatment over
several hours. When the siplizumab intravenous (IV) infusion is complete, the drugs
doxorubicin, etoposide, and vincristine will each be given by continuous IV infusion over the
next 4 days (that is, continuously for a total of 96 hours). When this infusion is completed,
the drugs rituximab and cyclophosphamide will be given by IV infusion over several hours on
Day 5. Prednisone will be given by mouth twice each day for 5 days. Patients may be given
other drugs to treat the side effects of chemotherapy and to prevent possible infections.
The siplizumab-EPOCH-R therapy will be repeated every 21 days, which is known as a cycle of
therapy, for a total of 6 cycles. Following the fourth and sixth treatment cycles
(approximately weeks 12 and 18) of siplizumab-EPOCH-R, study researchers will perform blood
tests and CT/MRI scans on all patients to assess their response to the treatment.