Bortezomib and Vorinostat in Treating Patients With Recurrent Mantle Cell Lymphoma or Recurrent and/or Refractory Diffuse Large B-Cell Lymphoma

Sponsor
National Cancer Institute (NCI) (NIH)
Overall Status
Completed
CT.gov ID
NCT00703664
Collaborator
(none)
65
12
1
112.8
5.4
0

Study Details

Study Description

Brief Summary

This phase II trial studies how well bortezomib and vorinostat work in treating patients with recurrent mantle cell lymphoma or recurrent and/or refractory diffuse large B-cell lymphoma. Bortezomib and vorinostat may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth.

Condition or Disease Intervention/Treatment Phase
Phase 2

Detailed Description

This was a multicenter, non-randomized phase 2 trial using a Simon two-stage design with 3 cohorts.

PRIMARY OBJECTIVES:
  1. Estimate the response rates of mantle cell and diffuse large B-cell lymphomas to bortezomib and vorinostat combination therapy.
SECONDARY OBJECTIVES:
  1. Assess the safety and tolerability of the study regimen. II. Observe progression-free survival and response durations. III. Observe the relationship between pretreatment lymphoma cell nuclear v-rel reticuloendotheliosis viral oncogene homolog A (relA) and response.
OUTLINE:

Patients receive vorinostat orally (PO) once daily (QD) on days 1-5 and 8-12. Patients also receive bortezomib intravenously (IV) over 3-5 seconds on days 1, 4, 8, and 11. Courses repeat every 3 weeks in the absence of disease progression or unacceptable toxicity.

Study Design

Study Type:
Interventional
Actual Enrollment :
65 participants
Allocation:
N/A
Intervention Model:
Single Group Assignment
Masking:
None (Open Label)
Primary Purpose:
Treatment
Official Title:
Phase II Trial of Bortezomib and Vorinostat in Mantle Cell and Diffuse Large B-Cell Lymphomas
Actual Study Start Date :
Jul 9, 2008
Actual Primary Completion Date :
Dec 1, 2017
Actual Study Completion Date :
Dec 1, 2017

Arms and Interventions

Arm Intervention/Treatment
Experimental: Treatment (vorinostat, bortezomib)

Participants receive vorinostat orally (PO) once daily (QD) on days 1-5 and 8-12. Participants also receive bortezomib intravenously (IV) over 3-5 seconds on days 1, 4, 8, and 11. Vorinostat precedes bortezomib on days of concurrent administration. Courses repeat every 3 weeks in the absence of disease progression - or unacceptable toxicity. After completion of study therapy, participants are followed periodically. Treatment arm consists of 3 cohorts, all receiving the same treatment: A: Mantle Cell Lymphoma (MCL) - with no prior bortezomib. B: Mantle Cell Lymphoma (MCL) - with no prior bortezomib. C: Diffuse Large B-Cell Lymphoma (DLBCL) - with no prior bortezomib.

Drug: Bortezomib
Bortezomib: 1.3 mg/m^2/d IV days 1, 4, 8, and 11.
Other Names:
  • [(1R)-3-Methyl-1-[[(2S)-1-oxo-3-phenyl-2-[(pyrazinylcarbonyl)amino]propyl]amino]butyl]boronic Acid
  • LDP 341
  • MLN341
  • PS-341
  • PS341
  • Velcade
  • Other: Laboratory Biomarker Analysis
    Correlative studies

    Drug: Vorinostat
    Vorinostat: 400 mg (total daily dose as a single dose) days 1-5 and 8-12.
    Other Names:
  • L-001079038
  • MSK-390
  • SAHA
  • Suberanilohydroxamic Acid
  • Suberoylanilide Hydroxamic Acid
  • Zolinza
  • Outcome Measures

    Primary Outcome Measures

    1. Overall Response Rate (ORR) [Up to 9 years]

      ORR: Complete Response (CR) + Partial Response (PR) assessed according to the Revised Response Criteria for Malignant Lymphoma.

    Secondary Outcome Measures

    1. Best Response [Up to 9 years]

      Number of participants per category: Partial Response (PR), Stable Disease (SD), Progressive Disease (PD). PR: Regression of measurable disease and no new sites. SD: Failure to attain Complete Response (CR), /PR or PD. Relapsed or Progressive Disease: Any new lesion or increase by ≥ 50% of previously involved sites from nadir.

    2. Progression-free Survival (PFS) [Up to 9 years]

      Median progression-free survival in months per cohort.

    3. Duration of Partial Response [Up to 9 years]

      Median duration of response per cohort.

    4. Duration of Stable Disease [Up to 9 years]

      Median duration of stable disease per cohort.

    Eligibility Criteria

    Criteria

    Ages Eligible for Study:
    18 Years and Older
    Sexes Eligible for Study:
    All
    Accepts Healthy Volunteers:
    No
    Inclusion Criteria:
    • Histologically confirmed mantle cell or diffuse large B-cell lymphoma; histological material must be available for central pathological review; unstained histological material -- slides or blocks -- must be available for correlative studies; archived material from previous biopsies is acceptable, unless a patient's lymphoma has been known to undergo histological transformation in the past, in which case a repeat biopsy to confirm histology prior to enrollment is required; availability of material must be confirmed at the time of registration, but material may be submitted subsequent to registration and initiation of study treatment

    • Measurable disease according to the Revised Response Criteria for Malignant Lymphoma; this requires at least one lesion greater than 1.0 cm in diameter in both the long and short axis as measured by spiral computed tomography (CT) scan or physical exam

    • Prior allogeneic stem cell transplant is allowed provided that all of the following conditions are met:

    • = 6 months have elapsed since allogeneic transplant

    • No graft vs. host disease (GVHD) is present

    • Not currently on immunosuppressive therapy

    • Prior therapy:

    • Mantle cell lymphoma:

    • Previously treated or untreated

    • No prior bortezomib

    • Diffuse large B-cell lymphoma:

    • At least one prior systemic therapy

    • No prior bortezomib

    • Note: Not intended for patients in first relapse who are candidates for high dose therapy with stem cell support

    • Life expectancy of greater than 3 months

    • Eastern Cooperative Oncology Group (ECOG) performance status 0, 1, or 2

    • Able to tolerate loperamide or other anti-diarrheal medications

    • Absolute neutrophil count >= 1.5 x 10^9/L

    • Platelets >= 75 x 10^9/L

    • Total bilirubin =< 1.5 x upper limit of normal (ULN)

    • Aspartate aminotransferase (AST) (serum glutamic oxaloacetic transferase [SGOT])/alanine aminotransferase (ALT) (serum glutamate pyruvate transaminase [SGPT]) =< 2.5 x institutional upper limit of normal

    • Creatinine within normal institutional limits or calculated creatinine clearance >= 60 mL/min according to the Cockcroft-Gault formula

    • For patients with known human immunodeficiency virus (HIV) infection, a cluster of differentiation (CD)4 count >= 0.5 x 10^9/L

    • For patients whose last treatment included bendamustine or fludarabine, a CD4 count >= 0.4 x 10^9/L

    • 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 and to report pregnancy or suspected pregnancy while participating in the study

    • Ability to understand and the willingness to sign a written informed consent document

    Exclusion Criteria:
    • Chemotherapy or large field radiotherapy within 3 weeks prior to entering the study

    • Prior histone deacetylase inhibitor as cancer treatment

    • Concurrent treatment with other investigational agents

    • Plans for other concurrent cancer treatment; if steroids for cancer control have been used, patients must be off these agents for >= 1 week before starting treatment; exception: maintenance therapy for non-malignant disease with prednisone or steroid equivalent dose < 10 mg/day is permitted

    • History of brain metastasis including leptomeningeal metastasis

    • Grade >= 2 neuropathy, regardless of cause

    • Unable to take oral medications

    • History of allergic reactions attributed to compounds of similar chemical or biologic composition to bortezomib or vorinostat

    • Not sufficiently recovered from previous treatment

    • Medical or other condition (for example: uncontrolled infection; potentially life threatening changes on electrocardiogram [EKG]) or concurrent treatment (for example, marrow suppressive agents such as zidovudine) that represents an inappropriate risk to the patient or likely would compromise achievement of the primary study objective; patients should be closely monitored when given bortezomib in combination with the cytochrome P450, family 3, subfamily A, polypeptide 4 (CYP3A4) inhibitors and inducers

    • Pregnant women are excluded from this study; breastfeeding should be discontinued

    • Active concurrent malignancy, except adequately treated non-melanoma skin cancer

    Contacts and Locations

    Locations

    Site City State Country Postal Code
    1 Moffitt Cancer Center Tampa Florida United States 33612
    2 Emory University Hospital/Winship Cancer Institute Atlanta Georgia United States 30322
    3 Northwestern University Chicago Illinois United States 60611
    4 University of Chicago Comprehensive Cancer Center Chicago Illinois United States 60637
    5 University of Maryland/Greenebaum Cancer Center Baltimore Maryland United States 21201
    6 Rutgers Cancer Institute of New Jersey New Brunswick New Jersey United States 08903
    7 Montefiore Medical Center-Weiler Hospital Bronx New York United States 10461
    8 Montefiore Medical Center - Moses Campus Bronx New York United States 10467
    9 Weill Medical College of Cornell University New York New York United States 10065
    10 UNC Lineberger Comprehensive Cancer Center Chapel Hill North Carolina United States 27599
    11 Vanderbilt University/Ingram Cancer Center Nashville Tennessee United States 37232
    12 Virginia Commonwealth University/Massey Cancer Center Richmond Virginia United States 23298

    Sponsors and Collaborators

    • National Cancer Institute (NCI)

    Investigators

    • Principal Investigator: Beata Holkova, Massey Cancer Center

    Study Documents (Full-Text)

    More Information

    Publications

    None provided.
    Responsible Party:
    National Cancer Institute (NCI)
    ClinicalTrials.gov Identifier:
    NCT00703664
    Other Study ID Numbers:
    • NCI-2009-00275
    • NCI-2009-00275
    • CDR0000598308
    • MCC-15428
    • 8064
    • N01CM00071
    • N01CM00100
    • N01CM62201
    • N01CM62204
    • N01CM62208
    • P30CA076292
    First Posted:
    Jun 23, 2008
    Last Update Posted:
    Aug 7, 2018
    Last Verified:
    Jul 1, 2018

    Study Results

    Participant Flow

    Recruitment Details Participants were enrolled at 12 participating cancer center sites in the United States, from July 2008 through December 2013.
    Pre-assignment Detail
    Arm/Group Title Treatment: Cohort A - MCL; No Prior Bortezomib Treatment: Cohort B - MCL; Prior Bortezomib Treatment: Cohort C - DLBCL; No Prior Bortezomib
    Arm/Group Description Mantle Cell Lymphoma (MCL): Treatment (vorinostat, bortezomib). Participants receive vorinostat orally (PO) once daily (QD) on days 1-5 and 8-12. Participants also receive bortezomib intravenously (IV) over 3-5 seconds on days 1, 4, 8, and 11. Vorinostat precedes bortezomib on days of concurrent administration. Courses repeat every 3 weeks in the absence of disease progression - or unacceptable toxicity. After completion of study therapy, participants are followed periodically. Mantle Cell Lymphoma MCL: Treatment (vorinostat, bortezomib). Participants receive vorinostat orally (PO) once daily (QD) on days 1-5 and 8-12. Participants also receive bortezomib intravenously (IV) over 3-5 seconds on days 1, 4, 8, and 11. Vorinostat precedes bortezomib on days of concurrent administration. Courses repeat every 3 weeks in the absence of disease progression - or unacceptable toxicity. After completion of study therapy, participants are followed periodically. Diffuse Large B-Cell Lymphoma (DLBCL): Treatment (vorinostat, bortezomib). Participants receive vorinostat orally (PO) once daily (QD) on days 1-5 and 8-12. Participants also receive bortezomib intravenously (IV) over 3-5 seconds on days 1, 4, 8, and 11. Vorinostat precedes bortezomib on days of concurrent administration. Courses repeat every 3 weeks in the absence of disease progression - or unacceptable toxicity. After completion of study therapy, participants are followed periodically.
    Period Title: Overall Study
    STARTED 22 4 39
    COMPLETED 22 4 39
    NOT COMPLETED 0 0 0

    Baseline Characteristics

    Arm/Group Title Treatment: Cohort A - MCL; No Prior Bortezomib Treatment: Cohort B - MCL; Prior Bortezomib Treatment: Cohort C - DLBCL; No Prior Bortezomib Total
    Arm/Group Description Mantle Cell Lymphoma (MCL): Treatment (vorinostat, bortezomib). Participants receive vorinostat orally (PO) once daily (QD) on days 1-5 and 8-12. Participants also receive bortezomib intravenously (IV) over 3-5 seconds on days 1, 4, 8, and 11. Vorinostat precedes bortezomib on days of concurrent administration. Courses repeat every 3 weeks in the absence of disease progression - or unacceptable toxicity. After completion of study therapy, participants are followed periodically. Mantle Cell Lymphoma MCL: Treatment (vorinostat, bortezomib). Participants receive vorinostat orally (PO) once daily (QD) on days 1-5 and 8-12. Participants also receive bortezomib intravenously (IV) over 3-5 seconds on days 1, 4, 8, and 11. Vorinostat precedes bortezomib on days of concurrent administration. Courses repeat every 3 weeks in the absence of disease progression - or unacceptable toxicity. After completion of study therapy, participants are followed periodically. Diffuse Large B-Cell Lymphoma (DLBCL): Treatment (vorinostat, bortezomib). Participants receive vorinostat orally (PO) once daily (QD) on days 1-5 and 8-12. Participants also receive bortezomib intravenously (IV) over 3-5 seconds on days 1, 4, 8, and 11. Vorinostat precedes bortezomib on days of concurrent administration. Courses repeat every 3 weeks in the absence of disease progression - or unacceptable toxicity. After completion of study therapy, participants are followed periodically. Total of all reporting groups
    Overall Participants 22 4 39 65
    Age (years) [Median (Full Range) ]
    Median (Full Range) [years]
    64
    63
    57
    60
    Sex: Female, Male (Count of Participants)
    Female
    5
    22.7%
    0
    0%
    13
    33.3%
    18
    27.7%
    Male
    17
    77.3%
    4
    100%
    26
    66.7%
    47
    72.3%
    Race (NIH/OMB) (Count of Participants)
    American Indian or Alaska Native
    0
    0%
    0
    0%
    0
    0%
    0
    0%
    Asian
    0
    0%
    0
    0%
    0
    0%
    0
    0%
    Native Hawaiian or Other Pacific Islander
    0
    0%
    0
    0%
    0
    0%
    0
    0%
    Black or African American
    2
    9.1%
    0
    0%
    5
    12.8%
    7
    10.8%
    White
    19
    86.4%
    4
    100%
    30
    76.9%
    53
    81.5%
    More than one race
    0
    0%
    0
    0%
    0
    0%
    0
    0%
    Unknown or Not Reported
    1
    4.5%
    0
    0%
    4
    10.3%
    5
    7.7%
    Region of Enrollment (Count of Participants)
    United States
    22
    100%
    4
    100%
    39
    100%
    65
    100%
    Eastern Cooperative Oncology Group (ECOG) Status (Count of Participants)
    Status: 0
    13
    59.1%
    3
    75%
    11
    28.2%
    27
    41.5%
    Status: 1
    9
    40.9%
    1
    25%
    19
    48.7%
    29
    44.6%
    Status: 2
    0
    0%
    0
    0%
    9
    23.1%
    9
    13.8%

    Outcome Measures

    1. Primary Outcome
    Title Overall Response Rate (ORR)
    Description ORR: Complete Response (CR) + Partial Response (PR) assessed according to the Revised Response Criteria for Malignant Lymphoma.
    Time Frame Up to 9 years

    Outcome Measure Data

    Analysis Population Description
    All participants.
    Arm/Group Title Cohort A - MCL Cohort B - MCL Cohort C - DLBCL
    Arm/Group Description Mantle Cell Lymphoma (MCL): Treatment (vorinostat, bortezomib). Mantle Cell Lymphoma MCL: Treatment (vorinostat, bortezomib). Diffuse Large B-Cell Lymphoma (DLBCL): Treatment (vorinostat, bortezomib).
    Measure Participants 22 4 39
    Number [percentage of participants]
    31.8
    144.5%
    0
    0%
    7.7
    19.7%
    2. Secondary Outcome
    Title Best Response
    Description Number of participants per category: Partial Response (PR), Stable Disease (SD), Progressive Disease (PD). PR: Regression of measurable disease and no new sites. SD: Failure to attain Complete Response (CR), /PR or PD. Relapsed or Progressive Disease: Any new lesion or increase by ≥ 50% of previously involved sites from nadir.
    Time Frame Up to 9 years

    Outcome Measure Data

    Analysis Population Description
    All participants evaluable and available at time of assessment.
    Arm/Group Title Cohort A - MCL Cohort B - MCL Cohort C - DLBCL
    Arm/Group Description Mantle Cell Lymphoma (MCL): Treatment (vorinostat, bortezomib). Mantle Cell Lymphoma MCL: Treatment (vorinostat, bortezomib). Diffuse Large B-Cell Lymphoma (DLBCL): Treatment (vorinostat, bortezomib).
    Measure Participants 19 4 34
    Partial Response
    7
    31.8%
    0
    0%
    3
    7.7%
    Stable Disease
    5
    22.7%
    2
    50%
    8
    20.5%
    Progressive Disease
    7
    31.8%
    2
    50%
    23
    59%
    3. Secondary Outcome
    Title Progression-free Survival (PFS)
    Description Median progression-free survival in months per cohort.
    Time Frame Up to 9 years

    Outcome Measure Data

    Analysis Population Description
    All evaluable participants at time of analysis. Cohort B was closed early due to lack of accrual.
    Arm/Group Title Cohort A - MCL Cohort B - MCL Cohort C - DLBCL
    Arm/Group Description Mantle Cell Lymphoma (MCL): Treatment (vorinostat, bortezomib). Mantle Cell Lymphoma MCL: Treatment (vorinostat, bortezomib). Diffuse Large B-Cell Lymphoma (DLBCL): Treatment (vorinostat, bortezomib).
    Measure Participants 22 0 39
    Median (95% Confidence Interval) [months]
    7.6
    1.8
    4. Secondary Outcome
    Title Duration of Partial Response
    Description Median duration of response per cohort.
    Time Frame Up to 9 years

    Outcome Measure Data

    Analysis Population Description
    All participants with Partial Response.
    Arm/Group Title Cohort A - MCL Cohort B - MCL Cohort C - DLBCL
    Arm/Group Description Mantle Cell Lymphoma (MCL): Treatment (vorinostat, bortezomib). Mantle Cell Lymphoma MCL: Treatment (vorinostat, bortezomib). Diffuse Large B-Cell Lymphoma (DLBCL): Treatment (vorinostat, bortezomib).
    Measure Participants 7 0 3
    Median (Full Range) [months]
    4.2
    2.1
    5. Secondary Outcome
    Title Duration of Stable Disease
    Description Median duration of stable disease per cohort.
    Time Frame Up to 9 years

    Outcome Measure Data

    Analysis Population Description
    All participants with stable disease.
    Arm/Group Title Cohort A - MCL Cohort B - MCL Cohort C - DLBCL
    Arm/Group Description Mantle Cell Lymphoma (MCL): Treatment (vorinostat, bortezomib). Mantle Cell Lymphoma MCL: Treatment (vorinostat, bortezomib). Diffuse Large B-Cell Lymphoma (DLBCL): Treatment (vorinostat, bortezomib).
    Measure Participants 5 2 8
    Median (Full Range) [months]
    3.8
    3.8
    1.3

    Adverse Events

    Time Frame 5 years
    Adverse Event Reporting Description NCI Common Terminology Criteria for Adverse Events (CTCAE) v3.0 was used for reporting adverse events until April 1, 2011, when mandatory conversion to CTCAE v4.0 supervened. Response was assessed using the Revised Response Criteria for Malignant Lymphoma.
    Arm/Group Title Cohort A - MCL Cohort B - MCL Cohort C - DLBCL
    Arm/Group Description Mantle Cell Lymphoma (MCL): Treatment (vorinostat, bortezomib). Mantle Cell Lymphoma MCL: Treatment (vorinostat, bortezomib). Diffuse Large B-Cell Lymphoma (DLBCL): Treatment (vorinostat, bortezomib).
    All Cause Mortality
    Cohort A - MCL Cohort B - MCL Cohort C - DLBCL
    Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events
    Total 0/22 (0%) 0/4 (0%) 4/39 (10.3%)
    Serious Adverse Events
    Cohort A - MCL Cohort B - MCL Cohort C - DLBCL
    Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events
    Total 9/22 (40.9%) 1/4 (25%) 22/39 (56.4%)
    Blood and lymphatic system disorders
    Anemia 1/22 (4.5%) 1 0/4 (0%) 0 1/39 (2.6%) 1
    Cardiac disorders
    Myocardial infarction 0/22 (0%) 0 0/4 (0%) 0 1/39 (2.6%) 1
    Sinus bradycardia 1/22 (4.5%) 1 0/4 (0%) 0 0/39 (0%) 0
    Sinus tachycardia 0/22 (0%) 0 0/4 (0%) 0 1/39 (2.6%) 1
    Ventricular arrhythmia 0/22 (0%) 0 1/4 (25%) 1 0/39 (0%) 0
    Eye disorders
    Dry Eye 1/22 (4.5%) 1 0/4 (0%) 0 0/39 (0%) 0
    Eye disorders - Other, Chalazion 1/22 (4.5%) 1 0/4 (0%) 0 0/39 (0%) 0
    Gastrointestinal disorders
    Abdominal pain 0/22 (0%) 0 0/4 (0%) 0 1/39 (2.6%) 2
    Diarrhea 3/22 (13.6%) 3 0/4 (0%) 0 1/39 (2.6%) 1
    Gastritis 1/22 (4.5%) 1 0/4 (0%) 0 0/39 (0%) 0
    Gastrointestinal disorders - Other, Duodenitis 1/22 (4.5%) 1 0/4 (0%) 0 0/39 (0%) 0
    Gastrointestinal disorders - Other, Cramping 0/22 (0%) 0 0/4 (0%) 0 1/39 (2.6%) 1
    Lower gastrointestinal hemorrhage 0/22 (0%) 0 0/4 (0%) 0 1/39 (2.6%) 1
    Nausea 1/22 (4.5%) 1 0/4 (0%) 0 2/39 (5.1%) 2
    Vomiting 1/22 (4.5%) 1 0/4 (0%) 0 3/39 (7.7%) 3
    General disorders
    Multi-organ failure - Death 0/22 (0%) 0 0/4 (0%) 0 1/39 (2.6%) 1
    Multi-organ failure 0/22 (0%) 0 0/4 (0%) 0 1/39 (2.6%) 1
    Chills 0/22 (0%) 0 0/4 (0%) 0 1/39 (2.6%) 1
    Edema limbs 0/22 (0%) 0 0/4 (0%) 0 1/39 (2.6%) 1
    Fatigue 0/22 (0%) 0 0/4 (0%) 0 1/39 (2.6%) 1
    Fever 0/22 (0%) 0 0/4 (0%) 0 1/39 (2.6%) 1
    Non-cardiac chest pain 0/22 (0%) 0 0/4 (0%) 0 1/39 (2.6%) 1
    Pain 0/22 (0%) 0 0/4 (0%) 0 2/39 (5.1%) 2
    Infections and infestations
    Appendicitis 0/22 (0%) 0 0/4 (0%) 0 1/39 (2.6%) 1
    Infectionsand infestations - Other 2/22 (9.1%) 2 0/4 (0%) 0 1/39 (2.6%) 1
    Skin infection 0/22 (0%) 0 0/4 (0%) 0 1/39 (2.6%) 1
    Wound infection 0/22 (0%) 0 0/4 (0%) 0 1/39 (2.6%) 1
    Investigations
    Creatinine increased 1/22 (4.5%) 1 0/4 (0%) 0 1/39 (2.6%) 1
    Ejection fraction decreased 1/22 (4.5%) 1 0/4 (0%) 0 0/39 (0%) 0
    Electrocardiogram QT corrected interval prolonged 0/22 (0%) 0 1/4 (25%) 1 1/39 (2.6%) 2
    Neutrophil count decreased 0/22 (0%) 0 0/4 (0%) 0 1/39 (2.6%) 1
    Platelet count decreased 0/22 (0%) 0 0/4 (0%) 0 6/39 (15.4%) 7
    Metabolism and nutrition disorders
    Dehydration 2/22 (9.1%) 3 0/4 (0%) 0 3/39 (7.7%) 3
    Hypercalcemia 0/22 (0%) 0 0/4 (0%) 0 2/39 (5.1%) 3
    Hypokalemia 1/22 (4.5%) 1 0/4 (0%) 0 0/39 (0%) 0
    Hyponatremia 2/22 (9.1%) 2 0/4 (0%) 0 1/39 (2.6%) 2
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Neoplasms benign, malignant and unspecified - Death 0/22 (0%) 0 0/4 (0%) 0 1/39 (2.6%) 1
    Tumor pain 0/22 (0%) 0 0/4 (0%) 0 2/39 (5.1%) 2
    Nervous system disorders
    Dizziness 1/22 (4.5%) 1 0/4 (0%) 0 0/39 (0%) 0
    Headache 0/22 (0%) 0 0/4 (0%) 0 2/39 (5.1%) 2
    Nervous system disorders - Other 0/22 (0%) 0 0/4 (0%) 0 1/39 (2.6%) 1
    Peripheral sensory neuropathy 1/22 (4.5%) 1 0/4 (0%) 0 0/39 (0%) 0
    Syncope 1/22 (4.5%) 1 0/4 (0%) 0 0/39 (0%) 0
    Psychiatric disorders
    Confusion 0/22 (0%) 0 0/4 (0%) 0 2/39 (5.1%) 2
    Renal and urinary disorders
    Acute kidney injury 0/22 (0%) 0 0/4 (0%) 0 2/39 (5.1%) 2
    Urinary incontinence 0/22 (0%) 0 0/4 (0%) 0 1/39 (2.6%) 1
    Respiratory, thoracic and mediastinal disorders
    Adult respiratory distress syndrome 0/22 (0%) 0 0/4 (0%) 0 2/39 (5.1%) 2
    Dyspnea 0/22 (0%) 0 1/4 (25%) 1 6/39 (15.4%) 6
    Hypoxia 1/22 (4.5%) 2 1/4 (25%) 1 0/39 (0%) 0
    Pneumonitis 1/22 (4.5%) 1 0/4 (0%) 0 0/39 (0%) 0
    Pulmonary fibrosis 1/22 (4.5%) 1 0/4 (0%) 0 0/39 (0%) 0
    Vascular disorders
    Hypotension 2/22 (9.1%) 2 0/4 (0%) 0 3/39 (7.7%) 3
    Thromboembolic event 0/22 (0%) 0 0/4 (0%) 0 2/39 (5.1%) 2
    Other (Not Including Serious) Adverse Events
    Cohort A - MCL Cohort B - MCL Cohort C - DLBCL
    Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events
    Total 22/22 (100%) 4/4 (100%) 39/39 (100%)
    Blood and lymphatic system disorders
    Anemia 7/22 (31.8%) 26 1/4 (25%) 1 20/39 (51.3%) 70
    Blood and lymphatic system disorders - Other, specify 1/22 (4.5%) 1 0/4 (0%) 0 1/39 (2.6%) 1
    Hemolysis 0/22 (0%) 0 0/4 (0%) 0 1/39 (2.6%) 2
    Thrombotic thrombocytopenic purpura 1/22 (4.5%) 1 0/4 (0%) 0 0/39 (0%) 0
    Cardiac disorders
    Sinus tachycardia 0/22 (0%) 0 0/4 (0%) 0 3/39 (7.7%) 4
    Sinus bradycardia 0/22 (0%) 0 0/4 (0%) 0 1/39 (2.6%) 1
    Atrial fibrillation 0/22 (0%) 0 0/4 (0%) 0 1/39 (2.6%) 1
    Ear and labyrinth disorders
    Hearing impaired 1/22 (4.5%) 1 0/4 (0%) 0 0/39 (0%) 0
    Vertigo 1/22 (4.5%) 1 0/4 (0%) 0 0/39 (0%) 0
    Eye disorders
    Dry eye 0/22 (0%) 0 0/4 (0%) 0 1/39 (2.6%) 1
    Blurred vision 1/22 (4.5%) 1 0/4 (0%) 0 0/39 (0%) 0
    Conjunctivitis 0/22 (0%) 0 0/4 (0%) 0 1/39 (2.6%) 1
    Eye disorders - Other, specify 1/22 (4.5%) 1 0/4 (0%) 0 0/39 (0%) 0
    Eyelid function disorder 0/22 (0%) 0 1/4 (25%) 1 0/39 (0%) 0
    Gastrointestinal disorders
    Diarrhea 20/22 (90.9%) 54 2/4 (50%) 2 24/39 (61.5%) 46
    Nausea 14/22 (63.6%) 33 2/4 (50%) 2 20/39 (51.3%) 47
    Vomiting 10/22 (45.5%) 16 0/4 (0%) 0 14/39 (35.9%) 24
    Constipation 7/22 (31.8%) 8 1/4 (25%) 1 12/39 (30.8%) 15
    Abdominal pain 5/22 (22.7%) 6 1/4 (25%) 1 10/39 (25.6%) 12
    Dyspepsia 1/22 (4.5%) 1 0/4 (0%) 0 5/39 (12.8%) 5
    Flatulence 0/22 (0%) 0 0/4 (0%) 0 3/39 (7.7%) 3
    Stomach pain 1/22 (4.5%) 1 0/4 (0%) 0 2/39 (5.1%) 2
    Abdominal distension 2/22 (9.1%) 2 0/4 (0%) 0 0/39 (0%) 0
    Dry mouth 1/22 (4.5%) 1 0/4 (0%) 0 1/39 (2.6%) 1
    Gastrointestinal disorders - Other, specify 1/22 (4.5%) 1 0/4 (0%) 0 0/39 (0%) 0
    Lower gastrointestinal hemorrhage 1/22 (4.5%) 1 0/4 (0%) 0 1/39 (2.6%) 1
    Dysphagia 0/22 (0%) 0 1/4 (25%) 1 0/39 (0%) 0
    Gastrointestinal pain 1/22 (4.5%) 1 0/4 (0%) 0 0/39 (0%) 0
    Gastroparesis 1/22 (4.5%) 1 0/4 (0%) 0 0/39 (0%) 0
    Ileus 1/22 (4.5%) 1 0/4 (0%) 0 0/39 (0%) 0
    Mucositis oral 0/22 (0%) 0 1/4 (25%) 1 0/39 (0%) 0
    Oral pain 1/22 (4.5%) 1 0/4 (0%) 0 0/39 (0%) 0
    General disorders
    Fatigue 18/22 (81.8%) 39 1/4 (25%) 4 22/39 (56.4%) 48
    Chills 7/22 (31.8%) 10 0/4 (0%) 0 2/39 (5.1%) 3
    Edema limbs 2/22 (9.1%) 2 0/4 (0%) 0 5/39 (12.8%) 6
    Fever 2/22 (9.1%) 3 0/4 (0%) 0 6/39 (15.4%) 9
    Pain 2/22 (9.1%) 2 0/4 (0%) 0 6/39 (15.4%) 7
    Malaise 2/22 (9.1%) 3 0/4 (0%) 0 0/39 (0%) 0
    Non-cardiac chest pain 0/22 (0%) 0 0/4 (0%) 0 1/39 (2.6%) 1
    Edema trunk 0/22 (0%) 0 0/4 (0%) 0 1/39 (2.6%) 1
    Facial pain 1/22 (4.5%) 1 0/4 (0%) 0 0/39 (0%) 0
    Irritability 0/22 (0%) 0 1/4 (25%) 1 0/39 (0%) 0
    Hepatobiliary disorders
    Gallbladder fistula 1/22 (4.5%) 1 0/4 (0%) 0 0/39 (0%) 0
    Immune system disorders
    Allergic reaction 1/22 (4.5%) 1 0/4 (0%) 0 0/39 (0%) 0
    Autoimmune disorder 0/22 (0%) 0 0/4 (0%) 0 1/39 (2.6%) 1
    Infections and infestations
    Infections and infestations - Other, specify 2/22 (9.1%) 2 0/4 (0%) 0 1/39 (2.6%) 1
    Papulopustular rash 2/22 (9.1%) 2 0/4 (0%) 0 0/39 (0%) 0
    Sinusitis 1/22 (4.5%) 3 0/4 (0%) 0 1/39 (2.6%) 1
    Hepatitis viral 1/22 (4.5%) 1 0/4 (0%) 0 0/39 (0%) 0
    Lung infection 0/22 (0%) 0 0/4 (0%) 0 1/39 (2.6%) 1
    Mucosal infection 1/22 (4.5%) 1 0/4 (0%) 0 0/39 (0%) 0
    Pharyngitis 1/22 (4.5%) 1 0/4 (0%) 0 0/39 (0%) 0
    Sepsis 0/22 (0%) 0 0/4 (0%) 0 1/39 (2.6%) 1
    Upper respiratory infection 1/22 (4.5%) 1 0/4 (0%) 0 0/39 (0%) 0
    Urinary tract infection 0/22 (0%) 0 0/4 (0%) 0 1/39 (2.6%) 1
    Wound infection 0/22 (0%) 0 0/4 (0%) 0 1/39 (2.6%) 1
    Injury, poisoning and procedural complications
    Bruising 1/22 (4.5%) 1 0/4 (0%) 0 1/39 (2.6%) 1
    Injury, poisoning and procedural complications - Other, specify 1/22 (4.5%) 1 0/4 (0%) 0 0/39 (0%) 0
    Vascular access complication 1/22 (4.5%) 1 0/4 (0%) 0 0/39 (0%) 0
    Wound dehiscence 1/22 (4.5%) 1 0/4 (0%) 0 0/39 (0%) 0
    Investigations
    Platelet count decreased 18/22 (81.8%) 126 3/4 (75%) 5 26/39 (66.7%) 141
    Lymphocyte count decreased 11/22 (50%) 30 1/4 (25%) 1 20/39 (51.3%) 65
    White blood cell decreased 13/22 (59.1%) 32 1/4 (25%) 1 14/39 (35.9%) 65
    Neutrophil count decreased 10/22 (45.5%) 19 0/4 (0%) 0 12/39 (30.8%) 32
    Creatinine increased 7/22 (31.8%) 19 1/4 (25%) 3 12/39 (30.8%) 42
    Aspartate aminotransferase increased 3/22 (13.6%) 6 0/4 (0%) 0 7/39 (17.9%) 10
    Alanine aminotransferase increased 3/22 (13.6%) 5 0/4 (0%) 0 5/39 (12.8%) 9
    Alkaline phosphatase increased 0/22 (0%) 0 0/4 (0%) 0 6/39 (15.4%) 8
    Electrocardiogram QT corrected interval prolonged 1/22 (4.5%) 1 0/4 (0%) 0 1/39 (2.6%) 1
    Weight loss 3/22 (13.6%) 3 0/4 (0%) 0 1/39 (2.6%) 1
    Investigations - Other, specify 1/22 (4.5%) 1 0/4 (0%) 0 2/39 (5.1%) 6
    INR increased 0/22 (0%) 0 1/4 (25%) 1 1/39 (2.6%) 1
    Weight gain 0/22 (0%) 0 1/4 (25%) 1 1/39 (2.6%) 1
    Activated partial thromboplastin time prolonged 1/22 (4.5%) 1 0/4 (0%) 0 0/39 (0%) 0
    Blood bilirubin increased 1/22 (4.5%) 1 0/4 (0%) 0 0/39 (0%) 0
    Cardiac troponin T increased 0/22 (0%) 0 0/4 (0%) 0 1/39 (2.6%) 3
    Cholesterol high 0/22 (0%) 0 0/4 (0%) 0 1/39 (2.6%) 1
    CPK increased 0/22 (0%) 0 0/4 (0%) 0 1/39 (2.6%) 2
    Metabolism and nutrition disorders
    Anorexia 11/22 (50%) 11 0/4 (0%) 0 15/39 (38.5%) 23
    Hyperglycemia 5/22 (22.7%) 7 3/4 (75%) 6 14/39 (35.9%) 25
    Hyponatremia 5/22 (22.7%) 14 0/4 (0%) 0 11/39 (28.2%) 15
    Hypocalcemia 5/22 (22.7%) 11 0/4 (0%) 0 10/39 (25.6%) 17
    Dehydration 2/22 (9.1%) 2 0/4 (0%) 0 4/39 (10.3%) 4
    Hypoalbuminemia 2/22 (9.1%) 2 0/4 (0%) 0 9/39 (23.1%) 12
    Hypokalemia 3/22 (13.6%) 5 0/4 (0%) 0 6/39 (15.4%) 17
    Hypoglycemia 2/22 (9.1%) 4 0/4 (0%) 0 6/39 (15.4%) 15
    Hypomagnesemia 2/22 (9.1%) 3 0/4 (0%) 0 6/39 (15.4%) 9
    Hypercalcemia 1/22 (4.5%) 1 0/4 (0%) 0 3/39 (7.7%) 4
    Hyperkalemia 3/22 (13.6%) 3 0/4 (0%) 0 1/39 (2.6%) 1
    Hypophosphatemia 1/22 (4.5%) 3 0/4 (0%) 0 3/39 (7.7%) 4
    Acidosis 1/22 (4.5%) 1 0/4 (0%) 0 1/39 (2.6%) 4
    Hyperuricemia 0/22 (0%) 0 0/4 (0%) 0 2/39 (5.1%) 2
    Musculoskeletal and connective tissue disorders
    Back pain 3/22 (13.6%) 3 1/4 (25%) 1 6/39 (15.4%) 6
    Pain in extremity 5/22 (22.7%) 8 0/4 (0%) 0 3/39 (7.7%) 6
    Generalized muscle weakness 0/22 (0%) 0 0/4 (0%) 0 4/39 (10.3%) 4
    Myalgia 2/22 (9.1%) 2 0/4 (0%) 0 2/39 (5.1%) 2
    Neck pain 3/22 (13.6%) 5 0/4 (0%) 0 0/39 (0%) 0
    Arthralgia 1/22 (4.5%) 2 1/4 (25%) 4 0/39 (0%) 0
    Flank pain 1/22 (4.5%) 1 0/4 (0%) 0 1/39 (2.6%) 1
    Bone pain 1/22 (4.5%) 1 0/4 (0%) 0 0/39 (0%) 0
    Joint range of motion decreased 0/22 (0%) 0 0/4 (0%) 0 1/39 (2.6%) 1
    Muscle weakness lower limb 0/22 (0%) 0 0/4 (0%) 0 1/39 (2.6%) 1
    Muscle weakness upper limb 0/22 (0%) 0 0/4 (0%) 0 1/39 (2.6%) 1
    Nervous system disorders
    Peripheral sensory neuropathy 10/22 (45.5%) 20 1/4 (25%) 2 10/39 (25.6%) 12
    Dizziness 12/22 (54.5%) 16 1/4 (25%) 1 7/39 (17.9%) 7
    Headache 2/22 (9.1%) 2 1/4 (25%) 1 11/39 (28.2%) 15
    Dysgeusia 3/22 (13.6%) 3 0/4 (0%) 0 1/39 (2.6%) 2
    Paresthesia 2/22 (9.1%) 2 0/4 (0%) 0 2/39 (5.1%) 2
    Peripheral motor neuropathy 1/22 (4.5%) 2 0/4 (0%) 0 2/39 (5.1%) 2
    Nervous system disorders - Other, specify 1/22 (4.5%) 3 0/4 (0%) 0 0/39 (0%) 0
    Syncope 1/22 (4.5%) 1 0/4 (0%) 0 1/39 (2.6%) 1
    Cognitive disturbance 1/22 (4.5%) 1 0/4 (0%) 0 0/39 (0%) 0
    Psychiatric disorders
    Anxiety 4/22 (18.2%) 5 0/4 (0%) 0 5/39 (12.8%) 6
    Insomnia 1/22 (4.5%) 1 0/4 (0%) 0 3/39 (7.7%) 3
    Confusion 1/22 (4.5%) 1 0/4 (0%) 0 1/39 (2.6%) 1
    Depression 0/22 (0%) 0 0/4 (0%) 0 3/39 (7.7%) 4
    Agitation 0/22 (0%) 0 1/4 (25%) 2 1/39 (2.6%) 1
    Restlessness 1/22 (4.5%) 1 0/4 (0%) 0 0/39 (0%) 0
    Renal and urinary disorders
    Acute kidney injury 1/22 (4.5%) 1 0/4 (0%) 0 1/39 (2.6%) 1
    Proteinuria 0/22 (0%) 0 0/4 (0%) 0 2/39 (5.1%) 2
    Renal and urinary disorders - Other, specify 0/22 (0%) 0 1/4 (25%) 1 1/39 (2.6%) 1
    Urinary frequency 1/22 (4.5%) 1 0/4 (0%) 0 1/39 (2.6%) 1
    Urinary incontinence 0/22 (0%) 0 0/4 (0%) 0 2/39 (5.1%) 2
    Urinary tract pain 0/22 (0%) 0/4 (0%) 0 1/39 (2.6%) 1
    Respiratory, thoracic and mediastinal disorders
    Dyspnea 3/22 (13.6%) 6 0/4 (0%) 0 12/39 (30.8%) 15
    Cough 2/22 (9.1%) 3 2/4 (50%) 2 7/39 (17.9%) 8
    Nasal congestion 1/22 (4.5%) 2 0/4 (0%) 0 2/39 (5.1%) 2
    Productive cough 1/22 (4.5%) 2 0/4 (0%) 0 1/39 (2.6%) 2
    Allergic rhinitis 1/22 (4.5%) 1 0/4 (0%) 0 0/39 (0%) 0
    Bronchopulmonary hemorrhage 0/22 (0%) 0 0/4 (0%) 0 1/39 (2.6%) 1
    Pleural effusion 0/22 (0%) 0 0/4 (0%) 0 1/39 (2.6%) 1
    Pneumonitis 0/22 (0%) 0 0/4 (0%) 0 1/39 (2.6%) 1
    Sore throat 1/22 (4.5%) 1 0/4 (0%) 0 0/39 (0%) 0
    Skin and subcutaneous tissue disorders
    Pruritus 2/22 (9.1%) 3 0/4 (0%) 0 4/39 (10.3%) 4
    Skin and subcutaneous tissue disorders - Other, specify 3/22 (13.6%) 3 1/4 (25%) 1 2/39 (5.1%) 2
    Rash maculo-papular 2/22 (9.1%) 3 0/4 (0%) 0 3/39 (7.7%) 3
    Hyperhidrosis 2/22 (9.1%) 2 0/4 (0%) 0 1/39 (2.6%) 1
    Alopecia 1/22 (4.5%) 1 0/4 (0%) 0 1/39 (2.6%) 1
    Rash acneiform 1/22 (4.5%) 1 0/4 (0%) 0 1/39 (2.6%) 1
    Dry skin 1/22 (4.5%) 1 0/4 (0%) 0 0/39 (0%) 0
    Palmar-plantar erythrodysesthesia syndrome 0/22 (0%) 0 0/4 (0%) 0 1/39 (2.6%) 1
    Periorbital edema 1/22 (4.5%) 1 0/4 (0%) 0 0/39 (0%) 0
    Purpura 0/22 (0%) 0 0/4 (0%) 0 1/39 (2.6%) 1
    Scalp pain 1/22 (4.5%) 1 0/4 (0%) 0 0/39 (0%) 0
    Skin induration 0/22 (0%) 0 1/4 (25%) 1 0/39 (0%) 0
    Vascular disorders
    Hypotension 3/22 (13.6%) 7 0/4 (0%) 0 4/39 (10.3%) 4
    Hypertension 2/22 (9.1%) 4 1/4 (25%) 1 1/39 (2.6%) 1
    Thromboembolic event 1/22 (4.5%) 1 0/4 (0%) 0 1/39 (2.6%) 3
    Lymphedema 0/22 (0%) 0 0/4 (0%) 0 1/39 (2.6%) 1
    Vascular disorders - Other, specify 1/22 (4.5%) 1 0/4 (0%) 0 0/39 (0%) 0

    Limitations/Caveats

    Cohort C met the 1st-stage efficacy endpoint to proceed to the 2nd stage but was closed with evidence that the 2nd-stage efficacy endpoint could not be achieved.

    More Information

    Certain Agreements

    Principal Investigators are NOT employed by the organization sponsoring the study.

    The only disclosure restriction on the PI is that the sponsor can review results communications prior to public release and can embargo communications regarding trial results for a period that is less than or equal to 60 days. The sponsor cannot require changes to the communication and cannot extend the embargo.

    Results Point of Contact

    Name/Title Dr. Beata Holkova
    Organization Massey Cancer Center, Virginia Commonwealth University
    Phone 804-628-2581
    Email bholkova@mcvh-vcu.edu
    Responsible Party:
    National Cancer Institute (NCI)
    ClinicalTrials.gov Identifier:
    NCT00703664
    Other Study ID Numbers:
    • NCI-2009-00275
    • NCI-2009-00275
    • CDR0000598308
    • MCC-15428
    • 8064
    • N01CM00071
    • N01CM00100
    • N01CM62201
    • N01CM62204
    • N01CM62208
    • P30CA076292
    First Posted:
    Jun 23, 2008
    Last Update Posted:
    Aug 7, 2018
    Last Verified:
    Jul 1, 2018