A Phase II Study of Bortezomib and Gemcitabine in Patients With Relapsed Mantle Cell Lymphoma
Inclusion Criteria
DISEASE CHARACTERISTICS:
- Histologically confirmed mantle cell lymphoma
- Relapsed disease
- Not refractory to prior therapy
- Must have received 1-3 prior systemic chemotherapy regimens AND has had no
disease progression while receiving chemotherapy or within 1 month of last dose
of most recent therapy
- Clinically and/or radiologically documented disease
- At least 1 site of disease must be bidimensionally measurable by CT scan or MRI
with ≥ 1 lesion meeting 1 of the following criteria:
- Lymph nodes ≥ 1.5 cm x 1.5 cm by spiral CT scan
- Non-nodal lesion ≥ 1 cm x 1 cm by MRI, CT scan, or physical exam
- No nonmeasurable disease only
- No preexisting ascites or pleural effusion ≥ grade 2
- No known CNS involvement by lymphoma
PATIENT CHARACTERISTICS:
- ECOG performance status 0-2
- Life expectancy ≥ 12 weeks
- Absolute granulocyte count ≥ 1,500/mm³
- Platelet count ≥ 75,000/mm³
- Creatinine ≤ 1.5 times upper limit of normal (ULN)
- Bilirubin ≤ 1.5 times ULN
- AST or ALT ≤ 2.5 times ULN
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective contraception
- LVEF ≥ 45% by echocardiogram or MUGA
- No history of allergic reactions attributed to compounds containing boron or mannitol
- No preexisting edema ≥ grade 2
- No preexisting neuropathy (sensory and/or pain) ≥ grade 2
- No preexisting shortness of breath ≥ grade 2
- No history of other malignancies, except adequately treated nonmelanoma skin cancer,
curatively treated in situ cancer of the cervix, or other solid tumors curatively
treated with no evidence of disease for ≥ 5 years
- No other serious illness or medical condition that would preclude compliance with
study requirements, including any of the following:
- Serious uncontrolled infection
- Uncontrolled or severe cardiovascular disease, including any of the following:
- Myocardial infarction within the past 6 months
- New York Heart Association class III-IV heart failure
- Uncontrolled angina
- Clinically significant pericardial disease
- Cardiac amyloidosis
- Significant neurological disorder
PRIOR CONCURRENT THERAPY:
- See Disease Characteristics
- At least 6 weeks since prior chemotherapy
- No prior radioactive monoclonal antibody therapy
- No prior bortezomib
- No prior investigational therapy (except for flavopiridol)
- No prior radiotherapy to > 25% of functioning bone marrow
- At least 4 weeks since prior radiotherapy and recovered
- Low-dose, nonmyelosuppressive radiotherapy may be allowed
- At least 2 weeks since prior major surgery
- No other concurrent anticancer therapy
- No concurrent corticosteroids
- No other concurrent cytotoxic chemotherapy
- No other concurrent investigational agents