Phase I/II Study of Combination Veltuzumab (Anti-CD20) and Fractionated 90Y- Epratuzumab (Anti-CD22) Radioimmunotherapy in Patients With Follicular Lymphoma
The treatment regimen consists of 2 elements. The first element is represented by one
courses of veltuzumab (4 weekly injections of 200 mg/m2). 90Y-epratuzumab will be given as
2 injections at escalating doses 1 week apart and administered starting one week following
the 4th veltuzumab injection.
After confirming eligibility and undergoing baseline assessments, the treatment starts with
an imaging study using 111In-epratuzumab (5-mCi 111In-DOTA-epratuzumab co-infused with a
total of 1.5 mg/kg unlabeled epratuzumab). Blood samples (~7 samples, 5 mL each) for
pharmacokinetic analysis will be collected over 5-7 days, and patients will be imaged on 4
separate occasions (e.g., the day of injection (Day 0), Day 1, Day 3, 4, or 5, and day 6 or
7).
The patient will then initiate veltuzumab treatments starting 7 days after the
111In-epratuzumab injection. Veltuzumab is given in 4 weekly doses, each 200 mg/m2. A
single blood sample will be taken before each veltuzumab dose to assess residual veltuzumab
concentrations in the serum, and then at 1 h later to determine peak values. Patients will
receive unlabeled, unconjugated epratuzumab (1.5 mg/kg) that will be infused over ~30
minutes. Patients will also receive 111In-epratuzumab immediately following the unlabeled
epratuzumab. Blood samples will be collected at the same intervals as after the first
111In-epratuzumab. Only 2 imaging sessions will be required, on Day 1 and then again on day
6 or 7 (these days should match those obtained after the first 111In-epratuzumab injection).
The 90Y-epratuzumab treatment will begin one week after the 4th veltuzumab injection.
Patients will receive unlabeled, unconjugated epratuzumab (1.5 mg/kg) that will be infused
over ~30 minutes. All patients will then receive a 90Y-epratuzumab dose. Dose will be
escalated by patient cohort starting at 2x15 mCi/m2 and, at 2x 20 mCi/m2, and 2x 25
mCi/m2.. Blood samples will be collected at the same intervals as after each
111In-epratuzumab.Patients will also receive 111In-epratuzumab immediately following the
unlabeled epratuzumab and immediately before the 90Y-epratuzumab injection. Blood samples
will be collected at the same intervals as after the first 111In-epratuzumab. Only 2
imaging sessions will be required, on Day 1 and then again on day 6 or 7 (these days should
match those obtained after the first 111In-epratuzumab injection).
The second 90Y-epratuzumab treatment will be given at the same dose, 1 week after the first
90Y-epratuzumab dose. CBC will be checked prior to administration of this second dose to
ensure blood counts continue to meet criteria for treatment as specified in inclusion
criteria. Blood samples will again be collected over the same period as the first
injection, but no imaging studies are required.
Patients are closely monitored during all infusions, and then at intervals over a 12-weeks
post-treatment evaluation period, with evaluation procedures including vital signs, physical
examination, CT (chest, abdomen, pelvis, other regions of involvement), CBC, serum
chemistries, serum immunoglobulins, urinalysis, peripheral blood B-cell levels
(immunophenotyping based on CD19), and serum samples for HAHA (veltuzumab and epratuzumab
ELISA to be analyzed by Immunomedics). Follow-up evaluations then continue every 3 months
for up to 5 years or until progression occurs or until resolution of treatment-related
toxicity.
Interventional
Allocation: Non-Randomized, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
determine the maximum tolerated 90Y dose
12 months
Yes
Rebecca Elstrom, MD
Principal Investigator
Weill Medical College of Cornell University
United States: Food and Drug Administration
1001010838
NCT01147393
October 2010
Name | Location |
---|---|
Weill Cornell Medical College | New York, New York 10021 |