monoclonal antibody therapy in treating patients with advanced cancer

Conditions: Chronic Myeloproliferative Disorders; Leukemia; Lymphoma; Multiple Myeloma and Plasma Cell Neoplasm; Myelodysplastic Syndromes; Precancerous/Nonmalignant Condition; Unspecified Adult Solid Tumor, Protocol Specific

Summary: rationale: monoclonal antibodies can locate tumor cells and either kill them or deliver tumor-killing substances to them without harming normal cells. purpose: phase i trial to study the effectiveness of monoclonal antibodies in treating patients who have advanced cancer.

objectives: i. determine the toxicities associated with a 4-hour infusion of antitransferrin receptor antibodies with one antibody administered by itself for 1 hour before the second antibody infusion is started. ii. determine the pharmacokinetics of monoclonal antibodies e2.3 and a27.15. outline: this is a dose escalating study. patients receive antitransferrin antibody a27.15 iv over 4 hours. one hour after the initiation of the a27.15 infusion, infusion of antibody e2-3 is added by iv piggy back. in the absence of antimouse antibodies and toxic effects, treatment continues once every 4 weeks in patients achieving minimal, partial, or complete remission. treatment ceases in patients experiencing stable or progressive disease. in the absence of dose limiting toxicity in the first 3 patients treated, subsequent cohorts of 6 patients each receive escalating doses of antitransferrin antibodies e2.3 and a27.15 on the same dose schedule. if dose limiting toxicity occurs in 2 of 6 patients at a given dose level, then dose escalation ceases and the next lower dose is declared the mtd. patients are followed for 3 weeks. projected accrual: this study will accrue 18-27 patients within 2 years.

Eligibility criteria:
disease characteristics: refractory or recurrent advanced malignancy following known standard effective therapy or advanced malignancy for which no standard effective therapy exists measurable or evaluable disease patient characteristics: age: 18 and over performance status: swog 0-2 life expectancy: at least 2 months hematopoietic: absolute neutrophil count at least 1800/mm3 hematocrit at least 30 mg/dl platelet count at least 50,000/mm3 hepatic: bilirubin no greater than 1.5 times normal unless due to disease, then less than 3.5 times normal transaminases less than 3 times upper limit of normal (uln) (less than 5 times uln if due to liver metastases) renal: creatinine no greater than 2.5 times normal cardiovascular: no severe cardiac abnormalities must have adequate venous access no history of sustained ventricular arrhythmia or unexplained syncope pulmonary: no severe pulmonary abnormalities other: not pregnant or nursing effective contraception required of fertile female patients no serious concurrent medical or psychiatric illness adequate nutrition no human antimouse antibodies prior concurrent therapy: at least 4 weeks since prior anticancer therapy and recovered if there was disease progression during therapy, at least 2 weeks since prior anticancer therapy and recovered biologic therapy: not specified chemotherapy: no concurrent chemotherapy endocrine therapy: concurrent topical steroids used in the chronic management of cutaneous t cell lymphoma allowed no other concurrent hormone therapy radiotherapy: no concurrent palliative radiotherapy surgery: not specified

Keywords: stage iii adult hodgkin lymphoma stage iv adult hodgkin lymphoma monoclonal gammopathy of undetermined significance recurrent adult hodgkin lymphoma isolated plasmacytoma of bone extramedullary plasmacytoma refractory multiple myeloma waldenstrom macroglobulinemia stage iii multiple myeloma stage iii chronic lymphocytic leukemia stage iv chronic lymphocytic leukemia recurrent adult acute myeloid leukemia recurrent adult acute lymphoblastic leukemia relapsing chronic myelogenous leukemia refractory chronic lymphocytic leukemia unspecified adult solid tumor, protocol specific chronic phase chronic myelogenous leukemia accelerated phase chronic myelogenous leukemia blastic phase chronic myelogenous leukemia meningeal chronic myelogenous leukemia untreated adult acute lymphoblastic leukemia untreated adult acute myeloid leukemia adult acute myeloid leukemia in remission adult acute lymphoblastic leukemia in remission polycythemia vera chronic idiopathic myelofibrosis essential thrombocythemia untreated hairy cell leukemia progressive hairy cell leukemia, initial treatment refractory hairy cell leukemia chronic myelomonocytic leukemia t-cell large granular lymphocyte leukemia acute undifferentiated leukemia stage iii grade 1 follicular lymphoma stage iii grade 2 follicular lymphoma stage iii grade 3 follicular lymphoma stage iii adult diffuse small cleaved cell lymphoma stage iii adult diffuse mixed cell lymphoma stage iii adult diffuse large cell lymphoma stage iii adult immunoblastic large cell lymphoma stage iii adult lymphoblastic lymphoma stage iii adult burkitt lymphoma stage iv grade 1 follicular lymphoma stage iv grade 2 follicular lymphoma stage iv grade 3 follicular lymphoma stage iv adult diffuse small cleaved cell lymphoma stage iv adult diffuse mixed cell lymphoma stage iv adult diffuse large cell lymphoma stage iv adult immunoblastic large cell lymphoma stage iv adult lymphoblastic lymphoma stage iv adult burkitt lymphoma recurrent grade 1 follicular lymphoma recurrent grade 2 follicular lymphoma recurrent grade 3 follicular lymphoma recurrent adult diffuse small cleaved cell lymphoma recurrent adult diffuse mixed cell lymphoma recurrent adult diffuse large cell lymphoma recurrent adult immunoblastic large cell lymphoma recurrent adult lymphoblastic lymphoma recurrent adult burkitt lymphoma stage iii adult t-cell leukemia/lymphoma stage iv adult t-cell leukemia/lymphoma recurrent adult t-cell leukemia/lymphoma secondary acute myeloid leukemia de novo myelodysplastic syndromes previously treated myelodysplastic syndromes secondary myelodysplastic syndromes prolymphocytic leukemia aids-related peripheral/systemic lymphoma aids-related primary cns lymphoma primary systemic amyloidosis stage iii mantle cell lymphoma stage iv mantle cell lymphoma recurrent mantle cell lymphoma angioimmunoblastic t-cell lymphoma anaplastic large cell lymphoma recurrent marginal zone lymphoma recurrent small lymphocytic lymphoma stage iii small lymphocytic lymphoma stage iii marginal zone lymphoma stage iv small lymphocytic lymphoma stage iv marginal zone lymphoma extranodal marginal zone b-cell lymphoma of mucosa-associated lymphoid tissue nodal marginal zone b-cell lymphoma splenic marginal zone lymphoma