Patient case: 18-year-old male with anaplastic large cell lymphoma; genetic feature: ALK

Clinical trial: Oral Clofarabine for Relapsed/Refractory Non-Hodgkin Lymphoma

Summary: Oral clofarabine is related to two intravenous chemotherapy drugs used for this disease and works in two different ways. It affects the development of new cancer cells by blocking two enzymes that cancer cells need to reproduce. When these enzymes are blocked, the cancer call can no longer prepare the DNA needed to make new cells. Clofarabine also encourages existing cancer cells to die by disturbing components within the cancer cell. This causes the release of a substance that is fatal to the cell.
  The phase I component of this research study is complete and demonstrated encouraging safety and efficacy in low-grade B-cell lymphomas. The phase II component of the trial is accruing to further study the efficacy of oral clofarabine in the treatment of relapsed non-Hodgkin lymphomas.

Detailed description: -  Each treatment cycle lasts four weeks during which time the participant will be taking study drug for the first three weeks only. Participants will be supplied with a study medication-dosing calendar for each treatment cycle.
  -  Clofarabine is a tablet that will be taken orally in the morning once daily on days 1 through 21 of each 28-day cycle. Participants can receive up to a total of 6 cycles if they do not experience any unacceptable side effects and if their cancer does not get worse.
  -  The following tests and procedures will be performed at specified intervals through out the treatment period: blood tests, physical examinations, vital signs, radiological exams and urine tests.

Eligibility: Inclusion Criteria:
  -  Histologically confirmed relapsed or refractory NHL that includes: follicular lymphoma of any grade; marginal zone lymphoma; small lymphocytic lymphoma/chronic lymphocytic leukemia; mantle cell lymphoma; lymphoplasmacytic lymphoma; low-grade B-cell lymphoma not otherwise specified; diffuse large B-cell lymphoma, anaplastic large cell lymphoma, peripheral T-cell lymphoma, angioimmunoblastic T-cell lymphoma.
  -  One or more prior line of chemotherapy, immunotherapy, or radioimmunotherapy.
  -  Measurable disease on cross sectional imaging of at least 2cm.
  -  ECOG Performance Status 0-2
  -  18 years of age or older
  -  Life expectancy of greater than 3 months
  -  Normal organ and marrow function as outlined in the protocol
  -  Must agree to use adequate contraception prior to study entry and for the duration of study participation
  Exclusion Criteria:
  -  Patients who have had chemotherapy, rituximab, or radiotherapy within 4 weeks, or radioimmunotherapy within 8 weeks prior to entering the study
  -  Receiving any other investigational agent
  -  Known brain metastases
  -  History of allergic reactions attributed to compounds of similar chemical or biologic composition to Clofarabine
  -  Systemic fungal, bacterial, viral, or other infection not controlled
  -  Pregnant or lactating
  -  Prior history of another malignancy (except for non-melanoma skin cancer or in situ cervical or breast cancer) unless disease free for over one year
  -  Uncontrolled intercurrent illness including, but not limited to ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements
  -  Prior allogeneic stem cell transplantation

Relevance to patient case: not relevant