Bortezomib in Treating Patients With Lymphoproliferative Disorders

Study Overview
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Brief Summary
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Phase II trial to study the effectiveness of bortezomib in treating patients who have low-grade lymphoproliferative disorders. Bortezomib may stop the growth of cancer cells by blocking the enzymes necessary for cancer cell growth.

Detailed Description
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PRIMARY OBJECTIVES: I. Determine the frequency and duration of complete and partial response rates in patients with grade I, II, or III follicular lymphoma or mantle cell lymphoma treated with bortezomib. SECONDARY OBJECTIVES: I. Determine the response of minimal residual disease by polymerase chain reaction (PCR) detectable or clonotypic PCR minimal residual disease in bone marrow of patients treated with this regimen. II. Determine the time to progression and overall survival of patients treated with this regimen. III. Determine the toxic effects of this regimen in these patients. OUTLINE: Patients are stratified according to disease type (follicular lymphoma vs mantle cell lymphoma). Patients receive an infusion of bortezomib over 3-5 seconds once weekly for 4 weeks. Treatment repeats every 6 weeks in the absence of disease progression or unacceptable toxicity. Patients who achieve at least a partial response lasting at least 6 months may receive retreatment. Patients are followed every 3 months for 1 year and then every 4 months for 2 years.

Official Title
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Phase II Study of PS-341 in Low Grade Lymphoproliferative Disorders

Conditions
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Recurrent Grade 1 Follicular Lymphoma, Recurrent Grade 2 Follicular Lymphoma, Recurrent Grade 3 Follicular Lymphoma, Recurrent Mantle Cell Lymphoma

Intervention / Treatment
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* Drug: bortezomib


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Histologically or cytologically confirmed lymphoproliferative disorder of 1 of the following subtypes: * Relapsed or refractory grade I, II, or III follicular center cell lymphoma Relapsed or refractory mantle cell lymphoma Measurable disease for non-Hodgkin's lymphoma (NHL) only At least 1 unidimensionally measurable lesion At least 2 cm by conventional techniques OR at least 1 cm by spiral CT scan Lymph nodes no greater than 1 cm in short axis considered normal Absolute lymphocytosis greater than 5,000/mm^3 with B-cell phenotype (CD19, 20,or 23 positive) with more than 30% bone marrow lymphocytes for CLL or other leukemic forms of NHL No known brain metastases Performance status - Karnofsky 70-100% At least 3 months See Disease Characteristics Absolute neutrophil count greater than 1,500/mm^3 (500/mm^3 if lymphomatous involvement of bone marrow) Platelet count greater than 50,000/mm^3 Bilirubin less than 1.5 times upper limit of normal (ULN) AST and ALT no greater than 2.5 times ULN (4 times ULN in case of liver metastases) Creatinine less than 1.5 times ULN No symptomatic congestive heart failure No New York Heart Association class III or IV heart disease No unstable angina pectoris No cardiac arrhythmia No myocardial infarction within the past 6 months No cerebrovascular accident or transient ischemic attack within the past 6 months No history of orthostatic hypotension No evidence of acute ischemia or significant conduction abnormality (left anterior hemiblock in the presence of right bundle branch block or second or third degree atrioventricular blocks) on electrocardiogram No uncontrolled hypertension requiring antihypertensive medication Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception Febrile episodes up to 38.5°C allowed if no evidence of active infection No other uncontrolled concurrent illness No known or active HIV infection No ongoing or active infection No psychiatric illness or social situation that would preclude study entry At least 3 months since prior monoclonal antibody therapy (e.g., rituximab) No more than 3 prior regimens of conventional cytotoxic chemotherapy At least 4 weeks since prior chemotherapy (6 weeks for nitrosoureas or mitomycin) and recovered At least 1 week since prior steroid therapy At least 4 weeks since prior radiotherapy and recovered At least 4 weeks since prior major surgery No other concurrent investigational agents

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Arm I<br>Patients receive an infusion of bortezomib (dose of 1.8 mg/m2) over 3-5 seconds once weekly for 4 weeks. Treatment repeats every 6 weeks in the absence of disease progression or unacceptable toxicity. Patients who achieve at least a partial response lasting at least 6 months may receive retreatment. | Drug: bortezomib<br>* Given IV<br>* Other names: VELCADE;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Response Rate | The response probability will be estimated. The 95% confidence interval will be provided. | Up to 3 years |