Carfilzomib, Rituximab and Dexamethasone in Waldenstrom's Macroglobulinemia
| Status: | Completed |
|---|---|
| Conditions: | Lymphoma, Hematology |
| Therapuetic Areas: | Hematology, Oncology |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 11/22/2018 |
| Start Date: | October 2011 |
| End Date: | September 2016 |
Carfilzomib, Rituximab, and Dexamethasone (CaRD) in Waldenstrom's Macroglobulinemia
Carfilzomib is a drug that has shown anti-tumor activity by inhibiting the proteasome within
the cell, which is responsible for degrading or breaking down a wide variety of proteins.
Carfilzomib has not been approved by the FDA.
Rituximab and dexamethasone are often used to treat Waldenstrom's Macroglobulinemia (WM),
alone or in combination with other drugs. Combinations with rituximab, dexamethasone and
proteasome inhibitors, like carfilzomib, show high levels of activity in WM patients.
In this research study, the investigators are testing the safety and efficacy of Carfilzomib
when used along with Rituximab and Dexamethasone as a possible treatment for Waldenstrom's
Macroglobulinemia.
the cell, which is responsible for degrading or breaking down a wide variety of proteins.
Carfilzomib has not been approved by the FDA.
Rituximab and dexamethasone are often used to treat Waldenstrom's Macroglobulinemia (WM),
alone or in combination with other drugs. Combinations with rituximab, dexamethasone and
proteasome inhibitors, like carfilzomib, show high levels of activity in WM patients.
In this research study, the investigators are testing the safety and efficacy of Carfilzomib
when used along with Rituximab and Dexamethasone as a possible treatment for Waldenstrom's
Macroglobulinemia.
If you take part in this research study, you will receive Carfilzomib and dexamethasone as an
infusion on Days 1, 2, 8, and 9 for Cycles 1-6. You will then have a Rituximab infusion on
Days 2 and 9. Each cycles lasts 21 days. After completing Cycle 6 and if you are eligible,
there will be a 2 month break before the maintenance phase is started. During this break, you
will have a study visit with a physical exam, blood tests, and a bone marrow biopsy. If you
continue to the maintenance phase, you will receive Carfilzomib and Dexamethasone on Days 1
and 2 and Rituximab on Day 2 of Cycles 1-8. Each cycle will continue to last 21 days, but
will take place every 2 months. Infusions will last between 2-6 hours.
During all cycles you will have a physical exam and you will be asked questions about your
general health and specific questions about any problems that you might be having and any
medications you may be taking. Blood tests will also be done at each Cycle visit, and you
will complete a questionnaire. Bone marrow and CT scan will only be repeated at physician
discretion when appropriate and in order to ensure your response to treatment.
infusion on Days 1, 2, 8, and 9 for Cycles 1-6. You will then have a Rituximab infusion on
Days 2 and 9. Each cycles lasts 21 days. After completing Cycle 6 and if you are eligible,
there will be a 2 month break before the maintenance phase is started. During this break, you
will have a study visit with a physical exam, blood tests, and a bone marrow biopsy. If you
continue to the maintenance phase, you will receive Carfilzomib and Dexamethasone on Days 1
and 2 and Rituximab on Day 2 of Cycles 1-8. Each cycle will continue to last 21 days, but
will take place every 2 months. Infusions will last between 2-6 hours.
During all cycles you will have a physical exam and you will be asked questions about your
general health and specific questions about any problems that you might be having and any
medications you may be taking. Blood tests will also be done at each Cycle visit, and you
will complete a questionnaire. Bone marrow and CT scan will only be repeated at physician
discretion when appropriate and in order to ensure your response to treatment.
Inclusion Criteria:
- Diagnosis of Waldenstrom's Macroglobulinemia
- Symptomatic disease
- Measurable disease
- Life expectancy of greater than 12 weeks
- Adequate organ and marrow function
- CD20 positive based on any previous performed bone marrow immunohistochemistry or flow
cytometric analysis
- Disease free of prior malignancies for >/= 5 years with the exception of currently
treated basal cell, squamous cell carcinoma of the skin, or carcinoma "in situ" of the
cervix or breast
Exclusion Criteria:
- More than one prior therapy
- Previous therapy with a proteasome inhibitor or rituximab
- Chemotherapy or radiotherapy within 4 weeks (6 weeks for nitrosoureas or mitomycin C)
prior to entering the study or not recovered from adverse events due to agents
administered more than 4 weeks earlier
- Currently receiving treatment for any malignancy
- Major surgery within 21 days prior to study entry
- Acute active infection requiring treatment (systemic antibiotics, antivirals, or
antifungals) within 14 days prior to study entry
- Uncontrolled hypertension or uncontrolled diabetes
- Significant neuropathy (Grades 3-4, or Grade 2 with pain) within 14 days prior to
study entry
- Known history of allergy to Captisol
- Receiving any other study agents
- Known brain metastases
- History of allergic reactions attributed to compounds of similar chemical or biologic
composition to carfilzomib, rituximab, and/or dexamethasone
- Contraindication to any of the required concomitant drugs or supportive treatments,
including hypersensitivity to all anticoagulation and antiplatelet options, antiviral
drugs, or intolerance to hydration due to preexisting pulmonary or cardiac impairment
- 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
- Pregnant or lactating
- HIV-positive on combination antiretroviral therapy
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