A Pilot Study of Sorafenib Examining Biomarkers in Refractory or Relapsed T-Cell Lymphoma Patients
| Status: | Completed |
|---|---|
| Conditions: | Lymphoma |
| Therapuetic Areas: | Oncology |
| Healthy: | No |
| Age Range: | 18 - 85 |
| Updated: | 10/18/2017 |
| Start Date: | October 2009 |
| End Date: | June 2013 |
This study will be a pilot study of sorafenib 400mg PO twice daily in refractory T-cell
lymphomas including peripheral T-cell lymphoma (PTCL), angioimmunoblastic lymphadenopathy
(AILD), cutaneous T cell lymphoma (CTCL), anaplastic large cell lymphoma (ALCL) and other
transformed T-cell lymphomas with the primary objective of studying the biological effects of
the multikinase inhibitor, sorafenib.
lymphomas including peripheral T-cell lymphoma (PTCL), angioimmunoblastic lymphadenopathy
(AILD), cutaneous T cell lymphoma (CTCL), anaplastic large cell lymphoma (ALCL) and other
transformed T-cell lymphomas with the primary objective of studying the biological effects of
the multikinase inhibitor, sorafenib.
Primary objectives:
• To study the biological effects of sorafenib 400mg BID on the mitogen-activated protein
kinase (MAPK) pathway, specifically the inhibition of extracellular signal-regulated kinases
(ERK) phosphorylation, and to correlate with clinical activity in patients with T-cell
lymphoma.
Secondary objectives:
- To observe the clinical activity of sorafenib 400mg BID by determining response rate,
and progression free survival in patients with T-cell lymphoma. Duration of response and
duration of stable disease will also be measured.
- To determine the tolerability of sorafenib in patients with T-cell lymphoma.
Exploratory objectives:
- To observe the effects of sorafenib on T-cell subsets (CD4/CD8 ratio, and Tregs), and
the effects of sorafenib on the monocytoid population.
- To observe the effects of sorafenib on the serum cytokine profile.
- To observe the effects of sorafenib on the T-cell receptor pathway, i.e. Lck, ZAP-70,
and Syk.
- To observe changes in lymph node or skin morphology including tumor cell infiltrate,
vasculature, and the tumor microenvironment in patients treated with sorafenib by
performing serial biopsies of lymph nodes or skin.
• To study the biological effects of sorafenib 400mg BID on the mitogen-activated protein
kinase (MAPK) pathway, specifically the inhibition of extracellular signal-regulated kinases
(ERK) phosphorylation, and to correlate with clinical activity in patients with T-cell
lymphoma.
Secondary objectives:
- To observe the clinical activity of sorafenib 400mg BID by determining response rate,
and progression free survival in patients with T-cell lymphoma. Duration of response and
duration of stable disease will also be measured.
- To determine the tolerability of sorafenib in patients with T-cell lymphoma.
Exploratory objectives:
- To observe the effects of sorafenib on T-cell subsets (CD4/CD8 ratio, and Tregs), and
the effects of sorafenib on the monocytoid population.
- To observe the effects of sorafenib on the serum cytokine profile.
- To observe the effects of sorafenib on the T-cell receptor pathway, i.e. Lck, ZAP-70,
and Syk.
- To observe changes in lymph node or skin morphology including tumor cell infiltrate,
vasculature, and the tumor microenvironment in patients treated with sorafenib by
performing serial biopsies of lymph nodes or skin.
Inclusion Criteria:
- Histologically confirmed T-cell lymphoma including PTCL, AITL, CTCL, ALCL (Alk+, and
Alk-), and other transformed T-cell lymphomas
- Age > 18 years old
- Measureable disease, as defined by the Cheson criteria
- ECOG Performance Status of 0 or 1
- Life expectancy > 12 weeks
- Adequate bone marrow, liver and renal function
- Patients with hemoglobin < 8.5g/dL, or ANC 500-1000/mm3, or platelets
50,000-75,000/mm3 (Grade 3), whose cytopenias are due to bone marrow involvement by
T-cell lymphoma will also be eligible
Exclusion Criteria:
- Prior treatment with sorafenib, or other agents with similar activity, i.e.
bevacizumab, imatinib, sunitinib.
- Prior treatment with allogeneic stem cell transplant
- Cardiac disease: Congestive heart failure > class II NYHA.
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