UCN-01 (7-Hydroxystaurosporine) to Treat Relapsed T-Cell Lymphomas
| Status: | Archived |
|---|---|
| Conditions: | Lymphoma |
| Therapuetic Areas: | Oncology |
| Healthy: | No |
| Age Range: | Any |
| Updated: | 7/1/2011 |
Phase II Study of UCN-01 in Relapsed or Refractory Systemic Anaplastic Large Cell and Mature T-Cell Lymphomas
This study will examine the effects of an experimental drug called UCN-01 on T-cell
lymphomas. UCN-01 inhibits the growth of several different tumor cells, and, in laboratory
studies, it has worked particularly well on tumor cells taken from patients with T cell
lymphomas.
Patients 9 years of age and older with T cell lymphoma that has relapsed or is not
responding to chemotherapy may be eligible for this study. Candidates will be screened with
a medical histories and physical examinations, blood and urine tests, electrocardiograms,
chest x-rays, and CT scans of the chest, abdomen and pelvis. Additional tests may be done if
clinically indicated, such as PET scans, bone marrow aspirations and biopsies, lumbar
punctures (spinal taps) and CTs or MRI scans if there is evidence of central nervous system
disease.
Participants are given UNC-01 in 28-day treatment cycles. The drug is given by vein in a
continuous 72-hour infusion on the first cycle and in 36-hour infusions on subsequent
cycles. The total number of cycles patients receive depends on how well the tumor responds
to the drug and how well the patient tolerates drug side effects. Patients who do well may
receive treatment for up to 1 year. Patients whose disease worsens with treatment or who do
not tolerate the therapy are taken off the study.
Some or all of the screening tests are repeated periodically during the course of treatment
to monitor safety and treatment response. X-rays and scans are done every other treatment
cycle for the first 6 cycles and then, if the cancer is stable or improving, the interval
between these imaging studies is lengthened to every 4 cycles. Patients whose tumors can be
safely biopsied undergo this procedure before entering the study and 3 to 5 days after
completing the first UCN-01 treatment. Biopsies requiring open surgery (e.g., in the chest
or abdomen) are done only if absolutely necessary for medical care. Biopsy tissue, blood,
and other fluids are analyzed for gene and protein studies related to lymphoma research.
Background:
- UCN-01, a non-specific protein kinase C (PKC) inhibitor appears to have several
mechanisms of action including PKC isoenzyme inhibition and cyclin dependent kinase
activation and inhibition.
- We have demonstrated that cell lines derived from T-cell lymphomas, including those
with the t (2; 5) translocation, are very sensitive to UCN-01. The t (2; 5)
translocation, associated with three quarters of cases of anaplastic large cell
lymphomas (ALCL), is an oncogenic fusion protein - nucleophosmin-anaplastic lymphoma
kinase (NPM-ALK).
- ALK is one potential target for UCN-01 action, and ALCL derived SUDHL-1 cells
containing the NPM-ALK protein have been shown to be very sensitive to UCN-01.
Objectives:
- To assess the clinical response to UCN-01 and progression-free and overall survival in
patients with relapsed or refractory systemic Anaplastic Large Cell and other mature
T-cell Lymphomas.
- To assess the effect of UCN-01 on ALK expression in ALCL cells.
- To assess the effect of UCN-01 on soluble TAC (CD25).
- To evaluate mature T-cell lymphoma malignant cells by cDNA microarray.
Eligibility:
- Relapsed or refractory systemic Anaplastic Large Cell Lymphoma (ALCL) with T or Null
phenotype or relapsed or refractory mature T-cell lymphomas.
- All patients should have evaluable or measurable disease on entry to study.
- Requires systemic therapy
- Performance Status ECOG less than or equal to 2
- Age 7 years or older
- HIV negative
- Patients should not have received systemic cytotoxic chemotherapy within 3 weeks of
study entry.
Design:
- The study will be a Phase II study.
- Patients will receive the first cycle of UCN-01 over 72 hours on days 1-3 and
subsequent cycles over 36 hours. Patients with stable disease may receive UCN-01 for up
to 1 year beyond achieving maximum response or stable disease, and restaging will be
done every 2 cycles for the first 6 cycles and every 4 cycles thereafter.
- Two sequential biopsies will be performed to investigate cDNA expression by microarray.
Soluble Tac (CD25) will be serially followed in patients.
- For each of the two histologies, this study will be conducted using a Simon two-stage
optimal design. Up to 37 patients will be treated.
We found this trial at
1
site
9000 Rockville Pike
Bethesda, Maryland 20892
Bethesda, Maryland 20892
301-496-2563
National Institutes of Health Clinical Center The National Institutes of Health (NIH) Clinical Center in...
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