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10-Propargyl-10-Deazaaminopterin in Treating Patients With Recurrent or Refractory Non-Hodgkin's Lymphoma or Hodgkin's Lymphoma

A Phase II Study of 10-Propargyl-10-Deazaaminopterin (PDX) in Relapsed or Refractory Aggressive Non-Hodgkin's Lymphomas and Hodgkin's Disease

Status
Completed
Phases
Phase 1Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT00052442
Enrollment
72
Registered
2003-01-27
Start date
2002-08-31
Completion date
2009-03-31
Last updated
2021-08-25

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Lymphoma

Keywords

recurrent adult diffuse large cell lymphoma, recurrent adult diffuse mixed cell lymphoma, recurrent adult Burkitt lymphoma, recurrent adult immunoblastic large cell lymphoma, recurrent adult lymphoblastic lymphoma, recurrent mantle cell lymphoma, recurrent adult Hodgkin lymphoma, recurrent grade 3 follicular lymphoma

Brief summary

RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. PURPOSE: Phase II trial to study the effectiveness of 10-propargyl-10-deazaaminopterin in treating patients who have recurrent or refractory non-Hodgkin's lymphoma or Hodgkin's lymphoma.

Detailed description

OBJECTIVES: * Determine the efficacy of 10-propargyl-10-deazaaminopterin, in terms of objective response rate, duration of response, and time to disease progression, in patients with relapsed or refractory aggressive non-Hodgkin's lymphoma or Hodgkin's lymphoma. * Determine the impact of pharmacokinetics on toxicity and drug elimination in patients treated with this drug. * Determine the toxicity of this drug in these patients. * Determine the effect of prior chemotherapy response duration on duration of response in patients treated with this drug. * Correlate, if possible, the pharmacodynamics (area under the curve) of this drug with tumor response and toxicity (mucositis) in these patients. * Correlate, if possible, intraerythrocytic folate or homocysteine levels with severity of mucositis in patients treated with this drug. * Determine whether levels of the RFC-1 folate transporter, folylpolyglutamate synthetase, and folylpolyglutamate hydrolase are markers of response in patients treated with this drug. OUTLINE: This is an open-label study. Patients receive 10-propargyl-10-deazaaminopterin IV over 1 hour on day 1. Courses repeat every 14 days in the absence of disease progression or unacceptable toxicity. Patients achieving a complete response (CR) may receive 2 additional courses beyond the CR. PROJECTED ACCRUAL: A total of 39-72 patients (12-35 for cohort 1 and 17-37 for cohort 2) will be accrued for this study within 10-36 months.

Interventions

DRUGpralatrexate

Sponsors

National Cancer Institute (NCI)
CollaboratorNIH
Memorial Sloan Kettering Cancer Center
CollaboratorOTHER
Spectrum Pharmaceuticals, Inc
Lead SponsorINDUSTRY

Study design

Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No

Inclusion criteria

DISEASE CHARACTERISTICS: * Histologically confirmed Hodgkin's lymphoma or, using the World Health Organization (WHO) classification, aggressive non-Hodgkin's lymphoma including: * Large B- or T-cell lymphomas (including transformed lymphomas) * Mantle cell lymphoma * Immunoblastic lymphoma * At least 1 unidimensionally measurable lesion * At least 2 centimeter (cm) by conventional techniques OR * At least 1 cm by spiral computerized tomography (CT) scan * Lymph nodes no greater than 1 cm in the short axis are considered normal * Relapsed or refractory disease after first-line chemotherapy * Cohort 1: * No more than 3 prior conventional cytotoxic chemotherapy regimens * Must have had at least a partial response (PR) lasting no more than 6 months or refractory disease * Patients with disease refractory to or relapsed less than 100 days from peripheral blood stem cell (PBSC) transplantation are not eligible * Cohort 2: * No limit on prior treatment * Must have had at least a PR to the last therapy lasting at least 6 months * Patients who have received high-dose chemotherapy as part of peripheral blood stem cells (PBSC) transplantation are eligible if relapse occurred at least 100 days after transplantation * No clinically significant pleural effusions or ascites * No active brain or leptomeningeal metastases * Treated Central nervous system (CNS) disease allowed PATIENT CHARACTERISTICS: Age * 18 and over Performance status * Karnofsky 70-100% Life expectancy * Not specified Hematopoietic * Absolute neutrophil count greater than 1,000/mm\^3 * Platelet count greater than 75,000/mm\^3 * Hemoglobin at least 10 g/dL Hepatic * Bilirubin less than 1.5 times upper limit of normal (ULN) * Aspartate aminotransferase/alanine aminotransferase (AST/ALT) no greater than 2.5 times ULN (4 times ULN if liver involvement) * Alkaline phosphatase no greater than 5 times ULN Renal * Creatinine no greater than 1.5 mg/dL OR * Creatinine clearance at least 50 mL/min Cardiovascular * 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, cerebrovascular accident, or transient ischemic attack within the past 6 months * No history of orthostatic hypotension * No ECG evidence of acute ischemia or significant conduction abnormality (e.g., bifascicular block or 2nd or 3rd degree atrioventricular blocks) * No uncontrolled hypertension requiring active manipulation of antihypertensive medications * No grade III or IV edema Other * Not pregnant or nursing * Negative pregnancy test * Fertile patients must use effective contraception * No ongoing or active infection * Febrile episodes up to 38.5° Celsius without signs of active infection allowed * No other concurrent active cancer * No other concurrent serious medical illness * No psychiatric illness or social situation that would preclude study compliance PRIOR CONCURRENT THERAPY: Biologic therapy * See Disease Characteristics * At least 3 months since prior monoclonal antibody therapy (e.g., rituximab) Chemotherapy * See Disease Characterisitics * At least 4 weeks since prior cytotoxic chemotherapy (6 weeks for mitomycin or nitrosoureas) and recovered Endocrine therapy * At least 7 days since prior steroids * No concurrent steroids Radiotherapy * See Disease Characteristics * At least 4 weeks since prior radiotherapy and recovered Surgery * More than 4 weeks since prior major surgery Other * No prior antifolates * No concurrent folic acid supplementation * No other concurrent investigational agents * No concurrent combination antiretroviral therapy for human immunodeficiency virus (HIV)-positive patients * No other concurrent investigational or commercial agents or therapies with the intent to treat the malignancy

Design outcomes

Primary

MeasureTime frameDescription
Response Rate3 weeksPer Response Evaluation Criteria in T-cell and B-cell Lymphoma for target lesions and assessed using computerized tomography (CT) and or Positron emission tomography CT (PET CT) by local investigators: Complete Response (CR), Disappearance of all target lesions; Partial Response (PR), \>=50% decrease in the sum of the longest diameter of target lesions; Overall Response (OR) = CR + PR.

Secondary

MeasureTime frameDescription
Toxicities of Pralatrexate3 weeksAdverse events; number of patients with at least one adverse events reported.

Countries

United States

Participant flow

Participants by arm

ArmCount
135 mg/m2 Pralatrexate 1/2 Weeks
Pralatrexate 135 mg/m\^2 administered as an IV infusion over one hour into a side arm of a running intravenous infusion of normal saline for 1/2 weeks.
16
30 mg/m2 Pralatrexate 3/4 Weeks
Pralatrexate 30 mg/m\^2 administered as an IV infusion over 15 minutes into a side arm of a running intravenous infusion of normal saline for 3/4 weeks.
3
30 mg/m2 Pralatrexate 6/7 Weeks
Pralatrexate 30 mg/m\^2 administered as an IV infusion over 15 minutes into a side arm of a running intravenous infusion of normal saline for 6/7 weeks.
27
45 mg/m2 Pralatrexate 6/7 Weeks
Pralatrexate 45 mg/m\^2 administered as an IV infusion over 15 minutes into a side arm of a running intravenous infusion of normal saline for 6/7 weeks.
11
270 mg/m2 Pralatrexate 2/4 Weeks
Pralatrexate 270 mg/m\^2 administered as an IV bolus over 3-5 minutes into a side arm of a running intravenous infusion of normal saline for 2/4 weeks.
15
Total72

Baseline characteristics

Characteristic45 mg/m2 Pralatrexate 6/7 WeeksTotal270 mg/m2 Pralatrexate 2/4 Weeks30 mg/m2 Pralatrexate 6/7 Weeks30 mg/m2 Pralatrexate 3/4 Weeks135 mg/m2 Pralatrexate 1/2 Weeks
Age, Continuous52.7 years
STANDARD_DEVIATION 11.4
54.1 years
STANDARD_DEVIATION 15.2
57.1 years
STANDARD_DEVIATION 15.1
55.7 years
STANDARD_DEVIATION 16.5
54.3 years
STANDARD_DEVIATION 14.4
49.3 years
STANDARD_DEVIATION 16.1
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
Asian
2 Participants6 Participants0 Participants2 Participants1 Participants1 Participants
Race (NIH/OMB)
Black or African American
2 Participants11 Participants3 Participants3 Participants1 Participants2 Participants
Race (NIH/OMB)
More than one race
0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
Unknown or Not Reported
2 Participants10 Participants3 Participants1 Participants1 Participants3 Participants
Race (NIH/OMB)
White
5 Participants45 Participants9 Participants21 Participants0 Participants10 Participants
Sex: Female, Male
Female
7 Participants28 Participants5 Participants10 Participants2 Participants4 Participants
Sex: Female, Male
Male
4 Participants44 Participants10 Participants17 Participants1 Participants12 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
EG002
affected / at risk
EG003
affected / at risk
EG004
affected / at risk
deaths
Total, all-cause mortality
— / —— / —— / —— / —— / —
other
Total, other adverse events
8 / 162 / 312 / 271 / 115 / 15
serious
Total, serious adverse events
8 / 161 / 315 / 2710 / 1110 / 15

Outcome results

Primary

Response Rate

Per Response Evaluation Criteria in T-cell and B-cell Lymphoma for target lesions and assessed using computerized tomography (CT) and or Positron emission tomography CT (PET CT) by local investigators: Complete Response (CR), Disappearance of all target lesions; Partial Response (PR), \>=50% decrease in the sum of the longest diameter of target lesions; Overall Response (OR) = CR + PR.

Time frame: 3 weeks

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
135 mg/m^2 Pralatrexate 1/2 WeeksResponse Rate15 Participants
30 mg/m^2 Pralatrexate 3/4 WeeksResponse Rate3 Participants
30 mg/m^2 Pralatrexate 6/7 WeeksResponse Rate27 Participants
45 mg/m^2 Pralatrexate 6/7 WeeksResponse Rate11 Participants
270 mg/m^2 Pralatrexate 2/4 WeeksResponse Rate15 Participants
Secondary

Toxicities of Pralatrexate

Adverse events; number of patients with at least one adverse events reported.

Time frame: 3 weeks

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
135 mg/m^2 Pralatrexate 1/2 WeeksToxicities of Pralatrexate16 Participants
30 mg/m^2 Pralatrexate 3/4 WeeksToxicities of Pralatrexate3 Participants
30 mg/m^2 Pralatrexate 6/7 WeeksToxicities of Pralatrexate27 Participants
45 mg/m^2 Pralatrexate 6/7 WeeksToxicities of Pralatrexate11 Participants
270 mg/m^2 Pralatrexate 2/4 WeeksToxicities of Pralatrexate15 Participants

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026