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Vorinostat in Treating Patients With Relapsed or Refractory Advanced Hodgkin's Lymphoma

A Phase II Trial of Suberoylanilide Hydroxamic Acid (NSC-701852) for Recurrent or Primary Refractory Hodgkin's Lymphoma

Status
Completed
Phases
Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT00132028
Enrollment
27
Registered
2005-08-19
Start date
2005-09-30
Completion date
2009-05-31
Last updated
2014-05-23

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

Conditions

Adult Favorable Prognosis Hodgkin Lymphoma, Adult Lymphocyte Depletion Hodgkin Lymphoma, Adult Lymphocyte Predominant Hodgkin Lymphoma, Adult Mixed Cellularity Hodgkin Lymphoma, Adult Nodular Lymphocyte Predominant Hodgkin Lymphoma, Adult Nodular Sclerosis Hodgkin Lymphoma, Adult Unfavorable Prognosis Hodgkin Lymphoma, Recurrent Adult Hodgkin Lymphoma

Brief summary

This phase II trial is studying how well vorinostat works in treating patients with relapsed or refractory advanced Hodgkin's lymphoma. Vorinostat may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth.

Detailed description

PRIMARY OBJECTIVES: I. To evaluate the response probability (complete, complete unconfirmed, and partial) in patients with relapsed or refractory Hodgkin's lymphoma. II. To estimate 1-year progression-free survival and overall survival in patients with relapsed or refractory Hodgkin's lymphoma treated with SAHA. III. To assess the toxicity profile of SAHA in this patient population. IV. To perform gene expression profiling on tumor tissue before and after treatment in order to explore in a preliminary manner the association between response and specific gene expression results. OUTLINE: This is a multicenter study. Patients receive oral vorinostat twice daily on days 1-14. Treatment repeats every 21 days in the absence of disease progression or unacceptable toxicity. Patients achieving a complete response (CR) receive 2 additional courses of therapy beyond CR. After completion of study treatment, patients are followed every 6 months for 2 years and then annually for 3 years.

Interventions

DRUGvorinostat

Given orally

OTHERlaboratory biomarker analysis

Correlative studies

Sponsors

National Cancer Institute (NCI)
Lead SponsorNIH

Study design

Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE

Eligibility

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

Inclusion criteria

* Patients must have histologically or cytologically confirmed relapsed/refractory Hodgkin's lymphoma of any subtype; patients with lymphocyte predominant Hodgkin's disease (LPHD) are also eligible; clear evidence of disease progression or lack of response after the most recent therapy, including local radiation is required * Patients must be willing to submit specimens for correlative studies * All patients must have bidimensionally measurable disease documented within 28 days prior to registration; patients with non-measurable disease in addition to measurable disease must have all non-measurable disease assessed within 42 days prior to registration * Patients must have unilateral bone marrow aspirate and biopsy performed within 42 days prior to registration * Patients may have had up to five prior chemotherapy regimens * Patients must have completed chemotherapy at least 28 days prior to registration and all toxicities must have resolved (in the opinion of the treating investigator); if last regimen included nitrosoureas or mitomycin then 42 days must have elapsed since completion of treatment; patients must not have taken valproic acid, or another histone deacetylase inhibitor, for at least 14 days prior to registration * Patients must have completed all radiotherapy at least 14 days prior to registration and all toxicities must have resolved (in the opinion of the treating investigator) * Patients who relapse after autologous stem cell transplant may be enrolled if they are at least three months after transplant, and after allogeneic transplant if they are at least one year posttransplant; patients should have no active related infections (i.e., fungal or viral); in the case of allogeneic transplant relapse, there should be no active acute graft versus host disease (GvHD) of any grade, and no chronic graft versus host disease other than mild skin, oral, or ocular GvHD not requiring systemic immunosuppression * Patients must have a Zubrod performance status of 0-2 * Patients must have a CT scan of the chest/abdomen and pelvis performed within 28 days prior to registration * Patients must not have clinical evidence of central nervous system involvement by lymphoma; any laboratory or radiographic tests performed to assess CNS involvement must be negative within 42 days of registration * Serum LDH must be measured within 28 days prior to registration * Absolute neutrophil count \>- 1,000/mcL * Platelet count \>= 100,000/mcL * SGOT/SGPT \< 2.5 x the institutional upper limit of normal * Serum creatinine \< 2 x the institutional upper limit of normal * Patients with a history of allergic reactions attributed to compounds of similar chemical or biological composition to SAHA are ineligible * Patients must not have plans to receive concurrent hormonal, biological or radiation therapy; patients with potentially curative options such as salvage therapy with chemotherapy or hematopoietic stem cell transplant (HSCT) are not eligible * Patients with a history of prior myocardial infarction, unstable angina, or stroke within 6 months are ineligible * Patients known to be HIV-positive and receiving combination antiretroviral therapy are ineligible; in addition, HIV-positive patients not receiving combination antiretroviral therapy are also ineligible * No prior malignancy is allowed except for the following: adequately treated basal cell or squamous cell skin cancer, in situ cervical cancer, adequately treated stage I or II cancer from which the patient is currently in complete remission, or any other cancer for which the patient has been disease-free for five years * Pregnant or nursing women may not participate; women or men of reproductive potential may not participate unless they have agreed to use an effective contraceptive method * Patients must be informed of the investigational nature of this study and must sign and give written informed consent in accordance with institutional and federal guidelines

Design outcomes

Primary

MeasureTime frameDescription
Assess Number of Patients Who Achieve Confirmed and Unconfirmed Complete Response (CR) or Partial Response (PR)after every 3 cycles on treatmentComplete Response(CR) is a complete disappearance of all disease with the exception of nodes. No new lesions. previously enlarged organs must have regressed and not be palpable. Bone marrow(BM) must be negative if positive at baseline. Normalization of markers. CR Unconfirmed (CRU) does not qualify for CR above, due to a residual nodal mass or an indeterminate BM. Partial Response(PR) is a 50% decrease in the SPD for up to 6 identified dominant lesions, including spleenic and hepatic nodules from baseline. No new lesions and no increase in the size of liver, spleen or other nodes.

Secondary

MeasureTime frameDescription
Progression-Free Survivalafter every 3 cycles on treatment, then every 6 months for 2 years, then annually for a total of 5 years.Measured from date of registration to date of first observation of progression or death, or last contact date. Progression is defined as a 50% increase in sum of products of greatest diameters (SPD) of target measurable lesions over the smallest sum observed (over baseline if no decrease during therapy) using the same techniques as baseline; appearance of a new lesion/site; unequivocal progression of non-measurable disease in the opinion of the treating physician; death due to disease without prior documentation of progression.
Overall Survivalafter every 3 cycles on treatment, then every 6 months for 2 years, then annually for a total of 5 years.Measured from date of registration to death, or last contact date

Countries

United States

Participant flow

Participants by arm

ArmCount
SAHA (Vorinostat)
Patients receive vorinostat 400 mg/day on days 1-14 of every 21-day cycle. Patients continue treatment until progression.
25
Total25

Withdrawals & dropouts

PeriodReasonFG000
Overall StudyAdverse Event7
Overall StudyDeath2
Overall StudyLack of Efficacy11
Overall Studynot eligible2
Overall StudyPhysician Decision3
Overall StudyWithdrawal by Subject2

Baseline characteristics

CharacteristicSAHA (Vorinostat)
Age, Continuous41.6 years
Ethnicity (NIH/OMB)
Hispanic or Latino
3 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
17 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
5 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
Race (NIH/OMB)
Asian
1 Participants
Race (NIH/OMB)
Black or African American
3 Participants
Race (NIH/OMB)
More than one race
0 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
Race (NIH/OMB)
Unknown or Not Reported
1 Participants
Race (NIH/OMB)
White
20 Participants
Sex: Female, Male
Female
11 Participants
Sex: Female, Male
Male
14 Participants

Adverse events

Event typeEG000
affected / at risk
deaths
Total, all-cause mortality
— / —
other
Total, other adverse events
25 / 25
serious
Total, serious adverse events
5 / 25

Outcome results

Primary

Assess Number of Patients Who Achieve Confirmed and Unconfirmed Complete Response (CR) or Partial Response (PR)

Complete Response(CR) is a complete disappearance of all disease with the exception of nodes. No new lesions. previously enlarged organs must have regressed and not be palpable. Bone marrow(BM) must be negative if positive at baseline. Normalization of markers. CR Unconfirmed (CRU) does not qualify for CR above, due to a residual nodal mass or an indeterminate BM. Partial Response(PR) is a 50% decrease in the SPD for up to 6 identified dominant lesions, including spleenic and hepatic nodules from baseline. No new lesions and no increase in the size of liver, spleen or other nodes.

Time frame: after every 3 cycles on treatment

Population: All patients who started treatment were included in assessing response estimates.

ArmMeasureGroupValue (NUMBER)
SAHA (Vorinostat)Assess Number of Patients Who Achieve Confirmed and Unconfirmed Complete Response (CR) or Partial Response (PR)Complete Response (CR)0 participants
SAHA (Vorinostat)Assess Number of Patients Who Achieve Confirmed and Unconfirmed Complete Response (CR) or Partial Response (PR)Partial Response (PR)1 participants
SAHA (Vorinostat)Assess Number of Patients Who Achieve Confirmed and Unconfirmed Complete Response (CR) or Partial Response (PR)Unconfirmed Complete Response (UCR)0 participants
SAHA (Vorinostat)Assess Number of Patients Who Achieve Confirmed and Unconfirmed Complete Response (CR) or Partial Response (PR)Unconfirmed Partial Response (UPR)0 participants
SAHA (Vorinostat)Assess Number of Patients Who Achieve Confirmed and Unconfirmed Complete Response (CR) or Partial Response (PR)No Response24 participants
Secondary

Overall Survival

Measured from date of registration to death, or last contact date

Time frame: after every 3 cycles on treatment, then every 6 months for 2 years, then annually for a total of 5 years.

Population: All eligible patients who started treatment were included in assessing overall survival.

ArmMeasureValue (MEDIAN)
SAHA (Vorinostat)Overall Survival15.7 months
Secondary

Progression-Free Survival

Measured from date of registration to date of first observation of progression or death, or last contact date. Progression is defined as a 50% increase in sum of products of greatest diameters (SPD) of target measurable lesions over the smallest sum observed (over baseline if no decrease during therapy) using the same techniques as baseline; appearance of a new lesion/site; unequivocal progression of non-measurable disease in the opinion of the treating physician; death due to disease without prior documentation of progression.

Time frame: after every 3 cycles on treatment, then every 6 months for 2 years, then annually for a total of 5 years.

Population: All eligible patients who started treatment were included in assessing progression-free survival.

ArmMeasureValue (MEDIAN)
SAHA (Vorinostat)Progression-Free Survival4.8 months

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