Clinical Trial: Intrathecal Rituximab in Lymphoid Malignancies Involving Central Nervous System

Study Status: Terminated
Recruit Status: Terminated
Study Type: Interventional

Official Title: Safety and Efficacy of Intrathecal Rituximab in Patients With Lymphoid Malignancies Involving the Central Nervous System

Brief Summary:

The goal of this clinical research study is to learn about the safety and effectiveness of rituximab given by spinal tap in patients with lymphoid malignancies involving the central nervous system.

A spinal tap (also called a lumbar puncture) is when fluid surrounding the spinal cord is collected by inserting a needle into the lower back. The affected area is numbed with local anesthetic during the procedure. It will also be used to give chemotherapy in this study.

Rituximab is designed to bind to a protein, called CD20, that is on the surface of the leukemia cells. This may cause the leukemia cells to die.


Detailed Summary:

Study Groups and Study Drug Administration:

If you are found to be eligible, you will be assigned to a study group based on when you join this study. Up to 12 participants will be enrolled in the Phase I portion of the study, and up to 13 participants will be enrolled in Phase II.

If you are enrolled in the Phase I portion, the dose of rituximab you receive will depend on when you joined this study. The first group of participants will receive the lowest dose level of rituximab. Each new group will receive a higher dose of rituximab than the group before it, if no intolerable side effects were seen. This will continue until the highest tolerable dose of rituximab is found.

If you are enrolled in the Phase II portion, you will receive rituximab at the highest dose that was tolerated in the Phase I portion.

Study Visits:

Once enrolled, you will return to the clinic and receive the study drug by spinal tap up to 2 times a week. You will receive treatment twice a week until 2 CSF samples in a row do not show any leukemia cells. After that, you will receive treatment 1 time a week for an additional 4 weeks, and then you will receive treatment once every other week for an additional 8 weeks. The number of doses you receive will depend on how many doses the study doctor thinks is needed.

At each study visit the following procedures will be performed:

  • You will have a physical exam, including measurement of your weight, and vital signs. °Your vital signs will be measured every 15 minutes for 1 hour after each dose of rituximab.
  • The percentage of participants whose cancer shrinks or disappears after treatment where participants are considered as responding to therapy if the Cerebrospinal fluid (CSF) is without evidence of blast cells after four lumbar punctures with rituximab.


Original Primary Outcome: Response Rate [ Time Frame: Response assessed after minimum 2 weeks/4 treatments (2 twice weekly treatments) ]

The percentage of participants whose cancer shrinks or disappears after treatment where participants are considered as responding to therapy if the CSF is without evidence of blast cells after four lumbar punctures with rituximab.


Current Secondary Outcome: Maximum Tolerated Dose (MTD) of Rituximab [ Time Frame: 2 weeks ]

MTD is dose level at which at least 1 of 3 participants experiences a dose-limiting toxicity (DLT). DLTdefined as clinically significant adverse event or abnormal laboratory value assessed as unrelated to disease progression, intercurrent illness, or concomitant medications and meeting the NCI common terminology criteria that are CTCAE Grade 3 or 4.


Original Secondary Outcome: Maximum Tolerated Dose (MTD) [ Time Frame: 2 weeks ]

MTD is dose level at which at least 1 of 3 participants experiences a dose-limiting toxicity (DLT).


Information By: M.D. Anderson Cancer Center

Dates:
Date Received: May 8, 2012
Date Started: January 24, 2013
Date Completion:
Last Updated: March 28, 2017
Last Verified: March 2017