Brief Title
Carfilzomib, Rituximab and Dexamethasone in Waldenstrom's Macroglobulinemia
Official Title
Carfilzomib, Rituximab, and Dexamethasone (CaRD) in Waldenstrom's Macroglobulinemia
Brief Summary
Carfilzomib is a drug that has shown anti-tumor activity by inhibiting the proteasome within the cell, which is responsible for degrading or breaking down a wide variety of proteins. Carfilzomib has not been approved by the FDA. Rituximab and dexamethasone are often used to treat Waldenstrom's Macroglobulinemia (WM), alone or in combination with other drugs. Combinations with rituximab, dexamethasone and proteasome inhibitors, like carfilzomib, show high levels of activity in WM patients. In this research study, the investigators are testing the safety and efficacy of Carfilzomib when used along with Rituximab and Dexamethasone as a possible treatment for Waldenstrom's Macroglobulinemia.
Detailed Description
If you take part in this research study, you will receive Carfilzomib and dexamethasone as an infusion on Days 1, 2, 8, and 9 for Cycles 1-6. You will then have a Rituximab infusion on Days 2 and 9. Each cycles lasts 21 days. After completing Cycle 6 and if you are eligible, there will be a 2 month break before the maintenance phase is started. During this break, you will have a study visit with a physical exam, blood tests, and a bone marrow biopsy. If you continue to the maintenance phase, you will receive Carfilzomib and Dexamethasone on Days 1 and 2 and Rituximab on Day 2 of Cycles 1-8. Each cycle will continue to last 21 days, but will take place every 2 months. Infusions will last between 2-6 hours. During all cycles you will have a physical exam and you will be asked questions about your general health and specific questions about any problems that you might be having and any medications you may be taking. Blood tests will also be done at each Cycle visit, and you will complete a questionnaire. Bone marrow and CT scan will only be repeated at physician discretion when appropriate and in order to ensure your response to treatment.
Study Phase
Phase 2
Study Type
Interventional
Primary Outcome
Overall Response Rate
Condition
Waldenstrom's Macroglobulinemia
Intervention
Dexamethasone
Study Arms / Comparison Groups
Treatment Arm
Description: Carfilzomib, dexamethasone, rituximab
Publications
* Includes publications given by the data provider as well as publications identified by National Clinical Trials Identifier (NCT ID) in Medline.
Recruitment Information
Recruitment Status
Drug
Estimated Enrollment
31
Start Date
October 2011
Completion Date
September 2016
Primary Completion Date
September 2016
Eligibility Criteria
Inclusion Criteria: - Diagnosis of Waldenstrom's Macroglobulinemia - Symptomatic disease - Measurable disease - Life expectancy of greater than 12 weeks - Adequate organ and marrow function - CD20 positive based on any previous performed bone marrow immunohistochemistry or flow cytometric analysis - Disease free of prior malignancies for >/= 5 years with the exception of currently treated basal cell, squamous cell carcinoma of the skin, or carcinoma "in situ" of the cervix or breast Exclusion Criteria: - More than one prior therapy - Previous therapy with a proteasome inhibitor or rituximab - Chemotherapy or radiotherapy within 4 weeks (6 weeks for nitrosoureas or mitomycin C) prior to entering the study or not recovered from adverse events due to agents administered more than 4 weeks earlier - Currently receiving treatment for any malignancy - Major surgery within 21 days prior to study entry - Acute active infection requiring treatment (systemic antibiotics, antivirals, or antifungals) within 14 days prior to study entry - Uncontrolled hypertension or uncontrolled diabetes - Significant neuropathy (Grades 3-4, or Grade 2 with pain) within 14 days prior to study entry - Known history of allergy to Captisol - Receiving any other study agents - Known brain metastases - History of allergic reactions attributed to compounds of similar chemical or biologic composition to carfilzomib, rituximab, and/or dexamethasone - Contraindication to any of the required concomitant drugs or supportive treatments, including hypersensitivity to all anticoagulation and antiplatelet options, antiviral drugs, or intolerance to hydration due to preexisting pulmonary or cardiac impairment - Uncontrolled intercurrent illness including, but not limited to ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements - Pregnant or lactating - HIV-positive on combination antiretroviral therapy
Gender
All
Ages
18 Years - N/A
Accepts Healthy Volunteers
No
Contacts
Steven P Treon, MD, PhD, ,
Location Countries
United States
Location Countries
United States
Administrative Informations
NCT ID
NCT01470196
Organization ID
11-279
Responsible Party
Principal Investigator
Study Sponsor
Dana-Farber Cancer Institute
Collaborators
Amgen
Study Sponsor
Steven P Treon, MD, PhD, Principal Investigator, Dana-Farber Cancer Institute
Verification Date
October 2018