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Addition of Inotuzumab Ozogamicin Pre- and Post-Allogeneic Transplantation


Description

The goal of this phase II clinical study is to learn about the safety of inotuzumab ozogamicin when given with fludarabine, with or without bendamustine, melphalan, and rituximab before and after a stem cell transplant. Researchers also want to learn if inotuzumab ozogamicin when given after a stem cell transplant can help control leukemia and lymphoma. Inotuzumab ozogamicin is a monoclonal antibody, called inotuzumab, linked to a chemotherapy drug called ozogamicin. Inotuzumab attaches to CD22-positive cancer cells in a targeted way and delivers ozogamicin to kill them. Giving chemotherapy before a bone marrow or peripheral blood stem cell transplant helps stop the growth of cells in the bone marrow, including normal blood-forming cells (stem cells) and cancer cells. Sometimes the transplanted cells from a donor attack the body's normal cells (called graft-versus-host disease). Giving tacrolimus and filgrastim before or after the transplant may stop this from happening. Fludarabine, b

Trial Eligibility

Inclusion Criteria: * Participants age 12 to 70. * English and non-English speaking participants are eligible. * CD22+ lymphoid malignancies including B-ALL * Eligible to receive a reduced-intensity alloSCT Participants with: * Indolent lymphoma participants who failed conventional treatment; or, * Acute lymphoblastic leukemia (ALL), aggressive lymphoma, indolent lymphoma in transformation, or those who have failed ≥ three small molecule inhibitors * Donor: HLA compatible related or matched unrelated donor (HLA-A, B, C, DRB1) * Performance status of 0 to 2, Lansky ≥ 80 for \< 16 years and Karnofsky ≥ 80 for ≥ 16 years of age. * Adequate organ function at time of study entry 1. Creatinine less than or equal to 1.6 mg/dL 2. Bilirubin less than 1.6 mg/dL 3. SGPT \< 2 x UL 4. Ejection fraction \>/= 40% 5. FEV1, FVC and cDLCO \>/= 40% * Negative Beta HCG test in a woman with child bearing potential defined as not post-menopausal for 12 months or no previous surgical sterilization) or currently breast-feeding. Pregnancy testing is not required for post-menopausal or surgically sterilized women. Exclusion Criteria: * Human immunodeficiency virus (HIV) positive. * Prior autologous transplant less than 1 year prior to consent. * Active and uncontrolled disease/infection. * Unable or unwilling to sign consent. * Current active hepatic or biliary disease (with exception of Gilbert's syndrome). * Active hepatitis B or C. * Recent chemotherapy or radiation within 3 weeks of study entry. Standard biological agents such as rituximab, TKIs such as ibrutinib, and venetoclax are allowed to be given within 3 days prior to receiving inotuzumab ozogamicin. * Prior inotuzumab ozogamicin within 3 weeks of study entry. * Peripheral blast count of greater than 10 K/mL. * QTcF interval \> 470 ms. * Participants with cognitive impairments and/or any serious unstable pre-existing medical condition or psychiatric disorder that can interfere with safety or with obtaining informed consent or compliance with study procedures.

Study Info

Organization

M.D. Anderson Cancer Center


Primary Outcome

Incidence of grade 3 or higher renal, hepatic, cardiac, pulmonary, or neurologic toxicity


Outcome Timeframe Up to 30 days after cycle 1 of maintenance therapy

NCTID NCT03856216

Phases PHASE2

Primary Purpose TREATMENT

Start Date 2019-10-28

Completion Date 2025-03-31

Enrollment Target 44

Interventions

PROCEDURE Allogeneic Bone Marrow Transplantation

DRUG Bendamustine

BIOLOGICAL Filgrastim-sndz

DRUG Fludarabine

BIOLOGICAL Inotuzumab Ozogamicin

DRUG Melphalan

PROCEDURE Peripheral Blood Stem Cell Transplantation

BIOLOGICAL Rituximab

DRUG Tacrolimus

Locations Recruiting

M D Anderson Cancer Center

United States, Texas, Houston


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