Anti-Tac(90 Y-HAT) to Treat Hodgkin's Disease, Non-Hodgkin's Lymphoma and Lymphoid Leukemia
Status:
Completed
Trial end date:
2013-11-01
Target enrollment:
Participant gender:
Summary
This study will examine the use of a radioactive monoclonal antibody called yttrium
90-labeled humanized anti-Tac (90 Y-HAT) for treating certain cancers. Monoclonal antibodies
are genetically engineered proteins made in large quantities and directed against a specific
target in the body. The anti-Tac antibody in this study is targeted to tumor cells and is
tagged (labeled) with a radioactive substance called Yttrium-90 (Y-90). The study will
determine the maximum tolerated dose of 90Y-HAT and examine its safety and effectiveness.
Patients 18 years of age and older with Hodgkin's disease, non-Hodgkin's lymphoma and
lymphoid leukemia who have proteins on their cancer cells that react with anti-Tac may be
eligible for this study. Candidates are screened with a medical history and physical
examination, blood and urine tests, electrocardiogram (EKG), chest x-ray, computed tomography
(CT) scan or ultrasound of the abdomen, positron emission tomography (PET) scan of the neck
and body, and skin test for immune reactivity to antigens (similar to skin tuberculin test).
Before beginning treatment, participants may undergo additional procedures, including the
following:
- Patients with suspicious skin lesions have a skin biopsy. An area of skin is numbed and
a circular piece of skin about 1/4-inch diameter is removed with a cookie cutter-like
instrument.
- Patients with hearing loss have a hearing test.
- Patients with neurological symptoms have a lumbar puncture (spinal tap). A local
anesthetic is given and a needle is inserted in the space between the bones in the lower
back where the cerebrospinal fluid circulates below the spinal cord. A small amount of
fluid is collected through the needle.
- Patients who have not had a bone marrow biopsy within 6 months of screening also undergo
this procedure. The skin and bone at the back of the hip are numbed with a local
anesthetic and a small piece of bone is withdrawn through a needle.
Patients receive 90 Y-HAT in escalating doses to determine the highest dose that can be
safely given. The first group of three patients receives a low dose and, if there are no
significant side effects at that dose, the next three patients receive a higher dose. This
continues with subsequent groups until the maximum study dose is reached. 90 Y-HAT is given
through a vein (intravenous (IV)) over a 2-hour period. In addition, a drug called Pentetate
Calcium Trisodium Inj (Ca-DTPA) is given via IV over 5 hours for 3 days to help reduce the
side effects of the 90Y-HAT. In some patients, the 90 Y-HAT may also be attached to a
radioactive metal called Indium-111 to monitor what happens to the injected material. During
infusion of the drug, patients undergo PET scanning to trace the path of the injected
material in the body. For this procedure, the patient lies in the scanner, remaining in one
position during the entire infusion.
Blood and urine specimens are collected periodically over a 6-week period following the
infusion to determine the level of the radioactive antibody. Bone marrow, lymph node, or skin
biopsies may be done to determine how much of the antibody entered these sites. Patients
whose disease remains stable or improves with therapy may receive up to six more infusions of
90 Y-HAT, with at least a 6-week interval between treatments.
Phase:
Phase 1/Phase 2
Details
Lead Sponsor:
National Cancer Institute (NCI)
Treatments:
Calcium Calcium, Dietary Daclizumab Edetic Acid Immunoglobulin G Pentetic Acid