Treatments or Clinical Trials > Clinical Trials of Interest
Overcoming Relapsed / Refractory lymphomas

Last update: 12/01/2011

Relapsed / Refractory

Studies GROUPED BY:

Monoclonal Antibody  | Novel Chemo Agents | Novel Targeted Agents | 
Novel Radio- / Immunotherapy Protocols | Novel Chemo-immunotherapy Protocols |
  Stem cell transplant-based   For DLBCL, not SCT| Radioimmunotherapy with Stem Cell Transplant

TOPIC SEARCH Drug Resistance and Lymphoma in ClinicalTrials.gov | 
Clinical Trials for Refractory Lymphoma

Goal:  Treating the disease using investigational therapies or new combinations of 
therapies that that may overcome drug resistance.   NOTE: By definition, clinical trials are investigational, and it is therefore  not known if the goals of treatments will be realized. 

 

What's New

	Study of interest:  Dendritic Cell Vaccine study at Mayo Clinic for lymphoma - for most types
	Study of interest:  Genetically Engineered Lymphocyte Therapy in Treating Patients With B-Cell Leukemia or Lymphoma That is Resistant or Refractory to Chemotherapy  | Discussion

 

Monoclonal Antibody

Monoclonal antibodies are man-made antibodies (proteins) that target receptors on lymphoma cells.

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Rituxan versus Bexxar at Relapse  Condition: Relapsed Follicular Non-Hodgkin's Lymphoma

Fenretinide* and Rituxan* Condition: B-cell lymphomas, including CLL TOPIC SEARCH Mechanisms - PubMed TOPIC SEARCH Outcome data - Medscape | PubMed TOPIC SEARCH Safety or Toxicity -  PubMed

Novel Chemotherapy Agents

Monoclonal antibodies are man-made antibodies (proteins) that target receptors on lymphoma cells.

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novel chemotherapy agent - similar to anthracyclines
 

Pixantrone (BBR 2778) Versus Other Chemotherapeutic Agents    Condition: Third line Relapsed Aggressive Lymphoma, Non-Hodgkin

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Novel Targeted Agents

Drugs that target pathways that may have high specificity to Lymphoma cells.

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	Brentuximab Vedotin Before Autologous Stem Cell Transplant for Hodgkin Lymphoma  http://1.usa.gov/p48iQa
	Azacitidine With Rituximab, Vincristine, and Cyclophosphamide in Refractory Follicular Lymphoma http://clinicaltrials.gov/ct2/show/NCT00901069
	All CLL/Lymphoma studies incorporating Azacytidine http://bit.ly/2qDAXc
	BMS-247550 (epothilone)    Conditions: Relapsed or Refractory Aggressive Non-Hodgkin's Lymphoma -  including grade 3 follicular   TOPIC SEARCH Mechanisms - PubMed TOPIC SEARCH Outcome data - ASCO | Medscape | PubMed TOPIC SEARCH Safety or Toxicity - ASCO | PubMed

Btk Inhibitor in Recurrent  B Cell Lymphoma Conditions: Relapsed or DLBCL (non-GCB subype) Details: http://bit.ly/9zOLVV

Combining novel chemo and  targeted agents
 

SDX-105 (Bendamustin/Treanda™) with Bortezomib (Velcade)    Condition: Relapsed or Refractory Indolent Non-Hodgkin's Lymphoma or B-CLL

MGCD0103 Given Three Times Weekly   Condition: Relapsed or refractory DLBCL or Follicular Lymphoma

CD3 immunotoxin therapy of cutaneous T cell lymphoma http://bit.ly/b8Wvma This novel immunotoxin has dramatic clinical activity even at the lowest dose in CTCL patients and merits applications at higher doses in CTCL and other CD3+ T cell leukemia/lymphoma patients. The lymphodepletion with recovery of T regulatory cells suggests the drug may be beneficial for immunosuppression of T cell autoimmune disorders. Clinical trials: http://bit.ly/cz7jlZ

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Novel Immunotherapy Protocols

 experimental ways to activate the immune system to target Lymphoma cells.

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Vaccine Therapy With or Without Cryosurgery in Treating Patients With Residual, Relapsed, or Refractory B-Cell Non-Hodgkin Lymphoma  http://bit.ly/farwZY  RATIONALE: Vaccines, such as dendritic cell therapy (DC) made from a person's tumor cells and white blood cells may help the body build an effective immune response to kill tumor cells. Cryosurgery kills cancer cells by freezing them. Giving vaccine therapy together with cryosurgery may kill more tumor cells. PURPOSE: This clinical trial studies giving vaccine therapy together with or without cryosurgery in treating patients with residual, relapsed, or refractory B-cell Non-Hodgkin's lymphoma Also see: Combined Dendritic Cell Cryotherapy of Tumor Induces Systemic Antimetastatic Immunity http://clincancerres.aacrjournals.org/content/11/13/4955.full

Wilm's Tumor 1 Protein Vaccine ... for relapsed NHL after allo SCT http://bit.ly/cGFFDG  Patients with the blood antigen HLA-A2 and the WT1 cancer protein who have persistent or recurrent blood cancers after [allo] stem cell transplantation. Background: "Most patients [with blood cancers] including NHL have a protein called Wilm's Tumor 1 (WT1) in their cancer cells. This protein is thought to be able to influence the growth of these cancers. A vaccine made with the WT1 protein may boost the immune system to help fight these cancers in patients whose cancer cells contain the protein."

	Donor Natural Killer Cell Infusion, Rituxan, Aldesleukin (IL-2), and Chemotherapy Condition:  relapsed cd-20 positive NHL or CLL
	Escalating Doses of Adoptively Infused Ex Vivo Expanded Autologous Natural Killer (NK) Cells Against Hematological Malignancies

Intratumoral Injection of CPG 7909, Combined With Low dose Local Radiation   NOTE:  Study closed as of March 2008,  might reopen before end of  year. Condition:  low-grade B-cell lymphoma of any initial stage or mycosis fungoides of stage IB-IVA. B-cell lymphoma patients must have failed at least one prior treatment. Mycosis fungoides patients must have failed or have been intolerant of at least 2 topical or one systemic treatment.

combining radiotherapy with radioimmunotherapy

Radiation and Bexxar Condition: Previously treated follicular lymphoma with > 5 cm nodal tumors.

targeted therapy: delivering chemotherapy with antibody

A Study Of anti-cd22 immunoconjugate (IO) Plus Rituximab  http://bit.ly/hBqoFd  Condition: For Relapsed/Refractory Aggressive NHL Patients Who Are NOT Candidates For Intensive High-Dose Chemotherapy.

IO is a humanized anti-CD22 antibody conjugated to calicheamicin, a cytotoxic agent (antibody with chemo attached). IO targets CD22, which is expressed in the majority of B-cell NHL.

2010 ASH report on IO: Anti-CD22 Immunoconjugate Inotuzumab Ozogamicin (CMC-544) + Rituximab In Relapsed DLBCL Patients Followed by Stem Cell Transplantation: Preliminary Safety and Efficacy http://ash.confex.com/ash/2010/webprogram/Paper33326.html 

 

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combining targeted agents with radioimmunotherapy
 

Combined Weekly Velcade and Bexxar    Condition: Relapsed or Refractory Follicular Lymphoma

utilizing genetically altered t-cells to target lymphoma cells
 

	Cellular Immunotherapy using Genetically Modified Autologous CD20-specific CD8+ T Cell Clones And:
	Cellular Immunotherapy With Autologous CD8+ Cytotoxic T Lymphocyte Clones After Chemo (Cyclophosphamide, Vincristine, and Prednisone) Condition: Relapsed CD20+ follicular lymphoma

genetically altered t-cells to target lymphoma cells
 

Genetically Engineered Lymphocyte Therapy in Treating Patients With B-Cell Leukemia or Lymphoma That is Resistant or Refractory to Chemotherapy http://1.usa.gov/n03Upb

novel immune modulating / targeted agent

	Lenalidomide (Revlimid)    Condition: Relapsed or Refractory Hodgkin Disease
	Lenalidomide (Revlimid)   Conditions: Refractory CLL or SLL TOPIC SEARCH Mechanisms - PubMed TOPIC SEARCH Outcome data - ASCO | Medscape | PubMed TOPIC SEARCH Safety or Toxicity - ASCO | PubMed

combines Rituxan with an immune modulating agent
 

• Rituxan and/or Lenalidomide (Revlimid)
   
  Condition: follicular lymphoma - relapsed following Rituxan-based combination therapy
  
  TOPIC SEARCH: Mechanisms PubMed 
  Outcome ASCO | Medscape | PubMed
  Safety ASCO | PubMed 

combines a targeted agent with rituxan immunotherapy
 

• CCI-779 and Rituxan
   
  Condition: Relapsed or Refractory Mantle Cell lymphoma

combines radioimmunotherapy with monoclonal antibody to treat challenging CNS lymphoma
 

• Rituxan and Zevalin
   
  Condition: Recurrent primary central nervous system (CNS) lymphoma
  

combines Rituxan and Radioimmunotherapy with an immune adjuvant
 

• Rituxan and Zevalin and Cp7909 (an immune adjuvant) 
   
  Condition: Refractory and relapsed NHL (including transformed follicular NHL, MALT, MCL, and DLBCL) 
   

combines Radioimmunotherapy with a second agent in T-cell and Hodgkins lymphomas
 

• Yttrium-90 Radiolabeled Humanized Anti-Tac and Calcium-DTPA
   
  Conditions: Tac-Expressing -
     Cutaneous T Cell Lymphoma; 
     Hodgkin's Disease; Neoplasm; 
     Non Hodgkin's Lymphoma; 
     Peripheral T Cell Lymphoma
   

adoptive immunotherapy in EBV-positive lymphomas
 

• LMP2a-Specific Cytotoxic T-Lymphocytes Following CD45 Antibody for Lymphoma
   
  Condition: EBV-positive Lymphoma
  
  
   

Novel Chemo-immunotherapy protocols

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• Vaccine with Interleukin-2 After Combination Chemotherapy
    
  Condition: Previously treated, or untreated, Mantle Cell Lymphoma
  

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Stem Cell Transplant (SCT)-based protocols

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utilizing cord blood for stem cell graft
 

• StemEx® Expanded Stem Cells Derived from Cord Blood to Treat Subjects With High Risk Hematologic Malignancies, Following Myeloablative Therapy (ExCell) 

  Conditions: 
     NHL with induction failure or relapse and sensitive to last chemotherapy course, and
     MDS with intermediate 2- or high-risk IPSS score. 
  
  Sponsor's website: http://stemexstudy.com/  

  
  TOPIC SEARCH Cord blood derived Stem Cell transplantation  PubMed

  added December 12, 2007

   

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  standard SCT with cord blood derived cells

  Umbilical Cord Blood Transplantation 
   
  Conditions: 
     High risk childhood non-Hodgkin's lymphoma; 
     Graft Versus Host Disease; 
     Leukemia; 
     Lymphoma; 
     Myelodysplastic (MDS) and myeloproliferative diseases
  

utilizing graft versus lymphoma affect

• SCT Donor Stem Cell Transplant
   
  Conditions:  
     Childhood Hodgkin's lymphoma; 
     Childhood non-Hodgkin's lymphoma; Leukemia; 
     Lymphoma; myelodysplastic and myeloproliferative diseases -
        (eligible if relapse from Auto SCT)
  

the goal of treatment is to consolidate SCT with investigational vaccine therapy

• Vaccine Therapy  Following Chemotherapy and Peripheral Stem Cell Transplantation 
   
  Condition: recurrent grade 1-3 follicular lymphoma

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For DLBCL, not eligible or desiring Stem Cell Transplant (SCT)

•  Studies recruiting for DLBCL, not eligible for transplant http://bit.ly/aVbuVF 

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Radioimmunotherapy and Stem Cell Transplant

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Radioimmunotherapy as part of conditioning for  Stem Cell Transplantation

• Rituxan/BEAM versus Bexxar/BEAM with Autologous Stem Cell Transplantation
  
  Conditions: Persistent or Relapsed Chemotherapy Sensitive Diffuse Large B-Cell NHL
  
  also see protocol/0401 
  

• Bexxar followed by BEAM conditioning study and Autologous Stem Cell Transplant
  
  Conditions: Relapsed Diffuse Large B-cell Lymphoma

• BEAM+Bexxar & Autologous Stem Cell Transplant 
  
  Ongoing, but no longer recruiting patients

• Bexxar, Etoposide, and Cyclophosphamide Followed by Autologous Stem Cell Transplantation 
   
  Conditions: Relapsed or Refractory non-Hodgkin's lymphoma 

• Bexxar Followed by Autologous Stem Cell Transplantation 
   
  Condition: Older patients with relapsed or refractory NHL

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