Monoclonal antibodies, such as rituximab, can locate cancer cells and either kill them or deliver cancer-killing substances to them without harming normal cells. Interleukin-12 may kill cancer cells by stopping blood flow to the tumor and by stimulating a person's white blood cells to kill cancer cells. Combining rituximab with interleukin-12 may kill more cancer cells. This randomized phase II trial is comparing how well giving rituximab together with two different schedules of interleukin-12 works in treating patients with B-cell non-Hodgkin lymphoma.
OBJECTIVES: I. Compare the objective response in patients with B-cell non-Hodgkin's lymphoma treated with rituximab and 2 different schedules of interleukin-12\*. II. Compare the toxic effects of these regimens in these patients. III. Determine the objective response rate in patients with mantle cell lymphoma treated with these regimens. IV. Determine the overall and progression-free survival of patients treated with these regimens. V, Compare the quality of life of patients treated with these regimens. NOTE: \*Interleukin-12 will no longer be available after 6/30/05. OUTLINE: This is a randomized, multicenter study. Patients are stratified according to histology (mantle cell lymphoma vs other \[closed to accrual as of 3/10/04\]) and International Prognostic Factor Index (low and low-intermediate risk \[closed to accrual as of 3/10/04\] vs high-intermediate and high risk). Patients are randomized to 1 of 2 treatment arms. ARM I: Patients receive rituximab IV on days 1, 8, 15, and 22. Patients receive interleukin-12\* subcutaneously (SC) twice weekly beginning on day 2 and continuing until disease progression. ARM II (closed to accrual as of 11/14/03): Patients receive rituximab as in arm I. Patients are evaluated at week 12. Patients with stable or progressive disease receive interleukin-12\* SC twice weekly until disease progression or for 24 weeks. Patients with a complete or partial response after rituximab are monitored until disease progression and then begin interleukin-12 SC twice weekly until further disease progression. NOTE: \*Interleukin-12 will no longer be available after 06/30/05. Patients proceed to follow-up as outlined below. Quality of life is assessed at baseline and at 3 and 6 months. Patients are followed every 3 months for 1 year and then every 6 months for up to 4 years. PROJECTED ACCRUAL: A total of 90 patients (45 per treatment arm \[arm II closed to accrual as of 11/14/03\]) will be accrued for this study within 3 years.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
99
Given IV
Given SC
Correlative studies
Ancillary studies
Ancillary studies
North Central Cancer Treatment Group
Rochester, Minnesota, United States
Objective response
The proportion of successes will be estimated by the number of successes divided by the total number of evaluable patients. In addition, confidence intervals for the response probability will be calculated according to the approach of Duffy and Santner.
Time frame: 12 weeks
Objective response
The proportion of successes will be estimated by the number of successes divided by the total number of evaluable patients. In addition, confidence intervals for the response probability will be calculated according to the approach of Duffy and Santner.
Time frame: 24 weeks
Overall response rate for MCL patients
Corresponding 95% confidence intervals will also be calculated.
Time frame: Up to 5 years
Overall survival
The distribution this time measure will be estimated using the method of Kaplan-Meier.
Time frame: From randomization to death due to any cause, assessed up to 5 years
Time to treatment failure
The distribution this time measure will be estimated using the method of Kaplan-Meier.
Time frame: From randomization to the treatment-specific definition of disease progression, death, or when the patient goes off study due to refusal or toxicity, assessed up to 5 years
Complete response rate
Will be assessed and descriptively summarized.
Time frame: Up to 5 years
Quality of life assessed using FACT-BRM
Before and after treatment comparisons will be made using a paired samples t-test or its nonparametric equivalent. This two-sided test will have at least 80% power to detect a moderate effect size (0.42 times the standard deviation) in the FACT-BRM scores.
Time frame: Baseline
Quality of life assessed using FACT-BRM
Before and after treatment comparisons will be made using a paired samples t-test or its nonparametric equivalent. This two-sided test will have at least 80% power to detect a moderate effect size (0.42 times the standard deviation) in the FACT-BRM scores.
Time frame: 3 months
Quality of life assessed using FACT-BRM
Before and after treatment comparisons will be made using a paired samples t-test or its nonparametric equivalent. This two-sided test will have at least 80% power to detect a moderate effect size (0.42 times the standard deviation) in the FACT-BRM scores.
Time frame: 6 months
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