The purpose of this study is to evaluate pidilizumab and its effect, bad and/or good, on the immune system in relation to its ability to fight cancer cells. Many cancers can be brought to a phase called complete remission (no cancer is found) but have a chance that they may come back. Researchers are working to improve therapy and to find new drugs that lower the chance of disease coming back. This study uses a drug called pidilizumab. The drug targets our immune system. It can change how our immune system finds cancer cells. The drug may kill any remaining cancer cells that we cannot see with computed tomography (CT) scans. The drug, pidilizumab, is being studied in other cancers.
PRIMARY OBJECTIVES: I. To estimate the rate of response, whereby either cluster of differentiation (CD)4+CD25+programmed death 1 ligand 1 (PD-L1)+ T lymphocytes or CD4+CD62L+CD127+ T lymphocytes has an "increase" following administration of pidilizumab in patients with diffuse large B-cell lymphoma (DLBCL) that have completed induction chemotherapy. SECONDARY OBJECTIVES: I. To determine the toxicity and tolerability of pidilizumab therapy following induction chemotherapy. II. To estimate the progression free survival (PFS) at 2 years. III. To estimate the overall survival (OS) at 2 years. IV. To estimate time to second line chemotherapy (TSLC) at 2 years. TERTIARY OBJECTIVES: I. To characterize programmed death 1 (PD-1) pathway specific expression markers from the diagnostic biopsy specimens. II. To characterize serum biomarkers of immune and inflammatory response during treatment with pidilizumab. III. To characterize levels of soluble PD-L1 related to treatment with pidilizumab. OUTLINE: Patients receive pidilizumab intravenously (IV) over approximately 5 hours on day 1. Treatment repeats every 42 days for 3 courses in the absence of disease progression or unacceptable toxicity. After completion of treatment, patients are followed up at 30 days and then every 3 months for 2 years.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
4
Correlative studies
Given IV
Georgia Regents University Medical Center
Augusta, Georgia, United States
Northwestern University
Chicago, Illinois, United States
Response to Pidilizumab
Response will be defined as the proportion of CD4+CD25+PD-L1+ T lymphocytes and CD4+CD62L+CD127+ T lymphocytes responders. Responders are defined as either a) a 50% increase or b) a half standard deviation increase in lymphocyte subsets. Lymphocyte subsets will be evaluated by flow cytometry on peripheral blood obtained at specified time points through the treatment period.
Time frame: Baseline to up to 127 days. Study terminated before this timeframe. As a result insufficient data was collected to be analyzed.
The Frequency and Severity of Toxicity - Number of Grade 1, 2, 3, 4, and 5, Adverse Events Experienced During Treatment of Pidilizumab Defined by NCI CTCAE v 4.03.
Adverse events (AEs) were graded according to the National Cancer Institute's Common Toxicity Criteria for Adverse Events (CTCAE) version 3.0. In general, AEs are graded according to the following: Grade 1 Mild AE Grade 2 Moderate AE Grade 3 Severe AE Grade 4 Life-threatening or disabling AE Grade 5 Death related to AE
Time frame: Start of treatment, and at days 22, 43, 85, 127 and every 3 months for up to 2 years. Due to early termination of the study, AEs for all patients were collected throughout treatment and up to the point of termination of the study.
Overall Survival (OS)
To estimate the overall survival (OS) at 2 years
Time frame: From study enrollment until death, or until last contact, assessed up to 2 years. Study terminated before this timeframe. As a result insufficient data was collected to be analyzed.
Progression Free Survival (PFS)
To estimate the progression free survival (PFS) at 2 years. PFS will be defined as time from study enrollment until the first occurrence of disease relapse, progression, re-initiation of cytotoxic chemotherapy, or death due to disease, or until last contact if the patient did not experience any of these.
Time frame: Up to 2 years. Study terminated before this timeframe. As a result insufficient data was collected to be analyzed.
Relapsed Disease
Time frame: Up to 2 years. Study terminated before this timeframe. As a result insufficient data was collected to be analyzed.
Time to Second Line Chemotherapy (TSLC)
To estimate time to second line chemotherapy (TSLC) at 2 years
Time frame: Up to 2 years
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.