BAY 59-8862 in Treating Patients With Refractory Non-Hodgkin's Lymphoma

RATIONALE: Drugs used in chemotherapy use different ways to stop cancer cells from dividing so they stop growing or die.

PURPOSE: Phase II trial to study the effectiveness of BAY 59-8862 in treating patients who have refractory non-Hodgkin's lymphoma.

OBJECTIVES:

• Determine the overall tumor response rate, including complete response (CR) and partial response (PR) rate, in patients with aggressive refractory non-Hodgkin's lymphoma treated with BAY 59-8862.
• Determine the overall survival in patients treated with this drug.
• Determine the time to progression in patients treated with this drug.
• Determine the duration of response (CR and PR) in patients treated with this drug.
• Determine the qualitative and quantitative toxicity profile of this drug in this patient population.
• Determine the pharmacokinetic profile of this drug in selected patients.

OUTLINE: This is a multicenter, open-label study.

Patients receive BAY 59-8862 IV over 1 hour on day 1. Courses repeat every 3 weeks in the absence of disease progression or unacceptable toxicity.

Patients are followed every 3 months until disease progression and then every 6 months thereafter for up to 2 years.

PROJECTED ACCRUAL: A total of 20-140 patients will be accrued for this study.

DISEASE CHARACTERISTICS:

• Histologically confirmed aggressive refractory non-Hodgkin's lymphoma (NHL) of one of the following classifications, and for which chemotherapy is deemed appropriate:

  • Diffuse large B-cell lymphoma
  • Transformed NHL
  • Follicular large cell lymphoma
  • Peripheral T cell lymphoma
  • Anaplastic large cell lymphoma
  • Mantle cell lymphoma
  • Unclassified aggressive histology
  • Immunoblastic lymphoma
• Failed at least 1 prior therapy (primary resistant) OR
• Previously achieved a remission and then progressed or relapsed within 6 months of therapy

• At least 1 bidimensionally measurable lesion

  • Lesions within a previously irradiated field are not considered measurable
• No relapse within 6 months after prior autologous bone marrow transplantation
• No prior allogeneic bone marrow or stem cell transplantation or post-transplant lymphoproliferative disorder
• No parenchymal or meningeal CNS involvement unless the patient received prior definitive therapy more than 6 months ago, has had a negative imaging study within the past 4 weeks, and is clinically stable with respect to the tumor at study entry

PATIENT CHARACTERISTICS:

Age:

• 18 and over

Performance status:

• ECOG 0-2

Life expectancy:

• At least 12 weeks

Hematopoietic:

• Absolute neutrophil count at least 1,500/mm^3
• Platelet count at least 75,000/mm^3
• Hemoglobin at least 9.0 g/dL

Hepatic:

• Total bilirubin no greater than 1.5 times upper limit of normal (ULN)
• ALT and AST no greater than 2.0 times ULN (5.0 times ULN if hepatic involvement)
• PT, INR, and PTT less than 1.5 times ULN
• No chronic hepatitis B or C

Renal:

• Creatinine no greater than 1.5 times ULN

Cardiovascular:

• No clinically evident congestive heart failure
• No New York Heart Association class III or IV heart disease
• No serious cardiac arrhythmias
• No active coronary artery disease or ischemia

Other:

• No prior hypersensitivity to taxane compounds
• No known or suspected allergy to the investigational study agent or any agent given in association with this study
• No other prior or concurrent malignancy except basal cell skin cancer or curatively treated carcinoma in situ of the bladder or cervix (adequately cone biopsied)
• No substance abuse or medical, psychological, or social conditions that would preclude study participation
• No active clinically serious infections
• No other condition that is unstable or would preclude study participation
• No grade 2 or greater pre-existing peripheral neuropathy

• No history of seizure disorder

  • Prior seizures related to brain metastases allowed provided that the patient has been seizure-free for at least 2 months
• HIV negative
• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective barrier contraception

PRIOR CONCURRENT THERAPY:

Biologic therapy:

• See Disease Characteristics
• See Chemotherapy
• At least 4 weeks since prior anticancer immunotherapy
• At least 3 weeks since prior biologic response modifiers (e.g., filgrastim [G-CSF])
• No concurrent anticancer immunotherapy
• No concurrent prophylactic G-CSF
• Concurrent G-CSF or other hematopoietic growth factors for acute toxicity (e.g., febrile neutropenia) allowed
• Concurrent chronic epoetin alfa allowed provided no dose adjustment occurred within 2 months prior to study

Chemotherapy:

• See Disease Characteristics
• At least 4 weeks since prior anticancer chemotherapy

• No more than 3 prior systemic chemotherapy regimens for metastatic NHL:

  • High-dose therapy for autologous hematopoietic stem cell transplantation (SCT) is considered 1 prior regimen
  • Salvage chemotherapy followed by autologous bone marrow transplant or peripheral SCT is considered 1 prior regimen
  • Antibody treatment is not considered 1 prior regimen
• No prior taxanes or oxaliplatin
• No other concurrent anticancer chemotherapy

Endocrine therapy:

• Patients with prior parenchymal or meningeal CNS involvement:

  • No concurrent acute or tapered steroid therapy
  • Concurrent chronic steroid therapy allowed provided the dose is stable for 1 month before and after screening radiographic studies

Radiotherapy:

• See Disease Characteristics
• At least 4 weeks since prior radiotherapy

• Concurrent palliative radiotherapy allowed provided:

  • No progressive disease
  • No more than 10% of bone marrow is irradiated
  • Radiation field does not encompass a target lesion
• No other concurrent radiotherapy

Surgery:

• At least 4 weeks since prior major surgery

Other:

• At least 4 weeks since prior investigational drugs
• No other concurrent investigational therapy or approved anticancer therapy
• No concurrent illicit drugs or other substances that would preclude study
• Concurrent therapeutic anticoagulants (e.g., warfarin or heparin) allowed provided there is no prior evidence of underlying abnormality with PT, INR, or PTT
• Concurrent nonconventional therapies (e.g., herbs or acupuncture) or vitamin/mineral supplements allowed provided that they do not interfere with study endpoints
• Concurrent bisphosphonates for prophylaxis or bone metastases allowed