Pivotal phase III trial of two dose levels of denileukin diftitox for the treatment of cutaneous T-cell lymphoma

E. Olsen, M. Duvic, A. Frankel, Y. Kim, A. Martin, E. Vonderheid, B. Jegasothy, G. Wood, M. Gordon, P. Heald, A. Oseroff, L. Pinter-Brown, G. Bowen, T. Kuzel, D. Fivenson, F. Foss, M. Glode, A. Molina, E. Knobler, S. Stewart & 6 others K. Cooper, S. Stevens, F. Craig, J. Reuben, P. Bacha, J. Nichols

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Abstract

Purpose: The objective of this phase III study was to determine the efficacy, safety, and pharmacokinetics of denileukin diftitox (DAB389IL-2, Ontak [Ligand Pharmaceuticals Inc, San Diego, CA]) in patients with stage Ib to IVa cutaneous T-cell lymphoma (CTCL) who have previously received other therapeutic interventions. Patients and Methods: Patients with biopsy-proven CTCL that expressed CD25 on ≥ 20% of lymphocytes were assigned to one or two dose levels (9 or 18 μg/kg/d) of denileukin diftitox administered 5 consecutive days every 3 weeks for up to 8 cycles. Patients were monitored for toxicity and clinical efficacy, the latter assessed by changes in disease burden and quality of life measurements. Antibody levels of antidenileukin diftitox and anti-interleukin-2 and serum concentrations of denileukin diftitox were also measured. Results: Overall, 30% of the 71 patients with CTCL treated with denileukin diftitox had an objective response (20% partial response; 10% complete response). The response rate and duration of response based on the time of the first dose of study drug for all responders (median of 6.9 months with a range of 2.7 to more than 46.1 months) were not statistically different between the two doses. Adverse events consisted of flu-like symptoms (fever/chills, nausea/vomiting, and myalgias/arthralgias), acute infusion-related events (hypotension, dyspnea, chest pain, and back pain), and a vascular leak syndrome (hypotension, hypoalbuminemia, edema). In addition, 61% of the patients experienced transient elevations of hepatic transaminase levels with 17% grade 3 or 4. Hypoalbuminemia occurred in 79%, including 15% with grade 3 or 4 changes. Tolerability at 9 and 18 μg/kg/d was similar, and there was no evidence of cumulative toxicity. Conclusion: Denileukin diftitox has been shown to be a useful and important agent in the treatment of patients whose CTCL is persistent or recurrent despite other therapeutic interventions.

Original languageEnglish (US)
Pages (from-to)376-388
Number of pages13
JournalJournal of Clinical Oncology
Volume19
Issue number2
StatePublished - Jan 15 2001

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Cutaneous T-Cell Lymphoma
Hypoalbuminemia
Hypotension
Therapeutics
Chills
Myalgia
Arthralgia
Back Pain
Transaminases
denileukin diftitox
Chest Pain
Pharmaceutical Preparations
Dyspnea
Nausea
Vomiting
Interleukin-2
Blood Vessels
Edema
Fever
Pharmacokinetics

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Olsen, E., Duvic, M., Frankel, A., Kim, Y., Martin, A., Vonderheid, E., ... Nichols, J. (2001). Pivotal phase III trial of two dose levels of denileukin diftitox for the treatment of cutaneous T-cell lymphoma. Journal of Clinical Oncology, 19(2), 376-388.

Pivotal phase III trial of two dose levels of denileukin diftitox for the treatment of cutaneous T-cell lymphoma. / Olsen, E.; Duvic, M.; Frankel, A.; Kim, Y.; Martin, A.; Vonderheid, E.; Jegasothy, B.; Wood, G.; Gordon, M.; Heald, P.; Oseroff, A.; Pinter-Brown, L.; Bowen, G.; Kuzel, T.; Fivenson, D.; Foss, F.; Glode, M.; Molina, A.; Knobler, E.; Stewart, S.; Cooper, K.; Stevens, S.; Craig, F.; Reuben, J.; Bacha, P.; Nichols, J.

In: Journal of Clinical Oncology, Vol. 19, No. 2, 15.01.2001, p. 376-388.

Research output: Contribution to journalArticle

Olsen, E, Duvic, M, Frankel, A, Kim, Y, Martin, A, Vonderheid, E, Jegasothy, B, Wood, G, Gordon, M, Heald, P, Oseroff, A, Pinter-Brown, L, Bowen, G, Kuzel, T, Fivenson, D, Foss, F, Glode, M, Molina, A, Knobler, E, Stewart, S, Cooper, K, Stevens, S, Craig, F, Reuben, J, Bacha, P & Nichols, J 2001, 'Pivotal phase III trial of two dose levels of denileukin diftitox for the treatment of cutaneous T-cell lymphoma', Journal of Clinical Oncology, vol. 19, no. 2, pp. 376-388.
Olsen, E. ; Duvic, M. ; Frankel, A. ; Kim, Y. ; Martin, A. ; Vonderheid, E. ; Jegasothy, B. ; Wood, G. ; Gordon, M. ; Heald, P. ; Oseroff, A. ; Pinter-Brown, L. ; Bowen, G. ; Kuzel, T. ; Fivenson, D. ; Foss, F. ; Glode, M. ; Molina, A. ; Knobler, E. ; Stewart, S. ; Cooper, K. ; Stevens, S. ; Craig, F. ; Reuben, J. ; Bacha, P. ; Nichols, J. / Pivotal phase III trial of two dose levels of denileukin diftitox for the treatment of cutaneous T-cell lymphoma. In: Journal of Clinical Oncology. 2001 ; Vol. 19, No. 2. pp. 376-388.
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abstract = "Purpose: The objective of this phase III study was to determine the efficacy, safety, and pharmacokinetics of denileukin diftitox (DAB389IL-2, Ontak [Ligand Pharmaceuticals Inc, San Diego, CA]) in patients with stage Ib to IVa cutaneous T-cell lymphoma (CTCL) who have previously received other therapeutic interventions. Patients and Methods: Patients with biopsy-proven CTCL that expressed CD25 on ≥ 20{\%} of lymphocytes were assigned to one or two dose levels (9 or 18 μg/kg/d) of denileukin diftitox administered 5 consecutive days every 3 weeks for up to 8 cycles. Patients were monitored for toxicity and clinical efficacy, the latter assessed by changes in disease burden and quality of life measurements. Antibody levels of antidenileukin diftitox and anti-interleukin-2 and serum concentrations of denileukin diftitox were also measured. Results: Overall, 30{\%} of the 71 patients with CTCL treated with denileukin diftitox had an objective response (20{\%} partial response; 10{\%} complete response). The response rate and duration of response based on the time of the first dose of study drug for all responders (median of 6.9 months with a range of 2.7 to more than 46.1 months) were not statistically different between the two doses. Adverse events consisted of flu-like symptoms (fever/chills, nausea/vomiting, and myalgias/arthralgias), acute infusion-related events (hypotension, dyspnea, chest pain, and back pain), and a vascular leak syndrome (hypotension, hypoalbuminemia, edema). In addition, 61{\%} of the patients experienced transient elevations of hepatic transaminase levels with 17{\%} grade 3 or 4. Hypoalbuminemia occurred in 79{\%}, including 15{\%} with grade 3 or 4 changes. Tolerability at 9 and 18 μg/kg/d was similar, and there was no evidence of cumulative toxicity. Conclusion: Denileukin diftitox has been shown to be a useful and important agent in the treatment of patients whose CTCL is persistent or recurrent despite other therapeutic interventions.",
author = "E. Olsen and M. Duvic and A. Frankel and Y. Kim and A. Martin and E. Vonderheid and B. Jegasothy and G. Wood and M. Gordon and P. Heald and A. Oseroff and L. Pinter-Brown and G. Bowen and T. Kuzel and D. Fivenson and F. Foss and M. Glode and A. Molina and E. Knobler and S. Stewart and K. Cooper and S. Stevens and F. Craig and J. Reuben and P. Bacha and J. Nichols",
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T1 - Pivotal phase III trial of two dose levels of denileukin diftitox for the treatment of cutaneous T-cell lymphoma

AU - Olsen, E.

AU - Duvic, M.

AU - Frankel, A.

AU - Kim, Y.

AU - Martin, A.

AU - Vonderheid, E.

AU - Jegasothy, B.

AU - Wood, G.

AU - Gordon, M.

AU - Heald, P.

AU - Oseroff, A.

AU - Pinter-Brown, L.

AU - Bowen, G.

AU - Kuzel, T.

AU - Fivenson, D.

AU - Foss, F.

AU - Glode, M.

AU - Molina, A.

AU - Knobler, E.

AU - Stewart, S.

AU - Cooper, K.

AU - Stevens, S.

AU - Craig, F.

AU - Reuben, J.

AU - Bacha, P.

AU - Nichols, J.

PY - 2001/1/15

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N2 - Purpose: The objective of this phase III study was to determine the efficacy, safety, and pharmacokinetics of denileukin diftitox (DAB389IL-2, Ontak [Ligand Pharmaceuticals Inc, San Diego, CA]) in patients with stage Ib to IVa cutaneous T-cell lymphoma (CTCL) who have previously received other therapeutic interventions. Patients and Methods: Patients with biopsy-proven CTCL that expressed CD25 on ≥ 20% of lymphocytes were assigned to one or two dose levels (9 or 18 μg/kg/d) of denileukin diftitox administered 5 consecutive days every 3 weeks for up to 8 cycles. Patients were monitored for toxicity and clinical efficacy, the latter assessed by changes in disease burden and quality of life measurements. Antibody levels of antidenileukin diftitox and anti-interleukin-2 and serum concentrations of denileukin diftitox were also measured. Results: Overall, 30% of the 71 patients with CTCL treated with denileukin diftitox had an objective response (20% partial response; 10% complete response). The response rate and duration of response based on the time of the first dose of study drug for all responders (median of 6.9 months with a range of 2.7 to more than 46.1 months) were not statistically different between the two doses. Adverse events consisted of flu-like symptoms (fever/chills, nausea/vomiting, and myalgias/arthralgias), acute infusion-related events (hypotension, dyspnea, chest pain, and back pain), and a vascular leak syndrome (hypotension, hypoalbuminemia, edema). In addition, 61% of the patients experienced transient elevations of hepatic transaminase levels with 17% grade 3 or 4. Hypoalbuminemia occurred in 79%, including 15% with grade 3 or 4 changes. Tolerability at 9 and 18 μg/kg/d was similar, and there was no evidence of cumulative toxicity. Conclusion: Denileukin diftitox has been shown to be a useful and important agent in the treatment of patients whose CTCL is persistent or recurrent despite other therapeutic interventions.

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