Phase II Trial of Sequential Chemotherapy and Radiotherapy for AIDS-Related Primary Central Nervous System Lymphoma

NCT ID: NCT00000801

Last Updated: 2012-11-01

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE2

Total Enrollment

33 participants

Study Classification

INTERVENTIONAL

Study Completion Date

1998-04-30

Brief Summary

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To estimate the response rate, overall and disease-free survival, toxicities, factors associated with outcome, and effect on quality of life in patients with AIDS-related primary CNS lymphoma treated with CHOD (cyclophosphamide, doxorubicin, vincristine, and dexamethasone) plus filgrastim (granulocyte-colony stimulating factor; G-CSF) and external beam irradiation. To determine other clinical markers present in this patient population.

Combined modality therapy may prove of benefit for patients with AIDS-related primary CNS lymphoma.

Detailed Description

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Combined modality therapy may prove of benefit for patients with AIDS-related primary CNS lymphoma.

Patients who upon staging workup are found to be without systemic involvement undergo one cycle of chemotherapy with cyclophosphamide, doxorubicin, vincristine, dexamethasone, and G-CSF. Cyclophosphamide, doxorubicin, and vincristine are administered intravenously on day 1. Dexamethasone is administered intravenously on day 1 and then orally thereafter with gradual discontinuation. G-CSF is administered subcutaneously daily beginning on day 2 and continuing for a total of 10 days or until blood counts have recovered to an acceptable level. Patients with evidence of cancer cells in their cerebrospinal fluid (CSF) will receive chemotherapy with intrathecal cytarabine twice weekly until no further evidence of cancer cells is found in the CSF, then once weekly for 6 weeks, and then monthly for 10 months. Seven to ten days following completion of one cycle of chemotherapy, patients undergo radiotherapy to the brain at a dose of 2.5 Gy daily for 5 days per week for approximately 4 weeks. Total dose to the whole brain and meninges is 30.0 Gy in 12 fractions, and total dose to the primary boost volume is 10.0 Gy in 4 fractions. During therapy, blood is drawn weekly and brain scans are performed every 3-12 weeks. An initial CSF sample will be obtained by lumbar puncture.

Conditions

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Lymphoma, Non-Hodgkin HIV Infections

Keywords

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Vincristine Cyclophosphamide Cytarabine Dexamethasone Doxorubicin Granulocyte Colony-Stimulating Factor Combined Modality Therapy Acquired Immunodeficiency Syndrome Antineoplastic Agents, Combined Brain Neoplasms Lymphoma, High-Grade Lymphoma, Intermediate-Grade

Study Design

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Primary Study Purpose

TREATMENT

Interventions

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Filgrastim

Intervention Type DRUG

Vincristine sulfate

Intervention Type DRUG

Doxorubicin hydrochloride

Intervention Type DRUG

Cyclophosphamide

Intervention Type DRUG

Cytarabine

Intervention Type DRUG

Dexamethasone

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

Concurrent Medication: Required:

* PCP prophylaxis with Bactrim, dapsone, or aerosolized pentamidine.
* Oral candidiasis prophylaxis with fluconazole, ketoconazole, or clotrimazole oral troches.
* Antiretroviral agent available by therapy IND.
* MAI prophylaxis with rifabutin (in patients with CD4 counts \< 100 cells/mm3).

Patients must have:

* HIV infection.
* Primary CNS lymphoma with NO systemic involvement.

Prior Medication:

Allowed:

* Prior corticosteroids.

Exclusion Criteria

Co-existing Condition:

Patients with the following symptoms or conditions are excluded:

* Concomitant malignancy other than Kaposi's sarcoma, curatively treated carcinoma in situ of the cervix, or squamous or basal cell carcinoma of the skin.
* Active uncontrolled infection.
* Renal failure, active nonmalignant duodenal ulcer, uncontrolled diabetes mellitus, or other serious medical conditions that would preclude aggressive cytotoxic chemotherapy administration.
* Active heart disease (congestive heart failure or heart block greater than first degree on EKG).

Concurrent Medication:

Excluded:

* Any investigational agent other than antiretroviral agents available by therapy IND.

Patients with the following prior conditions are excluded:

* No prior malignancy other than Kaposi's sarcoma, curatively treated carcinoma in situ of the cervix, or squamous cell or basal cell carcinoma of the skin.
* No new infectious complications within the past 2 weeks that require a change in antibiotics.
* History of myocardial infarction within the past 3 months.

Prior Medication:

Excluded:

* Prior chemotherapy other than for Kaposi's sarcoma.
Minimum Eligible Age

16 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Institute of Allergy and Infectious Diseases (NIAID)

NIH

Sponsor Role lead

Principal Investigators

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Krigel RL

Role: STUDY_CHAIR

Von Roenn J

Role: STUDY_CHAIR

Locations

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San Francisco AIDS Clinic / San Francisco Gen Hosp

San Francisco, California, United States

Site Status

San Francisco Gen Hosp

San Francisco, California, United States

Site Status

Univ of Colorado Health Sciences Ctr

Denver, Colorado, United States

Site Status

Beth Israel Deaconess - West Campus

Boston, Massachusetts, United States

Site Status

ECOG Data Management Office

Brookline, Massachusetts, United States

Site Status

Mount Sinai Med Ctr

New York, New York, United States

Site Status

Julio Arroyo

West Columbia, South Carolina, United States

Site Status

Countries

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United States

References

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Schultz C, Scott C, Sherman W, Donahue B, Fields J, Murray K, Fisher B, Abrams R, Meis-Kindblom J. Preirradiation chemotherapy with cyclophosphamide, doxorubicin, vincristine, and dexamethasone for primary CNS lymphomas: initial report of radiation therapy oncology group protocol 88-06. J Clin Oncol. 1996 Feb;14(2):556-64. doi: 10.1200/JCO.1996.14.2.556.

Reference Type BACKGROUND
PMID: 8636771 (View on PubMed)

Other Identifiers

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ECOG E 1493

Identifier Type: -

Identifier Source: secondary_id

ACTG 252

Identifier Type: -

Identifier Source: org_study_id