Positron Emission Tomography Guided Therapy of Aggressive Non-Hodgkin's Lymphomas

NCT ID: NCT00554164

Last Updated: 2017-05-05

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

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

1073 participants

Study Classification

INTERVENTIONAL

Study Start Date

2007-11-30

Study Completion Date

2017-03-31

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

The main purpose of the PETAL trial is to determine whether patients with aggressive non-Hodgkin's lymphomas with a persistently positive PET scan after two cycles of chemotherapy benefit from a change of the treatment protocol.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

Positron emission tomography performed after two cycles of (R-)CHOP chemotherapy (interim-PET) has been shown to predict long-term outcome in patients with aggressive non-Hodgkin's lymphomas. Patients with early normalization of pathological PET findings have an excellent prognosis, while patients with a persistently pathological PET scan have a high risk of non-response or relapse.

Patients with a negative interim-PET scan (part A of the trial) will be randomized to receive either another four cycles of the (R-)CHOP regimen (arm A1) or four cycles of the (R-)CHOP regimen plus two additional doses of rituximab (arm A2). Randomisation in part A of the trial was stopped when the number of patients required was reached (128 patients in each treatment arm). Since then patients have been uniformly treated according to arm A2.

Patients with a persistently positive interim-PET scan (part B of the trial) will be randomized to either continue treatment with another six (R-)CHOP cycles (arm B1) or switch to an alternative protocol used for the treatment of Burkitt's lymphoma (arm B2: six blocks according to the so-called B-ALL protocol of the German ALL study group).

Patients refractory to or relapsing within two years after treatment according to parts A or B of the trial will receive age-adapted salvage protocols (patients \< 60 years: high-dose chemotherapy with autologous stem cell transplantation; patients \> 60 years: (R-)ESHAP protocol)(part C of the trial).

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Lymphoma, High-grade

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

B1

Six cycles of the (R-)CHOP regimen.

Group Type ACTIVE_COMPARATOR

(R-)CHOP protocol

Intervention Type DRUG

Patients with a persistently positive interim-PET scan assigned to arm B1 will receive another six cycles of the (R-)CHOP regimen (rituximab, cyclophosphamide, doxorubicine, vincristine, prednisone).

B2

Six blocks of the B-ALL protocol.

Group Type EXPERIMENTAL

B-ALL protocol

Intervention Type DRUG

Patients with a persistently positive interim-PET scan assigned to arm B2 will receive six blocks of the B-ALL protocol (rituximab, methotrexate, ifosfamide, etoposide, cytarabine, vincristine, cyclophosphamide, doxorubicine, vindesine, dexamethasone).

A1

Four cycles of the (R-)CHOP regimen.

Group Type ACTIVE_COMPARATOR

(R-)CHOP protocol

Intervention Type DRUG

Patients with a negative interim-PET scan assigned to arm A1 will receive another four cycles of the (R-)CHOP regimen (rituximab, cyclophosphamide, doxorubicine, vincristine, prednisone). Arm A1 was closed when the number of patients required for the randomisation between arms A1 and A2 was reached.

A2

Four cycles of the (R-)CHOP regimen plus two additional doses rituximab.

Group Type ACTIVE_COMPARATOR

(R-)CHOP protocol

Intervention Type DRUG

Patients with a negative interim-PET scan assigned to arm A2 will receive another four cycles of the (R-)CHOP regimen (rituximab, cyclophosphamide, doxorubicine, vincristine, prednisone) plus two additional doses rituximab. Since the number of patients required for the randomisation between arms A1 and A2 has been reached, all patients with a negative interim-PET scan are treated according to arm A2.

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

(R-)CHOP protocol

Patients with a persistently positive interim-PET scan assigned to arm B1 will receive another six cycles of the (R-)CHOP regimen (rituximab, cyclophosphamide, doxorubicine, vincristine, prednisone).

Intervention Type DRUG

B-ALL protocol

Patients with a persistently positive interim-PET scan assigned to arm B2 will receive six blocks of the B-ALL protocol (rituximab, methotrexate, ifosfamide, etoposide, cytarabine, vincristine, cyclophosphamide, doxorubicine, vindesine, dexamethasone).

Intervention Type DRUG

(R-)CHOP protocol

Patients with a negative interim-PET scan assigned to arm A1 will receive another four cycles of the (R-)CHOP regimen (rituximab, cyclophosphamide, doxorubicine, vincristine, prednisone). Arm A1 was closed when the number of patients required for the randomisation between arms A1 and A2 was reached.

Intervention Type DRUG

(R-)CHOP protocol

Patients with a negative interim-PET scan assigned to arm A2 will receive another four cycles of the (R-)CHOP regimen (rituximab, cyclophosphamide, doxorubicine, vincristine, prednisone) plus two additional doses rituximab. Since the number of patients required for the randomisation between arms A1 and A2 has been reached, all patients with a negative interim-PET scan are treated according to arm A2.

Intervention Type DRUG

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* Aggressive B-cell or T-cell non-Hodgkin's lymphoma
* Pathological pre-treatment PET scan
* Performance status ECOG 0-3
* Age 18 - 80 years
* Ability to understand the purpose of the study and act accordingly
* Willingness to use adequate contraception
* Informed consent

Exclusion Criteria

* Burkitt's lymphoma
* Primary central nervous system lymphoma
* Previous chemo- and/or radiotherapy
* Other cancer within preceding 5 years
* HIV infection, active viral hepatitis or other uncontrolled infection
* Other medical conditions precluding administration of planned therapy
* Pregnancy or lactation
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

Deutsche Krebshilfe e.V., Bonn (Germany)

OTHER

Sponsor Role collaborator

University Hospital, Essen

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Ulrich Duehrsen

Prof. Dr. Ulrich Duehrsen

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Ulrich Duehrsen, Prof. Dr.

Role: PRINCIPAL_INVESTIGATOR

Department of Hematology, University Hospital Essen, Hufelandstrasse 55, 45122 Essen, Germany

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

Department of Hematology, University Hospital Essen

Essen, , Germany

Site Status

Countries

Review the countries where the study has at least one active or historical site.

Germany

References

Explore related publications, articles, or registry entries linked to this study.

Duhrsen U, Bockisch A, Hertenstein B, Karsten IE, Kroschinsky F, Heuser M, Hochhaus A, Hoffkes HG, Behringer D, Prange-Krex G, Tometten M, Grieshammer M, Grigoleit GU, Schmalz O, Jordan K, Bernhard H, Gaska T, Giagounidis A, Schroers R, Martens UM, Held G, Klapper W, Jockel KH, Nonnemacher M, Huttmann A; PETAL Trial Investigators. Response-guided first-line therapy and treatment of relapse in aggressive lymphoma: 10-year follow-up of the PETAL trial. Blood Neoplasia. 2024 May 21;1(3):100018. doi: 10.1016/j.bneo.2024.100018. eCollection 2024 Sep.

Reference Type DERIVED
PMID: 40453056 (View on PubMed)

Duhrsen U, Prange-Krex G, Moeller R, Held H, Heil G, Schwarzer A, Mahlmann S, Dienst A, Sandmann M, Maschmeyer G, Schutte J, Hahn D, Heike M, Nonnemacher M, Hanoun C, Huttmann A; PETAL trial investigators. Health-related quality of life in patients with aggressive non-Hodgkin lymphoma: results from the PETAL trial. Ann Hematol. 2025 May;104(5):2831-2845. doi: 10.1007/s00277-025-06402-1. Epub 2025 May 21.

Reference Type DERIVED
PMID: 40397196 (View on PubMed)

Broecker-Preuss M, Becher-Boveleth N, Muller SP, Huttmann A, Hanoun C, Grafe H, Richter J, Klapper W, Rekowski J, Bockisch A, Duhrsen U. Impact of germline polymorphisms in genes regulating glucose uptake on positron emission tomography findings and outcome in diffuse large B-cell lymphoma: results from the PETAL trial. J Cancer Res Clin Oncol. 2022 Oct;148(10):2611-2621. doi: 10.1007/s00432-021-03796-z. Epub 2021 Oct 27.

Reference Type DERIVED
PMID: 34708297 (View on PubMed)

Kaddu-Mulindwa D, Altmann B, Held G, Angel S, Stilgenbauer S, Thurner L, Bewarder M, Schwier M, Pfreundschuh M, Loffler M, Menhart K, Grosse J, Ziepert M, Herrmann K, Duhrsen U, Huttmann A, Barbato F, Poeschel V, Hellwig D. FDG PET/CT to detect bone marrow involvement in the initial staging of patients with aggressive non-Hodgkin lymphoma: results from the prospective, multicenter PETAL and OPTIMAL>60 trials. Eur J Nucl Med Mol Imaging. 2021 Oct;48(11):3550-3559. doi: 10.1007/s00259-021-05348-6. Epub 2021 Apr 29.

Reference Type DERIVED
PMID: 33928400 (View on PubMed)

Schmitz C, Rekowski J, Reinke S, Muller SP, Huttmann A, Klapper W, Duhrsen U. Metabolic tumor volume, cancer cell fraction, and prognosis - the case of T-cell/histiocyte-rich large B-cell lymphoma. Leuk Lymphoma. 2020 Jun;61(6):1372-1379. doi: 10.1080/10428194.2020.1713319. Epub 2020 Feb 5.

Reference Type DERIVED
PMID: 32022621 (View on PubMed)

Schmitz C, Huttmann A, Muller SP, Hanoun M, Boellaard R, Brinkmann M, Jockel KH, Duhrsen U, Rekowski J. Dynamic risk assessment based on positron emission tomography scanning in diffuse large B-cell lymphoma: Post-hoc analysis from the PETAL trial. Eur J Cancer. 2020 Jan;124:25-36. doi: 10.1016/j.ejca.2019.09.027. Epub 2019 Nov 9.

Reference Type DERIVED
PMID: 31710995 (View on PubMed)

Kurtz DM, Scherer F, Jin MC, Soo J, Craig AFM, Esfahani MS, Chabon JJ, Stehr H, Liu CL, Tibshirani R, Maeda LS, Gupta NK, Khodadoust MS, Advani RH, Levy R, Newman AM, Duhrsen U, Huttmann A, Meignan M, Casasnovas RO, Westin JR, Roschewski M, Wilson WH, Gaidano G, Rossi D, Diehn M, Alizadeh AA. Circulating Tumor DNA Measurements As Early Outcome Predictors in Diffuse Large B-Cell Lymphoma. J Clin Oncol. 2018 Oct 1;36(28):2845-2853. doi: 10.1200/JCO.2018.78.5246. Epub 2018 Aug 20.

Reference Type DERIVED
PMID: 30125215 (View on PubMed)

Duhrsen U, Muller S, Hertenstein B, Thomssen H, Kotzerke J, Mesters R, Berdel WE, Franzius C, Kroschinsky F, Weckesser M, Kofahl-Krause D, Bengel FM, Durig J, Matschke J, Schmitz C, Poppel T, Ose C, Brinkmann M, La Rosee P, Freesmeyer M, Hertel A, Hoffkes HG, Behringer D, Prange-Krex G, Wilop S, Krohn T, Holzinger J, Griesshammer M, Giagounidis A, Raghavachar A, Maschmeyer G, Brink I, Bernhard H, Haberkorn U, Gaska T, Kurch L, van Assema DME, Klapper W, Hoelzer D, Geworski L, Jockel KH, Scherag A, Bockisch A, Rekowski J, Huttmann A; PETAL Trial Investigators. Positron Emission Tomography-Guided Therapy of Aggressive Non-Hodgkin Lymphomas (PETAL): A Multicenter, Randomized Phase III Trial. J Clin Oncol. 2018 Jul 10;36(20):2024-2034. doi: 10.1200/JCO.2017.76.8093. Epub 2018 May 11.

Reference Type DERIVED
PMID: 29750632 (View on PubMed)

Huttmann A, Muller S, Jockel KH, Duhrsen U. Pitfalls of interim positron emission tomography scanning in diffuse large B-cell lymphoma. J Clin Oncol. 2010 Sep 20;28(27):e488-9; author reply e490-1. doi: 10.1200/JCO.2010.29.5428. Epub 2010 Jul 19. No abstract available.

Reference Type DERIVED
PMID: 20644097 (View on PubMed)

Duhrsen U, Huttmann A, Jockel KH, Muller S. Positron emission tomography guided therapy of aggressive non-Hodgkin lymphomas--the PETAL trial. Leuk Lymphoma. 2009 Nov;50(11):1757-60. doi: 10.3109/10428190903308031.

Reference Type DERIVED
PMID: 19863177 (View on PubMed)

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

EudraCT-Number 2006-001641-33

Identifier Type: -

Identifier Source: secondary_id

Krebshilfe Grant 107592

Identifier Type: -

Identifier Source: secondary_id

PETAL trial

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.

MPDL3280A-treatment-IST-UMCG
NCT02478099 ACTIVE_NOT_RECRUITING PHASE2
PET-CT in Lymphoma Among the Eldery
NCT07259941 NOT_YET_RECRUITING