Pegfilgrastim and Combination Chemotherapy With or Without Rituximab in Treating Older Patients With Aggressive B-Cell Non-Hodgkin Lymphoma

NCT ID: NCT00726700

Last Updated: 2021-07-07

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

109 participants

Study Classification

INTERVENTIONAL

Study Start Date

2004-05-31

Study Completion Date

2012-02-29

Brief Summary

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RATIONALE: Drugs used in chemotherapy, such as cyclophosphamide, doxorubicin, and vincristine, work in different ways to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Colony-stimulating factors, such as pegfilgrastim, may increase the number of immune cells found in bone marrow or peripheral blood and may help the immune system recover from the side effects of chemotherapy. Monoclonal antibodies, such as rituximab, can block cancer growth in different ways. Some find cancer cells and kill them or carry cancer-killing substances to them. Others interfere with the ability of cancer cells to grow and spread. It is not yet known whether combination chemotherapy and pegfilgrastim is more effective when given with or without rituximab in treating non-Hodgkin lymphoma.

PURPOSE: This phase II trial is studying the side effects of giving pegfilgrastim and combination chemotherapy together with or without rituximab and to see how well it works in treating older patients with aggressive B-cell non-Hodgkin lymphoma.

Detailed Description

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OBJECTIVES:

* Determine the side effects of pegfilgrastim and cyclophosphamide, doxorubicin hydrochloride, vincristine, and prednisone (CHOP) with or without rituximab in older patients with aggressive B-cell non-Hodgkin lymphoma.
* Determine adherence to therapy regimens in these patients.
* Determine antitumor effectivity of immunochemotherapy.

OUTLINE: This is a multicenter study.

All patients receive prephase treatment comprising vincristine on day -6 and prednisone on days -6 to 0. Patients are then randomized to 1 of 2 treatment arms.

* Arm I (without rituximab): Patients receive pegfilgrastim subcutaneously (SC) on day 2 or 4 and CHOP comprising cyclophosphamide IV, doxorubicin hydrochloride IV, and vincristine IV on day 1, and oral prednisone on days 1-5. Treatment repeats every 2 weeks for up to 6-8 courses in the absence of disease progression or unacceptable toxicity.
* Arm II (with rituximab): Patients receive pegfilgrastim and CHOP for up to 6-8 courses as in arm I. They also receive rituximab (administered 2 hours before beginning CHOP) on day 1. Treatment with rituximab repeats every 2 weeks for up to 8 courses.

Patients with bulky disease or extranodal disease also undergo radiotherapy.

Conditions

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Lymphoma

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Study Groups

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Arm I (without rituximab)

Patients receive pegfilgrastim subcutaneously (SC) on day 2 or 4 and CHOP comprising cyclophosphamide IV, doxorubicin IV, vincristine IV on day 1, and oral prednisone on days 1-5. Treatment repeats every 2 weeks for up to 6-8 courses in the absence of disease progression or unacceptable toxicity.

Group Type ACTIVE_COMPARATOR

pegfilgrastim

Intervention Type BIOLOGICAL

Given subcutaneously

cyclophosphamide

Intervention Type DRUG

Given IV

doxorubicin hydrochloride

Intervention Type DRUG

Given IV

prednisone

Intervention Type DRUG

Given orally

vincristine sulfate

Intervention Type DRUG

Given IV

Arm II (with rituximab)

Patients receive pegfilgrastim and CHOP for up to 6-8 courses as in arm I. They also receive rituximab (administered 2 hours before beginning CHOP) on day 1. Treatment with rituximab repeats every 2 weeks for up to 8 courses.

Group Type EXPERIMENTAL

pegfilgrastim

Intervention Type BIOLOGICAL

Given subcutaneously

rituximab

Intervention Type BIOLOGICAL

Given IV

cyclophosphamide

Intervention Type DRUG

Given IV

doxorubicin hydrochloride

Intervention Type DRUG

Given IV

prednisone

Intervention Type DRUG

Given orally

vincristine sulfate

Intervention Type DRUG

Given IV

Interventions

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pegfilgrastim

Given subcutaneously

Intervention Type BIOLOGICAL

rituximab

Given IV

Intervention Type BIOLOGICAL

cyclophosphamide

Given IV

Intervention Type DRUG

doxorubicin hydrochloride

Given IV

Intervention Type DRUG

prednisone

Given orally

Intervention Type DRUG

vincristine sulfate

Given IV

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

DISEASE CHARACTERISTICS:

* Diagnosis of CD20-positive B-cell non-Hodgkin lymphoma (NHL)

* Confirmed by an excisional biopsy of a lymph node or by a sufficiently extensive biopsy of an extranodal involvement (if there is no lymph node involvement)
* Results of the immunohistological analysis of expression of the CD20 antigen by lymphoma cells must be obtained
* Aggressive disease, including any of the following B-cell NHL

* Stage III follicular lymphoma
* Stage III follicular lymphoma and diffuse B-cell lymphoma
* Lymphoblastic precursor B-cell lymphoma
* Diffuse large B-cell lymphoma, including any of the following subtypes:

* Centroblastic
* Immunoblastic
* Plasmablastic
* Anaplastic large cell
* T-cell rich B-cell lymphoma
* Primary effusion lymphoma
* Intravasal B-cell lymphoma
* Primary mediastinal B-cell lymphoma
* Mantle zone lymphoma
* Burkitt or Burkitt-like lymphoma
* Aggressive marginal zone lymphoma (monocytoid)
* All risk group allowed

* Age adjusted IPI 0-3
* Previously untreated disease

PATIENT CHARACTERISTICS:

* ECOG performance status (PS) 0-2 OR Karnofsky PS 60-100%
* No other serious concurrent diseases

PRIOR CONCURRENT THERAPY:

* See Disease Characteristics
Minimum Eligible Age

61 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Universität des Saarlandes

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Frank Hartmann, MD

Role: STUDY_CHAIR

Universitaetsklinikum des Saarlandes

References

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Zwick C, Hartmann F, Zeynalova S, Poschel V, Nickenig C, Reiser M, Lengfelder E, Peter N, Schlimok G, Schubert J, Schmitz N, Loeffler M, Pfreundschuh M; German High-Grade Non-Hodgkin Lymphoma Study Group. Randomized comparison of pegfilgrastim day 4 versus day 2 for the prevention of chemotherapy-induced leukocytopenia. Ann Oncol. 2011 Aug;22(8):1872-7. doi: 10.1093/annonc/mdq674. Epub 2011 Feb 3.

Reference Type BACKGROUND
PMID: 21292644 (View on PubMed)

Muller C, Murawski N, Wiesen MH, Held G, Poeschel V, Zeynalova S, Wenger M, Nickenig C, Peter N, Lengfelder E, Metzner B, Rixecker T, Zwick C, Pfreundschuh M, Reiser M. The role of sex and weight on rituximab clearance and serum elimination half-life in elderly patients with DLBCL. Blood. 2012 Apr 5;119(14):3276-84. doi: 10.1182/blood-2011-09-380949. Epub 2012 Feb 15.

Reference Type DERIVED
PMID: 22337718 (View on PubMed)

Related Links

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Other Identifiers

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CDR0000454473

Identifier Type: REGISTRY

Identifier Source: secondary_id

EU-20534

Identifier Type: -

Identifier Source: secondary_id

DSHNHL-2003-2

Identifier Type: -

Identifier Source: org_study_id

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