R-ICE and High-Dose Cyclophosphamide With PET/CT for Diffuse Large B-Cell Non-Hodgkin's Lymphoma

NCT ID: NCT00809341

Last Updated: 2018-09-25

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

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Basic Information

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Recruitment Status

TERMINATED

Clinical Phase

PHASE2

Total Enrollment

27 participants

Study Classification

INTERVENTIONAL

Study Start Date

2009-01-31

Study Completion Date

2014-04-30

Brief Summary

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This research is being done to see if a PET scan that is obtained after 3 cycles of a standard chemotherapy regimen can help guide treatment for patients with a blood disease called Non-Hodgkin's Lymphoma.

The standard treatment for newly diagnosed lymphoma is 6 to 8 cycles of chemotherapy like the CHOP combination (Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone). This regimen can cure about half of patients with lymphoma, but in many others disease relapses (comes back). Relapses are generally treated with more chemotherapy.

We believe that a PET scan (a type of imaging study that "lights up" in areas of cells with high activity such as lymphoma), may identify patients early who are at high risk of relapse.

The purpose of this research study is to find out if people whose treatment is changed early to an intensification regimen (high dose chemotherapy) based on a positive PET scan will have longer remissions than they would if they did not receive that high dose chemotherapy.

Detailed Description

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Patients will receive 3 cycles of chemotherapy prior to mid-treatment PET-CT. Rituximab-CHOP, or an equivalent regimen must be used. During the third cycle of Rituximab-CHOP chemotherapy, a PET-CT scan will be performed. The PET scan will be designated as negative or positive. Based on the results, patients will either complete standard dose therapy or receive two cycles of R-ICE followed by high dose cyclophosphamide and rituximab.

A repeat PET-CT is required between 4 to 6 weeks following treatment completion. Patients will be followed-up every 4 months for 2 years, then every 6 months for one year, then annually until 5 years.

Conditions

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Non-Hodgkin's Lymphoma

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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PET Negative

R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone) or an equivalent anthracycline-containing regimen for 3 cycles, followed by PET scan. Participants with a negative PET scan will complete their chemotherapy regimen as prescribed by their oncologist.

Group Type ACTIVE_COMPARATOR

Rituximab

Intervention Type BIOLOGICAL

375 mg/m\^2 on Day 1 of each cycle as part of R-CHOP or R-ICE. Also given 375 mg/m\^2 on Days 1, 30, and 37 as part of HiCy.

Cyclophosphamide

Intervention Type DRUG

750 mg/m\^2 on Day 1 of each cycle as part of R-CHOP.

Doxorubicin

Intervention Type DRUG

50 mg/m\^2 on Day 1 of each cycle as part of R-CHOP.

Vincristine

Intervention Type DRUG

1.4 mg/m\^2 on Day 1 of each cycle as part of R-CHOP.

Prednisone

Intervention Type DRUG

100 mg/day on Days 1-5 of each cycle as part of R-CHOP.

PET scan

Intervention Type PROCEDURE

Performed once between Days 16-20 of cycle 3 of R-CHOP.

PET Positive

R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone) or an equivalent anthracycline-containing regimen for 3 cycles, followed by PET scan. Participants with a positive PET scan will receive two cycles of R-ICE (rituximab, ifosfamide, carboplatin, etoposide) followed by HiCy (high-dose cyclophosphamide).

Group Type ACTIVE_COMPARATOR

Rituximab

Intervention Type BIOLOGICAL

375 mg/m\^2 on Day 1 of each cycle as part of R-CHOP or R-ICE. Also given 375 mg/m\^2 on Days 1, 30, and 37 as part of HiCy.

Cyclophosphamide

Intervention Type DRUG

750 mg/m\^2 on Day 1 of each cycle as part of R-CHOP.

Doxorubicin

Intervention Type DRUG

50 mg/m\^2 on Day 1 of each cycle as part of R-CHOP.

Vincristine

Intervention Type DRUG

1.4 mg/m\^2 on Day 1 of each cycle as part of R-CHOP.

Prednisone

Intervention Type DRUG

100 mg/day on Days 1-5 of each cycle as part of R-CHOP.

Ifosfamide

Intervention Type DRUG

2000 mg/m\^2/day on Days 1-3 of each cycle as part of R-CHOP.

Carboplatin

Intervention Type DRUG

Given on Day 2 of each cycle as part of R-CHOP. Dosed according to renal function.

Etoposide

Intervention Type DRUG

100 mg/m\^2/day on Days 1-3 of each cycle as part of R-CHOP.

High-dose cyclophosphamide

Intervention Type DRUG

50 mg/kg/day on Days 2-5 of HiCy.

PET scan

Intervention Type PROCEDURE

Performed once between Days 16-20 of cycle 3 of R-CHOP.

Interventions

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Rituximab

375 mg/m\^2 on Day 1 of each cycle as part of R-CHOP or R-ICE. Also given 375 mg/m\^2 on Days 1, 30, and 37 as part of HiCy.

Intervention Type BIOLOGICAL

Cyclophosphamide

750 mg/m\^2 on Day 1 of each cycle as part of R-CHOP.

Intervention Type DRUG

Doxorubicin

50 mg/m\^2 on Day 1 of each cycle as part of R-CHOP.

Intervention Type DRUG

Vincristine

1.4 mg/m\^2 on Day 1 of each cycle as part of R-CHOP.

Intervention Type DRUG

Prednisone

100 mg/day on Days 1-5 of each cycle as part of R-CHOP.

Intervention Type DRUG

Ifosfamide

2000 mg/m\^2/day on Days 1-3 of each cycle as part of R-CHOP.

Intervention Type DRUG

Carboplatin

Given on Day 2 of each cycle as part of R-CHOP. Dosed according to renal function.

Intervention Type DRUG

Etoposide

100 mg/m\^2/day on Days 1-3 of each cycle as part of R-CHOP.

Intervention Type DRUG

High-dose cyclophosphamide

50 mg/kg/day on Days 2-5 of HiCy.

Intervention Type DRUG

PET scan

Performed once between Days 16-20 of cycle 3 of R-CHOP.

Intervention Type PROCEDURE

Other Intervention Names

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Rituxan Cytoxan Adriamycin Hydroxydaunorubicin Oncovin Ifex Paraplatin VP-16 HiCy FDG-PET

Eligibility Criteria

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Inclusion Criteria

* One of the following Biopsy-confirmed, aggressive non-Hodgkin's lymphoma

1. Diffuse large B-cell lymphoma
2. Mediastinal (thymic) B-cell lymphoma
* Any stage (I through IV) as defined by the Ann Arbor staging system
* ECOG performance status of 0 to 2
* Radiographically measurable disease
* No more than 3 cycles of chemotherapy for lymphoma
* Greater than or equal to 18 years
* Adequate pulmonary, cardiac, hepatic, or renal function
* HIV antibody negative
* Women- Not pregnant or breastfeeding
* Men of reproductive potential must agree to use contraception

Exclusion Criteria

* Patients with the following aggressive lymphomas are not eligible:

1. Mantle cell
2. Lymphoblastic
3. Burkitt's
4. Mycosis fungoides/Sezary's syndrome
5. HTLV-1 associated T-cell leukemia/lymphoma
6. Primary CNS lymphoma
7. HIV-associated lymphoma
8. Transformed lymphomas
9. Immunodeficiency-associated lymphomas
* Previous diagnosis of another hematologic malignancies
* Progressive disease on CHOP or Rituximab-CHOP
* Active CNS involvement by lymphoma
* Serious co-morbid disease that could preclude full participation in study
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Genentech, Inc.

INDUSTRY

Sponsor Role collaborator

Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Lode Swinnen, MD

Role: PRINCIPAL_INVESTIGATOR

Johns Hopkins University

Locations

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The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins

Baltimore, Maryland, United States

Site Status

Countries

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United States

Other Identifiers

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NA_00013656

Identifier Type: OTHER

Identifier Source: secondary_id

J0802

Identifier Type: OTHER

Identifier Source: secondary_id

J0802

Identifier Type: -

Identifier Source: org_study_id

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