Trial of R-GemOx Versus R-miniCHOP Regimen in First-line Treatment of Elderly Diffuse Large B Cell Lymphoma

NCT ID: NCT02767674

Last Updated: 2019-01-03

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

UNKNOWN

Clinical Phase

PHASE3

Total Enrollment

258 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-05-31

Study Completion Date

2020-12-31

Brief Summary

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The purpose of this study is to investigate efficacy and safety of R-GemOx Versus R-miniCHOP as first-line treatment of elderly patients with Diffuse large B cell lymphoma

Detailed Description

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Gemcitabine and Oxaliplatin(GemOx) shows effective activity in patients with relapsed diffuse large-cell lymphoma and other solid tumors. Our Previous study showed that two-weekly regimen of rituximab combined with GemOx regimen acheived comparable response rate to R-miniCHOP.The investigators therefore design this open-label,phase III and random trial to compared the safety and efficacy of R-Gemox versus R-miniCHOP as first-line treatment of elderly patients with diffuse large B cell lymphoma.

Primary Outcome Measures:

• 2-year overall survival rate

Secondary Outcome Measures:

* 2-year progression free survival rate
* overall response rate
* safety and toxicity Enrollment:258 Study Start Date: June 2016 Primary Completion Date: June 2019

Conditions

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Diffuse Large B Cell Lymphoma

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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R-GemOx

Rituximab: 375 mg/m2 IV day0, Gemcitabine 1g/m2 IV day 1, oxaliplatin 100mg/m2 IV day1(every 14 days)

Group Type EXPERIMENTAL

Rituximab

Intervention Type DRUG

375 mg/m2 IVD day0

Gemcitabine

Intervention Type DRUG

Gemcitabine 1 g/m2 IVD day 1

Oxaliplatin

Intervention Type DRUG

Oxaliplatin 100 mg/m2 IVD day1

R-miniCHOP

Rituximab, 375 mg/m2 IV d0 Cyclophosphamide 400 mg/m2 IV d1 Epirubicin 35 mg/m2 IV d1 vindesine 2 mg IVP d1 Prednisone 40mg/m2 PO d1-5(every 21 days a cycle)

Group Type ACTIVE_COMPARATOR

Rituximab

Intervention Type DRUG

375 mg/m2 IVD day0

Cyclophosphamide

Intervention Type DRUG

Cyclophosphamide 400 mg/m2 IVD d1

Epirubicin Injectable Product

Intervention Type DRUG

Epirubicin 35 mg/m2 IVD d1

Vindesine

Intervention Type DRUG

Vindesine 2 mg IVP d1

Prednisone

Intervention Type DRUG

Prednisone 40mg/m2 PO d1-5

Interventions

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Rituximab

375 mg/m2 IVD day0

Intervention Type DRUG

Gemcitabine

Gemcitabine 1 g/m2 IVD day 1

Intervention Type DRUG

Oxaliplatin

Oxaliplatin 100 mg/m2 IVD day1

Intervention Type DRUG

Cyclophosphamide

Cyclophosphamide 400 mg/m2 IVD d1

Intervention Type DRUG

Epirubicin Injectable Product

Epirubicin 35 mg/m2 IVD d1

Intervention Type DRUG

Vindesine

Vindesine 2 mg IVP d1

Intervention Type DRUG

Prednisone

Prednisone 40mg/m2 PO d1-5

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

1. Histologically confirmed diffuse large B cell lymphoma(With exception of Primary mediastinal large B cell lymphoma、Primary central nervous system lymphoma、HIV-related lymphoma);
2. New-diagnosed and untreated;
3. Age older than 80 years or older than 70 years with ECOG PS ≥ 2;
4. Ann Arbor stage I to stage IV disease;
5. Understand and voluntarily sign an informed consent form, able to adhere to the study visit schedule and other protocol requirements.

Exclusion Criteria

1. Poor hepatic and/or renal function, defined as total bilirubin, ALT, AST, Cr more than two fold of upper normal level, unless these abnormalities were related to the lymphoma;
2. Poor bone-marrow reserve, defined as neutrophil count less than 1.5×10⁹/L or platelet count less than 75×10⁹/L, unless caused by bone marrow infiltration;
3. Presence of Grade III nervous toxicity with two weeks;
4. New York Heart Association class III or IV cardiac failure; or Ejection fraction less than 50%;or history of following disease in past 6 months: acute coronary syndrome、acute heart failure、severe ventricular arrhythmia
5. Positive HIV, syphilis,HCV, or HBV virus load(HBV DNA)\> 1×10'4copies/ml;
6. CNS or meningeal involvement;
7. Concomitant malignancy other than aggressive B cell lymphoma and need to Treat, with the exception of non-melanoma skin tumours or stage 0 (in situ) cervical carcinoma,or history of cancer more than 5 years;
8. Concomitant with other hematologic diseases(such as leukemia, hemophilia primary myelofibrosis) which investigator it unsuitable to be enrolled into this clinical trial;
9. Active and severe infectious diseases;
10. Major surgery within three weeks;
11. Any potential drug abuse, medical, psychological or social conditions which may disturb this investigation and assessment.
12. In any conditions which investigator considered ineligible for this study.
13. Known sensitivity or allergy to investigational Product.
Minimum Eligible Age

70 Years

Maximum Eligible Age

90 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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The First Affiliated Hospital with Nanjing Medical University

OTHER

Sponsor Role lead

Responsible Party

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WEI XU

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Wei Xu, M.D., Ph.D.

Role: PRINCIPAL_INVESTIGATOR

The first Affiliated Hospital Of Nanjing Medical University(JiangSu Province Hospital)

Locations

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Tongji Medical College of HUST

Wuhan, Hubei, China

Site Status RECRUITING

The first Affiliated Hospital Of Nanjing Medical University(JiangSu Province Hospital)

Nanjing, Jiangsu, China

Site Status RECRUITING

QiLu Hospital of Shandong University

Jinan, Shandong, China

Site Status RECRUITING

Shandong Province Hospital

Jinan, Shandong, China

Site Status RECRUITING

Rui Jin Hospital Shanghai Jiao Tong University School of Medicine

Shanghai, Shanghai Municipality, China

Site Status RECRUITING

Sudan University Shanghai Cancer Center

Shanghai, Shanghai Municipality, China

Site Status RECRUITING

Countries

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China

Central Contacts

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Huayuan Zhu, M.D., Ph.D.

Role: CONTACT

+86 68136034

Wei Xu, M.D., Ph.D.

Role: CONTACT

+86 68136034

Facility Contacts

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Jianfeng Zou

Role: primary

Huayuan Zhu, M.D., Ph.D.

Role: primary

+86 68136034

Luqun Wang, M.D., Ph.D.

Role: primary

Xin Wang, M.D., Ph.D.

Role: primary

Weili Zhao, M.D., Ph.D.

Role: primary

Ye Guo, M.D., Ph.D.

Role: primary

References

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Coiffier B, Lepage E, Briere J, Herbrecht R, Tilly H, Bouabdallah R, Morel P, Van Den Neste E, Salles G, Gaulard P, Reyes F, Lederlin P, Gisselbrecht C. CHOP chemotherapy plus rituximab compared with CHOP alone in elderly patients with diffuse large-B-cell lymphoma. N Engl J Med. 2002 Jan 24;346(4):235-42. doi: 10.1056/NEJMoa011795.

Reference Type RESULT
PMID: 11807147 (View on PubMed)

Oyama T, Yamamoto K, Asano N, Oshiro A, Suzuki R, Kagami Y, Morishima Y, Takeuchi K, Izumo T, Mori S, Ohshima K, Suzumiya J, Nakamura N, Abe M, Ichimura K, Sato Y, Yoshino T, Naoe T, Shimoyama Y, Kamiya Y, Kinoshita T, Nakamura S. Age-related EBV-associated B-cell lymphoproliferative disorders constitute a distinct clinicopathologic group: a study of 96 patients. Clin Cancer Res. 2007 Sep 1;13(17):5124-32. doi: 10.1158/1078-0432.CCR-06-2823.

Reference Type RESULT
PMID: 17785567 (View on PubMed)

Peyrade F, Jardin F, Thieblemont C, Thyss A, Emile JF, Castaigne S, Coiffier B, Haioun C, Bologna S, Fitoussi O, Lepeu G, Fruchart C, Bordessoule D, Blanc M, Delarue R, Janvier M, Salles B, Andre M, Fournier M, Gaulard P, Tilly H; Groupe d'Etude des Lymphomes de l'Adulte (GELA) investigators. Attenuated immunochemotherapy regimen (R-miniCHOP) in elderly patients older than 80 years with diffuse large B-cell lymphoma: a multicentre, single-arm, phase 2 trial. Lancet Oncol. 2011 May;12(5):460-8. doi: 10.1016/S1470-2045(11)70069-9. Epub 2011 Apr 7.

Reference Type RESULT
PMID: 21482186 (View on PubMed)

Lopez A, Gutierrez A, Palacios A, Blancas I, Navarrete M, Morey M, Perello A, Alarcon J, Martinez J, Rodriguez J. GEMOX-R regimen is a highly effective salvage regimen in patients with refractory/relapsing diffuse large-cell lymphoma: a phase II study. Eur J Haematol. 2008 Feb;80(2):127-32. doi: 10.1111/j.1600-0609.2007.00996.x. Epub 2007 Nov 20.

Reference Type RESULT
PMID: 18005385 (View on PubMed)

Cabanillas F. Rituximab in DLBCL: 6 years on. Lancet Oncol. 2011 Oct;12(11):984-5. doi: 10.1016/S1470-2045(11)70251-0. Epub 2011 Sep 21. No abstract available.

Reference Type RESULT
PMID: 21940215 (View on PubMed)

Park S, Lee J, Ko YH, Han A, Jun HJ, Lee SC, Hwang IG, Park YH, Ahn JS, Jung CW, Kim K, Ahn YC, Kang WK, Park K, Kim WS. The impact of Epstein-Barr virus status on clinical outcome in diffuse large B-cell lymphoma. Blood. 2007 Aug 1;110(3):972-8. doi: 10.1182/blood-2007-01-067769. Epub 2007 Mar 30.

Reference Type RESULT
PMID: 17400912 (View on PubMed)

Other Identifiers

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JSPH-002

Identifier Type: -

Identifier Source: org_study_id

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