Outpatient Administration of R-DHAP in Relapsed/Refractory Non-Hodgkin Lymphoma

NCT ID: NCT03892421

Last Updated: 2021-05-18

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

PHASE1/PHASE2

Total Enrollment

22 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-04-05

Study Completion Date

2021-04-30

Brief Summary

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The goal of this study is to evaluate the efficacy and safety of a combination of the anti-CD20 monoclonal antibody Rituximab, Dexamethasone, daily high dose Cytarabine twice, and Carboplatin; delivered in an outpatient setting.

Detailed Description

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The R-DHAP (Rituximab, Dexamethasone, Cytarabine, and Cisplatin) schedule includes high-dose cytarabine every 12 hours and requires careful monitoring of renal toxicity because of cisplatin. These conditions limit the use of this protocol in an outpatient setting.

The S phase of lymphoma cells is longer than 12 hours, then cytarabine can be used daily without reduction of the antineoplastic effect. Carboplatin does not have remarkable renal toxicity so is not necessary to monitor blood chemistry or IV fluids during its administration.

The study hypothesis is that modifications to the original R-DHAP protocol, using cytarabine on a daily basis and the substitution of cisplatin by carboplatin can preserve the efficacy, reducing the incidence of renal events. The investigators hypothesize that those modifications can make the schedule more suitable for an outpatient administration in relapsed or refractory non-Hodgkin lymphoma patients.

After 3 cycles of chemotherapy, the overall response and the incidence of adverse events will be evaluated.

In order to achieve the purpose of this trial, 130 participants will be included.

Conditions

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Relapsed Non Hodgkin Lymphoma Refractory Non-Hodgkin Lymphoma

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Modified DHAP

Rituximab 375 mg/m² day 1, i.v. Carboplatin AUC(Area Under Curve) 5 day 1, i.v. Cytarabine 2000 mg/m², on day 2 and 3, i.v. Dexamethasone 40 mg, days 1-4, i.v. Filgrastim 300 mcg, days 10-15, s.c.

Group Type EXPERIMENTAL

Rituximab

Intervention Type DRUG

Rituximab 375 mg/m²

Carboplatin

Intervention Type DRUG

Carboplatin AUC5

Cytarabine Injection

Intervention Type DRUG

Cytarabine 2000 mg/m² qd 2 days

Dexamethasone

Intervention Type DRUG

Dexamethasone 40 mg

Filgrastim 0.3 MG/ML

Intervention Type DRUG

One subcutaneous injection daily for 5 days

Interventions

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Rituximab

Rituximab 375 mg/m²

Intervention Type DRUG

Carboplatin

Carboplatin AUC5

Intervention Type DRUG

Cytarabine Injection

Cytarabine 2000 mg/m² qd 2 days

Intervention Type DRUG

Dexamethasone

Dexamethasone 40 mg

Intervention Type DRUG

Filgrastim 0.3 MG/ML

One subcutaneous injection daily for 5 days

Intervention Type DRUG

Other Intervention Names

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MabThera Neupogen

Eligibility Criteria

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Inclusion Criteria

* Diagnosis of recurrent or refractory B-cell non-Hodgkin lymphoma
* Performance status: Eastern Cooperative Oncology Group 0-2
* At least three weeks from last chemotherapy
* Toxicities by Common Terminology Criteria Version 4.0 ≤ 1
* Glomerular filtration rate \>50 ml/min
* Women of childbearing potential must use effective methods of contraception

Exclusion Criteria

* Post-transplant relapse of lymphoma
* Central nervous system involvement of lymphoma
* Serious infections
* Known allergies to one or more of the experimental drugs
* Diabetes with glucose \>200 mg/dl
* Pregnant or lactating females
* Known HIV or B Hepatitis positivity
* Known allergies to filgrastim
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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La Raza Medical Center

OTHER

Sponsor Role lead

Responsible Party

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Alvaro Hernandez Caballero MD MS

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Study Officials H Caballero, MD Ms

Role: PRINCIPAL_INVESTIGATOR

Hematology Department La Raza Medical Center

Locations

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Hospital Especialidades Centro Medico La Raza

Mexico City, Azcapotzalco, Mexico

Site Status

Countries

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Mexico

References

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Velasquez WS, Cabanillas F, Salvador P, McLaughlin P, Fridrik M, Tucker S, Jagannath S, Hagemeister FB, Redman JR, Swan F, et al. Effective salvage therapy for lymphoma with cisplatin in combination with high-dose Ara-C and dexamethasone (DHAP). Blood. 1988 Jan;71(1):117-22.

Reference Type BACKGROUND
PMID: 3334893 (View on PubMed)

Momparler RL. Optimization of cytarabine (ARA-C) therapy for acute myeloid leukemia. Exp Hematol Oncol. 2013 Aug 6;2:20. doi: 10.1186/2162-3619-2-20. eCollection 2013.

Reference Type BACKGROUND
PMID: 23919448 (View on PubMed)

Yanik G, Yousuf N, Miller MA, Swerdlow SH, Lampkin B, Raza A. In vivo determination of cell cycle kinetics of non-Hodgkin's lymphomas using iododeoxyuridine and bromodeoxyuridine. J Histochem Cytochem. 1992 May;40(5):723-8. doi: 10.1177/40.5.1573252.

Reference Type BACKGROUND
PMID: 1573252 (View on PubMed)

Sandlund JT, Santana VM, Hudson MM, Onciu M, Head D, Murry DJ, Ribeiro R, Wallace D, Rencher R, Pui CH. Combination of dexamethasone, high-dose cytarabine, and carboplatin is effective for advanced large-cell non-Hodgkin lymphoma of childhood. Cancer. 2008 Aug 15;113(4):782-90. doi: 10.1002/cncr.23630.

Reference Type BACKGROUND
PMID: 18618501 (View on PubMed)

Other Identifiers

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R-2018-3501-014

Identifier Type: -

Identifier Source: org_study_id

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