Doxorubicin Pharmacokinetics and Response in Non Hodgkin's Lymphoma
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Purpose
In previous studies, the investigators found that in patients with Hodgkin's lymphoma (HL) treated with ABVD (adriamycin, bleomycin, vinblastine and decarbazine) the absence of alopecia may predict for a poor response to treatment [complete remission (CR) rate 79% versus 31%, P < 0.0005, respectively]. Also, patients without alopecia had fewer episodes of either leucopenia, neutropenia, deferral of treatment courses or number of courses with dose reduction [88% vs. 62.5%, P=0.05, for the presence of at least one of them].
One of the explanations for this phenomenon is related to a lower systemic exposure of chemotherapeutic drugs in patients who retain their hair. There is a wide interpatient variability in the pharmacokinetic and pharmacodynamic parameters of doxorubicin systemic exposure and the degree of myelosuppression.
In a pilot study on 18 patients the investigators could not find the previous association between alopecia, response to chemotherapy and bone marrow depression. However, when analyzing doxorubicin pharmacokinetics, patients who had no remission had 2 fold lower AUC (area under the curve) and 3 fold lower peaks (p=0.06). The investigators' lack to approve the previous findings might be explained by the small study group.
| Condition | Intervention | Phase |
|---|---|---|
|
Non-Hodgkin's Lymphoma |
Drug: Doxorubicin |
Phase 4 |
| Study Type: | Interventional |
| Study Design: | Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Association Between Response to Aggressive Chemotherapy and Doxorubicin Pharmacokinetics in Non Hodgkin's Lymphoma Patients |
- Doxorubicin, pharmacokinetics at first chemotherapy course [ Time Frame: 1 year ] [ Designated as safety issue: No ]
- Association between doxorubicin pharmacokinetics and response [ Time Frame: 1 year ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 30 |
| Study Start Date: | September 2009 |
| Estimated Study Completion Date: | December 2012 |
| Primary Completion Date: | December 2011 (Final data collection date for primary outcome measure) |
-
Drug: Doxorubicin
Aim of the study:
To evaluate the association between response to chemotherapy, the degree of myelosuppression and the pharmacokinetics of doxorubicin in non-Hodgkin's lymphoma (NHL) patients.
Methods:
Study protocol:
At diagnosis
Demographic and clinical parameters be collected (Appendix 1)
- At course 2:
1. Doxorubicin will be given by 5-7 minutes infusion before the other medications (Doxorubicin doses will be collected (Appendix 1))
2. Blood will be sampled in course 2, at:
0 minutes 30 minutes 120 minutes 24 hours
Two 2ml EDT tubes will be drawn at each time The tubes will be centrifuged at 3000 RPM for 15 min. Plasma samples will be stored in - 700C
3. At the end of chemotherapy courses the following data will be collected (Appendix 2):
- Episodes of bone marrow depression (leucopenia, neutropenia) Treatment delays Dose reductions Neutropenic fever
- Remission status
[Complete remission (CR) - disappearance of clinical signs and symptoms of NHL along with normal laboratory and radiological findings].
4. At the end of one year of CR
Remission status
Number of patients: 30
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Age ≥ 18 years
- Biopsy proven intermediate grade NHL
- No previous chemotherapy
- At least 4 courses of R-CHOP at maximal doses are planned
- An informed consent
Exclusion Criteria:
- Do not meet all inclusion criteria
Contacts and Locations| Contact: Avishay Elis, MD | 09-7472185 | avishayel@clalit.org.il |
| Israel | |
| Departmetn of Medicine. Meir Medical Center | Recruiting |
| Kfar-Saba, Israel, 44281 | |
| Contact: Avishay Elis, MD 09-7472185 avishayel@clalit.org.il | |
| Principal Investigator: Avishay Elis, MD | |
| Principal Investigator: | Avishay Elis, MD | Meir Medical Center |
More Information
No publications provided
| Responsible Party: | Meir Medical Center |
| ClinicalTrials.gov Identifier: | NCT00969462 History of Changes |
| Other Study ID Numbers: | 1. NHL, non |
| Study First Received: | August 17, 2009 |
| Last Updated: | March 15, 2012 |
| Health Authority: | Israel: non |
Keywords provided by Meir Medical Center:
|
Doxorubicin pharmacokinetics non-Hodgkin's lymphoma response |
association between response to chemotherapy myelosuppression degree doxorubicin pharmacokinetics |
Additional relevant MeSH terms:
|
Lymphoma Lymphoma, Non-Hodgkin Neoplasms by Histologic Type Neoplasms Lymphoproliferative Disorders Lymphatic Diseases Immunoproliferative Disorders |
Immune System Diseases Doxorubicin Antibiotics, Antineoplastic Antineoplastic Agents Therapeutic Uses Pharmacologic Actions |
ClinicalTrials.gov processed this record on May 19, 2013