Rituximab Augmentation Following R-CHOP Induction Chemotherapy in Extremely Elderly Patients With Diffuse Large B Cell Lymphoma
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Purpose
Rituximab (R) plus CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisolone) combination is considered as the new gold standard for the first-line treatment of elderly patients with diffuse large B-cell lymphoma (DLBCL).
The study is aimed to evaluate the overall response rate and the safety of four cycles of R-CHOP chemotherapy and followed by rituximab augmentation (weekly four times infusion) in newly diagnosed DLBCL patients with aged more than 70 years.
| Condition | Intervention | Phase |
|---|---|---|
|
Lymphoma, Large B-cell, Diffuse |
Drug: rituximab |
Phase 2 |
| Study Type: | Interventional |
| Study Design: | Endpoint Classification: Safety/Efficacy Study Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Phase II Trial of Rituximab (R) Augmentation Following R-CHOP (Cyclophosphamide, Doxorubicin, Vincristine, and Prednisolone) Induction Chemotherapy in Extremely Elderly Patients With Diffuse Large B Cell Lymphoma (DLBCL) |
- the overall response rate [ Time Frame: three years after the completion of rituximab augmentation ] [ Designated as safety issue: Yes ]To evaluate the objective overall response rate of four cycles of R-CHOP and followed by four times weekly rituximab augmentation in exteremely elderly patients with DLBCL.
- Number of patients with adverse events [ Time Frame: three years ] [ Designated as safety issue: Yes ]All patients will be evaluated for the toxicity during the treatment. Toxicity is graded according to the National Cancer Institute Common Toxicity Criteria (NCI-CTC v3.0).
- progression-free survival [ Time Frame: Three years after the completion of rituximab augmentation ] [ Designated as safety issue: Yes ]
| Estimated Enrollment: | 50 |
| Study Start Date: | August 2010 |
| Estimated Study Completion Date: | September 2014 |
| Estimated Primary Completion Date: | March 2012 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
| Experimental: rituximab |
Drug: rituximab
A dose of 375mg/m2 rituximab will be administered intravenously on day 1 of first to fourth R-CHOP chemotherapy and on day 1, 8, 15, 22 of each augmentation chemotherapy.
|
Detailed Description:
Four cycles of R-CHOP chemotherapy for the induction treatment [Dose intensity of CHOP chemotherapy is modulated according to Charlson Comorbidity Index (CCI)]
If patients with CCI <1
- Rituximab: 375 mg/m2, day 1 every 3 weeks.
- Conventional dose of CHOP chemotherapy repeat every 3 weeks.
If patients with CCI ≥1
- Rituximab: 375 mg/m2, day 1 every 3 weeks.
- 75% of conventional CHOP repeat every 3 weeks.
Rituximab augmentation
- Rituximab: 375 mg/m2, every week x 4 times.
- Trimethoprim-sulfamethoxazole 1 tablet per day during augmentation
Eligibility| Ages Eligible for Study: | 70 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Histologically confirmed CD20 positive DLBCL
- Age ≥ 70
- Ann Arbor stage II, III and IV
- No prior chemotherapy or radiotherapy for DLBCL
- Performance status (Eastern Cooperative Oncology Group) ≤ 2
At least one or more bidimensionally measurable lesion(s)
- ≥ 2 cm by conventional computerized tomography (CT)
- ≥ 1 cm by spiral CT
- skin lesion (photographs should be taken) ≥ 2 cm
- measurable lesion by physical examination ≥ 2 cm
- Cardiac ejection fraction ≥ 50% as measured by echocardiogram without clinically significant abnormalities
- Adequate renal function: serum creatinine level < 2 mg/dL (177 μmol/L)
- Adequate liver functions:
Adequate bone marrow functions:
hemoglobin ≥ 9 g/dL absolute neutrophil count ≥ 1,500/μL and platelet count ≥ 75,000/μL, unless abnormalities are due to bone marrow involvement by lymphoma
- Life expectancy more than 6 months
- Informed consent
Exclusion Criteria:
- Other subtypes of non-Hodgkin's lymphoma
- Patients who transformed follicular lymphoma or other indolent lymphoma
- Primary Central Nervous System (CNS) DLBCL
- CNS involvement by lymphoma or any evidence of spinal cord compression.
- Patients with a known history of human immunodeficiency virus (HIV) seropositivity or hepatitis C virus (+).
- Any other malignancies within the past 5 years except curatively treated non-melanoma skin cancer or in situ carcinoma of cervix uteri
- Pregnant or lactating women, women of childbearing potential not employing adequate contraception
- Other serious illness or medical conditions
Contacts and Locations| Contact: Deok-Hwan Yang, M.D. and Ph.D. | 82-61-379-7636 | drydh1685@gmail.com |
| Contact: Je-Jung Lee, M.D. and Ph.D. | 82-61-3797638 | drjejung@chonnam.ac.kr |
| Korea, Republic of | |
| Chonnam National University Hwasun Hosptial | Recruiting |
| Jeollanam-do, Korea, Republic of, 519-809 | |
| Contact: Deok-Hwan Yang, M.D. and Ph.D. 82-61-3797636 drydh1685@gmail.com | |
| Contact: So-Young Lee, Nurse 82-61-3768090 kaosin@naver.com | |
More Information
No publications provided
| Responsible Party: | Deok-Hwan Yang, Professor, Chonnam National University Hospital |
| ClinicalTrials.gov Identifier: | NCT01181999 History of Changes |
| Other Study ID Numbers: | ML25393 |
| Study First Received: | August 11, 2010 |
| Last Updated: | September 21, 2011 |
| Health Authority: | Korea:Korean Food and Drug Administration (KFDA) |
Keywords provided by Chonnam National University Hospital:
|
diffuse large B-cell lymphoma elderly patients rituximab augmentation |
Additional relevant MeSH terms:
|
Lymphoma Lymphoma, B-Cell Lymphoma, Large B-Cell, Diffuse Neoplasms by Histologic Type Neoplasms Lymphoproliferative Disorders Lymphatic Diseases Immunoproliferative Disorders Immune System Diseases |
Lymphoma, Non-Hodgkin Rituximab Immunologic Factors Physiological Effects of Drugs Pharmacologic Actions Antirheumatic Agents Therapeutic Uses Antineoplastic Agents |
ClinicalTrials.gov processed this record on May 23, 2013