CHOEP + High Dose Therapy + Auto SCT for T-Cell Lymphoma
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Purpose
This is a phase II study of CHOEP induction chemotherapy followed by autologous stem cell transplant using gemcitabine/busulfan/melphalan conditioning in patients with newly diagnosed systemic T-cell non-Hodgkin lymphoma.
| Condition | Intervention | Phase |
|---|---|---|
|
T-cell Non-Hodgkin Lymphoma |
Drug: Cyclophosphamide Drug: Doxorubicin Drug: Vincristine Drug: Etoposide Drug: Prednisone Drug: Filgrastim Drug: Plerixafor Procedure: Stem Cell Collection Drug: Palifermin Drug: Gemcitabine Drug: Busulfan Drug: Melphalan Procedure: Stem Cell Transplant |
Phase 2 |
| Study Type: | Interventional |
| Study Design: | Endpoint Classification: Efficacy Study Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | A Phase II Study of CHOEP Induction Followed by Gemcitabine/Busulfan/Melphalan Autologous Stem Cell Transplantation for Patients With Newly Diagnosed T-Cell Lymphoma |
- 24 month progression-free survival [ Time Frame: 2 years ] [ Designated as safety issue: No ]To estimate the proportion of patients alive and progression-free after 24 months after the beginning of CHOEP + Gem/Bu/Mel HDT/ASCT among patients younger than 70 years old with untreated TCL
- Response rate [ Time Frame: 2 years ] [ Designated as safety issue: No ]To estimate the response rate (completed remission [CR] and partial remission [PR]) after CHOEP x 6 and after Gem/Bu/Mel ASCT
- Overall survival [ Time Frame: 2 years ] [ Designated as safety issue: No ]Overall survival of patients at 2 years
- Grade 3 and above toxicity related to study regimen [ Time Frame: 2 years ] [ Designated as safety issue: Yes ]To estimate the toxicity (grade 3 and above) with this regimen using CTCAE v4.0. All grade 3 and above adverse events, and all serious adverse events will be recorded. This will be reported as number of events and as number of patients with events for all events of interest.
- Stem cell mobilization rate [ Time Frame: 6 months ] [ Designated as safety issue: No ]To estimate the rate of successful stem cell mobilization after CHOEP in responding patients.
- Proportion of patients who successfully complete regimen [ Time Frame: 2 years ] [ Designated as safety issue: No ]To estimate the proportion of patients who can successfully complete the entire treatment regimen
- Engraftment time [ Time Frame: 6 months ] [ Designated as safety issue: No ]To estimate the time to engraftment of neutrophil and platelet engraftment after ASCT
- Relapse [ Time Frame: 2 years ] [ Designated as safety issue: No ]To estimate the cumulative incidence of relapse at 24 months
- Treatment-related mortality [ Time Frame: 2 years ] [ Designated as safety issue: Yes ]To estimate the cumulative incidence of treatment-related mortality at 24 months
| Estimated Enrollment: | 24 |
| Study Start Date: | February 2013 |
| Estimated Study Completion Date: | September 2016 |
| Estimated Primary Completion Date: | February 2015 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Experimental Arm
Induction chemotherapy: Cyclophosphamide, Doxorubicin, Vincristine, Etoposide and Prednisone Stem Cell Mobilization/Harvest: filgrastim +/- plerixafor Stem Cell Collection by leukapheresis Conditioning Chemotherapy: gemcitabine, busulfan, melphalan, with palifermin support Autologous stem cell transplantation
|
Drug: Cyclophosphamide
Intravenous, on Day 1, 3 or 6 cycles
Other Name: cytoxan
Drug: Doxorubicin
Intravenously, on Day 1, 3 or 6 cycles
Other Name: adriamycin
Drug: Vincristine
Intravenously, on Day 1, 3 or 6 cycles
Other Name: oncovin
Drug: Etoposide
Intravenously or orally, Day 1,2 and 3, 3 or 6 cycles
Drug: Prednisone
Taken orally, days 1-5
Drug: Filgrastim
Subcutaneous daily injection for 5-7 days
Other Names:
Drug: Plerixafor
daily subcutaneous injections for 0-2 days
Other Name: mozobil
Procedure: Stem Cell Collection
Leukapheresis used to collect stem cells from peripheral blood
Other Name: Leukapheresis
Drug: Palifermin
Daily intravenous infusion
Other Names:
Drug: Gemcitabine
intravenous infusion for 2 days
Other Name: gemzaar
Drug: Busulfan
intravenous infusion for 4 days
Other Name: busulfex
Drug: Melphalan
intravenous infusion for 2 days
Procedure: Stem Cell Transplant
Reinfusion of stored peripheral blood stem cells
Other Name: Stem Cell Infusion
|
Detailed Description:
This is a phase II study of CHOEP (cyclophosphamide, doxorubicin, vincristine, etoposide and prednisone)induction chemotherapy followed by autologous stem cell transplant using gemcitabine/busulfan/melphalan conditioning in patients with newly diagnosed systemic T-cell non-Hodgkin lymphoma. The study treatment comprises 6 cycles of CHOEP, followed (for responding patients) by stem cell mobilization and harvesting (using neupogen +/- plerixafor) followed by high dose therapy and autologous stem cell transplantation,
Eligibility| Ages Eligible for Study: | 18 Years to 70 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Diagnosis of T-Cell lymphoma with mandatory pathologic review at Brigham and Women's Hospital or Massachusetts General Hospital
- Measurable disease
- Candidate for Autologous Stem Cell Transplant
Exclusion Criteria:
- Prior anti-lymphoma chemotherapy (except steroids/radiotherapy for urgent palliation, one prior cycle of CHOP or up to 2 prior cycles of CHOEP)
- Pregnant or breastfeeding
- Alk-positive ACL
- Significant neuropathy precluding vincristine administration
- Known hypersensitivity to any of the agents used in the treatment
- Uncontrolled intercurrent illness
- Receiving other investigational agents
- History of a different malignancy except if disease free for at least 5 years or have cervical cancer in situ or basal cell/squamous cell carcinoma of the skin
- HIV positive on anti-retroviral therapy
Contacts and Locations| Contact: Philippe Armand, MD | 6176322305 | parmand@partners.org |
| United States, Massachusetts | |
| Dana-Farber Cancer Institute | Recruiting |
| Boston, Massachusetts, United States, 02215 | |
| Contact: Philippe Armand, MD 617-632-2305 parmand@partners.org | |
| Principal Investigator: Philippe Armand, MD | |
| Brigham and Women's Hospital | Recruiting |
| Boston, Massachusetts, United States, 02215 | |
| Contact: Philippe Armand, MD 617-632-2305 parmand@partners.org | |
| Principal Investigator: Philippe Armand, MD | |
| Principal Investigator: | Philippe Armand, MD | Dana-Farber Cancer Institute |
More Information
No publications provided
| Responsible Party: | Philippe Armand, MD, PhD, Principal Investigator, Dana-Farber Cancer Institute |
| ClinicalTrials.gov Identifier: | NCT01746173 History of Changes |
| Other Study ID Numbers: | 12-388 |
| Study First Received: | December 4, 2012 |
| Last Updated: | February 26, 2013 |
| Health Authority: | United States: Food and Drug Administration |
Keywords provided by Dana-Farber Cancer Institute:
|
T Cell lymphoma |
Additional relevant MeSH terms:
|
Lymphoma Lymphoma, Non-Hodgkin Lymphoma, T-Cell Neoplasms by Histologic Type Neoplasms Lymphoproliferative Disorders Lymphatic Diseases Immunoproliferative Disorders Immune System Diseases Busulfan Cyclophosphamide Melphalan Gemcitabine Etoposide phosphate Doxorubicin |
Etoposide Prednisone Vincristine Lenograstim JM 3100 Immunosuppressive Agents Immunologic Factors Physiological Effects of Drugs Pharmacologic Actions Antineoplastic Agents, Alkylating Alkylating Agents Molecular Mechanisms of Pharmacological Action Antineoplastic Agents Therapeutic Uses Myeloablative Agonists |
ClinicalTrials.gov processed this record on May 19, 2013