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R-CHOP Alone vs. R-CHOP Plus Radiotherapy for Localized CD20+ DLBCL (ASPIRE)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT02054559
Recruitment Status : Withdrawn (No consensus among trial centers regarding protocol)
First Posted : February 4, 2014
Last Update Posted : February 23, 2016
Information provided by (Responsible Party):
Cheolwon Suh, Asan Medical Center

Brief Summary:
To compare the efficacy and safety of chemotherapy alone and combined modality therapy in the treatment of localized CD20 (+) diffuse large B-cell lymphoma

Condition or disease Intervention/treatment Phase
Diffuse Large B-cell Lymphoma Drug: R-CHOP Radiation: Radiotherapy Phase 3

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 0 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Randomized Phase III Trial Comparing R-CHOP Alone and R-CHOP Plus Radiotherapy for Localized CD20+ Diffuse Large B-cell Lymphoma (DLBCL)
Estimated Primary Completion Date : January 2020
Estimated Study Completion Date : January 2020

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Lymphoma

Arm Intervention/treatment
Active Comparator: Total 6 cycles of R-CHOP Drug: R-CHOP
R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone (or prednisolone))

Experimental: Total 3 cycles of R-CHOP + RT
Total 3 cycles of R-CHOP followed by radiotherapy (involved field or involved site radiotherapy, 30-50 Gy/ 15-25 fractions)
Drug: R-CHOP
R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone (or prednisolone))

Radiation: Radiotherapy

Primary Outcome Measures :
  1. To compare 3-year event-free survival [ Time Frame: 3 years ]
    definition of events: failure to achieve CR after completion of planned 1st-line treatment, progression of disease, relapse, institution of a new anticancer treatment or any cause of death) rate in patients with CD20 (+) diffuse large B-cell lymphoma treated with either R-CHOP chemotherapy alone or R-CHOP plus radiotherapy

Secondary Outcome Measures :
  1. To evaluate and compare OS between the two arms [ Time Frame: 3 years ]
  2. To evaluate and compare the ORR and CR rate [ Time Frame: after completion of treatment ]
  3. To evaluate and compare disease-free survival (DFS) [ Time Frame: 3 years ]
  4. To evaluate treatment-failure pattern [ Time Frame: 3 years ]
  5. Number of Participants with Adverse Events in each arm [ Time Frame: 3 years ]
  6. To assess patient-reported outcomes (PROs) in both arms [ Time Frame: 3 years ]
  7. A role of interim PET after 3 cycles of R-CHOP chemotherapy: correlation with PFS and OS [ Time Frame: 3 years ]

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Written informed consent
  • Histologically confirmed CD20-positive Diffuse Large B-cell Lymphoma (DLBCL), NOS
  • Immunostains for CD20, CD5, CD3, CD10, MUM-1, BCL-6, BCL-2 and Ki-67 and the in situ hybridization for Epstein-Barr virus are recommended for diagnosis of DLBCL, NOS.
  • No prior treatment for DLBCL
  • Stage I or contiguous II disease (Involvement of two adjacent lymph node regions or organ involvement with regional lymph nodes)
  • Performance status: ECOG 0-2.
  • Age ≥ 18 years
  • Cardiac ejection fraction ≥ 45% as measured by MUGA or 2D ECHO without clinically significant abnormalities
  • Adequate renal function: serum creatinine level < 2 mg/dL
  • Adequate liver functions
  • Adequate hematological function: hemoglobin ≥ 9.0 g/dL absolute neutrophil count (ANC) ≥ 1,500/μL and platelet count ≥ 75,000/μL, unless abnormalities are due to bone marrow involvement by lymphoma
  • Life expectancy >= 6 months
  • A negative serum or urine pregnancy test prior to treatment must be available both for pre menopausal women and for women who are < 1 years after the onset of menopause.
  • Female patients of child bearing potential must use an effective method of birth control (i.e. hormonal contraceptive, intrauterine device,diaphragm with spermicide, condom with spermicide or abstinence) during treatment period and 1 month thereafter; Males must use an effective method of birth control during treatment period and 3 months thereafter.

Exclusion Criteria:

  • Other subtypes NHL than CD20 (+) DLBCL, NOS
  • Transformed DLBCL from follicular lymphoma or other indolent lymphomas
  • Bulky disease ( longest diameter >=10 cm)
  • Previous treatment for DLBCL with immunotherapy or chemotherapy except for short-term corticosteroids (duration of ≤ 8 days) before inclusion
  • CNS involvement by lymphoma or any evidence of spinal cord compression.
  • Primary Central Nervous System (CNS) DLBCL
  • Primary testicular lymphoma
  • Primary breast lymphoma
  • Patients with a known history of HIV seropositivity or HCV (+). (Patients who have HBV (+) are eligible. However, primary prophylaxis using antiviral agents (i.e. lamivudine, etc) is recommended for HBV carrier to prevent HBV reactivation during whole treatment period.)
  • Prior history of malignancies other than lymphoma (except for basal cell or squamous cell carcinoma of the skin, early gastric cancer or carcinoma in situ of the cervix or breast or untreated prostatic cancer without any plan for a treatment) unless the patient has been free of the disease for ≥ 3 years
  • Pregnant or lactating women
  • Men who are not surgically sterile and women of childbearing potential not employing adequate contraception
  • Other serious illness or medical conditions
  • Unstable cardiac disease despite treatment, myocardial infarction within 6 months prior to study entry
  • History of significant neurological or psychiatric disorders including dementia or seizures
  • Active uncontrolled infection (viral, bacterial or fungal infection)
  • Other serious medical illnesses
  • Known hypersensitivity to any of the study drugs or its ingredients
  • Concomitant administration of any other experimental drug under investigation, or concomitant chemotherapy, hormonal therapy, or immunotherapy.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT02054559

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Korea, Republic of
Asan Medical Center
Seoul, Korea, Republic of, 138-736
Sponsors and Collaborators
Asan Medical Center

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Responsible Party: Cheolwon Suh, Professor, Asan Medical Center Identifier: NCT02054559    
Other Study ID Numbers: AMC_NHL02
First Posted: February 4, 2014    Key Record Dates
Last Update Posted: February 23, 2016
Last Verified: February 2016
Keywords provided by Cheolwon Suh, Asan Medical Center:
diffuse large B-cell lymphoma
R-CHOP chemotherapy
Additional relevant MeSH terms:
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Lymphoma, B-Cell
Lymphoma, Large B-Cell, Diffuse
Neoplasms by Histologic Type
Lymphoproliferative Disorders
Lymphatic Diseases
Immunoproliferative Disorders
Immune System Diseases
Lymphoma, Non-Hodgkin
Immunosuppressive Agents
Immunologic Factors
Physiological Effects of Drugs
Antirheumatic Agents
Antineoplastic Agents, Alkylating
Alkylating Agents
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents
Myeloablative Agonists
Anti-Inflammatory Agents
Hormones, Hormone Substitutes, and Hormone Antagonists
Antineoplastic Agents, Hormonal
Antineoplastic Agents, Phytogenic