- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT00025636
Combination Chemotherapy and Peripheral Stem Cell Transplant in Treating Patients With Relapsed Hodgkin's Lymphoma
A Randomized Trial Of BEAM Plus PBSCT Versus Single Agent High-Dose Therapy Followed By BEAM Plus PBSCT In Patients With Relapsed Hodgkin's Disease
RATIONALE: Drugs used in chemotherapy use different ways to stop cancer cells from dividing so they stop growing or die. Peripheral stem cell transplant may allow the doctors to give higher doses of chemotherapy drugs and kill more cancer cells. It is not yet known which combination chemotherapy regimen given before peripheral stem cell transplant is more effective in treating relapsed Hodgkin's lymphoma.
PURPOSE: This randomized phase III trial is comparing different regimens of combination chemotherapy followed by peripheral stem cell transplant to see how well they work in treating patients with relapsed Hodgkin's lymphoma.
Study Overview
Status
Conditions
Intervention / Treatment
- Drug: cyclophosphamide
- Drug: cytarabine
- Drug: dexamethasone
- Drug: etoposide
- Drug: methotrexate
- Drug: vincristine sulfate
- Drug: cisplatin
- Procedure: peripheral blood stem cell transplantation
- Biological: filgrastim
- Drug: melphalan
- Drug: carmustine
- Procedure: bone marrow ablation with stem cell support
Detailed Description
OBJECTIVES:
- Compare the efficacy of induction chemotherapy followed by combination chemotherapy and autologous peripheral blood stem cell transplantation with or without high-dose sequential chemotherapy in terms of freedom from treatment failure in patients with relapsed Hodgkin's lymphoma.
- Compare the toxicity of these regimens in these patients.
- Compare the complete remission/unconfirmed complete remission rate at 3 months, relapse-free survival, and overall survival of patients treated with these regimens.
- Compare the frequency of severe toxic effects and secondary neoplasia in patients treated with these regimens.
OUTLINE: This is a randomized, multicenter study. Patients are stratified according to participating center, type of relapse (early first relapse [remission duration 3-12 months] vs late first relapse [remission duration more than 12 months] vs second relapse without prior high-dose chemotherapy salvage [remission duration after salvage at least 3 months]), disease status at relapse (stage I or II vs stage III or IV), age (18 to 49 vs 50 to 60), and response after 2 courses of study induction chemotherapy (complete remission vs partial remission vs no change).
All patients receive induction chemotherapy comprising dexamethasone IV over 30 minutes on days 1-4 and 15-18, cisplatin IV continuously over 24 hours on days 1 and 15, cytarabine IV over 3 hours every 12 hours on days 2 and 16, and filgrastim (G-CSF) subcutaneously (SC) once daily on days 5-12 and days 19-26. Patients with complete remission (CR), unconfirmed CR, partial remission, or no change are randomized to one of two treatment arms.
- Arm I: Patients receive BEAM chemotherapy comprising carmustine IV over 30 minutes and melphalan IV over 30 minutes on day 37 and etoposide IV over 30 minutes every 12 hours and cytarabine IV over 30 minutes every 12 hours on days 37-40. Patients also receive G-CSF SC twice daily beginning on day 41 and continuing until blood counts recover. Autologous peripheral blood stem cells (PBSCs) are reinfused on day 42.
- Arm II: Patients receive high-dose cyclophosphamide IV over 8 hours on day 37, high-dose methotrexate IV over 6 hours and high-dose vincristine IV on day 51, and high-dose etoposide IV over 8 hours on days 58-61. Patients then receive BEAM chemotherapy comprising carmustine IV over 30 minutes and melphalan IV over 30 minutes on day 80 and etoposide IV over 30 minutes every 12 hours and cytarabine IV over 30 minutes every 12 hours on days 80-83. Patients also receive G-CSF SC once on days 38 and 62 and twice daily beginning on day 84 and continuing until blood counts recover. Autologous PBSCs are reinfused on day 85.
Patients with residual lymphoma at 100 days after completion of BEAM chemotherapy may receive radiotherapy.
Patients are followed at 100 days after PBSC transplantation, every 3 months for 2 years, every 6 months for 2 years, and then annually thereafter.
PROJECTED ACCRUAL: A minimum of 220 patients (110 per treatment arm) will be accrued for this study within 5 years.
Study Type
Enrollment (Anticipated)
Phase
- Phase 3
Contacts and Locations
Study Locations
-
-
-
Antwerp, Belgium, 2020
- Ziekenhuis Netwerk Antwerpen Middelheim
-
Brussels, Belgium, 1000
- Institut Jules Bordet
-
Edegem, Belgium, B-2650
- Universitair Ziekenhuis Antwerpen
-
Ghent, Belgium, B-9000
- Algemeen Ziekenhuis Sint Lucas
-
-
-
-
-
Zagreb, Croatia, 10000
- University Hospital Rebro
-
-
-
-
-
Copenhagen, Denmark, 2100
- Rigshospitalet - Copenhagen University Hospital
-
-
-
-
-
Berlin, Germany, D-10117
- Charité - Campus Charité Mitte
-
Berlin, Germany, D-12200
- Charite - Universitaetsmedizin Berlin - Campus Benjamin Franklin
-
Berlin, Germany, D-13353
- Charité - Campus Virchow Klinikum
-
Bonn, Germany, D-53111
- Medizinische Poliklinik
-
Cologne, Germany, D-50924
- Medizinische Universitaetsklinik I at the University of Cologne
-
Dessau, Germany, D-06822
- Staedtisches Klinikum Dessau
-
Essen, Germany, D-45122
- Universitaetsklinikum Essen
-
Essen, Germany, D-45239
- Evangelisches Krankenhaus Essen Werden
-
Greifswald, Germany, D-17475
- Klinik Fuer Innere Medizin, Hematology/Oncology, Ernst Moritz Armdt Universitaet
-
Halle, Germany, D-06120
- Martin Luther Universitaet
-
Hamburg, Germany, D-20099
- Asklepios Klinik St. Georg
-
Hamburg, Germany, D-20246
- Universitaetsklinikum Hamburg-Eppendorf
-
Hamm, Germany, DOH-59063
- Evangelische Krankenhaus Hamm
-
Hannover, Germany, D-30625
- Medizinische Hochschule Hannover
-
Hannover, Germany, D-30449
- Krankenhaus Siloah - Medizinische Klinik II
-
Heidelberg, Germany, 69115
- Medizinische Universitaetsklinik und Poliklinik
-
Hildeshem, Germany, D-31134
- St. Bernward Krankenhaus
-
Homburg, Germany, D-66424
- Universitaetsklinikum des Saarlandes
-
Idar-Oberstein, Germany, D-55743
- Clinic for Bone Marrow Transplantation and Hematology and Oncology
-
Jena, Germany, D-07740
- Klinikum der Friedrich-Schiller Universitaet Jena
-
Karlsruhe, Germany, 76133
- Staedtisches Klinikum Karlsruhe gGmbH
-
Luebeck, Germany, D-23538
- Universitaetsklinikum Schleswig-Holstein - Campus Luebeck
-
Munich, Germany, D-81377
- Klinikum der Universitaet Muenchen - Grosshadern Campus
-
Munich, Germany, 80804
- Krankenhaus Muenchen Schwabing
-
Munich, Germany, D-81675
- Klinikum Rechts der Isar - Technische Universitaet Muenchen
-
Stuttgart, Germany, D-70176
- Diakonie Klinikum Stuttgart
-
Wiesbaden, Germany, D-65199
- Dr. Horst-Schmidt-Kliniken
-
-
-
-
-
Amsterdam, Netherlands, 1091 HA
- Onze Lieve Vrouwe Gasthuis
-
Amsterdam, Netherlands, 1066 CX
- Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital
-
Amsterdam, Netherlands, 1105 AZ
- Academisch Medisch Centrum at University of Amsterdam
-
Groningen, Netherlands, 9700 RB
- University Medical Center Groningen
-
Leiden, Netherlands, 2300 RC
- Leiden University Medical Center
-
Maastricht, Netherlands, 6202 AZ
- Academisch Ziekenhuis Maastricht
-
Nijmegen, Netherlands, NL-6500 HB
- Universitair Medisch Centrum St. Radboud - Nijmegen
-
Veldhoven, Netherlands, 5500 MB
- Maxima Medisch Centrum - Veldhoven
-
-
-
-
-
Warsaw, Poland, 02-781
- Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology
-
-
-
-
-
Coimbra, Portugal, P-3001-301
- Hospitais da Universidade de Coimbra (HUC)
-
-
-
-
-
Zurich, Switzerland, CH-8091
- Universitaetsspital Zuerich
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
DISEASE CHARACTERISTICS:
- Histologically confirmed Hodgkin's lymphoma
Early or late first relapse
- Complete or partial remission for at least 3 months after completion of prior COPP/ABVD, COPP/ABV/IMEP, MOPP/ABV, ABVD, BEACOPP, or other polychemotherapy regimen with or without radiotherapy
- No prior salvage therapy OR
Second relapse
- Any prior salvage therapy
- No prior high-dose chemotherapy
PATIENT CHARACTERISTICS:
Age:
- 18 to 60
Performance status:
- Karnofsky 70-100% OR
- ECOG 0-2
Life expectancy:
- More than 3 months with treatment
Hematopoietic:
- Absolute neutrophil count at least 2,500/mm^3
- Platelet count at least 100,000/mm^3
Hepatic:
- Not specified
Renal:
- Creatinine clearance at least 60 mL/min
Cardiovascular:
- No uncontrolled hypertension (diastolic blood pressure greater than 115 mm Hg)
- No unstable angina
- No New York Heart Association class III or IV heart disease (congestive heart failure)
- No myocardial infarction within the past 6 months
- No uncontrolled atrial or ventricular cardiac arrhythmias
Pulmonary:
- No chronic pulmonary disease
Other:
- Not pregnant or nursing
- Fertile patients must use effective contraception
- HIV negative
- No active infection
- No poorly controlled diabetes
- No cerebral disorder
- No other concurrent malignancy except adequately treated basal cell skin cancer or cervical intraepithelial neoplasia
- No significant non-malignant disease
- No psychiatric, addictive, or other disorder that would preclude study compliance
PRIOR CONCURRENT THERAPY:
Biologic therapy:
- Not specified
Chemotherapy:
- See Disease Characteristics
- No other concurrent chemotherapy
Endocrine therapy:
- Not specified
Radiotherapy:
- See Disease Characteristics
Surgery:
- Not specified
Other:
- At least 6 months since prior coronary angioplasty
- No other concurrent investigational drugs
- No concurrent non-steroidal anti-inflammatory drugs, salicylate, sulfonamide, trimethoprim, allopurinol, aminoglycoside, amoxicillin, or probenecid during high-dose methotrexate administration
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
---|
Efficacy at 3 months
|
Toxicity at 3 months
|
Secondary Outcome Measures
Outcome Measure |
---|
Complete remission at 3 months
|
Relapse-free survival at 3 months
|
Overall survival at 3 months
|
Collaborators and Investigators
Collaborators
Investigators
- Andreas Engert, MD, Medizinische Universitaetsklinik I at the University of Cologne
- J. W. Baars, MD, PhD, The Netherlands Cancer Institute
- Norbert Schmitz, MD, PhD, Asklepios Klinik St. Georg
Publications and helpful links
Study record dates
Study Major Dates
Study Start
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Immune System Diseases
- Neoplasms by Histologic Type
- Neoplasms
- Lymphoproliferative Disorders
- Lymphatic Diseases
- Immunoproliferative Disorders
- Lymphoma
- Physiological Effects of Drugs
- Molecular Mechanisms of Pharmacological Action
- Anti-Infective Agents
- Autonomic Agents
- Peripheral Nervous System Agents
- Antiviral Agents
- Nucleic Acid Synthesis Inhibitors
- Enzyme Inhibitors
- Anti-Inflammatory Agents
- Antirheumatic Agents
- Antimetabolites, Antineoplastic
- Antimetabolites
- Antineoplastic Agents
- Immunosuppressive Agents
- Immunologic Factors
- Tubulin Modulators
- Antimitotic Agents
- Mitosis Modulators
- Antiemetics
- Gastrointestinal Agents
- Glucocorticoids
- Hormones
- Hormones, Hormone Substitutes, and Hormone Antagonists
- Antineoplastic Agents, Hormonal
- Antineoplastic Agents, Alkylating
- Alkylating Agents
- Myeloablative Agonists
- Antineoplastic Agents, Phytogenic
- Topoisomerase II Inhibitors
- Topoisomerase Inhibitors
- Dermatologic Agents
- Reproductive Control Agents
- Abortifacient Agents, Nonsteroidal
- Abortifacient Agents
- Folic Acid Antagonists
- Dexamethasone
- Cyclophosphamide
- Etoposide
- Melphalan
- Cytarabine
- Methotrexate
- Vincristine
- Carmustine
Other Study ID Numbers
- CDR0000068981
- GHSG-HD-R2
- EBMT-GHSG-HD-R2
- EORTC-20011
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Lymphoma
-
Marcela V. Maus, M.D.,Ph.D.RecruitingFollicular Lymphoma | Mantle Cell Lymphoma | Marginal Zone Lymphoma | Diffuse Large B Cell Lymphoma | Refractory Non-Hodgkin Lymphoma | Primary Mediastinal Large B-cell Lymphoma (PMBCL) | Non-hodgkin Lymphoma | High-grade B-cell Lymphoma | Grade 3b Follicular Lymphoma | Relapsed Non-Hodgkin LymphomaUnited States
-
Novartis PharmaceuticalsBristol-Myers SquibbRecruitingNon-Hodgkin Lymphoma, Diffuse Large B Cell Lymphoma, Follicular Lymphoma, Mantle Cell Lymphoma, Marginal Zone LymphomaUnited States, Germany, Italy, Korea, Republic of, Spain, Singapore, China, Japan, Australia
-
Zhejiang UniversityShanghai First Song Therapeutics Co., LtdNot yet recruitingHodgkin Lymphoma | Anaplastic Large Cell Lymphoma | Angioimmunoblastic T-cell Lymphoma | Diffuse Large B Cell Lymphoma | Gray Zone Lymphoma | NK/T Cell Lymphoma | Peripheral T Cell Lymphoma, Unspecified | Mediastinal B-Cell Diffuse Large Cell LymphomaChina
-
IGM Biosciences, Inc.ADC Therapeutics S.A.Active, not recruitingFollicular Lymphoma | Mantle Cell Lymphoma | Marginal Zone Lymphoma | Non-Hodgkin Lymphoma | DLBCLUnited States, Korea, Republic of, Spain, France, Australia, Czechia, Italy
-
Massachusetts General HospitalTG TherapeuticsActive, not recruitingLymphoma | Follicular Lymphoma | Marginal Zone Lymphoma | Follicular Lymphoma, Grade 1 | Follicular Lymphoma Grade IIIa | Marginal Zone B Cell Lymphoma | Follicular Lymphoma Grade 2United States
-
Fred Hutchinson Cancer CenterNational Cancer Institute (NCI)CompletedFollicular Lymphoma | Mantle Cell Lymphoma | Non-Hodgkin Lymphoma | B-Cell Non-Hodgkin Lymphoma | Adult Diffuse Large B-Cell Lymphoma | T-Cell Non-Hodgkin LymphomaUnited States
-
Children's Oncology GroupNational Cancer Institute (NCI)CompletedMantle Cell Lymphoma | Marginal Zone Lymphoma | Non-Hodgkin Lymphoma | Small Lymphocytic Lymphoma | Lymphoproliferative Disorder | Primary Cutaneous B-Cell Non-Hodgkin Lymphoma | Grade 1 Follicular Lymphoma | Grade 2 Follicular Lymphoma | Primary Cutaneous T-Cell Non-Hodgkin Lymphoma | Grade 3 Follicular... and other conditionsUnited States, Canada, Australia, Puerto Rico
-
Massachusetts General HospitalNational Comprehensive Cancer NetworkCompletedFollicular Lymphoma | Mantle Cell Lymphoma | Non-Hodgkin Lymphoma | Peripheral T-cell Lymphoma | Diffuse Large B-cell LymphomaUnited States
-
Novartis PharmaceuticalsCompletedDiffuse Large B-cell Lymphoma, Mantle Cell Lymphoma, Follicular LymphomaUnited States, Belgium, Germany, France, Italy, Korea, Republic of, Spain, Turkey
-
SymBio PharmaceuticalsCompletedFollicular Lymphoma | Non-Hodgkin's Lymphoma | Lymphoma, Large Cell | Diffuse, Mantle Cell Lymphoma, Lymphoma | Large B-Cell, DiffuseJapan, Korea, Republic of
Clinical Trials on cyclophosphamide
-
Children's Hospital Los AngelesLucile Packard Children's HospitalTerminatedMetabolic Diseases | Stem Cell Transplantation | Chronic Granulomatous Disease | Bone Marrow Transplantation | Thalassemia | Wiskott-Aldrich Syndrome | Genetic Diseases | Peripheral Blood Stem Cell Transplantation | Pediatrics | Diamond-Blackfan Anemia | Allogeneic Transplantation | Combined Immune Deficiency | X-linked Lymphoproliferative Disease
-
Medical College of WisconsinNational Cancer Institute (NCI); National Heart, Lung, and Blood Institute... and other collaboratorsCompletedAnemia, AplasticUnited States
-
Columbia UniversityUnknownSevere Combined Immunodeficiency | Fanconi Anemia | Bone Marrow Failure | OsteopetrosisUnited States
-
National Cancer Institute, NaplesImmatics Biotechnologies GmbH; CureVac; European Commission -FP7-Health-2013-Innovation-1CompletedHepatocellular CarcinomaBelgium, Germany, Italy, Spain, United Kingdom
-
Mahidol UniversityTerminatedRenal Insufficiency | InfectionThailand
-
Eisai Inc.CompletedBreast Cancer | Ovarian Cancer | Prostate Cancer | Colon Cancer | Renal CancerUnited States
-
Centre Oscar LambretCompleted
-
Baylor Research InstituteCompletedMalignant Melanoma Stage IVUnited States
-
University of Turin, ItalyUnknown
-
Merck KGaA, Darmstadt, GermanyCompleted