- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02128061
Efficacy of Lenalidomide in Combination With Subcutaneous Rituximab + miniCHOP in DLBCL Patients of 80 y/o or+
Sub-cutaneous Rituximab-miniCHOP Versus Sub-cutaneous Rituximab-miniCHOP + Lenalidomide (R2-miniCHOP) in Diffuse Large B Cell Lymphoma for Patients of 80 Years Old or More. A Multicentric Phase III Study of the LYSA Association
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
The purpose of this study is to compare the efficacy of R2-miniCHOP (Sub-cutaneous Rituximab-miniCHOP + lenalidomide) and R-miniCHOP (Sub-cutaneous Rituximab-miniCHOP) in patients aged 80 years old or more with not previously treated cluster of differentiation antigen 20 positive (CD20+) diffuse large B-cell lymphoma as measured by the overall survival (OS).
Primary endpoint of the study is to compare the efficacy of R2-miniCHOP (Sub-cutaneous Rituximab-miniCHOP + lenalidomide) and R-miniCHOP ((Sub-cutaneous Rituximab-miniCHOP) in patients of 80 years old or more with not previously treated CD20+ diffuse large B-cell lymphoma as measured by the overall survival (OS).
Secondary endpoints are:
- To evaluate the efficacy and the safety of R2-miniCHOP as measured by the PFS (Progression Free Survival), EFS (Event Free Survival), the DoR (duration of response), the DFS (disease free survival), response rate at the end of the treatment, the additional toxicities
- To evaluate the simplified scale prognostic impact (IADL, MNA, G8, CIRS-G)
- To assess the quality of life before and after treatment This study is a multicentric, phase III, open-label, randomized (1:1) trial evaluating the efficacy of R2-miniCHOP in patients aged of 80 years or more with non-previously treated CD20+ diffuse large B-cell lymphoma (age-adjusted IPI= 0 to 3), Ann Arbor stage II to IV with a performance status ECOG from 0 to 2.
This study includes a run in phase to assess feasibility, safety and tolerance of subcutaneous rituximab injections and oral lenalidomide (10 mg D1-D14) in combination with dose-reduced intensity CHOP regimen.
Study Type
Enrollment (Actual)
Phase
- Phase 3
Contacts and Locations
Study Locations
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Antwerpen, Belgium
- ZNA Stuivenberg
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Bruges, Belgium, 8000
- A. Z. Sint-Jan
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Brussel, Belgium
- Hopital Erasme
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Bruxelles, Belgium, 1000
- Institut Jules Bordet
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Bruxelles, Belgium, 1200
- Université Catholique de Louvain Saint Luc
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Charleroi, Belgium, 6000
- Grand Hopital de Charleroi
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Gent, Belgium
- Universitair Ziekenhuis Gent
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Kortrijk, Belgium, 8500
- AZ Groeninge
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Liege, Belgium, 4000
- CHU de Liège
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Liege, Belgium, 4000
- CHR Citadelle
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Namur, Belgium, 5000
- Hopital Sainte Elisabeth
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Ottignies, Belgium, 1340
- Clinique Saint Pierre
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Verviers, Belgium, 4800
- CHR Peltzer La Tourelle
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Yvoir, Belgium
- CHRU Mont Godinne
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Abbeville, France, 80142
- CH d'Abbeville
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Aix-en-Provence, France, 13606
- CH du Pays d'Aix
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Amiens, France, 80054
- CHU d'Amiens
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Angers, France, 49000
- CHU d'Angers
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Argenteuil, France, 95107
- CH Victor Dupouy
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Arras, France, 62022
- CH d'Arras
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Avignon, France, 84902
- CH d Avignon - Hopital Henri Duffaut
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Bayonne, France, 64100
- CH Cote Basque
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Besancon, France, 25030
- CHU Jean Minjoz
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Blois, France, 41000
- CH de Blois
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Bordeaux, France, 33076
- Institut Bergonie
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Bordeaux, France, 33300
- Polyclinique Bordeaux Nord
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Boulogne-sur-mer, France, 62321
- CH de Boulogne-sur-Mer
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Bourg-en-bresse, France, 01000
- CH de Bourg en Bresse
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Brest, France, 29609
- CHU Morvan
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Brive, France, 19190
- CH de Brive
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Caen, France
- IHBN
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Cannes, France, 06401
- CH de Cannes
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Castelnau-le-lez, France, 34170
- Clinique du Parc
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Challes-les-Eaux, France, 73191
- Médipôle de Savoie
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Chalon-sur-Sâone, France
- CHU de Châlon sur Sâone
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Chambery, France, 73011
- CH Metropole Savoie
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Clamart, France, 92141
- Hôpital d'Instruction des Armées PERCY
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Clermont-Ferrand, France, 63000
- CHU Estaing
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Clermont-Ferrand, France, 63050
- Pôle Santé République
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Corbeil-Essonnes, France, 91108
- CH Sud Francilien de Corbeil
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Creteil, France, 94010
- APHP - Hopital Henri Mondor
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Dijon, France, 21034
- CHU de Dijon - Hopital le Bocage
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Dunkerque, France, 59385
- CH de Dunkerque
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Evreux, France, 27015
- CH Eure Seine
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Grenoble, France, 38000
- CHU de Grenoble
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Grenoble, France, 38028
- Institut Daniel Hollard
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La Roche sur Yon, France
- CH Départemental de Vendée
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La Rochelle, France, 17019
- Hopital St Louis
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Le Chesnay, France, 78157
- CH de Versailles - Hôpital André Mignot
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Le Kremlin Bicetre, France, 94275
- Hôpital Bicêtre
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Le Mans, France, 72000
- CH du Mans
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Le Mans, France, 72000
- Clinique Victor Hugo
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Lille, France
- Hopital Saint Vincent De Paul
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Lille, France, 59037
- CHRU LILLE - Hôpital Claude Huriez
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Limoges, France, 87042
- CHU de Limoges
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Lyon, France
- Centre LEON BERARD
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Macon, France, 71018
- CH des Chanaux
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Marseille, France, 13385
- Hôpital de la Conception
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Marseille, France, 13273
- Institut Paoli Calmette
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Meaux, France, 77104
- CH de Meaux
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Metz, France, 57038
- Hopital de Mercy
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Metz-Tessy, France, 74374
- Centre Hospitalier Annecy Genevois
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Montpellier, France
- CHU de Montpellier
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Mulhouse, France, 68070
- CHU de Mulhouse
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Nantes, France, 44093
- CHU de Nantes
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Nice, France, 06189
- Centre Antoine Lacassagne
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Nimes, France, 30029
- CHU de Nimes
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Orleans, France, 45100
- CHR de la Source
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Paris, France, 75012
- Hopital Saint Antoine
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Paris, France, 75743
- APHP - Hopital Necker
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Paris, France, 75651
- Hopital de la Pitie Salpetriere
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Paris, France, 75475
- Aphp - Hopital Saint Louis
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Perigueux, France, 24019
- Ch Perigueux
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Perigueux, France, 24004
- Clinique Francheville
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Perpignan, France, 66000
- CH de Perpigan
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Pessac, France, 33604
- CHU du Haut Leveque
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Pierre-Bénite, France, 69495
- CHU Lyon Sud
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Poitiers, France, 96021
- CHU de Poitiers
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Pontoise, France, 95301
- CH René Dubos
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Quimper, France, 29107
- CH de Cornouaille
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Reims, France, 51092
- CHU Robert Debré
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Rennes, France, 35033
- CHU de Rennes
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Roubaix, France, 59100
- CH de Roubaix
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Rouen, France, 76038
- Centre Henri Becquerel
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Saint Malo, France, 35400
- CHU de Saint Malo
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Saint Pierre, France, 97448
- Groupe hospitalier Sud Reunion
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Saint Quentin, France, 02321
- CH Saint Quentin
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Saint-Brieuc, France, 22000
- CH de Saint Brieuc
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Saint-Cloud, France, 92210
- Centre René Huguenin - Institut Curie
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Strasbourg, France, 67000
- Strasbourg Oncologie Libérale
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Strasbourg, France, 67098
- CHU de Strasbourg
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Toulon, France, 83056
- CHI Toulon La Seyne-sur-mer
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Toulouse, France, 31059
- CHU Purpan - Toulouse
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Tours, France, 37044
- CHRU Bretonneau
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Valence, France, 26953
- Hôpital de Valence
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Vandoeuvre les Nancy, France, 54511
- CHU de Brabois
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Vannes, France, 56017
- CH de Bretagne Atlantique
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Patient with histologically proven CD20+ diffuse large B-cell lymphoma (DLBCL) (WHO classification 2008) including all clinical subtypes (primary mediastinal, intravascular, etc…), with all age-adjusted International Prognostic Index (aaIPI).
May also be included: De Novo transformed DLBCL from low grade lymphoma (Follicular, other...) and DLBCL associated with some small cell Infiltration in bone marrow or lymph node; or CD20+ B-cell lymphoma, with intermediate features between DLBCL and Burkitt or with intermediate features between DLBCL and classical Hodgkin lymphoma; or CD20+ Follicular lymphoma grade 3B (according to WHO classification); or CD20+ Aggressive B-cell lymphoma unclassifiable.
- With a Cluster of Differentiation antigen 10 (CD10) immunostaining performed by the participating center pathologist
- Aged ≥ 80 years old
- Ann Arbor stage II, III or IV
- Patient previously untreated for DLBCL Lymphoma
- Eastern Cooperative Oncology Group (ECOG) performance status ≤ 2
- With a minimum life expectancy of 3 months
- Negative HIV, HBV and HCV serologies test within 4 weeks before inclusion (except after hepatitis B vaccination or for patients who are HBs Ag negative, anti-HBs positive and/or anti-HBc positive but viral DNA negative)
- Patient able to give his consent and having signed a written Informed consent
- Patient affiliated to social security system, if applicable
- Male patients must practice complete abstinence or agree to use a condom during sexual contact with a pregnant female or a female of childbearing potential while participating in the study, during dose interruptions, and for 3 months following study drug discontinuation, even if they have undergone a successful vasectomy.
- All patients must agree to fulfill the global Lenalidomide Pregnancy Prevention Risk Management Plan as applicable according to the randomization arm (randomization arm)
Exclusion Criteria:
- Any other histological type of lymphoma, Burkitt included
- Any history of treated or non-treated small-B cell lymphoma
- Central nervous system or meningeal involvement by lymphoma
- Contra-indication to any drug contained in the chemotherapy regimens ; for anthracycline use, ejection fraction should be > 50%
- Any serious active disease (according to the investigator's decision)
- History of deep venous thrombosis or arterial thromboembolism events within the past 12 months before inclusion
- Poor renal function (creatinine clearance < 40 ml/min, according to Modification of Diet in Renal Disease (MDRD) formula)
- Poor hepatic function (total bilirubin level >30mmol/l, transaminases >2.5 maximum normal level) unless these abnormalities are related to the lymphoma
- Poor bone marrow reserve as defined by neutrophils <1.5 G/l or platelets <100 G/l, unless related to bone marrow infiltration
- Any history of cancer during the last 5 years with the exception of non-melanoma skin tumors or stage 0 (in situ) cervical carcinoma Patients previously diagnosed with prostate cancer are eligible if (1) their disease was T1-T2a, N0, M0, with a Gleason score ≤7, and a prostate specific antigen (PSA) ≤10 ng/mL prior to initial therapy, (2) they had definitive curative therapy (i.e., prostatectomy or radiotherapy) 2 years before Day 1 of Cycle 1, and (3) at a minimum 2 years following therapy they had no clinical evidence of prostate cancer, and their PSA was undetectable if they underwent prostatectomy or <1 ng/mL if they did not undergo prostatectomy
- Treatment with any investigational drug within 30 days before planned first cycle of chemotherapy and during the study
- Prior treatment with anti-CD20 monoclonal antibody or alemtuzumab within 3 months prior to start of therapy
- Prior use of lenalidomide
- Prior ≥ Grade 3 allergic reaction/hypersensitivity to thalidomide
- Prior ≥ Grade 3 rash or any desquamating (blistering) rash while taking thalidomide
- Subjects with ≥ Grade 2 neuropathy
- Adult patient under tutelage
- Female of childbearing potential are excluded. (Note: Females are defined as not of childbearing potential if there is documentation of "natural menopause for at least 24 consecutive months, a hysterectomy or bilateral oophorectomy")
Study Plan
How is the study designed?
Design Details
- Primary Purpose: TREATMENT
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: NONE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
ACTIVE_COMPARATOR: R-miniCHOP
All patients will be treated with R-miniCHOP at a three-weeks interval for 6 cycles CYCLOPHOSPHAMIDE IV: 400 mg/m² Day 1 (D1) DOXORUBICINE IV : 25 mg/m² D1 VINCRISTINE IV : 1 mg Total Dose (TD) D1 PREDNISONE PO : 40 mg/m² D1 to D5 RITUXIMAB SC* : 1400 mg TD D1 *The first cycle of rituximab is delivered by IV at the dose of 375 mg/m2 |
Other Names:
|
EXPERIMENTAL: R2-miniCHOP
All patients will be treated with R2-miniCHOP at a three-weeks interval for 6 cycles CYCLOPHOSPHAMIDE IV: 400 mg/m² D1 - DOXORUBICINE IV : 25 mg/m² D1 - VINCRISTINE IV : 1 mg TD D1 - PREDNISONE PO : 40 mg/m² D1 to D5 - RITUXIMAB SC* : 1400 mg TD D1 LENALIDOMIDE PO** :10 mg TD D1 to D14 *The first cycle of rituximab is delivered by IV at the dose of 375 mg/m2 |
Other Names:
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
The overall survival (OS)
Time Frame: OS rates at 2 years
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OS will be measured from the date of randomization to the date of death from any cause.
Alive patients will be censored at their last contact.
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OS rates at 2 years
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Progression-Free Survival (PFS)
Time Frame: PFS rates at 2 years
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PFS is defined as the time from randomization into the study to the first observation of documented disease progression/relapse or death due to any cause.
If a subject has not progressed or died, PFS will be censored at the time of last visit with adequate assessment.
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PFS rates at 2 years
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Event-Free Survival (EFS)
Time Frame: EFS rates at 2 years
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EFS will be measured from the date of randomization to the date of first documented disease progression/relapse (Cheson 1999), initiation of new anti-lymphoma therapy or death from any cause.
Patients without documented event at the time of analysis will be censored at their visit with adequate assessment.
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EFS rates at 2 years
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Duration of Response (DoR)
Time Frame: DoR rates at 2 years
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DoR will be measured from the time of attainment of Complete Response/unconfirmed Complete Response (CR/CRu) or Partial Response (PR) to the date of first documented disease progression/relapse or death from any cause.
Patients alive and free of progression will be censored at their last visit with adequate assessment.
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DoR rates at 2 years
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Disease-Free Survival (DFS)
Time Frame: DFS rates at 2 years
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DFS will be measured from the date of attainment of a complete or unconfirmed complete response (at the end of treatment or at permanent treatment discontinuation evaluation) to the date of first observation of documented disease progression or death due to any cause.
Complete Response/unconfirmed Complete Response (CR/CRu) patients who have not progressed or died will be censored at the time of last visit with adequate assessment.
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DFS rates at 2 years
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OS according to GCB/non-GCB phenotype
Time Frame: OS according to GCB/non-GCB phenotype rates at 2 years
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OS will be described for the R2-miniCHOP group according to Hans algorithm (GCB/non-GCB phenotype).
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OS according to GCB/non-GCB phenotype rates at 2 years
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Response Rate at the end of treatment
Time Frame: 22 weeks (28 days after the end of the 6, three-weeks interval, cycles of treatment) or within 28 days following permanent treatment discontinuation
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Disease response evaluation at end of treatment (after 6 cycles) will be used to determine the Response Rate. Response will be assessed at end of treatment (after end of the 6th cycle of treatment or at permanent treatment discontinuation). Assessment of response will be based on the International Workshop to Standardize Response criteria for non-Hodgkin's lymphoma (NHL) (Criteria for evaluation of response in NHL (Cheson, 1999)). |
22 weeks (28 days after the end of the 6, three-weeks interval, cycles of treatment) or within 28 days following permanent treatment discontinuation
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Simplified Geriatric Scales
Time Frame: At baseline
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Four geriatric tools will be performed before any chemotherapy administration (Instrumental Activities of Daily Living (IADL), Mini Nutritional Assessment (MNA), G8, and Cumulative Illness Rating Scale for Geriatrics (CIRS-G) scales).
Each scale will be analyzed in order to have a picture of the population at baseline.
Thereafter, the prognosis impact in OS and PFS of each scale will be evaluated using univariate (Kaplan Meier) and multivariate analyses (Cox model).
Safety analyses will also be performed according to each scale in order to evaluate the toxicity predictive power of these scales.
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At baseline
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Health related Quality of Life (HRQOL)
Time Frame: At randomization and 22 weeks after Day 1 of Cycle 1 of R-miniCHOP or R2-miniCHOP (28 days after the end of the 6, three-weeks interval, cycles of treatment)
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HRQOL will be assessed by the Quality of Life Questionnaire-C30 and Elderly14 (QLQ-C30 and the QLQ-ELD14) at randomization and at end of treatment. The improvement or not of the QoL will therefore be assessed. The QLQ-ELD14 was developed to supplement the QLQ-C30 for measuring HRQoL in patients aged >70 years in oncology studies. |
At randomization and 22 weeks after Day 1 of Cycle 1 of R-miniCHOP or R2-miniCHOP (28 days after the end of the 6, three-weeks interval, cycles of treatment)
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Collaborators and Investigators
Collaborators
Investigators
- Principal Investigator: Fabrice Jardin, MD,Professor, The Lymphoma Study Association - LYSA
Study record dates
Study Major Dates
Study Start (ACTUAL)
Primary Completion (ACTUAL)
Study Completion (ACTUAL)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (ESTIMATE)
Study Record Updates
Last Update Posted (ACTUAL)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Immune System Diseases
- Neoplasms by Histologic Type
- Neoplasms
- Lymphoproliferative Disorders
- Lymphatic Diseases
- Immunoproliferative Disorders
- Lymphoma, Non-Hodgkin
- Lymphoma
- Lymphoma, B-Cell
- Lymphoma, Large B-Cell, Diffuse
- Physiological Effects of Drugs
- Antirheumatic Agents
- Antineoplastic Agents
- Immunologic Factors
- Antineoplastic Agents, Immunological
- Angiogenesis Inhibitors
- Angiogenesis Modulating Agents
- Growth Substances
- Growth Inhibitors
- Lenalidomide
- Rituximab
Other Study ID Numbers
- SENIOR
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
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.
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