- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02777736
CNS Prophylaxis in Diffuse Large B-cell Lymphoma (CLSG-CNS-001)
Study Evaluating Relapses in Central Nervous System in Patients With Diffuse Large B-Cell Lymphoma Treated With Chemotherapy With or Without CNS Prophylaxis. Multicentric, Prospective, Randomized Phase III Study
Study Overview
Detailed Description
Patients with diffuse large B-cell lymphoma are evaluated for risk factors of CNS relapse during initial staging (age > 60years, lactate dehydrogenase (LDH) > reference range, clinical stage III/IV, performance status according to Eastern Cooperative Oncology Group (ECOG) >1, kidney and/or adrenal gland involvement, involvement > 1 extranodal organ) including evaluation of cerebrospinal fluid.
All patients with systemic DLBCL without CNS involvement are treated with systemic chemotherapy: either 6 cycles of R CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednison) +2xR (rituximab) or 6 cycles of DA EPOCH R (dose adjusted etoposide, prednison, vincristin, cyclophosphamide, doxorubicin) +2xR (rituximab). Patients with ≥ 2 risk factors for CNS relapse or with occult meningeal involvement will be randomized in 1:1 ratio either into arm A with 2 cycles of prophylactic methotrexate 3g/m2 i.v., or into arm B with prophylactic 6x intrathecal methotrexate 12mg (1x intrathecal methotrexate in each cycle of systemic chemotherapy). Patients with 0-1 risk factor will be allocated into arm C without CNS prophylaxis. Patients will be observed for CNS relapse during the follow-up of 1year after the end of the first-line treatment.
Study Type
Enrollment (Anticipated)
Phase
- Phase 3
Contacts and Locations
Study Contact
- Name: Heidi Mocikova, M.D., Ph.D.
- Phone Number: +420267163554
- Email: heidi.mocikova@fnkv.cz
Study Locations
-
-
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Brno, Czech Republic, 62500
- Recruiting
- University Hospital Brno-Bohunice
-
Contact:
- Andrea Janikova, M.D.,Ph.D.
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Hradec Králové, Czech Republic, 50005
- Recruiting
- University hospital Hradec Králové
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Contact:
- David Belada, M.D., Ph.D.
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Ostrava, Czech Republic, 708 52
- Recruiting
- University Hospital Ostrava
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Contact:
- Juraj Ďuraš, M.D.
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Pilsen, Czech Republic, 304 60
- Recruiting
- University Hospital Pilsen
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Contact:
- Martin Pachner, M.D.
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Prague, Czech Republic, 100 34
- Recruiting
- University Hospital Kralovske Vinohrady
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Contact:
- Heidi Mocikova, M.D., Ph.D.
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Prague, Czech Republic, 12808
- Recruiting
- General University Hospital Prague
-
Contact:
- Robert Pytlik, M.D.
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- histologically confirmed DLBCL
- age 18-72 years
- signed informed consent with the study
- first-line treatment 6 cycles of R CHOP +2x R or 6 cycles of DA EPOCH R+ 2xR
Exclusion Criteria:
- DLBCL and concomitant initial CNS involvement
- PMBL (primary mediastinal B-cell lymphoma)
- treatment with another chemotherapy than R CHOP or DA EPOCH R
- HIV positive, or active hepatitis B or C
- other concomitant serious disease (based on the decision of the physician-investigator)
- non-compliance of a patient
- any contraindication for application of anthracycline based chemotherapy or high dose methotrexate
- pregnancy or breast-feeding
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Arm A - Methotrexate i.v.
Patients with risk factors for CNS relapse ≥ 2 or with occult meningeal involvement will receive 2 cycles of methotrexate 3g/m2 i.v. after the 3rd and 6th cycle of systemic chemotherapy (R CHOP or DA EPOCH R).
|
i.v. or intrathecal CNS prophylaxis
Other Names:
|
Active Comparator: Arm B - Methotrexate i.t.
Patients with risk factors for CNS relapse ≥ 2 or with occult meningeal involvement will receive intrathecal methotrexate 12mg in each cycle of systemic chemotherapy (6x).
|
i.v. or intrathecal CNS prophylaxis
Other Names:
|
No Intervention: Arm C - no Methotrexate
Patients with 0-1 risk factor for CNS relapse will not receive CNS prophylaxis.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Cumulative incidence of CNS relapse in patients treated either with methotrexate i.v. or methotrexate i.t. or without CNS prophylaxis
Time Frame: 1 year
|
1 year
|
Secondary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Overall survival
Time Frame: 2 years
|
2 years
|
Progression-free survival
Time Frame: 2 years
|
2 years
|
Overall response rate
Time Frame: 1 year
|
1 year
|
Complete remission rate
Time Frame: 1 year
|
1 year
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Heidi Mocikova, M.D., Ph.D., University Hospital Kralovske Vinohrady, Prague, Czech Republic
- Study Director: Marek Trněný, prof.M.D., General University Hospital, Prague
Publications and helpful links
Helpful Links
Study record dates
Study Major Dates
Study Start
Primary Completion (Anticipated)
Study Completion (Anticipated)
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
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
- Molecular Mechanisms of Pharmacological Action
- Nucleic Acid Synthesis Inhibitors
- Enzyme Inhibitors
- Antirheumatic Agents
- Antimetabolites, Antineoplastic
- Antimetabolites
- Antineoplastic Agents
- Immunosuppressive Agents
- Immunologic Factors
- Dermatologic Agents
- Reproductive Control Agents
- Abortifacient Agents, Nonsteroidal
- Abortifacient Agents
- Folic Acid Antagonists
- Methotrexate
Other Study ID Numbers
- CLSG-CNS-001
- 2015-000591-97 (EudraCT Number)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Study Data/Documents
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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