- ICH GCP
- Registr klinických studií v USA
- Klinická studie NCT04799275
Testování CC-486 (orální azacitidin) plus standardní léková terapie u pacientů ve věku 75 let nebo starších s nově diagnostikovaným difuzním velkobuněčným B lymfomem
Randomizovaná studie fáze II/III R-MiniCHOP s nebo bez CC-486 (orální azacitidin) u účastníků ve věku 75 let nebo starších s nově diagnostikovaným difuzním velkobuněčným B lymfomem, folikulárním lymfomem IIIB stupně, transformovaným lymfomem a vysokým stupněm B -Buněčné lymfomy s přeuspořádáním MYC A BCL2 a/nebo BCL6
This phase II/III trial compares the side effects and activity of oral azacitidine in combination with the standard drug therapy (reduced dose rituximab-cyclophosphamide, doxorubicin, vincristine, and prednisone [R-miniCHOP]) versus R-miniCHOP alone in treating patients 75 years or older with newly diagnosed diffuse large B cell lymphoma. R-miniCHOP includes a monoclonal antibody (a type of protein), called rituximab, which attaches to the lymphoma cells and may help the immune system kill these cells. R-miniCHOP also includes prednisone which is an anti-inflammatory medication and a combination of 3 chemotherapy drugs, cyclophosphamide, doxorubicin, and vincristine. These 3 chemotherapy drugs, as well as oral azacitidine, work in different ways to stop the growth of cancer cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Combining oral azacitidine with R-miniCHOP may shrink the cancer or extend the time without disease symptoms coming back or extend patient's survival when compared to R-miniCHOP alone.
Přehled studie
Postavení
Podmínky
- Lymfoplasmacytický lymfom
- Ann Arbor fáze III difúzní velký B-buněčný lymfom
- Ann Arbor Fáze IV difúzní velký B-buněčný lymfom
- B-buněčný lymfom vysokého stupně s přeuspořádáním MYC a BCL2 nebo BCL6
- B-buněčný lymfom vysokého stupně s přeuspořádáním MYC, BCL2 a BCL6
- Folikulární lymfom 3b. stupně
- Difuzní velký B-buněčný lymfom, jinak nespecifikovaný
- EBV-pozitivní difuzní velký B-buněčný lymfom, jinak nespecifikováno
- B-buněčný lymfom vysokého stupně, jinak nespecifikováno
- Difuzní velký B-buněčný lymfom spojený s chronickým zánětem
- Primární kožní difúzní velký B-buněčný lymfom, typ nohy
- Transformovaný folikulární lymfom na difúzní velkobuněčný B-lymfom
- Intravaskulární velký B-buněčný lymfom
- Velký B-buněčný lymfom bohatý na T-buňky/histiocyty
- B-buněčný lymfom vysokého stupně s přeuspořádáním MYC a BCL2 a/nebo BCL6
- Typ B-buněk aktivovaný difuzním velkým B-lymfomem
- Difúzní velký B-buněčný lymfom zárodečný typ B-buněk
- HHV8-pozitivní difuzní velký B-buněčný lymfom, jinak nespecifikováno
- Lymfom transformované marginální zóny na difúzní velký B-buněčný lymfom
- Ann Arbor fáze IIX (objemný) difuzní velký B-buněčný lymfom
- Lymfom B-buněk s převahou uzlinových lymfocytů
Intervence / Léčba
- Lék: Cyclophosphamide
- Lék: Doxorubicin Hydrochloride
- Lék: Prednisone
- Postup: Biospecimen Collection
- Biologický: Rituximab
- Lék: Vincristine Sulfate
- Jiný: Questionnaire Administration
- Postup: Echocardiography Test
- Postup: Multigated Acquisition Scan
- Postup: Positron Emission Tomography
- Biologický: Rituximab and Hyaluronidase Human
- Postup: Computed Tomography
- Lék: Oral Azacitidine
Detailní popis
PRIMARY OBJECTIVES:
I. To determine if the addition of CC-486 (oral azacitidine) to R-miniCHOP results in excess toxicity compared to R-miniCHOP alone that would preclude the combination from being studied further. (Safety run-in) II. To determine if the CC-486 + R-miniCHOP regimen should be tested further (Phase III) against the control R-miniCHOP alone based on progression-free survival (PFS). (Phase II component) III. To compare the overall survival (OS) between CC-486 + R-miniCHOP and R-miniCHOP alone. (Phase III component)
SECONDARY OBJECTIVES:
I. To assess the feasibility of delivering at least 4 cycles of CC-486 with R-miniCHOP in this population.
II. To assess toxicity for CC-486 + R-miniCHOP and for R-miniCHOP. III. To compare complete response rates, as defined by Lugano 2014 classification, between CC-486 + R-miniCHOP and R-miniCHOP alone.
INTEGRATED CORRELATIVE GERIATRIC ASSESSMENTS:
I. To compare functioning as assessed by the S1918 Comprehensive Geriatric Assessment (S1918 CGA) between participants treated with CC-486 + R-miniCHOP versus R-miniCHOP alone.
II. To evaluate if frailty status (fit/unfit versus [vs] frail/superfrail) as assessed by the FIL tool is associated with OS.
III. To evaluate if frailty as measured by the FIL tool correlates with the summary frailty index as measured using components of the S1918 CGA.
BANKING OBJECTIVE:
I. To bank specimens for future correlative studies.
OUTLINE:
Beginning 7 days prior to starting [protocol treatment, all patients receive vincristine sulfate intravenously (IV) on day 1, and prednisone orally (PO) daily on days 1-7.
Patients are then randomized to 1 of 2 arms.
ARM I: Patients receive CC-486 PO for 7 days prior to cycle 1. Patients then receive CC-486 PO on days 8-21. Treatment repeats every 21 days for cycles 1-5 in the absence of disease progression or unacceptable toxicity. Patients also receive rituximab IV (or rituximab and hyaluronidase human subcutaneously [SC] for cycles 2-6), cyclophosphamide IV, doxorubicin hydrochloride IV, and vincristine sulfate IV on day 1, and prednisone PO on days 1-5. Treatment repeats every 21 days for cycles 1-6 (6 cycles total) in the absence of disease progression or unacceptable toxicity. Patients undergo echocardiography (ECHO) or multigated acquisition scan (MUGA) at screening and undergo positron emission tomography (PET)-computed tomography (CT) and blood sample collection throughout the study.
ARM II: Patients receive rituximab IV (or rituximab and hyaluronidase human SC for cycles 2-6), cyclophosphamide IV, doxorubicin hydrochloride IV, and vincristine sulfate IV on day 1, and prednisone PO on days 1-5. Treatment repeats every 21 days for up to 6 cycles in the absence of disease progression or unacceptable toxicity. Patients undergo ECHO or MUGA at screening and undergo PET-CT and blood sample collection throughout the study.
After completion of study treatment, patients are followed up periodically until 5 years from the date of registration.
Typ studie
Zápis (Odhadovaný)
Fáze
- Fáze 2
- Fáze 3
Kontakty a umístění
Studijní místa
-
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Arizona
-
Tucson, Arizona, Spojené státy, 85719
- Banner University Medical Center - Tucson
-
Tucson, Arizona, Spojené státy, 85719
- University of Arizona Cancer Center-North Campus
-
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Arkansas
-
Little Rock, Arkansas, Spojené státy, 72205
- University of Arkansas for Medical Sciences
-
-
California
-
Anaheim, California, Spojené státy, 92806
- Kaiser Permanente-Anaheim
-
Baldwin Park, California, Spojené státy, 91706
- Kaiser Permanente-Baldwin Park
-
Bellflower, California, Spojené státy, 90706
- Kaiser Permanente-Bellflower
-
Beverly Hills, California, Spojené státy, 90211
- Tower Cancer Research Foundation
-
Costa Mesa, California, Spojené státy, 92627
- UC Irvine Health Cancer Center-Newport
-
Duarte, California, Spojené státy, 91010
- City of Hope Comprehensive Cancer Center
-
Fontana, California, Spojené státy, 92335
- Kaiser Permanente-Fontana
-
Harbor City, California, Spojené státy, 90710
- Kaiser Permanente South Bay
-
Huntington Beach, California, Spojené státy, 92648
- City of Hope Seacliff
-
Irvine, California, Spojené státy, 92618
- Kaiser Permanente-Irvine
-
Irvine, California, Spojené státy, 92618
- City of Hope at Irvine Lennar
-
Lancaster, California, Spojené státy, 93534
- City of Hope Antelope Valley
-
Long Beach, California, Spojené státy, 90822
- Tibor Rubin VA Medical Center
-
Long Beach, California, Spojené státy, 90813
- City of Hope at Long Beach Elm
-
Los Angeles, California, Spojené státy, 90048
- Cedars-Sinai Medical Center
-
Los Angeles, California, Spojené státy, 90027
- Kaiser Permanente Los Angeles Medical Center
-
Los Angeles, California, Spojené státy, 90034
- Kaiser Permanente West Los Angeles
-
Newport Beach, California, Spojené státy, 92660
- City of Hope Newport Beach
-
Ontario, California, Spojené státy, 91761
- Kaiser Permanente-Ontario
-
Orange, California, Spojené státy, 92868
- UC Irvine Health/Chao Family Comprehensive Cancer Center
-
Palo Alto, California, Spojené státy, 94304
- Stanford Cancer Institute Palo Alto
-
Panorama City, California, Spojené státy, 91402
- Kaiser Permanente - Panorama City
-
Riverside, California, Spojené státy, 92505
- Kaiser Permanente-Riverside
-
San Diego, California, Spojené státy, 92120
- Kaiser Permanente-San Diego Zion
-
San Marcos, California, Spojené státy, 92078
- Kaiser Permanente-San Marcos
-
San Mateo, California, Spojené státy, 94402
- UCSF Cancer Center - San Mateo
-
South Pasadena, California, Spojené státy, 91030
- City of Hope South Pasadena
-
Torrance, California, Spojené státy, 90503
- City of Hope South Bay
-
Upland, California, Spojené státy, 91786
- City of Hope Upland
-
Woodland Hills, California, Spojené státy, 91367
- Kaiser Permanente-Woodland Hills
-
-
Colorado
-
Golden, Colorado, Spojené státy, 80401
- Lutheran Hospital - Cancer Centers of Colorado
-
-
Delaware
-
Newark, Delaware, Spojené státy, 19713
- Helen F Graham Cancer Center
-
Newark, Delaware, Spojené státy, 19713
- Delaware Clinical and Laboratory Physicians PA
-
Newark, Delaware, Spojené státy, 19713
- Medical Oncology Hematology Consultants PA
-
-
Florida
-
Miami, Florida, Spojené státy, 33136
- University of Miami Miller School of Medicine-Sylvester Cancer Center
-
-
Georgia
-
Atlanta, Georgia, Spojené státy, 30308
- Emory University Hospital Midtown
-
Atlanta, Georgia, Spojené státy, 30322
- Emory University Hospital/Winship Cancer Institute
-
Atlanta, Georgia, Spojené státy, 30342
- Emory Saint Joseph's Hospital
-
Augusta, Georgia, Spojené státy, 30912
- Augusta University Medical Center
-
-
Hawaii
-
Honolulu, Hawaii, Spojené státy, 96813
- Queen's Medical Center
-
Honolulu, Hawaii, Spojené státy, 96813
- Hawaii Cancer Care Inc - Waterfront Plaza
-
Honolulu, Hawaii, Spojené státy, 96813
- Queen's Cancer Cenrer - POB I
-
Honolulu, Hawaii, Spojené státy, 96813
- Straub Clinic and Hospital
-
Honolulu, Hawaii, Spojené státy, 96817
- Queen's Cancer Center - Kuakini
-
‘Aiea, Hawaii, Spojené státy, 96701
- Hawaii Cancer Care - Westridge
-
‘Aiea, Hawaii, Spojené státy, 96701
- Pali Momi Medical Center
-
-
Illinois
-
Centralia, Illinois, Spojené státy, 62801
- Centralia Oncology Clinic
-
Chicago, Illinois, Spojené státy, 60611
- Northwestern University
-
Chicago, Illinois, Spojené státy, 60637
- University of Chicago Comprehensive Cancer Center
-
Chicago, Illinois, Spojené státy, 60612
- University of Illinois
-
Danville, Illinois, Spojené státy, 61832
- Carle at The Riverfront
-
DeKalb, Illinois, Spojené státy, 60115
- Northwestern Medicine Cancer Center Kishwaukee
-
Decatur, Illinois, Spojené státy, 62526
- Decatur Memorial Hospital
-
Decatur, Illinois, Spojené státy, 62526
- Cancer Care Specialists of Illinois - Decatur
-
Effingham, Illinois, Spojené státy, 62401
- Crossroads Cancer Center
-
Effingham, Illinois, Spojené státy, 62401
- Carle Physician Group-Effingham
-
Evanston, Illinois, Spojené státy, 60201
- NorthShore University HealthSystem-Evanston Hospital
-
Geneva, Illinois, Spojené státy, 60134
- Northwestern Medicine Cancer Center Delnor
-
Glenview, Illinois, Spojené státy, 60026
- NorthShore University HealthSystem-Glenbrook Hospital
-
Glenview, Illinois, Spojené státy, 60026
- Northwestern Medicine Glenview Outpatient Center
-
Grayslake, Illinois, Spojené státy, 60030
- Northwestern Medicine Grayslake Outpatient Center
-
Highland Park, Illinois, Spojené státy, 60035
- NorthShore University HealthSystem-Highland Park Hospital
-
Lake Forest, Illinois, Spojené státy, 60045
- Northwestern Medicine Lake Forest Hospital
-
Mattoon, Illinois, Spojené státy, 61938
- Carle Physician Group-Mattoon/Charleston
-
New Lenox, Illinois, Spojené státy, 60451
- UC Comprehensive Cancer Center at Silver Cross
-
O'Fallon, Illinois, Spojené státy, 62269
- Cancer Care Center of O'Fallon
-
Orland Park, Illinois, Spojené státy, 60462
- University of Chicago Medicine-Orland Park
-
Orland Park, Illinois, Spojené státy, 60462
- Northwestern Medicine Orland Park
-
Peoria, Illinois, Spojené státy, 61615
- Illinois CancerCare-Peoria
-
Shiloh, Illinois, Spojené státy, 62269
- Memorial Hospital East
-
Urbana, Illinois, Spojené státy, 61801
- Carle Cancer Center
-
Warrenville, Illinois, Spojené státy, 60555
- Northwestern Medicine Cancer Center Warrenville
-
-
Iowa
-
Ames, Iowa, Spojené státy, 50010
- McFarland Clinic - Ames
-
Ankeny, Iowa, Spojené státy, 50023
- UI Health Care Mission Cancer and Blood - Ankeny Clinic
-
Clive, Iowa, Spojené státy, 50325
- UI Health Care Mission Cancer and Blood - West Des Moines Clinic
-
Des Moines, Iowa, Spojené státy, 50309
- Iowa Methodist Medical Center
-
Des Moines, Iowa, Spojené státy, 50309
- UI Health Care Mission Cancer and Blood - Des Moines Clinic
-
Des Moines, Iowa, Spojené státy, 50314
- UI Health Care Mission Cancer and Blood - Laurel Clinic
-
-
Louisiana
-
Monroe, Louisiana, Spojené státy, 71202
- Ochsner LSU Health Monroe Medical Center
-
Shreveport, Louisiana, Spojené státy, 71103
- LSU Health Sciences Center at Shreveport
-
-
Massachusetts
-
Boston, Massachusetts, Spojené státy, 02111
- Tufts Medical Center
-
-
Michigan
-
Ann Arbor, Michigan, Spojené státy, 48106
- Trinity Health Saint Joseph Mercy Hospital Ann Arbor
-
Brighton, Michigan, Spojené státy, 48114
- Trinity Health IHA Medical Group Hematology Oncology - Brighton
-
Brighton, Michigan, Spojené státy, 48114
- Trinity Health Medical Center - Brighton
-
Canton, Michigan, Spojené státy, 48188
- Trinity Health IHA Medical Group Hematology Oncology - Canton
-
Canton, Michigan, Spojené státy, 48188
- Trinity Health Medical Center - Canton
-
Chelsea, Michigan, Spojené státy, 48118
- Trinity Health IHA Medical Group Hematology Oncology - Chelsea Hospital
-
Chelsea, Michigan, Spojené státy, 48118
- Chelsea Hospital
-
Livonia, Michigan, Spojené státy, 48154
- Trinity Health Saint Mary Mercy Livonia Hospital
-
Livonia, Michigan, Spojené státy, 48154
- Hope Cancer Clinic
-
Ypsilanti, Michigan, Spojené státy, 48197
- Trinity Health IHA Medical Group Hematology Oncology Ann Arbor Campus
-
Ypsilanti, Michigan, Spojené státy, 48106
- Huron Gastroenterology PC
-
-
Minnesota
-
Deer River, Minnesota, Spojené státy, 56636
- Essentia Health - Deer River Clinic
-
Duluth, Minnesota, Spojené státy, 55805
- Essentia Health Cancer Center
-
Hibbing, Minnesota, Spojené státy, 55746
- Essentia Health Hibbing Clinic
-
Sandstone, Minnesota, Spojené státy, 55072
- Essentia Health Sandstone
-
Virginia, Minnesota, Spojené státy, 55792
- Essentia Health Virginia Clinic
-
-
Mississippi
-
Oxford, Mississippi, Spojené státy, 38655
- Baptist Memorial Hospital and Cancer Center-Oxford
-
Southhaven, Mississippi, Spojené státy, 38671
- Baptist Memorial Hospital and Cancer Center-Desoto
-
-
Missouri
-
Cape Girardeau, Missouri, Spojené státy, 63703
- Saint Francis Medical Center
-
Chesterfield, Missouri, Spojené státy, 63017
- Saint Luke's Hospital
-
City of Saint Peters, Missouri, Spojené státy, 63376
- Siteman Cancer Center at Saint Peters Hospital
-
Creve Coeur, Missouri, Spojené státy, 63141
- Siteman Cancer Center at West County Hospital
-
Saint Joseph, Missouri, Spojené státy, 64506
- Heartland Regional Medical Center
-
St Louis, Missouri, Spojené státy, 63110
- Washington University School of Medicine
-
St Louis, Missouri, Spojené státy, 63129
- Siteman Cancer Center-South County
-
St Louis, Missouri, Spojené státy, 63136
- Siteman Cancer Center at Christian Hospital
-
-
Nebraska
-
Lincoln, Nebraska, Spojené státy, 68516
- Cancer Partners of Nebraska
-
-
New Jersey
-
Basking Ridge, New Jersey, Spojené státy, 07920
- Memorial Sloan Kettering Basking Ridge
-
Englewood, New Jersey, Spojené státy, 07631
- Englewood Hospital and Medical Center
-
Lakewood, New Jersey, Spojené státy, 08701
- Monmouth Medical Center Southern Campus
-
Long Branch, New Jersey, Spojené státy, 07740
- Monmouth Medical Center
-
Middletown, New Jersey, Spojené státy, 07748
- Memorial Sloan Kettering Monmouth
-
Montvale, New Jersey, Spojené státy, 07645
- Memorial Sloan Kettering Bergen
-
New Brunswick, New Jersey, Spojené státy, 08903
- Rutgers Cancer Institute of New Jersey
-
Newark, New Jersey, Spojené státy, 07112
- Newark Beth Israel Medical Center
-
Toms River, New Jersey, Spojené státy, 08755
- Community Medical Center
-
-
New York
-
Buffalo, New York, Spojené státy, 14263
- Roswell Park Cancer Institute
-
Commack, New York, Spojené státy, 11725
- Memorial Sloan Kettering Commack
-
Glens Falls, New York, Spojené státy, 12801
- Glens Falls Hospital
-
Harrison, New York, Spojené státy, 10604
- Memorial Sloan Kettering Westchester
-
Mineola, New York, Spojené státy, 11501
- NYU Langone Hospital - Long Island
-
New York, New York, Spojené státy, 10065
- Memorial Sloan Kettering Cancer Center
-
New York, New York, Spojené státy, 10032
- NYP/Columbia University Medical Center/Herbert Irving Comprehensive Cancer Center
-
New York, New York, Spojené státy, 10065
- NYP/Weill Cornell Medical Center
-
New York, New York, Spojené státy, 10016
- Laura and Isaac Perlmutter Cancer Center at NYU Langone
-
Oswego, New York, Spojené státy, 13126
- Upstate Cancer Center at Oswego
-
Syracuse, New York, Spojené státy, 13210
- State University of New York Upstate Medical University
-
Uniondale, New York, Spojené státy, 11553
- Memorial Sloan Kettering Nassau
-
Verona, New York, Spojené státy, 13478
- Upstate Cancer Center at Verona
-
-
North Carolina
-
Chapel Hill, North Carolina, Spojené státy, 27599
- UNC Lineberger Comprehensive Cancer Center
-
-
Ohio
-
Cleveland, Ohio, Spojené státy, 44195
- Cleveland Clinic Foundation
-
Cleveland, Ohio, Spojené státy, 44111
- Cleveland Clinic Cancer Center/Fairview Hospital
-
Columbus, Ohio, Spojené státy, 43210
- Ohio State University Comprehensive Cancer Center
-
Dayton, Ohio, Spojené státy, 45415
- Dayton Physician LLC - Englewood
-
Independence, Ohio, Spojené státy, 44131
- Cleveland Clinic Cancer Center Independence
-
Kettering, Ohio, Spojené státy, 45409
- Greater Dayton Cancer Center
-
Mansfield, Ohio, Spojené státy, 44906
- Cleveland Clinic Cancer Center Mansfield
-
Mayfield Heights, Ohio, Spojené státy, 44124
- Hillcrest Hospital Cancer Center
-
Sandusky, Ohio, Spojené státy, 44870
- North Coast Cancer Care
-
Strongsville, Ohio, Spojené státy, 44136
- Cleveland Clinic Cancer Center Strongsville
-
Warrensville Heights, Ohio, Spojené státy, 44122
- South Pointe Hospital
-
Wooster, Ohio, Spojené státy, 44691
- Cleveland Clinic Wooster Family Health and Surgery Center
-
-
Oklahoma
-
Lawton, Oklahoma, Spojené státy, 73505
- Cancer Centers of Southwest Oklahoma Research
-
Oklahoma City, Oklahoma, Spojené státy, 73104
- University of Oklahoma Health Sciences Center
-
-
Oregon
-
Portland, Oregon, Spojené státy, 97225
- Providence Saint Vincent Medical Center
-
Portland, Oregon, Spojené státy, 97239
- Portland VA Medical Center
-
-
South Carolina
-
Charleston, South Carolina, Spojené státy, 29425
- Medical University of South Carolina
-
Greenville, South Carolina, Spojené státy, 29607
- Saint Francis Cancer Center
-
Greenville, South Carolina, Spojené státy, 29601
- Saint Francis Hospital
-
-
Tennessee
-
Memphis, Tennessee, Spojené státy, 38120
- Baptist Memorial Hospital and Cancer Center-Memphis
-
-
Utah
-
Salt Lake City, Utah, Spojené státy, 84112
- Huntsman Cancer Institute/University of Utah
-
Salt Lake City, Utah, Spojené státy, 84148
- George E Wahlen Department of Veterans Affairs Medical Center
-
-
Virginia
-
Charlottesville, Virginia, Spojené státy, 22908
- University of Virginia Cancer Center
-
Fairfax, Virginia, Spojené státy, 22031
- Inova Schar Cancer Institute
-
Richmond, Virginia, Spojené státy, 23298
- VCU Massey Comprehensive Cancer Center
-
-
Washington
-
Bellevue, Washington, Spojené státy, 98004
- FHCC Overlake
-
Kirkland, Washington, Spojené státy, 98034
- FHCC at EvergreenHealth
-
Seattle, Washington, Spojené státy, 98133
- FHCC at Northwest Hospital
-
-
West Virginia
-
Charleston, West Virginia, Spojené státy, 25304
- Vandalia Health/CAMC Institute for Academic Medicine
-
-
Wisconsin
-
Ashland, Wisconsin, Spojené státy, 54806
- Duluth Clinic Ashland
-
Eau Claire, Wisconsin, Spojené státy, 54701
- Marshfield Medical Center-EC Cancer Center
-
Green Bay, Wisconsin, Spojené státy, 54301
- Saint Vincent Hospital Cancer Center Green Bay
-
Green Bay, Wisconsin, Spojené státy, 54303
- Saint Vincent Hospital Cancer Center at Saint Mary's
-
La Crosse, Wisconsin, Spojené státy, 54601
- Gundersen Lutheran Medical Center
-
Marshfield, Wisconsin, Spojené státy, 54449
- Marshfield Medical Center-Marshfield
-
Minocqua, Wisconsin, Spojené státy, 54548
- Marshfield Medical Center - Minocqua
-
Oconto Falls, Wisconsin, Spojené státy, 54154
- Saint Vincent Hospital Cancer Center at Oconto Falls
-
Rice Lake, Wisconsin, Spojené státy, 54868
- Marshfield Medical Center-Rice Lake
-
Sheboygan, Wisconsin, Spojené státy, 53081
- Saint Vincent Hospital Cancer Center at Sheboygan
-
Stevens Point, Wisconsin, Spojené státy, 54482
- Marshfield Medical Center-River Region at Stevens Point
-
Sturgeon Bay, Wisconsin, Spojené státy, 54235-1495
- Saint Vincent Hospital Cancer Center at Sturgeon Bay
-
Weston, Wisconsin, Spojené státy, 54476
- Marshfield Medical Center - Weston
-
-
Kritéria účasti
Kritéria způsobilosti
Věk způsobilý ke studiu
Přijímá zdravé dobrovolníky
Pohlaví způsobilá ke studiu
Popis
Inclusion Criteria:
-
Participants must have histologically or cytologically confirmed diffuse large B-cell lymphoma (DLBCL), Ann Arbor Stage IIX (bulky), III or IV. Participants with DLBCL transformed from follicular lymphoma (FL) or marginal zone lymphoma (MZL, including mucosa-associated lymphoid tissue [MALT] lymphomas), lymphoplasmacytic lymphoma (LPL), or nodular lymphocyte-predominant Hodgkin Lymphoma (NLPHL) are eligible. Participants with Grade IIIB follicular lymphoma (FL) or high-grade B-cell lymphomas with MYC and BCL2 and/or BCL6 rearrangements are also eligible. Participants with DLBCL that arose from prior CLL (Richter's transformation) are not eligible.
-
As defined by the World Health Organization (WHO), eligible lymphoma subtypes include the following:
- DLBCL, not otherwise specified (NOS)
- DLBCL, germinal-center B-cell type (GCB)
- DLBCL, activated B-cell type (ABC)
- T-cell histiocyte-rich B-cell lymphomas (THRBCL)
- Primary cutaneous DLBCL, leg type
- Intravascular large B cell lymphoma
- EBV+ DLBCL, NOS
- DLBCL associated with chronic inflammation
- HHV8+ DLBCL, NOS
- High-grade B-cell lymphoma with MYC and BCL2 and/or BCL6 rearrangements
- High grade B-cell lymphoma, NOS
- Follicular lymphoma grade 3b
-
Participants must have staging imaging performed within 28 days prior to registration, as follows. PET-CT baseline scans are strongly preferred; diagnostic quality magnetic resonance imaging (MRI), contrast-enhanced CT, or contrast-enhanced MRI scans are also acceptable if PET-CT is not feasible at baseline. Note: PET-CT will be required at end of treatment (EOT) and progression for response assessment. Participants must have measurable disease (at least one lesion with longest diameter ≥ 1.5 cm). All measurable lesions (longest diameter >= 1.5 cm) must be assessed within 28 days prior to registration. Tests to assess non-measurable disease must be performed within 42 days prior to registration.
-
Participants with known human immunodeficiency virus (HIV)-infection are eligible providing they are on effective anti-retroviral therapy and have undetectable viral load at their most recent viral load test (must be within 26 weeks prior to registration). Participants with known HIV must have a CD4 count checked within 28 days prior to registration, but may proceed with therapy regardless of CD4 count.
-
All participants must be screened for chronic hepatitis B virus (HBV) within 28 days prior to registration. Participants with known HBV infection (positive serology) must also have a HBV viral load performed within 28 days prior to registration, and participants must have an undetectable HBV viral load on suppressive therapy within 28 days prior to registration. Participants found to be HBV carriers during screening are eligible and must receive standard of care prophylaxis. Participants with active hepatitis B (HBV viral load > 500 IU/mL) within 28 days prior to registration are not eligible
-
Participants with a known history of hepatitis C virus (HCV) infection must have an undetectable HCV viral load within in 28 days prior to registration
-
Participants must not have known lymphomatous involvement of the central nervous system (CNS)
-
Participants must not have active inflammatory bowel disease (such as, Crohn's disease, ulcerative colitis), celiac disease (i.e., sprue), prior gastrectomy or upper bowel removal, or any other gastrointestinal disorder or defect that would interfere with the absorption, distribution, metabolism, or excretion of the study drug and/or predispose the subject to an increased risk of gastrointestinal toxicity
-
Participants must not have a history of acute leukemia having been treated with intensive induction therapy. Participants with a prior or concurrent malignancy whose natural history or treatment does not have the potential to interfere with the safety or efficacy assessment of the investigational regimen are eligible for this trial
-
Participants must not have received any prior cytotoxic chemotherapy or rituximab for treatment of the newly diagnosed DLBCL except for the pre-phase treatment (within specified dose range) that may have either started before or may start after registration to S1918. Inhaled, nasal, and topical steroid use is allowed. Prior cytotoxic chemotherapy and/or antibody therapy for an indolent lymphoma prior to transformation is allowed. Up to 4 doses of intrathecal (IT) chemotherapy administered for central nervous system (CNS) prophylaxis is allowed in addition to protocol therapy. High-dose intravenous methotrexate is not allowed.
-
Participants must not have received more than a cumulative of dose 250 mg/m^2 of prior doxorubicin (or equivalent dose of another anthracycline, such as epirubicin) therapy (at any time prior to registration).
-
Participants must not currently be receiving any other investigational agents
-
Participant must not have a history of allergic reactions attributed to azacitidine, mannitol, or other hypomethylating agents
-
Participants must be age ≥ 75
-
Participants must have a Zubrod performance status of 0-2
-
Participants must have adequate renal function, as demonstrated by a creatinine clearance, calculated by the Cockcroft and Gault formula, of >= 30 ml/min that was obtained within 28 days prior to registration
-
Aspartate aminotransferase (AST) =< 2.5 x institutional upper limit of normal (IULN), alanine aminotransferase (ALT) =< 2.5 x IULN (within 28 days prior to registration)
-
Total bilirubin =< 2 x institutional upper limit of normal (IULN), unless due to Gilbert's disease, hemolysis, or lymphomatous involvement of liver (within 28 days prior to registration). Note: If total bilirubin is elevated, and direct bilirubin is subsequently performed (within 28 days prior to registration) and resulted to be =< 2 x IULN, the participant will be considered eligible
-
Absolute neutrophil count (ANC) >= 1000/mcL (within 28 days prior to registration)
-
Platelets >= 75,000/mcL (within 28 days prior to registration)
-
Hemoglobin (Hgb) >= 8 g/ dL (within 28 days prior to registration)
-
If there is a documented lymphomatous involvement of the bone marrow, bone marrow function within 28 days prior to registration, as evidenced by:
- ANC >= 500/mcL
- Platelets >= 50,000/mcL
- Hgb >= 8 g/ dL
-
Participants must have a left ventricular ejection (LVEF) fraction >= 45% as measured by echocardiogram or radionuclide (multigated acquisition scan [MUGA]) ventriculography within 56 days prior to registration
-
For the duration of the study treatment period and for at least 4 months following the last dose of study drug, male participants must agree to use effective contraceptive methods during sexual contact with a female of childbearing potential (FCBP) and must agree to refrain from semen or sperm donation during the same timeframe. Effective contraceptive methods include a history of vasectomy, use of hormonal contraception or an intrauterine device (IUD) by the female partner, or use of condoms
- A FCBP is a sexually mature woman who: 1) has not undergone a hysterectomy or bilateral oophorectomy; or 2) has not been naturally postmenopausal for at least 24 consecutive months (i.e., has had menses at any time in the preceding 24 consecutive months)
-
Participants must not have active infection (systemic fungal, bacterial, or viral infection) that is not controlled (defined as ongoing signs/symptoms related the infection without improvement despite appropriate antibiotics, antiviral therapy, and/or other treatment)
-
Participants must not have active cardiac disease within 26 weeks prior to registration, including: symptomatic congestive heart failure (New York Heart Association [NYHA] class 4), unstable angina pectoris, hemodynamically unstable cardiac arrhythmia, or myocardial infarction
-
Participants must not have >= grade 2 neuropathy, by Common Terminology Criteria for Adverse Events (CTCAE) version (v.) 5.0, within 28 days prior to registration
-
Participants must not have any other known uncontrolled intercurrent illness including, but not limited to ongoing psychiatric illness/social situations that would limit compliance with study requirements
-
Participants must not have a concurrent primary malignancy undergoing active therapy. Exceptions: participants may have non-melanomatous skin cancers requiring only surgical intervention. Participants may have a history of early stage breast cancer or prostate cancer in remission after surgical and/or radiation therapy on adjuvant hormonal therapy only
Studijní plán
Jak je studie koncipována?
Detaily designu
- Primární účel: Léčba
- Přidělení: Randomizované
- Intervenční model: Paralelní přiřazení
- Maskování: Žádné (otevřený štítek)
Zbraně a zásahy
Skupina účastníků / Arm |
Intervence / Léčba |
|---|---|
|
Experimentální: Arm I (oral azacitidine, R-miniCHOP)
Patients receive CC-486 PO for 7 days prior to cycle 1. Patients then receive CC-486 PO on days 8-21. Treatment repeats every 21 days for cycles 1-5 in the absence of disease progression or unacceptable toxicity. Patients also receive rituximab IV (or rituximab and hyaluronidase human SC for cycles 2-6), cyclophosphamide IV, doxorubicin hydrochloride IV, and vincristine sulfate IV on day 1, and prednisone PO on days 1-5. Treatment repeats every 21 days for cycles 1-6 (6 cycles total) in the absence of disease progression or unacceptable toxicity. Patients undergo ECHO or MUGA at screening and undergo PET-CT and blood sample collection throughout the study. |
Given IV
Ostatní jména:
Given IV
Ostatní jména:
Given PO
Ostatní jména:
Undergo blood sample collection
Ostatní jména:
Given IV
Ostatní jména:
Given IV
Ostatní jména:
Ancillary studies Undergo ECHO
Ostatní jména:
Undergo MUGA
Ostatní jména:
Undergo PET-CT
Ostatní jména:
Given SC
Ostatní jména:
Undergo PET-CT
Ostatní jména:
Given PO
Ostatní jména:
|
|
Aktivní komparátor: Arm II (R-miniCHOP)
Patients receive rituximab IV (or rituximab and hyaluronidase human SC for cycles 2-6), cyclophosphamide IV, doxorubicin hydrochloride IV, and vincristine sulfate IV on day 1, and prednisone PO on days 1-5. Treatment repeats every 21 days for up to 6 cycles in the absence of disease progression or unacceptable toxicity. Patients undergo ECHO or MUGA at screening and undergo PET-CT and blood sample collection throughout the study. |
Given IV
Ostatní jména:
Given IV
Ostatní jména:
Given PO
Ostatní jména:
Undergo blood sample collection
Ostatní jména:
Given IV
Ostatní jména:
Given IV
Ostatní jména:
Ancillary studies Undergo ECHO
Ostatní jména:
Undergo MUGA
Ostatní jména:
Undergo PET-CT
Ostatní jména:
Given SC
Ostatní jména:
Undergo PET-CT
Ostatní jména:
|
Co je měření studie?
Primární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
|---|---|---|
|
Excess toxicity as a result of adding oral azacitidine (CC-486) to reduced dose rituximab-cyclophosphamide, doxorubicin, vincristine, and prednisone (R-miniCHOP) (Safety run-in)
Časové okno: Up to completion of cycle 6
|
Will determine if the addition of CC-486 to R-miniCHOP results in excess toxicity compared to R-miniCHOP alone that would preclude the combination from being studied further. |
Up to completion of cycle 6
|
|
Progression-free survival (PFS) (Phase II)
Časové okno: From date of registration to date of first observation of progressive disease according to the 2014 Lugano classification, or death due to any cause, assessed up to 1 year
|
Will determine if the CC-486 + R-miniCHOP regimen should be tested further (Phase III) against the control R-miniCHOP alone based on PFS. After accruing 130 patients (65 per arm, 21 months of accrual and potentially pausing accrual for 6 months follow-up to reach a target 63 events across arms), a one-sided stratified .10 log-rank test will inform a go/no-go decision based on sufficient evidence of efficacy to continue to the Phase III portion of the study. |
From date of registration to date of first observation of progressive disease according to the 2014 Lugano classification, or death due to any cause, assessed up to 1 year
|
|
Overall survival (Phase III)
Časové okno: From date of registration to date of death due to any cause, assessed up to 2 years
|
Will compare overall survival in the control arm of R-miniCHOP to the experimental arm of CC-486 (oral azacitidine) + R-miniCHOP. Will be evaluated using a 1-sided .025 level stratified logrank test. |
From date of registration to date of death due to any cause, assessed up to 2 years
|
Sekundární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
|---|---|---|
|
Metabolic complete response (CR)
Časové okno: Up to end of cycle 6 or end of treatment
|
Will be defined using 2014 Lugano classification. Fisher's exact test will be used to compare CR rates between the experimental arm of CC-486 + R-miniCHOP and the control arm of R-miniCHOP alone. |
Up to end of cycle 6 or end of treatment
|
|
Incidence of adverse events
Časové okno: Until disease progression, assessed up to 5 years
|
Will be assessed using Common Terminology Criteria for Adverse Events version 5. The maximum Grade for each toxicity will be recorded for each patient, and frequency tables will be reviewed to determine toxicity patterns. Treatment-related toxicities between arms will be compared using Fisher's exact test. |
Until disease progression, assessed up to 5 years
|
|
Overall survival (Phase III)
Časové okno: From date of registration to date of death due to any cause, assessed up to 5 years
|
An additional secondary analysis of overall survival of the Phase III comparison will adjust for patients with identified double-hit phenotype in addition to the pre-specified stratification factors. Will also prospectively collect the number of days between diagnostic biopsy and cycle 1 day 1 of therapy for a pre-planned secondary analysis. |
From date of registration to date of death due to any cause, assessed up to 5 years
|
Další výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
|---|---|---|
|
Changes in function (Integrated Correlative Geriatric Assessments Substudy)
Časové okno: From time of randomization up to 24 months after date of registration
|
Will be assessed by a Comprehensive Geriatric Assessment (Carolina Frailty Index [CFI] Score) between patients treated with CC-486 + R-miniCHOP and those treated with R-miniCHOP alone. Linear regression will be used for each examination, adjusting for the stratification factors from the clinical study and the baseline score (for the examination of change from 12 to 24 months, the 12-month score will be considered the baseline score). Although the number of timepoints is limited to 3, longitudinal assessments of the CFI Score over time will also be conducted using linear mixed models, adjusting for the stratification factors and the baseline score, with patient considered a random effect. |
From time of randomization up to 24 months after date of registration
|
|
Frailty status (fit/unfit vs frail) (Integrated Correlative Geriatric Assessments Substudy)
Časové okno: Baseline
|
Will evaluate if frailty status (fit/unfit versus frail) as assessed by the Italian Lymphoma Foundation (FIL) tool is associated with overall survival. Multivariable Cox regression will be conducted, adjusting for the stratification variables and the randomized treatment arm as covariates. Will also examine whether randomization to CC-486 + R-miniCHOP is associated with better overall survival compared to treatment with R-miniCHOP alone in the subset of fit and unfit patients. Multivariable Cox regression will be conducted, adjusting for the stratification variables as covariates. |
Baseline
|
|
Frailty status (Integrated Correlative Geriatric Assessments Substudy)
Časové okno: Up to 24 months after date of registration
|
Will evaluate if frailty status (fit/unfit versus frail) as assessed by the FIL tool correlates with the summary frailty indexed as measured by the S1918 Comprehensive Geriatric Assessment (CGA). In particular, agreement between the FIL and CGA will measured using an unweighted Kappa statistic; moderate or better agreement is defined as a Kappa coefficient of >= 0.41. |
Up to 24 months after date of registration
|
Spolupracovníci a vyšetřovatelé
Sponzor
Vyšetřovatelé
- Vrchní vyšetřovatel: Elizabeth A Brem, SWOG Cancer Research Network
Publikace a užitečné odkazy
Termíny studijních záznamů
Hlavní termíny studia
Začátek studia (Aktuální)
Primární dokončení (Odhadovaný)
Dokončení studie (Odhadovaný)
Termíny zápisu do studia
První předloženo
První předloženo, které splnilo kritéria kontroly kvality
První zveřejněno (Aktuální)
Aktualizace studijních záznamů
Poslední zveřejněná aktualizace (Aktuální)
Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality
Naposledy ověřeno
Více informací
Termíny související s touto studií
Další relevantní podmínky MeSH
- Novotvary
- Onemocnění imunitního systému
- Novotvary podle histologického typu
- Lymfatická onemocnění
- Lymfoproliferativní poruchy
- Imunoproliferativní poruchy
- Lymfom, Non-Hodgkin
- Lymfom, B-buňka
- Lymfom
- Hemická a lymfatická onemocnění
- Lymfom, velký B-buňka, difuzní
- Lymfom, B-buňka, okrajová zóna
- Aminokyseliny, peptidy a proteiny
- Proteiny
- Organické chemikálie
- Heterocyklické sloučeniny, 1 kruh
- Heterocyklické sloučeniny
- Heterocyklické sloučeniny, 2-prsten
- Heterocyklické sloučeniny, fúzované kroužek
- Vyšetřovací techniky
- Klinické laboratorní techniky
- Diagnostické techniky a postupy
- Diagnóza
- Nukleové kyseliny, nukleotidy a nukleosidy
- Uhlovodíky
- Uhlovodíky, cyklické
- Uhlohydráty
- Alkaloidy
- Polycyklické aromatické uhlovodíky
- Uhlovodíky, aromatické
- Polycyklické sloučeniny
- Glykosidy
- Glykosidové hydrolázy
- Hydrolázy
- Enzymy
- Enzymy a koenzymy
- Polysacharid-lyázy
- Lyázy uhlíkového kyslíku
- Lyázy
- Indoly
- Protilátky, monoklonální
- Protilátky
- Imunoglobuliny
- Imunoproteiny
- Krevní proteiny
- Sérové globuliny
- Globuliny
- Cytidin
- Pyrimidinové nukleosidy
- Pyrimidiny
- Těhotenství
- Těhotenství
- Steroidy
- Sloučeniny roztaveného kruhu
- Techniky chemie, analytické
- Analýza spektra
- Fosforamidové hořčice
- Sloučeniny hořčice dusíku
- Hořčičné sloučeniny
- Uhlovodíky, halogenované
- Fosforamidy
- Organofosforové sloučeniny
- Aza sloučeniny
- Nukleosidy
- Ribonukleosidy
- Těhotenství
- Vinca alkaloidy
- Alkaloidy tryptaminu sezologaninu
- Indolské alkaloidy
- Indolizidiny
- Indoliziny
- Antracykliny
- Nafthacenes
- Aminoglykosidy
- Protilátky, monoklonální, omyl odvozený
- Daunorubicin
- Rituximab
- Prednison
- Cyklofosfamid
- Azacitidin
- Doxorubicin
- Vinkristine
- Hyaluronoglukosaminidáza
- Manipulace se vzorkem
- Magnetická rezonanční spektroskopie
- CC-486
- CT-P10
- deltacortene
- prednyliden
Další identifikační čísla studie
- NCI-2020-01256
- U10CA180888 (Grant/smlouva NIH USA)
- NCI-2020-01256 (Identifikátor registru: CTRP (Clinical Trial Reporting Program))
- S1918 (Jiný identifikátor: CTEP)
- S1918 (Jiný identifikátor: SWOG)
Plán pro data jednotlivých účastníků (IPD)
Plánujete sdílet data jednotlivých účastníků (IPD)?
Popis plánu IPD
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