Kombinationskemoterapi med eller uden autolog stamcelletransplantation til behandling af patienter med B-cellelymfom i centralnervesystemet
Et randomiseret fase II-forsøg med myeloablativ versus ikke-myeloablativ konsolideringskemoterapi for nyligt diagnosticeret primært CNS B-celle lymfom
The purpose of this study is to find out what effects (good and/or bad) treatment with chemotherapy and stem cell transplant compared with chemotherapy alone will have on primary CNS B-cell lymphoma. Currently the best treatment for patients with primary CNS B-cell lymphoma is not known.
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Detaljeret beskrivelse
Primary Objective:
To compare the two-year progression-free survival (PFS) of patients treated with the myeloablative consolidation treatment strategy of HDT/ASCT versus those treated with non-myeloablative consolidation chemotherapy with cytarabine and etoposide
Secondary Objectives:
- To compare the two-year event-free survival (EFS) of patients treated with consolidation HDT/ASCT versus those treated with consolidation chemotherapy consisting of etoposide and cytarabine
- To compare the overall survival (OS) of patients treated with the consolidation HDT/ASCT versus those treated with consolidation chemotherapy consisting of etoposide and cytarabine
- To assess the toxicities associated with consolidation HDT/ASCT versus consolidation consisting of etoposide and cytarabine
- To determine diffusion MRI metrics (ADCmini, ADC25%, and ADCmean) prior to induction chemotherapy, after one full induction chemotherapy cycle, and at the end of induction chemotherapy as a predictor of response and outcome (CALGB 581101)
- To determine brain FDG-PET metrics (tumor SUV and tumor versus background SUV) prior to induction chemotherapy, after one full induction chemotherapy cycle, and at the end of induction chemotherapy as a predictor of response and outcome (CALGB 581101)
- To determine whether low baseline ADC measurements are associated with shorter PFS and OS (CALGB 581101)
- To determine whether reduction in tumor SUV by > 25% on brain FDG-PET/CT after one cycle of induction therapy is associated with improved PFS and OS (CALGB 581101)
- To determine which IHC-based biomarkers are predictive of an adverse prognosis (CALGB 151113)
- To determine which IHC-based biomarkers are predictive of a favorable prognosis (CALGB 151113) for BCL6 (B-cell CLL/lymphoma 6), and STAT 6 (signal transducer and activator of transcription 6, interleukin-4 induced)
- To analyze tumor tissue for gene expression profiles, and to correlate these profiles with treatment outcomes (CALGB 151113)
- To determine whether CSF proteome is a predictor of outcomes (prognostic marker) irrespective of treatment arm (CALGB 151113) for (IL-10 (interleukin 10) and C3 (complement component 3)
- To assess the neurocognitive function of patients treated with consolidation HDT/ASCT versus those treated with consolidation chemotherapy (etoposide and cytarabine) as measured by serial administration of the International PCNSL Collaborative Group (IPCG) neurocognitive battery and evaluate the long-term survivorship differences between the two arms (CALGB 71105)
Undersøgelsestype
Undersøgelsestype
Tilmelding (Faktiske)
Tilmelding
Fase
Fase
- Fase 2
Kontakter og lokationer
Studiesteder
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Alaska
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Anchorage, Alaska, Forenede Stater, 98508
- Anchorage Associates in Radiation Medicine
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Anchorage, Alaska, Forenede Stater, 99508
- Alaska Breast Care and Surgery LLC
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Anchorage, Alaska, Forenede Stater, 99508
- Alaska Oncology and Hematology LLC
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Anchorage, Alaska, Forenede Stater, 99508
- Alaska Women's Cancer Care
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Anchorage, Alaska, Forenede Stater, 99508
- Anchorage Oncology Centre
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Anchorage, Alaska, Forenede Stater, 99508
- Katmai Oncology Group
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Anchorage, Alaska, Forenede Stater, 99508
- Providence Alaska Medical Center
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Anchorage, Alaska, Forenede Stater, 99504
- Anchorage Radiation Therapy Center
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California
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Burbank, California, Forenede Stater, 91505
- Providence Saint Joseph Medical Center/Disney Family Cancer Center
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La Jolla, California, Forenede Stater, 92093
- UC San Diego Moores Cancer Center
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Sacramento, California, Forenede Stater, 95817
- University of California Davis Comprehensive Cancer Center
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San Francisco, California, Forenede Stater, 94115
- UCSF Medical Center-Mount Zion
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San Francisco, California, Forenede Stater, 94143
- UCSF Medical Center-Parnassus
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Connecticut
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New Haven, Connecticut, Forenede Stater, 06520
- Yale University
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Florida
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Tampa, Florida, Forenede Stater, 33612
- Moffitt Cancer Center
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Georgia
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Atlanta, Georgia, Forenede Stater, 30322
- Emory University/Winship Cancer Institute
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Idaho
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Boise, Idaho, Forenede Stater, 83712
- Saint Luke's Mountain States Tumor Institute
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Fruitland, Idaho, Forenede Stater, 83619
- Saint Luke's Mountain States Tumor Institute - Fruitland
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Meridian, Idaho, Forenede Stater, 83642
- Saint Luke's Mountain States Tumor Institute - Meridian
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Nampa, Idaho, Forenede Stater, 83686
- Saint Luke's Mountain States Tumor Institute - Nampa
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Twin Falls, Idaho, Forenede Stater, 83301
- Saint Luke's Mountain States Tumor Institute-Twin Falls
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Illinois
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Chicago, Illinois, Forenede Stater, 60637
- University of Chicago Comprehensive Cancer Center
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Chicago, Illinois, Forenede Stater, 60612
- University of Illinois
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Indiana
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Richmond, Indiana, Forenede Stater, 47374
- Reid Health
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Kansas
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Kansas City, Kansas, Forenede Stater, 66160
- University of Kansas Cancer Center
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Kentucky
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Crestview Hills, Kentucky, Forenede Stater, 41017
- Oncology Hematology Care Inc-Crestview
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Louisiana
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New Orleans, Louisiana, Forenede Stater, 70112
- Tulane University Health Sciences Center
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Maryland
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Baltimore, Maryland, Forenede Stater, 21287
- Johns Hopkins University/Sidney Kimmel Cancer Center
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Massachusetts
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Boston, Massachusetts, Forenede Stater, 02215
- Dana-Farber Cancer Institute
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Boston, Massachusetts, Forenede Stater, 02115
- Brigham and Women's Hospital
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Boston, Massachusetts, Forenede Stater, 02114
- Massachusetts General Hospital Cancer Center
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Michigan
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Battle Creek, Michigan, Forenede Stater, 49017
- Bronson Battle Creek
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Grand Rapids, Michigan, Forenede Stater, 49503
- Spectrum Health at Butterworth Campus
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Grand Rapids, Michigan, Forenede Stater, 49503
- Mercy Health Saint Mary's
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Kalamazoo, Michigan, Forenede Stater, 49007
- West Michigan Cancer Center
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Kalamazoo, Michigan, Forenede Stater, 49007
- Bronson Methodist Hospital
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Kalamazoo, Michigan, Forenede Stater, 49001
- Borgess Medical Center
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Muskegon, Michigan, Forenede Stater, 49444
- Mercy Health Mercy Campus
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Niles, Michigan, Forenede Stater, 49120
- Lakeland Community Hospital
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Reed City, Michigan, Forenede Stater, 49677
- Spectrum Health Reed City Hospital
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Saint Joseph, Michigan, Forenede Stater, 49085
- Marie Yeager Cancer Center
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Saint Joseph, Michigan, Forenede Stater, 49085
- Lakeland Hospital
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Traverse City, Michigan, Forenede Stater, 49684
- Munson Medical Center
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Wyoming, Michigan, Forenede Stater, 49519
- Metro Health Hospital
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Minnesota
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Rochester, Minnesota, Forenede Stater, 55905
- Mayo Clinic
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Missouri
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St Louis, Missouri, Forenede Stater, 63110
- Washington University School of Medicine
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Nebraska
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Omaha, Nebraska, Forenede Stater, 68198
- University of Nebraska Medical Center
-
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New York
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New York, New York, Forenede Stater, 10065
- Weill Medical College of Cornell University
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Rochester, New York, Forenede Stater, 14642
- University of Rochester
-
Stony Brook, New York, Forenede Stater, 11794
- Stony Brook University Medical Center
-
Syracuse, New York, Forenede Stater, 13210
- State University of New York Upstate Medical University
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North Carolina
-
Durham, North Carolina, Forenede Stater, 27710
- Duke University Medical Center
-
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Ohio
-
Centerville, Ohio, Forenede Stater, 45459
- Dayton Physicians LLC-Miami Valley South
-
Cincinnati, Ohio, Forenede Stater, 45242
- Oncology Hematology Care Inc-Blue Ash
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Cincinnati, Ohio, Forenede Stater, 45202
- Oncology Hematology Care Inc-Eden Park
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Cincinnati, Ohio, Forenede Stater, 45211
- Oncology Hematology Care Inc-Mercy West
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Cincinnati, Ohio, Forenede Stater, 45236
- Oncology Hematology Care Inc-Kenwood
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Cincinnati, Ohio, Forenede Stater, 45230
- Oncology Hematology Care Inc - Anderson
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Dayton, Ohio, Forenede Stater, 45406
- Good Samaritan Hospital - Dayton
-
Dayton, Ohio, Forenede Stater, 45409
- Miami Valley Hospital
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Dayton, Ohio, Forenede Stater, 45415
- Dayton Physicians LLC-Samaritan North
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Dayton, Ohio, Forenede Stater, 45415
- Samaritan North Health Center
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Dayton, Ohio, Forenede Stater, 45420
- Dayton NCI Community Oncology Research Program
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Fairfield, Ohio, Forenede Stater, 45014
- Oncology Hematology Care Inc-Healthplex
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Findlay, Ohio, Forenede Stater, 45840
- Blanchard Valley Hospital
-
Findlay, Ohio, Forenede Stater, 45840
- Armes Family Cancer Center
-
Findlay, Ohio, Forenede Stater, 45840
- Orion Cancer Care
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Franklin, Ohio, Forenede Stater, 45005-1066
- Atrium Medical Center-Middletown Regional Hospital
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Franklin, Ohio, Forenede Stater, 45005
- Dayton Physicians LLC-Atrium
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Greenville, Ohio, Forenede Stater, 45331
- Wayne Hospital
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Greenville, Ohio, Forenede Stater, 45331
- Dayton Physicians LLC-Wayne
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Kettering, Ohio, Forenede Stater, 45429
- Kettering Medical Center
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Kettering, Ohio, Forenede Stater, 45409
- Greater Dayton Cancer Center
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Middletown, Ohio, Forenede Stater, 45042
- Dayton Physicians LLC-Signal Point
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Sidney, Ohio, Forenede Stater, 45365
- Dayton Physicians LLC-Wilson
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Springfield, Ohio, Forenede Stater, 45505
- Springfield Regional Medical Center
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Springfield, Ohio, Forenede Stater, 45504
- Springfield Regional Cancer Center
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Troy, Ohio, Forenede Stater, 45373
- Upper Valley Medical Center
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Troy, Ohio, Forenede Stater, 45373
- Dayton Physicians LLC-Upper Valley
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Oklahoma
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Tulsa, Oklahoma, Forenede Stater, 74136
- Surgical Associates Inc
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Tulsa, Oklahoma, Forenede Stater, 74146
- Warren Clinic Oncology-Tulsa
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Oregon
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Bend, Oregon, Forenede Stater, 97701
- Saint Charles Health System
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Clackamas, Oregon, Forenede Stater, 97015
- Clackamas Radiation Oncology Center
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Clackamas, Oregon, Forenede Stater, 97015
- Providence Oncology and Hematology Care Southeast
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Coos Bay, Oregon, Forenede Stater, 97420
- Bay Area Hospital
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Milwaukie, Oregon, Forenede Stater, 97222
- Providence Milwaukie Hospital
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Newberg, Oregon, Forenede Stater, 97132
- Providence Newberg Medical Center
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Oregon City, Oregon, Forenede Stater, 97045
- Providence Willamette Falls Medical Center
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Portland, Oregon, Forenede Stater, 97213
- Providence Portland Medical Center
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Portland, Oregon, Forenede Stater, 97225
- Providence Saint Vincent Medical Center
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Pennsylvania
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Danville, Pennsylvania, Forenede Stater, 17822
- Geisinger Medical Center
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Lewistown, Pennsylvania, Forenede Stater, 17044
- Lewistown Hospital
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Pittsburgh, Pennsylvania, Forenede Stater, 15232
- University of Pittsburgh Cancer Institute (UPCI)
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Utah
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Salt Lake City, Utah, Forenede Stater, 84112
- Huntsman Cancer Institute/University of Utah
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Vermont
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Berlin Corners, Vermont, Forenede Stater, 05602
- Central Vermont Medical Center/National Life Cancer Treatment
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Burlington, Vermont, Forenede Stater, 05401
- University of Vermont Medical Center
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Burlington, Vermont, Forenede Stater, 05405
- University of Vermont College of Medicine
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Virginia
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Richmond, Virginia, Forenede Stater, 23298
- Virginia Commonwealth University/Massey Cancer Center
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Washington
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Aberdeen, Washington, Forenede Stater, 98520
- Providence Regional Cancer System-Aberdeen
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Anacortes, Washington, Forenede Stater, 98221
- Cancer Care Center at Island Hospital
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Bellevue, Washington, Forenede Stater, 98005
- Swedish Cancer Institute-Eastside Oncology Hematology
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Bellingham, Washington, Forenede Stater, 98225
- PeaceHealth Saint Joseph Medical Center
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Centralia, Washington, Forenede Stater, 98531
- Providence Regional Cancer System-Centralia
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Edmonds, Washington, Forenede Stater, 98026
- Swedish Medical Center-Edmonds
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Everett, Washington, Forenede Stater, 98201
- Providence Regional Cancer Partnership
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Issaquah, Washington, Forenede Stater, 98029
- Swedish Cancer Institute-Issaquah
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Lacey, Washington, Forenede Stater, 98503
- Providence Regional Cancer System-Lacey
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Longview, Washington, Forenede Stater, 98632
- PeaceHealth Saint John Medical Center
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Seattle, Washington, Forenede Stater, 98109
- Fred Hutchinson Cancer Research Center
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Seattle, Washington, Forenede Stater, 98109
- Seattle Cancer Care Alliance
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Seattle, Washington, Forenede Stater, 98195
- University of Washington Medical Center
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Seattle, Washington, Forenede Stater, 98107
- Swedish Medical Center-Ballard Campus
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Seattle, Washington, Forenede Stater, 98104
- Minor and James Medical PLLC
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Seattle, Washington, Forenede Stater, 98104
- Pacific Gynecology Specialists
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Seattle, Washington, Forenede Stater, 98112
- Group Health Cooperative-Seattle
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Seattle, Washington, Forenede Stater, 98122-4307
- Swedish Medical Center-First Hill
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Shelton, Washington, Forenede Stater, 98584
- Providence Regional Cancer System-Shelton
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Spokane, Washington, Forenede Stater, 99204
- Rockwood Cancer Treatment Center-DHEC-Downtown
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Spokane Valley, Washington, Forenede Stater, 99216
- Rockwood Clinic Cancer Treatment Center-Valley
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Vancouver, Washington, Forenede Stater, 98664
- PeaceHealth Southwest Medical Center
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Vancouver, Washington, Forenede Stater, 98684
- Compass Oncology Vancouver
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Walla Walla, Washington, Forenede Stater, 99362
- Providence Saint Mary Regional Cancer Center
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Yakima, Washington, Forenede Stater, 98902
- North Star Lodge Cancer Center at Yakima Valley Memorial Hospital
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Yelm, Washington, Forenede Stater, 98597
- Providence Regional Cancer System-Yelm
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Wisconsin
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La Crosse, Wisconsin, Forenede Stater, 54601
- Mayo Clinic Health System-Franciscan Healthcare
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Madison, Wisconsin, Forenede Stater, 53792
- University of Wisconsin Hospital and Clinics
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Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
Tager imod sunde frivillige
Køn, der er berettiget til at studere
Beskrivelse
- Documentation of Disease: Diagnosis of primary CNS diffuse large B-cell lymphoma confirmed by one of the following: brain biopsy or resection, cerebrospinal fluid and vitreous fluid.
- Other Lymphomas: Patients must have no evidence or history of non-Hodgkin lymphoma (NHL) outside of CNS.
- Previous Treatment: Patients must have no prior chemotherapy or radiation therapy for lymphoma.
- Age- Patients must be between the ages of 18 and 75 years.
- Karnofsky Performance Scale - Patients must measure Karnofsky Performance Scale ≥ 30 (≥ 50 for patients ages 60-70).
- Pregnancy and Nursing Status - Patients must be non-pregnant and non-nursing; women of childbearing potential must have a negative serum or urine pregnancy test 10-14 days prior to registration; in addition, women and men of childbearing potential must commit to use an effective form of contraception throughout their participation in this study; appropriate methods of birth control include abstinence, oral contraceptives, implantable hormonal contraceptives, or double barrier method (diaphragm plus condom)
- HIV - Patients must have negative HIV serology.
- Hepatitis - Patients must have negative HCV serology (unless HBsAb positive patient has recently received HBV vaccine, in this case HBcAb should be negative). All patients must be screened for hepatitis B infection before starting treatment. Those patients who test positive for hepatitis B should be closely monitored for evidence of active HBV infection and hepatitis during and for several months after rituximab treatment. PCNSL patients with a history of hepatitis B infection should be treated with entecavir or lamivudine (physician discretion for choice of drug) as antiviral prophylaxis to prevent hepatitis B reactivation.
- Organ Transplant or Immunosuppressant Therapy - Patient must have no history of organ transplantation or ongoing immunosuppressant therapy.
- Required Initial Laboratory Values: ANC ≥ 1500/mcL, AST and ALT < 2 x upper limit of normal (ULN), total bilirubin ≤ 3 mg/dL, creatinine clearance ≥ 50 mL/min, platelet count ≥ 100,000/mcL
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Ingen (Åben etiket)
Antal våben
Våben og indgreb
Deltagergruppe / ArmDeltagergruppe / Arm |
Intervention / BehandlingIntervention / Behandling |
|---|---|
|
Andet: Arm I
Patients undergo induction therapy for five cycles as defined in the protocol. Patients undergo stem cell transplant. |
Given IV Given IV |
|
Andet: Arm II
Patients undergo induction therapy for five cycles as defined in the protocol. Patients undergo consolidation chemotherapy. |
Given IV Given IV |
Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Progression Free Survival
Tidsramme: 2 years
|
The primary endpoint is to compare the two-year progression-free survival (PFS) of patients treated with the myeloablative consolidation treatment strategy of HDT/ASCT versus those treated with non-myeloablative consolidation chemotherapy with cytarabine and etoposide. PFS time = time from Registration to earliest date of Progression or Death due to any cause, censoring non-progressed and alive patients at the date of last disease status evaluation. Response will be defined using the modified IPCG criteria. Progressive disease is defined as > 25% increase in contrast-enhancing CNS (brain and spine if latter abnormal at baseline) disease, appearance of any new, measurable (>/= 10mm) contrast-enhancing disease or recurrent or new ocular or CSF disease. |
2 years
|
Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Event Free Survival
Tidsramme: 2 years
|
To compare the two-year event-free survival (EFS) of patients treated with consolidation HDT/ASCT versus those treated with consolidation chemotherapy consisting of etoposide and cytarabine. EFS event = same definition as PFS with non-protocol treatment also considered an event |
2 years
|
|
Number of Participants With Treatment-related Adverse Events as Assessed by CTCAE v4.0
Tidsramme: 7 years
|
Number of patients reporting at least one adverse event at least possibly related to treatment. |
7 years
|
|
Overall Survival
Tidsramme: 2 years
|
To compare the overall survival (OS) of patients treated with the consolidation HDT/ASCT versus those treated with consolidation chemotherapy consisting of etoposide and cytarabine. OS event = Registration/Randomization to Death due to any cause |
2 years
|
Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Samarbejdspartnere
Samarbejdspartnere
Efterforskere
Efterforskere
- Studiestol: Tracy Batchelor, MD, MPH, Massachusetts General Hospital
Publikationer og nyttige links
Datoer for undersøgelser
Studer store datoer
Studiestart
Studiestart
Primær færdiggørelse (Faktiske)
Primær færdiggørelse
Studieafslutning (Faktiske)
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Anslået)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering sendt
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Nøgleord
- stadium III voksent diffust storcellet lymfom
- stadium IV voksent diffust storcellet lymfom
- primært non-Hodgkin lymfom i centralnervesystemet
- ikke-sammenhængende stadium II voksent diffust storcellet lymfom
- sammenhængende stadium II voksent diffust storcellet lymfom
- stadium I voksent diffust storcellet lymfom
Yderligere relevante MeSH-vilkår
- Neoplasmer
- Sygdomme i immunsystemet
- Neoplasmer efter histologisk type
- Lymfesygdomme
- Lymfoproliferative lidelser
- Immunproliferative lidelser
- Lymfom, Non-Hodgkin
- Lymfom, B-celle
- Hemiske og lymfatiske sygdomme
- Lymfom
- Lymfom, stor B-celle, diffus
- Peptider
- Aminosyrer, peptider og proteiner
- Proteiner
- Organiske kemikalier
- Heterocykliske forbindelser, 1-ring
- Heterocykliske forbindelser
- Terapeutik
- Kirurgiske procedurer, operative
- Nukleinsyrer, nukleotider og nukleosider
- Kulbrinter
- Kulbrinter, cyklisk
- Biologiske faktorer
- Kulhydrater
- Podophyllotoxin
- Tetrahydronaphthalenes
- Naphthalenes
- Polycykliske aromatiske kulbrinter
- Kulbrinter, aromatisk
- Polycykliske forbindelser
- Glukosider
- Glycosider
- Transplantation
- Amider
- Cytidin
- Pyrimidin -nukleosider
- Pyrimidiner
- Phosphoramider
- Organophosphorforbindelser
- Nukleosider
- Intercellulære signalpeptider og proteiner
- Arabinonucleosider
- Glycoproteiner
- Glycoconjugates
- Celletransplantation
- Celle- og vævsbaseret terapi
- Biologisk terapi
- Triethylenephosphoramid
- Aziridiner
- Aziriner
- Kolonistimulerende faktorer
- Hæmatopoietiske cellevækstfaktorer
- Cytokiner
- Nitrosourea -forbindelser
- Urea
- Nitroso -forbindelser
- Cytarabin
- Carmustine
- Etoposid
- Thiotepa
- Stamcelletransplantation
- Granulocytkolonistimulerende faktor
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- CALGB-51101
- CDR0000721927 (Registry Identifier: NCI Physician Data Query)
- NCI-2012-00110 (Registry Identifier: NCI Clinical Trial Reporting Program)
Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .