- ICH GCP
- US Clinical Trials Registry
- Klinisk forsøg NCT01325194
CHemoImmunotherapy With Early Central Nervous System (CNS) Prophylaxis (CHIC)
2. marts 2020 opdateret af: Nordic Lymphoma Group
Dose Densified Chemoimmunotherapy With Early CNS Prophylaxis in Patients Less Than 65 Years With High Risk (aaIPI≥ 2) Diffuse Large B-Cell Lymphoma
The purpose is to test whether early central nervous system (CNS) prophylaxis given at the beginning of therapy for young high risk diffuse large B-cell lymphoma (DLBCL) patients is feasible and could reduce the risk of CNS relapses.
Early CNS prophylaxis with two courses high dose methotrexate (HD-MTX) in combination with rituximab-cyclophosphamide-doxorubicin-vincristine-prednison (R-CHOP) is followed by four courses of R-CHOP14 and etoposide (E) and one course of HD-Ara-C.
In addition the patients will receive three courses of liposomal cytarabine intrathecally.
The results will be compared to a recent Nordic CRY-04 study.
Shifting of CNS prophylaxis to the beginning of the therapy offers a potential to overcome the subclinical disease and thus reduce the risk of early clinical CNS recurrence.
As flow cytometry (FCM) can improve the sensitivity for detecting occult leptomeningeal disease over cytology , FCM from cerebrospinal fluid will be incorporated into the staging procedures.
Studieoversigt
Undersøgelsestype
Interventionel
Tilmelding (Faktiske)
143
Fase
- Fase 2
Kontakter og lokationer
Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.
Studiesteder
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Århus, Danmark
- Department of Hematology, Århus University Hospital
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Helsinki, Finland
- Department of Oncology, Helsinki University Central Hospital
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Oslo, Norge
- Department of Oncology, Oslo University Hospital
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Lund, Sverige
- Department of Oncology, Lund University Hospital
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Deltagelseskriterier
Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.
Berettigelseskriterier
Aldre berettiget til at studere
18 år til 64 år (Voksen)
Tager imod sunde frivillige
Ingen
Køn, der er berettiget til at studere
Alle
Beskrivelse
Inclusion Criteria:
- Age ≥ 18 - < 65 years. Histologically confirmed CD20+ diffuse large B-cell lymphoma (DLBCL) based on WHO 2008 Lymphoma Classification
- Follicular lymphomas (FLs) grade 3b is allowed
Patients in at least stage II with age adjusted international prognostic score (IPI score) of 2 or 3:
- Stage III /IV and elevated LDH
- Stage III/IV and WHO performance status 2 - 3
- Stage II and elevated LDH and WHO performance status 2 - 3 And/or patients with
- More than one extranodal site
- Testicular lymphoma, stage IIE and higher
- Paranasal sinus and orbital lymphoma with destruction of bone
- Large cell infiltration of the bone marrow
Exclusion Criteria:
- Severe cardiac disease: cardiac function grade 3-4
- Impaired liver, renal or other organ function not caused by lymphoma, which will interfere with the treatment schedule
- Pregnancy/lactation
- Men and women of reproductive potential not agreeing to use an acceptable method of birth control during treatment and for six months after completion of treatment
- Patients with other severe medical problems and with an expected short survival for non-lymphoma reasons
- Known HIV positivity
- Uncontrolled infectious disease, including meningeal infection
- Active cancer except basal cell carcinoma and cervical carcinoma in situ during the last five years
- Earlier treatment containing anthracyclins
- Psychiatric or mental disorder which make the patient unable to give an informed consent and/or adhere to the protocol
- CNS disease as diagnosed by MRI or cerebrospinal fluid (CSF) cytology. Positive CSF flow cytometry below diagnostic threshold level by cytology is allowed
- Pleural or peritoneal fluid that cannot be drained safely
- Hypersensitivity to the active substance or any of the other ingredients
- Patients participating in other clinical studies, unless followed for survival
Studieplan
Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: N/A
- Interventionel model: Enkelt gruppeopgave
- Maskning: Ingen (Åben etiket)
Våben og indgreb
Deltagergruppe / Arm |
Intervention / Behandling |
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Eksperimentel: CNS prophylaxis
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50 mg intrathecally three times
Andre navne:
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Hvad måler undersøgelsen?
Primære resultatmål
Resultatmål |
Tidsramme |
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Time to treatment failure
Tidsramme: 3 and 5 years
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3 and 5 years
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Sekundære resultatmål
Resultatmål |
Tidsramme |
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Progressionsfri overlevelse
Tidsramme: 3 og 5 år
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3 og 5 år
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Samlet overlevelse
Tidsramme: 3 og 5 år
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3 og 5 år
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Maximal hematological, gastrointestinal, neuronal and other toxicities
Tidsramme: Treatment period (5 years)
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Treatment period (5 years)
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Clinical response rate
Tidsramme: Treatment period (5 years)
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Treatment period (5 years)
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Incidence of central nervous system(CNS) relapse in cerebrospinal fluid (CSF )cytology neg/flow cytometry positive cases
Tidsramme: 3 and 5 years
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3 and 5 years
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Incidence of CNS relapse in a subgroup of patients with more than one extranodal site and elevated lactate dehydrogenase (LDH)
Tidsramme: 3 and 5 years
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3 and 5 years
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Molecular predictors
Tidsramme: 3 years
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3 years
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CNS relapse rate
Tidsramme: 1,5 years
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1,5 years
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Samarbejdspartnere og efterforskere
Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.
Sponsor
Publikationer og nyttige links
Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.
Generelle publikationer
- Vajavaara H, Leivonen SK, Jorgensen J, Holte H, Leppa S. Low lymphocyte-to-monocyte ratio predicts poor outcome in high-risk aggressive large B-cell lymphoma. EJHaem. 2022 Jun 23;3(3):681-687. doi: 10.1002/jha2.409. eCollection 2022 Aug.
- Leppa S, Jorgensen J, Tierens A, Meriranta L, Ostlie I, de Nully Brown P, Fagerli UM, Larsen TS, Mannisto S, Munksgaard L, Maisenholder M, Vasala K, Meyer P, Jerkeman M, Bjorkholm M, Fluge O, Jyrkkio S, Liestol K, Ralfkiaer E, Spetalen S, Beiske K, Karjalainen-Lindsberg ML, Holte H. Patients with high-risk DLBCL benefit from dose-dense immunochemotherapy combined with early systemic CNS prophylaxis. Blood Adv. 2020 May 12;4(9):1906-1915. doi: 10.1182/bloodadvances.2020001518.
- Autio M, Leivonen SK, Bruck O, Mustjoki S, Meszaros Jorgensen J, Karjalainen-Lindsberg ML, Beiske K, Holte H, Pellinen T, Leppa S. Immune cell constitution in the tumor microenvironment predicts the outcome in diffuse large B-cell lymphoma. Haematologica. 2021 Mar 1;106(3):718-729. doi: 10.3324/haematol.2019.243626.
Hjælpsomme links
Datoer for undersøgelser
Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.
Studer store datoer
Studiestart (Faktiske)
1. marts 2011
Primær færdiggørelse (Faktiske)
1. november 2018
Studieafslutning (Faktiske)
31. december 2019
Datoer for studieregistrering
Først indsendt
14. marts 2011
Først indsendt, der opfyldte QC-kriterier
28. marts 2011
Først opslået (Skøn)
29. marts 2011
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
3. marts 2020
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
2. marts 2020
Sidst verificeret
1. marts 2020
Mere information
Begreber relateret til denne undersøgelse
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
- NLG-LBC-05
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 .