Methotrexate and Thiotepa in Treating Patients With Newly Diagnosed Primary CNS Lymphoma

A Phase II Study of Methotrexate and Thiotepa Chemotherapy for Patients With Newly Diagnosed Primary CNS Lymphoma


Hauptsponsor: New Approaches to Brain Tumor Therapy Consortium

Mitarbeiter: National Cancer Institute (NCI)

Quelle National Cancer Institute (NCI)
Kurze Zusammenfassung

RATIONALE: Drugs used in chemotherapy, such as methotrexate and thiotepa, work in different ways to stop cancer cells from dividing so they stop growing or die. Combining more than one drug may kill more tumor cells.

PURPOSE: Phase II trial to study the effectiveness of combining methotrexate with thiotepa in treating patients who have newly-diagnosed primary CNS lymphoma.

detaillierte Beschreibung


- Determine the complete radiographic response in patients with newly diagnosed primary CNS lymphoma treated with methotrexate and thiotepa.

- Determine the duration of progression-free survival and overall survival of patients treated with this regimen.

- Determine the toxicity of this regimen in these patients.

- Determine whether tumor expression of BCL-6 is associated with response to this chemotherapy regimen and survival of these patients.

- Describe the relationship between initial response to steroids (if administered), response to this chemotherapy regimen, and survival of these patients.

OUTLINE: This is a multicenter study.

Patients receive thiotepa IV over 15 minutes on day 1. Patients also receive methotrexate IV over 4 hours on days 1 (8 hours after thiotepa) and 14. Beginning 24 hours after the start of methotrexate infusion, patients receive leucovorin calcium IV or orally every 6 hours until rescue is achieved. Treatment repeats every 28 days for up to 4 courses in the absence of disease progression or unacceptable toxicity. Patients achieving disappearance of enhancement of disease on MRI receive an additional 28-day course followed by maintenance therapy comprising thiotepa and methotrexate once a month for 11 courses.

Patients undergo neuro-ophthalmologic exams annually for 2 years.

Patients are followed every 2 months.

PROJECTED ACCRUAL: A total of 23-39 patients will be accrued for this study within 8-20 months.

Gesamtstatus Completed
Anfangsdatum October 2002
Fertigstellungstermin January 2006
Phase Phase 2
Studientyp Interventional
Primärer Ausgang
Messen Zeitfenster
Complete radiographic response
Sekundäres Ergebnis
Messen Zeitfenster
Duration of progression-free survival and overall survival
Association of tumor BCL-6 expression with response
Relationship among initial response to steroids, response to chemotherapy, and survival

Interventionsart: Drug

Interventionsname: leucovorin calcium

Interventionsart: Drug

Interventionsname: methotrexate

Interventionsart: Drug

Interventionsname: thiotepa




- Histologically confirmed primary CNS lymphoma

- Confirmed by 1 of the following:

- Brain biopsy or resection

- CSF cytology

- Positive cytology or immunohistochemical diagnosis of monoclonality and measurable intracranial tumor

- Vitreal biopsy

- Measurable and contrast-enhancing disease on the postoperative, pretreatment MRI or CT scan

- No radiographic evidence of ascites or pleural effusions



- 18 and over

Performance status

- Karnofsky 60-100%

Life expectancy

- Not specified


- Absolute neutrophil count at least 1,500/mm^3

- Platelet count at least 100,000/mm^3


- Bilirubin no greater than 2.0 mg/dL

- SGOT no greater than 4 times upper limit of normal


- Creatinine no greater than 2 mg/dL

- Creatinine clearance at least 50 mL/min


- Mini mental score of at least 15

- HIV negative

- Able to achieve hydration

- No other malignancy within the past 5 years except curatively treated basal cell or squamous cell skin cancer or carcinoma in situ

- No allergy to methotrexate

- No serious infection

- No medical illness that would preclude study participation

- Not pregnant or nursing

- Negative pregnancy test

- Fertile patients must use effective contraception


Biologic therapy

- No prior immunotherapy or biologic therapy for this disease


- No prior chemotherapy for this disease

- No other concurrent chemotherapeutic agents

Endocrine therapy

- No prior hormonal therapy for this disease

- Prior glucocorticoid therapy allowed


- No prior radiotherapy for this disease

- No prior cranial irradiation


- See Disease Characteristics


- At least 1 week since prior salicylates, non-steroidal anti-inflammatory drugs, probenecid, folic acid, or sulfonamide medications

- No other concurrent investigational agents

Geschlecht: All

Mindestalter: 18 Years

Maximales Alter: N/A

Gesunde Freiwillige: No

Insgesamt offiziell
Nachname Rolle Zugehörigkeit
Tracy Batchelor, MD, MPH Study Chair Massachusetts General Hospital
Comprehensive Cancer Center at University of Alabama at Birmingham | Birmingham, Alabama, 35294-3410, United States
H. Lee Moffitt Cancer Center and Research Institute at University of South Florida | Tampa, Florida, 33612-9497, United States
Winship Cancer Institute of Emory University | Atlanta, Georgia, 30322, United States
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins | Baltimore, Maryland, 21231-2410, United States
Massachusetts General Hospital Cancer Center | Boston, Massachusetts, 02114, United States
Josephine Ford Cancer Center at Henry Ford Hospital | Detroit, Michigan, 48202, United States
Comprehensive Cancer Center at Wake Forest University | Winston-Salem, North Carolina, 27157-1096, United States
Cleveland Clinic Taussig Cancer Center | Cleveland, Ohio, 44195, United States
Abramson Cancer Center of the University of Pennsylvania | Philadelphia, Pennsylvania, 19104-4283, United States
Standort Länder

United States


December 2005

Hat den Zugriff erweitert No
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Studiendesign Info

Hauptzweck: Treatment

Maskierung: None (Open Label)