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SWOG-9239 Reduction of Immunosuppression Plus Interferon Alfa and Combination Chemotherapy in Treating Patients With Malignant Tumors That Develop After Organ Transplant

22 gennaio 2013 aggiornato da: Southwest Oncology Group

Phase II Trial of Sequential Modification of Immunosuppression, Interferon Alpha, and Promace-Cytabom For Treatment of Post-Cardiac Transplant Lymphoproliferation.

RATIONALE: Reducing the amount of drugs used to prevent transplant rejection may help a person's body kill tumor cells. Giving biological therapy, such as interferon alfa, which may interfere with the growth of cancer cells, or combination chemotherapy, which uses different ways to stop tumor cells from dividing so they stop growing or die, may kill more tumor cells.

PURPOSE: Phase II trial to study the effectiveness of reducing immunosuppression, and giving interferon alfa and combination chemotherapy, in treating patients who have malignant tumors that develop after organ transplant.

Panoramica dello studio

Descrizione dettagliata

OBJECTIVES: I. Evaluate the complete remission rate and survival of patients with lymphoproliferation following organ transplantation treated with a defined sequential approach: modification of immunosuppression, with surgery or limited radiotherapy for an isolated site of disease; interferon alfa; and chemotherapy (ProMACE-CytaBOM; cyclophosphamide, doxorubicin, etoposide, prednisone, cytarabine, bleomycin, vincristine, methotrexate).

OUTLINE: All patients receive modification of immunocompetence, unless rejection is present at outset. These patients proceed directly to interferon treatment. Group 1 (see Disease Characteristics): Patients receive reduced doses of their current immunosuppressive therapy for 10 days. Group 2: Patients receive reduced doses of some of their current immunosuppressive therapy and discontinue some of the other therapy for 14 days. Immunosuppressive therapy then resumes on day 15. Immunosuppressive therapy continues throughout other therapy, unless otherwise noted. Some patients may then undergo surgery or radiotherapy. Interferon therapy: Patients receive interferon alfa (IFNA) subcutaneously or intramuscularly on days 1-28 for a maximum of 3 courses. Patients then receive maintenance therapy with IFNA 3 days a week for 4 weeks for up to 6 courses. Chemotherapy (ProMACE-CytaBOM): Immunosuppressive therapy is stopped on days 1-20. Patients receive cyclophosphamide IV, doxorubicin IV, and etoposide IV over 60 minutes on day 1, oral prednisone on days 1-14, and cytarabine IV, bleomycin IV, vincristine IV, and methotrexate IV on day 8. Treatment is repeated every 21 days for up to 6 courses. Patients with positive CSF cytology receive intrathecal methotrexate or cytarabine on days 1, 3, 5, 7, and 14. Some patients may continue this therapy on day 21 , then every 3 weeks for 5 doses, or may receive cranial irradiation. Patients are followed monthly for 1 year, every 2 months for 1 year, every 4 months for 1 year, then every 6 months thereafter.

PROJECTED ACCRUAL: A total of 50 patients will be accrued for this study within 4-5 years.

Tipo di studio

Interventistico

Iscrizione (Effettivo)

20

Fase

  • Fase 2

Contatti e Sedi

Questa sezione fornisce i recapiti di coloro che conducono lo studio e informazioni su dove viene condotto lo studio.

Luoghi di studio

    • Alabama
      • Mobile, Alabama, Stati Uniti, 36688
        • MBCCOP - University of South Alabama
    • Arizona
      • Phoenix, Arizona, Stati Uniti, 85006-2726
        • CCOP - Greater Phoenix
      • Phoenix, Arizona, Stati Uniti, 85012
        • Veterans Affairs Medical Center - Phoenix (Hayden)
      • Tucson, Arizona, Stati Uniti, 85724
        • Arizona Cancer Center
      • Tucson, Arizona, Stati Uniti, 85723
        • Veterans Affairs Medical Center - Tucson
    • Arkansas
      • Little Rock, Arkansas, Stati Uniti, 72205
        • University of Arkansas for Medical Sciences
      • Little Rock, Arkansas, Stati Uniti, 72205
        • Veterans Affairs Medical Center - Little Rock (McClellan)
    • California
      • Long Beach, California, Stati Uniti, 90822
        • Veterans Affairs Medical Center - Long Beach
      • Los Angeles, California, Stati Uniti, 90033-0800
        • USC/Norris Comprehensive Cancer Center
      • Los Angeles, California, Stati Uniti, 90095-1781
        • Jonsson Comprehensive Cancer Center, UCLA
      • Los Angeles, California, Stati Uniti, 91010
        • Beckman Research Institute, City of Hope
      • Martinez, California, Stati Uniti, 94553
        • Veterans Affairs Outpatient Clinic - Martinez
      • Oakland, California, Stati Uniti, 94609-3305
        • CCOP - Bay Area Tumor Institute
      • Sacramento, California, Stati Uniti, 95817
        • University of California Davis Medical Center
      • Santa Rosa, California, Stati Uniti, 95403
        • CCOP - Santa Rosa Memorial Hospital
      • Travis Air Force Base, California, Stati Uniti, 94535
        • David Grant Medical Center
    • Colorado
      • Denver, Colorado, Stati Uniti, 80220
        • Veterans Affairs Medical Center - Denver
      • Denver, Colorado, Stati Uniti, 80262
        • University of Colorado Cancer Center
    • Georgia
      • Atlanta, Georgia, Stati Uniti, 30342-1701
        • CCOP - Atlanta Regional
    • Hawaii
      • Honolulu, Hawaii, Stati Uniti, 96813
        • Cancer Research Center of Hawaii
    • Illinois
      • Decatur, Illinois, Stati Uniti, 62526
        • CCOP - Central Illinois
      • Hines, Illinois, Stati Uniti, 60141
        • Veterans Affairs Medical Center - Hines (Hines Junior VA Hospital)
      • Maywood, Illinois, Stati Uniti, 60153
        • Loyola University Medical Center
    • Kansas
      • Kansas City, Kansas, Stati Uniti, 66160-7357
        • University of Kansas Medical Center
      • Wichita, Kansas, Stati Uniti, 67214-3882
        • CCOP - Wichita
      • Wichita, Kansas, Stati Uniti, 67218
        • Veterans Affairs Medical Center - Wichita
    • Kentucky
      • Lexington, Kentucky, Stati Uniti, 40511-1093
        • Veterans Affairs Medical Center - Lexington
      • Lexington, Kentucky, Stati Uniti, 40536-0084
        • Albert B. Chandler Medical Center, University of Kentucky
    • Louisiana
      • New Orleans, Louisiana, Stati Uniti, 70112
        • Tulane University School of Medicine
      • New Orleans, Louisiana, Stati Uniti, 70112
        • MBCCOP - LSU Medical Center
      • New Orleans, Louisiana, Stati Uniti, 70112
        • Veterans Affairs Medical Center - New Orleans
      • Shreveport, Louisiana, Stati Uniti, 71130-3932
        • Louisiana State University Health Sciences Center - Shreveport
      • Shreveport, Louisiana, Stati Uniti, 71130
        • Veterans Affairs Medical Center - Shreveport
    • Massachusetts
      • Boston, Massachusetts, Stati Uniti, 02118
        • Boston Medical Center
      • Jamaica Plain, Massachusetts, Stati Uniti, 02130
        • Veterans Affairs Medical Center - Boston (Jamaica Plain)
    • Michigan
      • Ann Arbor, Michigan, Stati Uniti, 48109-0752
        • University of Michigan Comprehensive Cancer Center
      • Ann Arbor, Michigan, Stati Uniti, 48105
        • Veterans Affairs Medical Center - Ann Arbor
      • Detroit, Michigan, Stati Uniti, 48201
        • Barbara Ann Karmanos Cancer Institute
      • Detroit, Michigan, Stati Uniti, 48202
        • Henry Ford Hospital
      • Detroit, Michigan, Stati Uniti, 48201-1932
        • Veterans Affairs Medical Center - Detroit
      • Grand Rapids, Michigan, Stati Uniti, 49503
        • CCOP - Grand Rapids Clinical Oncology Program
      • Southfield, Michigan, Stati Uniti, 48075-9975
        • Providence Hospital - Southfield
    • Minnesota
      • Saint Louis Park, Minnesota, Stati Uniti, 55416
        • CCOP - Metro-Minnesota
    • Mississippi
      • Biloxi, Mississippi, Stati Uniti, 39531-2410
        • Veterans Affairs Medical Center - Biloxi
      • Jackson, Mississippi, Stati Uniti, 39216-4505
        • University of Mississippi Medical Center
      • Jackson, Mississippi, Stati Uniti, 39216
        • Veterans Affairs Medical Center - Jackson
      • Keesler AFB, Mississippi, Stati Uniti, 39534-2576
        • Keesler Medical Center - Keesler AFB
    • Missouri
      • Kansas City, Missouri, Stati Uniti, 64128
        • Veterans Affairs Medical Center - Kansas City
      • Kansas City, Missouri, Stati Uniti, 64131
        • CCOP - Kansas City
      • Saint Louis, Missouri, Stati Uniti, 63110-0250
        • St. Louis University Health Sciences Center
      • Saint Louis, Missouri, Stati Uniti, 63141
        • CCOP - St. Louis-Cape Girardeau
      • Springfield, Missouri, Stati Uniti, 65807
        • CCOP - Cancer Research for the Ozarks
    • Montana
      • Billings, Montana, Stati Uniti, 59101
        • CCOP - Montana Cancer Consortium
    • New Mexico
      • Albuquerque, New Mexico, Stati Uniti, 87108-5138
        • Veterans Affairs Medical Center - Albuquerque
      • Albuquerque, New Mexico, Stati Uniti, 87131
        • MBCCOP - University of New Mexico HSC
    • New York
      • Brooklyn, New York, Stati Uniti, 11209
        • Veterans Affairs Medical Center - Brooklyn
      • New York, New York, Stati Uniti, 10032
        • Herbert Irving Comprehensive Cancer Center
    • Ohio
      • Cincinnati, Ohio, Stati Uniti, 45219
        • Barrett Cancer Center, The University Hospital
      • Cincinnati, Ohio, Stati Uniti, 45220-2288
        • Veterans Affairs Medical Center - Cincinnati
      • Cleveland, Ohio, Stati Uniti, 44195
        • Cleveland Clinic Cancer Center
      • Columbus, Ohio, Stati Uniti, 43206
        • CCOP - Columbus
      • Dayton, Ohio, Stati Uniti, 45428
        • Veterans Affairs Medical Center - Dayton
      • Kettering, Ohio, Stati Uniti, 45429
        • CCOP - Dayton
    • Oklahoma
      • Oklahoma City, Oklahoma, Stati Uniti, 73104
        • Oklahoma Medical Research Foundation
      • Oklahoma City, Oklahoma, Stati Uniti, 73104
        • Veterans Affairs Medical Center - Oklahoma City
    • Oregon
      • Portland, Oregon, Stati Uniti, 97201-3098
        • Oregon Cancer Center at Oregon Health Sciences University
      • Portland, Oregon, Stati Uniti, 97207
        • Veterans Affairs Medical Center - Portland
      • Portland, Oregon, Stati Uniti, 97213
        • CCOP - Columbia River Program
    • South Carolina
      • Greenville, South Carolina, Stati Uniti, 29615
        • CCOP - Greenville
      • Spartanburg, South Carolina, Stati Uniti, 29303
        • CCOP - Upstate Carolina
    • Tennessee
      • Nashville, Tennessee, Stati Uniti, 37232-6838
        • Vanderbilt Cancer Center
      • Nashville, Tennessee, Stati Uniti, 37212
        • Veterans Affairs Medical Center - Nashville
    • Texas
      • Fort Sam Houston, Texas, Stati Uniti, 78234
        • Brooke Army Medical Center
      • Galveston, Texas, Stati Uniti, 77555-1329
        • University of Texas Medical Branch
      • Lubbock, Texas, Stati Uniti, 79423
        • Texas Tech University Health Science Center
      • San Antonio, Texas, Stati Uniti, 78284-7811
        • University of Texas Health Science Center at San Antonio
      • San Antonio, Texas, Stati Uniti, 78284
        • Veterans Affairs Medical Center - San Antonio (Murphy)
      • Temple, Texas, Stati Uniti, 76504
        • Veterans Affairs Medical Center - Temple
      • Temple, Texas, Stati Uniti, 76508
        • CCOP - Scott and White Hospital
    • Utah
      • Salt Lake City, Utah, Stati Uniti, 84132
        • Huntsman Cancer Institute
      • Salt Lake City, Utah, Stati Uniti, 84148
        • Veterans Affairs Medical Center - Salt Lake City
    • Washington
      • Seattle, Washington, Stati Uniti, 98101
        • CCOP - Virginia Mason Research Center
      • Seattle, Washington, Stati Uniti, 98104
        • Swedish Cancer Institute
      • Seattle, Washington, Stati Uniti, 98108
        • Veterans Affairs Medical Center - Seattle
      • Seattle, Washington, Stati Uniti, 98109
        • Puget Sound Oncology Consortium
      • Tacoma, Washington, Stati Uniti, 98405-0986
        • CCOP - Northwest

Criteri di partecipazione

I ricercatori cercano persone che corrispondano a una certa descrizione, chiamata criteri di ammissibilità. Alcuni esempi di questi criteri sono le condizioni generali di salute di una persona o trattamenti precedenti.

Criteri di ammissibilità

Età idonea allo studio

15 anni e precedenti (Bambino, Adulto, Adulto più anziano)

Accetta volontari sani

No

Sessi ammissibili allo studio

Tutto

Descrizione

DISEASE CHARACTERISTICS: Histologically proven lymphoproliferation following organ (kidney, liver, or heart) allograft Bidimensionally measurable disease If all disease removed at biopsy, eligible only if recurrence is bidimensionally measurable Group 1 (clinically urgent disease): Histologically proven involvement of the allograft OR Histologically proven bone marrow involvement OR Liver involvement with hepatic insufficiency Bilirubin greater than upper limit of normal (ULN) OR SGOT or SGPT at least 2 times ULN OR Clinical hepatic encephalopathy OR LDH at least 3 times ULN OR Systemic sepsis OR Locally urgent lesions Tonsillar enlargement that threatens airway Superior vena cava syndrome Bilateral hydronephrosis Postobstructive pneumonia OR Small noncleaved lymphocytic lymphoma (i.e., adult Burkitt's lymphoma) Group 2: All other patients No CNS disease only

PATIENT CHARACTERISTICS: Age: 15 and over Performance status: Not specified Hematopoietic: Not specified Hepatic: See Disease Characteristics Renal: Not specified Cardiovascular: See Disease Characteristics Pulmonary: See Disease Characteristics Other: No known AIDS, HIV-associated complex, or positive HIV antibody No other malignancy within past 5 years, except: Adequately treated basal or squamous cell skin cancer Adequately treated stage I or II cancer or other noninvasive cancers Carcinoma in situ of the cervix Not pregnant or nursing Fertile patients must use effective contraception

PRIOR CONCURRENT THERAPY: Biologic therapy: No prior interferon for lymphoma No prior bone marrow transplantation Chemotherapy: No prior chemotherapy for lymphoma Endocrine therapy: Not specified Radiotherapy: Not specified Surgery: See Disease Characteristics Other: Intra-aortic balloon pump allowed only for heart failure caused by acute rejection or lymphomatous involvement

Piano di studio

Questa sezione fornisce i dettagli del piano di studio, compreso il modo in cui lo studio è progettato e ciò che lo studio sta misurando.

Come è strutturato lo studio?

Dettagli di progettazione

  • Scopo principale: Trattamento
  • Assegnazione: N / A
  • Modello interventistico: Assegnazione di gruppo singolo
  • Mascheramento: Nessuno (etichetta aperta)

Armi e interventi

Gruppo di partecipanti / Arm
Intervento / Trattamento
Sperimentale: Immumosuppression, IFN-a, ProMACE-CytaBOM
Doses and schedules of immunosuppressive drugs (cyclosporin (or FK506), prednisone, and acyclovir) will depend on whether patients are judged to have clinically urgent disease or not. Patients who do not have a CR after initial immunosuppression will receive 3 cycles (28 days each) Interferon alpha 2b at 3.0 x 10^6 IU/m^2 on days 1-28. Patients who have a CR will then receive 6 additional cycles with 3 doses per week, then go onto observation. Patients who do not have a CR will then receive a maximum of 6 21-day cycles of chemotherapy, consisting of: cyclophosphamide 650 mg/m^2 on day 1, adriamycin 25 mg/m^2 on day 1, etoposide 120 mg/m^2 on day 1, prednisone 60 mg/m^2 on days 1-14, cytosine arabinoside 300 mg/m^2 on day 8, bleomycin 5 mg/m^2 on day 8, vincristine 1.4 mg/m^2 on day 8, methotrexate 120 mg/m^2 on day 8, leucovorin 25 mg/m^2 q 6 hours on days 8-9, G-CSF 5 ug/kg/day on days 2-14, and one double strength tablet trimethoprim-sulfamethoxazole 3 times per week.
1,4mg/m^2
5 mg/m^2
3.0 x 10^6 IU/m^2
650 mg/m^2
300 mg/m^2
25 mg/m^2
Altri nomi:
  • adriamicina
120 mg/m^2
120 mg/m^2
dose varies during initial immunosuppression. During chemotherapy, 60 mg/m^2.
Simple excision, for those patients who have resectable disease after initial immunosuppression.
For treatment of localized disease that remains after initial immunosuppression.

Cosa sta misurando lo studio?

Misure di risultato primarie

Misura del risultato
Lasso di tempo
Risposta
Lasso di tempo: ogni 3 mesi durante il trattamento del protocollo
ogni 3 mesi durante il trattamento del protocollo

Misure di risultato secondarie

Misura del risultato
Lasso di tempo
sopravvivenza globale
Lasso di tempo: ogni 3 mesi durante il trattamento, successivamente ogni 6 mesi
ogni 3 mesi durante il trattamento, successivamente ogni 6 mesi

Collaboratori e investigatori

Qui è dove troverai le persone e le organizzazioni coinvolte in questo studio.

Investigatori

  • Cattedra di studio: Lode J. Swinnen, MD, Loyola University
  • Cattedra di studio: Leo I. Gordon, MD, Robert H. Lurie Cancer Center

Pubblicazioni e link utili

La persona responsabile dell'inserimento delle informazioni sullo studio fornisce volontariamente queste pubblicazioni. Questi possono riguardare qualsiasi cosa relativa allo studio.

Pubblicazioni generali

Studiare le date dei record

Queste date tengono traccia dell'avanzamento della registrazione dello studio e dell'invio dei risultati di sintesi a ClinicalTrials.gov. I record degli studi e i risultati riportati vengono esaminati dalla National Library of Medicine (NLM) per assicurarsi che soddisfino specifici standard di controllo della qualità prima di essere pubblicati sul sito Web pubblico.

Studia le date principali

Inizio studio

1 maggio 1995

Completamento primario (Effettivo)

1 novembre 2003

Completamento dello studio (Effettivo)

1 luglio 2011

Date di iscrizione allo studio

Primo inviato

1 novembre 1999

Primo inviato che soddisfa i criteri di controllo qualità

21 giugno 2004

Primo Inserito (Stima)

22 giugno 2004

Aggiornamenti dei record di studio

Ultimo aggiornamento pubblicato (Stima)

24 gennaio 2013

Ultimo aggiornamento inviato che soddisfa i criteri QC

22 gennaio 2013

Ultimo verificato

1 gennaio 2013

Maggiori informazioni

Termini relativi a questo studio

Parole chiave

Altri numeri di identificazione dello studio

  • CDR0000064200
  • U10CA032102 (Sovvenzione/contratto NIH degli Stati Uniti)
  • SWOG-9239 (Altro identificatore: SWOG)
  • E-S9239 (Altro identificatore: ECOG)

Queste informazioni sono state recuperate direttamente dal sito web clinicaltrials.gov senza alcuna modifica. In caso di richieste di modifica, rimozione o aggiornamento dei dettagli dello studio, contattare register@clinicaltrials.gov. Non appena verrà implementata una modifica su clinicaltrials.gov, questa verrà aggiornata automaticamente anche sul nostro sito web .

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