Diffuse Large B Cell Non-Hodgkin's Lymphoma in the Vulnerable/Frail Elderly. A Multicentric Randomized Phase II Trial (FRAIL-06)
Diffuse Large B Cell Non-Hodgkin's Lymphoma in the Vulnerable/Frail Elderly. A Multicentric Randomized Phase II Trial With Emphasis on Geriatric Assessment and Quality of Life
RATIONALE: Monoclonal antibodies, such as rituximab, can block cancer growth in different ways. Some block the ability of cancer cells to grow and spread. Others find cancer cells and help kill them or carry cancer-killing substances to them. Drugs used in chemotherapy, such as cyclophosphamide, vincristine sulfate, prednisone, and liposome-encapsulated doxorubicin citrate, work in different ways to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. It is not yet known whether rituximab and combination chemotherapy are more effective when given together with or without liposome-encapsulated doxorubicin citrate in treating older patients with diffuse large B-cell non-Hodgkin lymphoma.
PURPOSE: This randomized phase II trial is studying the side effects of giving rituximab together with cyclophosphamide, vincristine sulfate, and prednisone with or without liposome-encapsulated doxorubicin citrate and to see how well it works in treating older patients with stage II, stage III, or stage IV diffuse large B-cell non-Hodgkin lymphoma.
調査の概要
状態
条件
詳細な説明
OBJECTIVES:
Primary
- To assess the therapeutic efficacy of rituximab, cyclophosphamide, vincristine sulfate, and prednisone with vs without liposome-encapsulated doxorubicin citrate, in terms of complete remission rate at 6 months, in vulnerable or frail elderly patients with stage II, III, or IV diffuse large B-cell non-Hodgkin lymphoma.
- To assess the safety of these regimens in these patients.
Secondary
- To evaluate the progression-free survival, event-free survival, and overall survival rates at 6 and 24 months in patients treated with these regimens.
- To evaluate the overall response rate at 6 and 24 months in patients treated with these regimens.
- To evaluate the duration of complete remission in patients treated with these regimens.
- To evaluate the acute side effects (according to the International CTC scale) of these regimens in these patients.
- To evaluate the geriatric condition and quality of life of patients treated with these regimens.
OUTLINE: This is a multicenter study. Patients are randomized to 1 of 2 treatment arms.
- Arm I (R-COP regimen): Patients receive rituximab IV, cyclophosphamide IV, and vincristine sulfate IV on day 1. Patients also receive oral prednisone on days 1-5 and filgrastim subcutaneously (SC) on days 8-14 or pegfilgrastim SC on day 2. Treatment repeats every 21 days for at least 3 courses.
- Arm II (R-COPY regimen): Patients receive rituximab, cyclophosphamide, vincristine sulfate, prednisone, and filgrastim or pegfilgrastim as in arm I. Patients also receive liposome-encapsulated doxorubicin citrate IV on day 1. Treatment repeats every 21 days for at least 3 courses.
After 3 courses of R-COP or R-COPY, patients undergo evaluation. Patients with disease progression or a response of < 25% are removed from the study. Patients with a response of ≥ 25% receive 3 more courses of R-COP or R-COPY, followed by rituximab IV alone on day 1 of courses 7 and 8 in the absence of disease progression or unacceptable toxicity.
After the completion of chemotherapy, some patients may undergo radiotherapy.
Patients complete quality of life and geriatric assessment questionnaires at baseline and periodically during study treatment.
After completion of study treatment, patients are followed every 3 months for 1 year, every 6 months for 2 years.
研究の種類
入学 (実際)
段階
- フェーズ2
連絡先と場所
研究場所
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-
-
Bordeaux、フランス、33076
- Institut Bergonié
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-
参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
DISEASE CHARACTERISTICS:
Diagnosis of diffuse large B-cell non-Hodgkin lymphoma
Stage II, III, or IV disease (according to the WHO classification), including all morphological and clinical variants
- No Burkitt-like lymphoma (presence of small cells in the bone marrow biopsy allowed)
- CD20+ disease
- Has ≥ 1 measurable target lesion ≥ 1.1 cm (according to the International Workshop Criteria)
Poor physiological status, as defined by ≥ 1 of the following criteria:
- WHO performance status 3
- Clinical evaluation and measurement of LVEF that would preclude doxorubicin administration (i.e., LVEF < 50%)
- Creatinine clearance < 50 mL/min
- Serum bilirubin > 30 μmol/L
- Severe comorbidity that would preclude the use of CHOP chemotherapy
- Ineligible for standard R-CHOP therapy
- No cerebral or meningeal involvement
PATIENT CHARACTERISTICS:
- WHO performance status 0-3
- ANC > 750/mm^3
- Platelet count > 50,000/mm^3
- LVEF > 35%
- Able to receive either R-COP or R-COPY therapy
- No congestive heart failure, serious arrhythmia, or myocardial infarction within the past 6 months
- No other malignancy within the past 5 years except for adequately treated basal cell carcinoma of the skin or curatively treated carcinoma in situ of the cervix
- No active infection
- No active viral hepatitis B or C by serology
- No known HIV positivity
- No hypersensitivity to rituximab, any of its excipients, or to murine proteins
- No documented history of allergy to eggs or egg products
- No psychological, familial, sociological, or geographical condition that would preclude compliance with study treatment or follow-up schedule
PRIOR CONCURRENT THERAPY:
- No prior therapy for this cancer
- No prior anthracycline administration with a cumulative dose > 240 mg/m² of doxorubicin hydrochloride or > 400 mg/m² of epirubicin hydrochloride
- More than 30 days since prior participation in another clinical trial involving investigational drugs
- No other concurrent antineoplastic agents
研究計画
研究はどのように設計されていますか？
デザインの詳細
- 主な目的：処理
- 割り当て：ランダム化
- 介入モデル：並列代入
- マスキング：なし（オープンラベル）
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
|
実験的：Arm I (R-COP regimen)
Patients receive rituximab IV, cyclophosphamide IV, and vincristine sulfate IV on day 1.
Patients also receive oral prednisone on days 1-5 and filgrastim subcutaneously (SC) on days 8-14 or pegfilgrastim SC on day 2. Treatment repeats every 21 days for at least 3 courses.
|
与えられた IV
与えられた IV
与えられた IV
経口投与
皮下投与
皮下投与
|
|
実験的：Arm II (R-COPY regimen)
Patients receive rituximab, cyclophosphamide, vincristine sulfate, prednisone, and filgrastim or pegfilgrastim as in arm I. Patients also receive liposome-encapsulated doxorubicin citrate IV on day 1.
Treatment repeats every 21 days for at least 3 courses.
|
与えられた IV
与えられた IV
与えられた IV
経口投与
皮下投与
皮下投与
Given IV
|
この研究は何を測定していますか？
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Number of Participants in Complete Remission 6 Months After Randomization
時間枠：6 months after randomization
|
Complete remission [CR] is defined according to Cheson criteria. CR requires the following:
|
6 months after randomization
|
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Number of Participants With Severe Toxicity
時間枠：6 months after randomization
|
Severe toxicity, defined as febrile neutropenia or toxic death. Febrile neutropenia is defined in the International CTC toxicity scale as "fever of unknown origin without clinically or microbiologically documented infection: neutrophils < 1.0 x 109/l and fever ≥ 38.5° C. Toxic death is defined as any death which occur during treatment (from day 1 of the first cycle of chemotherapy up to day 30 of the last cycle) and is not related to lymphoma. |
6 months after randomization
|
二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Overall Survival Time
時間枠：from randomization, up to 5 years
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OS is defined as the delay between the date of randomization and the date of death
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from randomization, up to 5 years
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Progression-free Survival Time
時間枠：from randomization, up to 5 years
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Delay between the date of randomization and the date of progression or death.
Progression is defined according to the Cheson criteria.
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from randomization, up to 5 years
|
協力者と研究者
スポンサー
捜査官
- 主任研究者：Pierre Soubeyran, MD, PhD、Institut Bergonié
研究記録日
主要日程の研究
研究開始 (実際)
一次修了 (実際)
研究の完了 (実際)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (見積もり)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
追加の関連 MeSH 用語
- 免疫系疾患
- 組織型別の新生物
- 新生物
- リンパ増殖性疾患
- リンパ疾患
- 免疫増殖性疾患
- リンパ腫
- リンパ腫、B細胞
- リンパ腫、非ホジキン
- 薬の生理作用
- 薬理作用の分子機構
- 酵素阻害剤
- 抗炎症剤
- 抗リウマチ剤
- 抗悪性腫瘍薬
- 免疫抑制剤
- 免疫学的要因
- チューブリンモジュレーター
- 抗有糸分裂剤
- 有糸分裂モジュレーター
- グルココルチコイド
- ホルモン
- ホルモン、ホルモン代替物、およびホルモン拮抗薬
- 抗腫瘍剤、ホルモン剤
- 抗悪性腫瘍薬、アルキル化
- アルキル化剤
- 骨髄破壊的アゴニスト
- 抗悪性腫瘍剤、ファイトジェニック
- トポイソメラーゼ II 阻害剤
- トポイソメラーゼ阻害剤
- 抗悪性腫瘍剤、免疫
- 抗生物質、抗悪性腫瘍薬
- シクロホスファミド
- リツキシマブ
- プレドニゾン
- ドキソルビシン
- リポソームドキソルビシン
- ビンクリスチン
その他の研究ID番号
- CDR0000636032
- IB-FRAIL06 (その他の識別子：Institut Bergonié)
- INCA-RECF0892 (その他の識別子：Institut National du Cancer)
- IB-2008-25 (その他の識別子：Institut Bergonié)
- EUDRACT-2008-001506-16 (その他の識別子：EUDRACT)
医薬品およびデバイス情報、研究文書
米国FDA規制医薬品の研究
米国FDA規制機器製品の研究
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