새로 진단된 원발성 종격동 B세포 림프종 치료를 위한 화학면역요법과 니볼루맙의 병용
새로 진단된 원발성 종격동 B세포 림프종의 치료를 위한 화학-면역요법과 병용한 Nivolumab(NSC# 748726)의 무작위 3상 시험
This phase III trial compares the effects of nivolumab with chemo-immunotherapy versus chemo-immunotherapy alone in treating patients with newly diagnosed primary mediastinal B-cell lymphoma (PMBCL). Immunotherapy with monoclonal antibodies, such as nivolumab, may help the body's immune system attack the cancer, and may interfere with the ability of cancer cells to grow and spread. Treatment for PMBCL involves chemotherapy combined with an immunotherapy called rituximab. Chemotherapy drugs work in different ways to stop the growth of cancer cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Rituximab is a monoclonal antibody. It binds to a protein called CD20, which is found on B cells (a type of white blood cell) and some types of cancer cells. This may help the immune system kill cancer cells. Giving nivolumab with chemo-immunotherapy may help treat patients with PMBCL.
연구 개요
상태
개입 / 치료
- 의약품: Cyclophosphamide
- 의약품: Doxorubicin Hydrochloride
- 의약품: Prednisone
- 생물학적: Rituximab
- 의약품: Vincristine Sulfate
- 절차: Echocardiography Test
- 생물학적: Nivolumab
- 절차: Computed Tomography
- 절차: Positron Emission Tomography
- 의약품: Etoposide Phosphate
- 생물학적: Filgrastim
- 절차: Bone Marrow Aspiration
- 절차: Bone Marrow Biopsy
- 방사능: Radiation Therapy
- 의약품: Prednisolone
- 생물학적: Pegfilgrastim
- 절차: Lumbar Puncture
- 절차: Biospecimen Collection
- 생물학적: Rituximab and Hyaluronidase Human
상세 설명
PRIMARY OBJECTIVE:
I. To determine if nivolumab + chemo-immunotherapy results in a superior long term progression-free survival (PFS) (events defined as disease progression confirmed by central review or death) when compared with chemo-immunotherapy alone in patients with newly diagnosed primary mediastinal B-cell lymphoma.
SECONDARY OBJECTIVES:
I. To compare the rates of "efficacy-related event-free survival (EFS)" (eEFS) (events defined as progression, change in therapy due to finding that led to concern about efficacy, biopsy + disease after 6 cycles of therapy, or death) between chemo-immunotherapy alone and chemo-immunotherapy + nivolumab in patients with newly diagnosed PMBCL.
II. To compare the rates of "therapy-related EFS" (tEFS) (events defined as relapse/progression, change in therapy for any reason, biopsy + disease after 6 cycles of therapy, secondary malignancy [SMN] or death) between chemo-immunotherapy alone and chemo-immunotherapy + nivolumab in patients with newly diagnosed PMBCL.
III. To compare the rates of overall survival (OS) between chemo-immunotherapy alone and chemo-immunotherapy + nivolumab in patients with newly diagnosed PMBCL.
IV. To establish the rate of a positive positron emission tomography (PET)-computed tomography (CT) (defined as Deauville score 4 or 5) at the completion of 6 cycles of nivolumab + rituximab (R)- cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP)/dose-adjusted (DA)-etoposide, prednisone, vincristine, cyclophosphamide, and doxorubicin (EPOCH)-R and R-CHOP/DA-EPOCH-R in patients with newly diagnosed PMBCL and evaluate the prognostic significance of such a finding.
EXPLORATORY OBJECTIVES:
I. To bank radiology images for further studies. II. To bank specimens for future correlative studies. III. Characterize the immune profile of patients treated with nivolumab + chemo-immunotherapy to identify markers predictive of response.
IV. Define the rate of complete response at the completion of initial planned therapy.
OUTLINE: Patients are randomly assigned to backbone therapy or backbone therapy + nivolumab within each of 6 strata. The strata are determined by physician's choice of backbone (DA-EPOCH-R versus [vs.] R-CHOP vs. R-CHOP + RT) and whether or not the patient had 1 prior cycle of therapy.
ARM A (DA-EPOCH-R): Patients receive prednisone or prednisolone orally (PO) once daily (QD) on days 1-5 and rituximab intravenously (IV) or rituximab and hyaluronidase human subcutaneously (SC) over 5 minutes on day 1 or 5. Patients also receive etoposide phosphate, doxorubicin hydrochloride, and vincristine sulfate IV over 96 hours on days 1-4 and cyclophosphamide IV over 30-60 minutes on day 5. Beginning 24-72 hours after completing cyclophosphamide, patients receive filgrastim or pegylated filgrastim SC daily until absolute neutrophil count (ANC) is >= 500/uL after the expected nadir. Treatment repeats every 21 days for up to 6 cycles (5 if the patient had 1 prior cycle of treatment) in the absence of disease progression or unacceptable toxicity. Patients undergo echocardiography (ECHO) during screening and as clinically indicated and a lumbar puncture (LP) for cerebral spinal fluid (CSF) collection optionally during screening. Patients also undergo computed tomography (CT) or positron emission tomography (PET)/CT throughout the trial. Additionally, patients undergo bone marrow biopsy and aspiration optionally during screening and as clinically indicated on study. Patients undergo blood sample collection on study.
ARM B (DA-EPOCH-R + NIVOLUMAB): Patients receive treatment as in Arm A. Patients also receive nivolumab IV over 30 minutes on day 1. Patients undergo ECHO during screening and as clinically indicated and LP for CSF collection optionally during screening. Patients also undergo CT or PET/CT throughout the trial. Additionally, patients undergo bone marrow biopsy and aspiration optionally during screening and as clinically indicated on study. Patients undergo blood sample collection on study.
ARM C (R-CHOP): Patients receive prednisone or prednisolone PO QD on days 1-5 and rituximab IV or rituximab and hyaluronidase human SC over 5 minutes on day 1 or 5. Patients also receive cyclophosphamide IV over 30-60 minutes, doxorubicin hydrochloride IV over 1-15 minutes or up to 60 minutes, and vincristine sulfate IV over 1 or up to 60 minutes on day 1. Treatment repeats every 21 days for up to 6 cycles (5 if the patient had 1 prior cycle of treatment) in the absence of disease progression or unacceptable toxicity. Patients undergo ECHO during screening and as clinically indicated and LP for CSF collection optionally during screening. Patients also undergo CT or PET/CT throughout the trial. Additionally, patients undergo bone marrow biopsy and aspiration optionally during screening and as clinically indicated on study. Patients undergo blood sample collection on study.
ARM D (R-CHOP + NIVOLUMAB): Patients receive treatment as in Arm C. Patients also receive nivolumab IV over 30 minutes on day 1. Patients undergo ECHO during screening and as clinically indicated and LP for CSF collection optionally during screening. Patients also undergo CT or PET/CT throughout the trial. Additionally, patients undergo bone marrow biopsy and aspiration optionally during screening and as clinically indicated on study. Patients undergo blood sample collection on study.
ARM E (R-CHOP + RADIOTHERAPY): Patients receive treatment as in Arm C. Within 6-8 weeks after completion of chemotherapy, patients undergo radiation therapy over 25 fractions. Patients undergo ECHO during screening and as clinically indicated and LP for CSF collection optionally during screening. Patients also undergo CT or PET/CT throughout the trial. Additionally, patients undergo bone marrow biopsy and aspiration optionally during screening and as clinically indicated on study. Patients undergo blood sample collection on study.
ARM F (R-CHOP + RADIOTHERAPY + NIVOLUMAB): Patients receive treatment as in Arm D. Within 6-8 weeks after completion of chemotherapy, patients undergo radiation therapy over 25 fractions. Patients undergo ECHO during screening and as clinically indicated and LP for CSF collection optionally during screening. Patients also undergo CT or PET/CT throughout the trial. Additionally, patients undergo bone marrow biopsy and aspiration optionally during screening and as clinically indicated on study. Patients undergo blood sample collection on study.
After completion of study treatment, patients are followed up every 3 months for year 1, every 6 months for years 2-3, and annually thereafter.
연구 유형
등록 (추정된)
단계
- 3단계
연락처 및 위치
연구 장소
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Alabama
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Birmingham, Alabama, 미국, 35233
- Children's Hospital of Alabama
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Mobile, Alabama, 미국, 36604
- USA Health Strada Patient Care Center
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Alaska
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Anchorage, Alaska, 미국, 99508
- Providence Alaska Medical Center
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Arizona
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Mesa, Arizona, 미국, 85202
- Banner Children's at Desert
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Tucson, Arizona, 미국, 85719
- Banner University Medical Center - Tucson
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Arkansas
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Little Rock, Arkansas, 미국, 72202-3591
- Arkansas Children's Hospital
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California
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Costa Mesa, California, 미국, 92627
- UC Irvine Health Cancer Center-Newport
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Downey, California, 미국, 90242
- Kaiser Permanente Downey Medical Center
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Duarte, California, 미국, 91010
- City of Hope Comprehensive Cancer Center
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Irvine, California, 미국, 92618
- City of Hope at Irvine Lennar
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Irvine, California, 미국, 92612
- UCI Health - Chao Family Comprehensive Cancer Center and Ambulatory Care
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Loma Linda, California, 미국, 92354
- Loma Linda University Medical Center
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Long Beach, California, 미국, 90806
- Miller Children's and Women's Hospital Long Beach
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Los Angeles, California, 미국, 90048
- Cedars-Sinai Medical Center
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Los Angeles, California, 미국, 90027
- Children's Hospital Los Angeles
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Los Angeles, California, 미국, 90095
- Mattel Children's Hospital UCLA
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Madera, California, 미국, 93636
- Valley Children's Hospital
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Oakland, California, 미국, 94611
- Kaiser Permanente-Oakland
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Orange, California, 미국, 92868
- UC Irvine Health/Chao Family Comprehensive Cancer Center
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Orange, California, 미국, 92868
- Children's Hospital of Orange County
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Palo Alto, California, 미국, 94304
- Lucile Packard Children's Hospital Stanford University
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Sacramento, California, 미국, 95817
- University of California Davis Comprehensive Cancer Center
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San Diego, California, 미국, 92123
- Rady Children's Hospital - San Diego
-
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Colorado
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Aurora, Colorado, 미국, 80045
- Children's Hospital Colorado
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Denver, Colorado, 미국, 80218
- Rocky Mountain Hospital for Children-Presbyterian Saint Luke's Medical Center
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Connecticut
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Hartford, Connecticut, 미국, 06106
- Connecticut Children's Medical Center
-
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Delaware
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Wilmington, Delaware, 미국, 19803
- Alfred I duPont Hospital for Children
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District of Columbia
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Washington D.C., District of Columbia, 미국, 20010
- Children's National Medical Center
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Washington D.C., District of Columbia, 미국, 20007
- MedStar Georgetown University Hospital
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Florida
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Fort Lauderdale, Florida, 미국, 33316
- Broward Health Medical Center
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Fort Myers, Florida, 미국, 33908
- Golisano Children's Hospital of Southwest Florida
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Gainesville, Florida, 미국, 32610
- UF Health Cancer Institute - Gainesville
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Hollywood, Florida, 미국, 33021
- Memorial Regional Hospital/Joe DiMaggio Children's Hospital
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Jacksonville, Florida, 미국, 32207
- Nemours Children's Clinic-Jacksonville
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Miami, Florida, 미국, 33136
- University of Miami Miller School of Medicine-Sylvester Cancer Center
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Orlando, Florida, 미국, 32827
- Nemours Children's Hospital
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Orlando, Florida, 미국, 32806
- Arnold Palmer Hospital for Children
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St. Petersburg, Florida, 미국, 33701
- Johns Hopkins All Children's Hospital
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Tampa, Florida, 미국, 33606
- Tampa General Hospital
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Tampa, Florida, 미국, 33607
- Saint Joseph's Hospital/Children's Hospital-Tampa
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Georgia
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Atlanta, Georgia, 미국, 30308
- Emory University Hospital Midtown
-
Atlanta, Georgia, 미국, 30322
- Emory University Hospital/Winship Cancer Institute
-
Atlanta, Georgia, 미국, 30342
- Emory Saint Joseph's Hospital
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Atlanta, Georgia, 미국, 30308
- Emory Proton Therapy Center
-
Atlanta, Georgia, 미국, 30329
- Children's Healthcare of Atlanta - Arthur M Blank Hospital
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Savannah, Georgia, 미국, 31404
- Memorial Health University Medical Center
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Hawaii
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Honolulu, Hawaii, 미국, 96826
- Kapiolani Medical Center for Women and Children
-
-
Idaho
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Boise, Idaho, 미국, 83712
- Saint Luke's Cancer Institute - Boise
-
-
Illinois
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Aurora, Illinois, 미국, 60504
- Rush-Copley Medical Center
-
Chicago, Illinois, 미국, 60611
- Northwestern University
-
Chicago, Illinois, 미국, 60637
- University of Chicago Comprehensive Cancer Center
-
Chicago, Illinois, 미국, 60612
- University of Illinois
-
Chicago, Illinois, 미국, 60611
- Lurie Children's Hospital-Chicago
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Danville, Illinois, 미국, 61832
- Carle at The Riverfront
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DeKalb, Illinois, 미국, 60115
- Northwestern Medicine Cancer Center Kishwaukee
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Decatur, Illinois, 미국, 62526
- Decatur Memorial Hospital
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Effingham, Illinois, 미국, 62401
- Carle Physician Group-Effingham
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Geneva, Illinois, 미국, 60134
- Northwestern Medicine Cancer Center Delnor
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Lake Forest, Illinois, 미국, 60045
- Northwestern Medicine Lake Forest Hospital
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Mattoon, Illinois, 미국, 61938
- Carle Physician Group-Mattoon/Charleston
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Maywood, Illinois, 미국, 60153
- Loyola University Medical Center
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O'Fallon, Illinois, 미국, 62269
- HSHS Saint Elizabeth's Hospital
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Oak Lawn, Illinois, 미국, 60453
- Advocate Children's Hospital-Oak Lawn
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Park Ridge, Illinois, 미국, 60068
- Advocate Children's Hospital-Park Ridge
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Peoria, Illinois, 미국, 61637
- OSF Children's Hospital of Illinois
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Springfield, Illinois, 미국, 62702
- Southern Illinois University School of Medicine
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Springfield, Illinois, 미국, 62702
- Springfield Clinic
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Springfield, Illinois, 미국, 62781
- Springfield Memorial Hospital
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Urbana, Illinois, 미국, 61801
- Carle Cancer Center
-
Warrenville, Illinois, 미국, 60555
- Northwestern Medicine Cancer Center Warrenville
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Indiana
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Indianapolis, Indiana, 미국, 46202
- Riley Hospital for Children
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Richmond, Indiana, 미국, 47374
- Reid Health
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Iowa
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Ankeny, Iowa, 미국, 50023
- UI Health Care Mission Cancer and Blood - Ankeny Clinic
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Clive, Iowa, 미국, 50325
- UI Health Care Mission Cancer and Blood - West Des Moines Clinic
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Des Moines, Iowa, 미국, 50314
- Mercy Medical Center - Des Moines
-
Des Moines, Iowa, 미국, 50309
- Blank Children's Hospital
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Des Moines, Iowa, 미국, 50314
- UI Health Care Mission Cancer and Blood - Laurel Clinic
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Iowa City, Iowa, 미국, 52242
- University of Iowa/Holden Comprehensive Cancer Center
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Sioux City, Iowa, 미국, 51101
- Siouxland Regional Cancer Center
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Waukee, Iowa, 미국, 50263
- UI Health Care Mission Cancer and Blood - Waukee Clinic
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Kansas
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Wichita, Kansas, 미국, 67214
- Wesley Medical Center
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Kentucky
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Lexington, Kentucky, 미국, 40536
- University of Kentucky/Markey Cancer Center
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Louisville, Kentucky, 미국, 40202
- Norton Children's Hospital
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Louisiana
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New Orleans, Louisiana, 미국, 70121
- Ochsner Medical Center Jefferson
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New Orleans, Louisiana, 미국, 70118
- Children's Hospital New Orleans
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Maine
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Bangor, Maine, 미국, 04401
- Eastern Maine Medical Center
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Scarborough, Maine, 미국, 04074
- Maine Children's Cancer Program
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Maryland
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Baltimore, Maryland, 미국, 21287
- Johns Hopkins University/Sidney Kimmel Cancer Center
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Baltimore, Maryland, 미국, 21215
- Sinai Hospital of Baltimore
-
Baltimore, Maryland, 미국, 21204
- Greater Baltimore Medical Center
-
Baltimore, Maryland, 미국, 21201
- University of Maryland/Greenebaum Cancer Center
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Bethesda, Maryland, 미국, 20889-5600
- Walter Reed National Military Medical Center
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Massachusetts
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Boston, Massachusetts, 미국, 02215
- Dana-Farber Cancer Institute
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Boston, Massachusetts, 미국, 02111
- Tufts Medical Center
-
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Michigan
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Ann Arbor, Michigan, 미국, 48109
- C S Mott Children's Hospital
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Detroit, Michigan, 미국, 48202
- Henry Ford Hospital
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Detroit, Michigan, 미국, 48201
- Children's Hospital of Michigan
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East Lansing, Michigan, 미국, 48823
- Michigan State University
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Grand Rapids, Michigan, 미국, 49503
- Corewell Health Grand Rapids Hospitals - Helen DeVos Children's Hospital
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Kalamazoo, Michigan, 미국, 49007
- Bronson Methodist Hospital
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Niles, Michigan, 미국, 49120
- Corewell Health Lakeland Hospitals - Niles Hospital
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Royal Oak, Michigan, 미국, 48073
- Corewell Health Children's
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Minnesota
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Burnsville, Minnesota, 미국, 55337
- Minnesota Oncology - Burnsville
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Coon Rapids, Minnesota, 미국, 55433
- Mercy Hospital
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Edina, Minnesota, 미국, 55435
- Fairview Southdale Hospital
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Fridley, Minnesota, 미국, 55432
- Unity Hospital
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Maplewood, Minnesota, 미국, 55109
- Minnesota Oncology Hematology PA-Maplewood
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Minneapolis, Minnesota, 미국, 55404
- Children's Hospitals and Clinics of Minnesota - Minneapolis
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Minneapolis, Minnesota, 미국, 55407
- Abbott-Northwestern Hospital
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Saint Louis Park, Minnesota, 미국, 55416
- Park Nicollet Clinic - Saint Louis Park
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Saint Paul, Minnesota, 미국, 55102
- United Hospital
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Mississippi
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Jackson, Mississippi, 미국, 39216
- University of Mississippi Medical Center
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-
Missouri
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Chesterfield, Missouri, 미국, 63017
- Saint Luke's Hospital
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City of Saint Peters, Missouri, 미국, 63376
- Siteman Cancer Center at Saint Peters Hospital
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Creve Coeur, Missouri, 미국, 63141
- Siteman Cancer Center at West County Hospital
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Kansas City, Missouri, 미국, 64108
- Children's Mercy Hospitals and Clinics
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St Louis, Missouri, 미국, 63110
- Washington University School of Medicine
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St Louis, Missouri, 미국, 63129
- Siteman Cancer Center-South County
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St Louis, Missouri, 미국, 63136
- Siteman Cancer Center at Christian Hospital
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St Louis, Missouri, 미국, 63141
- Mercy Hospital Saint Louis
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Nebraska
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Omaha, Nebraska, 미국, 68198
- University of Nebraska Medical Center
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Omaha, Nebraska, 미국, 68114
- Children's Hospital and Medical Center of Omaha
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Nevada
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Las Vegas, Nevada, 미국, 89135
- Alliance for Childhood Diseases/Cure 4 the Kids Foundation
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Reno, Nevada, 미국, 89502
- Renown Regional Medical Center
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-
New Hampshire
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Lebanon, New Hampshire, 미국, 03756
- Dartmouth Hitchcock Medical Center/Dartmouth Cancer Center
-
-
New Jersey
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Basking Ridge, New Jersey, 미국, 07920
- Memorial Sloan Kettering Basking Ridge
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Hackensack, New Jersey, 미국, 07601
- Hackensack University Medical Center
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Middletown, New Jersey, 미국, 07748
- Memorial Sloan Kettering Monmouth
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Montvale, New Jersey, 미국, 07645
- Memorial Sloan Kettering Bergen
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Morristown, New Jersey, 미국, 07960
- Morristown Medical Center
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New Brunswick, New Jersey, 미국, 08903
- Rutgers Cancer Institute of New Jersey
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New Brunswick, New Jersey, 미국, 08903
- Rutgers Cancer Institute of New Jersey-Robert Wood Johnson University Hospital
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Paterson, New Jersey, 미국, 07503
- Saint Joseph's Regional Medical Center
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New Mexico
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Albuquerque, New Mexico, 미국, 87106
- Presbyterian Hospital
-
-
New York
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Albany, New York, 미국, 12208
- Albany Medical Center
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Buffalo, New York, 미국, 14263
- Roswell Park Cancer Institute
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Commack, New York, 미국, 11725
- Memorial Sloan Kettering Commack
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Harrison, New York, 미국, 10604
- Memorial Sloan Kettering Westchester
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New Hyde Park, New York, 미국, 11040
- The Steven and Alexandra Cohen Children's Medical Center of New York
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New York, New York, 미국, 10065
- Memorial Sloan Kettering Cancer Center
-
New York, New York, 미국, 10032
- NYP/Columbia University Medical Center/Herbert Irving Comprehensive Cancer Center
-
New York, New York, 미국, 10065
- NYP/Weill Cornell Medical Center
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Rochester, New York, 미국, 14642
- University of Rochester
-
Stony Brook, New York, 미국, 11794
- Stony Brook University Medical Center
-
Syracuse, New York, 미국, 13210
- State University of New York Upstate Medical University
-
The Bronx, New York, 미국, 10467
- Montefiore Medical Center - Moses Campus
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Uniondale, New York, 미국, 11553
- Memorial Sloan Kettering Nassau
-
Valhalla, New York, 미국, 10595
- New York Medical College
-
Webster, New York, 미국, 14580
- Wilmot Cancer Institute at Webster
-
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North Carolina
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Asheville, North Carolina, 미국, 28801
- Mission Hospital
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Asheville, North Carolina, 미국, 28803
- AdventHealth Infusion Center Asheville
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Charlotte, North Carolina, 미국, 28203
- Carolinas Medical Center/Levine Cancer Institute
-
Charlotte, North Carolina, 미국, 28204
- Novant Health Presbyterian Medical Center
-
Greenville, North Carolina, 미국, 27834
- East Carolina University
-
Hendersonville, North Carolina, 미국, 28792
- AdventHealth Hendersonville
-
Winston-Salem, North Carolina, 미국, 27157
- Wake Forest University Health Sciences
-
-
North Dakota
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Fargo, North Dakota, 미국, 58122
- Sanford Broadway Medical Center
-
-
Ohio
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Akron, Ohio, 미국, 44308
- Children's Hospital Medical Center of Akron
-
Cincinnati, Ohio, 미국, 45229
- Cincinnati Children's Hospital Medical Center
-
Cleveland, Ohio, 미국, 44195
- Cleveland Clinic Foundation
-
Cleveland, Ohio, 미국, 44106
- Rainbow Babies and Childrens Hospital
-
Columbus, Ohio, 미국, 43205
- Nationwide Children's Hospital
-
Dayton, Ohio, 미국, 45404
- Dayton Children's Hospital
-
Dayton, Ohio, 미국, 45415
- Dayton Physician LLC - Englewood
-
Kettering, Ohio, 미국, 45429
- Kettering Medical Center
-
Kettering, Ohio, 미국, 45409
- Greater Dayton Cancer Center
-
Toledo, Ohio, 미국, 43606
- ProMedica Toledo Hospital/Russell J Ebeid Children's Hospital
-
-
Oklahoma
-
Oklahoma City, Oklahoma, 미국, 73104
- University of Oklahoma Health Sciences Center
-
-
Oregon
-
Portland, Oregon, 미국, 97239
- Oregon Health and Science University
-
Portland, Oregon, 미국, 97227
- Legacy Emanuel Children's Hospital
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Pennsylvania
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Allentown, Pennsylvania, 미국, 18103
- Lehigh Valley Hospital-Cedar Crest
-
Danville, Pennsylvania, 미국, 17822
- Geisinger Medical Center
-
Hershey, Pennsylvania, 미국, 17033
- Penn State Children's Hospital
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Philadelphia, Pennsylvania, 미국, 19104
- Children's Hospital of Philadelphia
-
Philadelphia, Pennsylvania, 미국, 19134
- Saint Christopher's Hospital for Children
-
Pittsburgh, Pennsylvania, 미국, 15224
- Children's Hospital of Pittsburgh of UPMC
-
-
Rhode Island
-
Providence, Rhode Island, 미국, 02903
- Rhode Island Hospital
-
-
South Carolina
-
Columbia, South Carolina, 미국, 29203
- Prisma Health Richland Hospital
-
Greenville, South Carolina, 미국, 29607
- Saint Francis Cancer Center
-
Greenville, South Carolina, 미국, 29615
- Prisma Health Cancer Institute - Eastside
-
Greenville, South Carolina, 미국, 29601
- Saint Francis Hospital
-
Greenville, South Carolina, 미국, 29605
- BI-LO Charities Children's Cancer Center
-
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South Dakota
-
Sioux Falls, South Dakota, 미국, 57117-5134
- Sanford USD Medical Center - Sioux Falls
-
-
Tennessee
-
Knoxville, Tennessee, 미국, 37916
- East Tennessee Childrens Hospital
-
Memphis, Tennessee, 미국, 38105
- Saint Jude Children's Research Hospital
-
Nashville, Tennessee, 미국, 37232
- Vanderbilt University/Ingram Cancer Center
-
Nashville, Tennessee, 미국, 37203
- The Children's Hospital at TriStar Centennial
-
-
Texas
-
Amarillo, Texas, 미국, 79106
- Texas Tech University Health Sciences Center-Amarillo
-
Austin, Texas, 미국, 78723
- Dell Children's Medical Center of Central Texas
-
Corpus Christi, Texas, 미국, 78411
- Driscoll Children's Hospital
-
Dallas, Texas, 미국, 75390
- UT Southwestern/Simmons Cancer Center-Dallas
-
Dallas, Texas, 미국, 75230
- Medical City Dallas Hospital
-
El Paso, Texas, 미국, 79905
- El Paso Children's Hospital
-
Houston, Texas, 미국, 77030
- UT MD Anderson Cancer Center
-
Houston, Texas, 미국, 77030
- Houston Methodist Hospital
-
Houston, Texas, 미국, 77030
- Baylor College of Medicine/Dan L Duncan Comprehensive Cancer Center
-
Lubbock, Texas, 미국, 79410
- Covenant Children's Hospital
-
Lubbock, Texas, 미국, 79415
- UMC Cancer Center / UMC Health System
-
San Antonio, Texas, 미국, 78229
- University of Texas Health Science Center at San Antonio
-
San Antonio, Texas, 미국, 78207
- Children's Hospital of San Antonio
-
San Antonio, Texas, 미국, 78229
- Methodist Children's Hospital of South Texas
-
-
Utah
-
Salt Lake City, Utah, 미국, 84113
- Primary Children's Hospital
-
-
Virginia
-
Charlottesville, Virginia, 미국, 22908
- University of Virginia Cancer Center
-
Falls Church, Virginia, 미국, 22042
- Inova Fairfax Hospital
-
Norfolk, Virginia, 미국, 23507
- Children's Hospital of The King's Daughters
-
Richmond, Virginia, 미국, 23298
- VCU Massey Comprehensive Cancer Center
-
Roanoke, Virginia, 미국, 24014
- Carilion Children's
-
-
Washington
-
Renton, Washington, 미국, 98055
- Valley Medical Center
-
Seattle, Washington, 미국, 98105
- Seattle Children's Hospital
-
Spokane, Washington, 미국, 99204
- Providence Sacred Heart Medical Center and Children's Hospital
-
Tacoma, Washington, 미국, 98405
- Mary Bridge Children's Hospital and Health Center
-
Tacoma, Washington, 미국, 98431
- Madigan Army Medical Center
-
-
West Virginia
-
Charleston, West Virginia, 미국, 25304
- Vandalia Health/CAMC Institute for Academic Medicine
-
-
Wisconsin
-
Madison, Wisconsin, 미국, 53792
- University of Wisconsin Carbone Cancer Center - University Hospital
-
Marshfield, Wisconsin, 미국, 54449
- Marshfield Medical Center-Marshfield
-
-
-
-
-
Québec, 캐나다, G1V 4G2
- CHU de Quebec-Centre Hospitalier de l'Universite Laval (CHUL)
-
-
Alberta
-
Edmonton, Alberta, 캐나다, T6G 2B7
- University of Alberta Hospital
-
-
Manitoba
-
Winnipeg, Manitoba, 캐나다, R3E 0V9
- CancerCare Manitoba
-
-
Newfoundland and Labrador
-
St. John's, Newfoundland and Labrador, 캐나다, A1B 3V6
- Janeway Child Health Centre
-
-
Nova Scotia
-
Halifax, Nova Scotia, 캐나다, B3K 6R8
- IWK Health Centre
-
-
Ontario
-
Hamilton, Ontario, 캐나다, L8N 3Z5
- McMaster Children's Hospital at Hamilton Health Sciences
-
London, Ontario, 캐나다, N6A 5W9
- Children's Hospital
-
Ottawa, Ontario, 캐나다, K1H 8L1
- Children's Hospital of Eastern Ontario
-
Toronto, Ontario, 캐나다, M5G 1X8
- Hospital for Sick Children
-
-
Quebec
-
Montreal, Quebec, 캐나다, H3H 1P3
- The Montreal Children's Hospital of the MUHC
-
Montreal, Quebec, 캐나다, H3T 1C5
- Centre Hospitalier Universitaire Sainte-Justine
-
Sherbrooke, Quebec, 캐나다, J1H 5N4
- Centre Hospitalier Universitaire de Sherbrooke-Fleurimont
-
-
-
-
-
Caguas, 푸에르토 리코, 00726
- HIMA San Pablo Oncologic Hospital
-
-
-
-
New South Wales
-
Hunter Regional Mail Centre, New South Wales, 호주, 2310
- John Hunter Children's Hospital
-
Westmead, New South Wales, 호주, 2145
- The Children's Hospital at Westmead
-
-
Queensland
-
South Brisbane, Queensland, 호주, 4101
- Queensland Children's Hospital
-
-
Victoria
-
Parkville, Victoria, 호주, 3052
- Royal Children's Hospital
-
-
Western Australia
-
Perth, Western Australia, 호주, 6009
- Perth Children's Hospital
-
-
참여기준
자격 기준
공부할 수 있는 나이
건강한 자원 봉사자를 받아들입니다
연구 대상 성별
설명
Inclusion Criteria:
-
Age >= 2 years
-
Patient must have histologically confirmed primary mediastinal B-cell lymphoma (PMBCL) as defined by World Health Organization (WHO) criteria
-
Eastern Cooperative Oncology Group (ECOG) performance status of 0, 1, or 2 or ECOG performance status of 3 if poor performance is related to lymphoma
- Children's Oncology Group (COG) Institutions: Use Karnofsky for patients >= 17 and < 18 years of age and Lansky for patients < 17 years of age
-
Adults (age 18 or older): Creatinine clearance >= 30 mL/min, as estimated by the Cockcroft and Gault formula. The creatinine value used in the calculation must have been obtained within 28 days prior to registration. Estimated creatinine clearance is based on actual body weight
-
Pediatric Patients (age < 18 years): The following must have been obtained within 14 days prior to registration:
-
Measured or calculated (based on institutional standard) creatinine clearance or radioisotope glomerular filtration rate (GFR) >= 70 ml/min/1.73 m^2, or
-
Serum creatinine =< 1.5 x institutional upper limit of normal (IULN), or a serum creatinine based on age/sex as follows:
- Age : 2 to < 6 year; Maximum serum creatinine (mg/dL): 0.8 (male; 0.8 (female)
- Age : 6 to < 10 years; Maximum serum creatinine (mg/dL): 1 (male); 1 (female)
- Age : 10 to < 13 years; Maximum serum creatinine (mg/dL): 1.2 (male); 1.2 (female)
- Age : 13 to < 16 years; Maximum serum creatinine (mg/dL): 1.5 (male); 1.4 (female)
- Age : >= 16 years to < 18 years; Maximum serum creatinine (mg/dL): 1.7 (male); 1.4 (female)
-
-
Patients with abnormal liver function will be eligible to enroll if the lab abnormality is thought to be due to the lymphoma or Gilbert's syndrome
-
Age >= 18 years: Ejection fraction of >= 50% by echocardiogram
-
Age < 18 years: Shortening fraction of >= 27% by echocardiogram, or ejection fraction of >= 50% by radionuclide angiogram
-
Human immunodeficiency virus (HIV)-infected patients on effective anti-retroviral therapy with undetectable viral load within 6 months are eligible for this trial
-
For patients with evidence of chronic hepatitis B virus (HBV) infection, the HBV viral load must be undetectable on suppressive therapy, if indicated
-
Patients with a history of hepatitis C virus (HCV) infection must have been treated and cured. For patients with HCV infection who are currently on treatment, they are eligible if they have an undetectable HCV viral load
-
All patients and/or their parents or legal guardians must sign a written informed consent
-
All institutional, Food and Drug Administration (FDA), and National Cancer Institute (NCI) requirements for human studies must be met
Exclusion Criteria:
-
Administration of prior anti-cancer therapy except as outlined below:
- A short course (=< 2 weeks) of corticosteroids for the relief of lymphoma-related symptoms
- A single course of COP (cyclophosphamide, vincristine, and prednisone)
- One cycle of chemo-immunotherapy including R-CHOP, DA-EPOCH-R, a pediatric mature B-cell non-Hodgkin lymphoma (B-NHL) induction therapy (such as ANHL1131), or intrathecal chemotherapy that has not started more than 21 days prior to enrollment
-
Active ischemic heart disease or heart failure
-
Active uncontrolled infection
-
Central nervous system (CNS) involvement of lymphoma
-
Patients with a prior or concurrent malignancy whose natural history or treatment has the potential to interfere with safety or efficacy assessment of this trial
-
Active autoimmune disease that has required systemic treatment (such as disease modifying agents, corticosteroids, or immunosuppressive agents) in the past 2 years. Replacement therapy such as thyroxine, insulin or physiologic corticosteroid for adrenal or pituitary insufficiency is not considered a form of systemic treatment
-
In patients < 18 years of age hepatitis B serologies consistent with past or current infections
-
Patients with severe hepatic impairment (Child-Pugh class C or serum total bilirubin > 5.0 mg/dL) unless thought to be due to lymphoma or Gilbert's syndrome
-
Female patients who are pregnant since fetal toxicities and teratogenic effects have been noted for several of the study drugs. A pregnancy test is required for female patients of childbearing potential
-
Sexually active patients of reproductive potential who have not agreed to use a highly effective contraceptive method (failure rate of < 1% per year when used consistently and correctly) for the duration of their study participation
-
Lactating females are not eligible unless they have agreed not to breastfeed their infants starting with the first dose of study therapy and for at least 6 months after the last dose of rituximab
공부 계획
연구는 어떻게 설계됩니까?
디자인 세부사항
- 주 목적: 치료
- 할당: 무작위
- 중재 모델: 병렬 할당
- 마스킹: 없음(오픈 라벨)
무기와 개입
참가자 그룹 / 팔 |
개입 / 치료 |
|---|---|
|
활성 비교기: Arm A (DA-EPOCH-R)
See Detailed Description |
Given IV
다른 이름들:
Given IV
다른 이름들:
Given PO
다른 이름들:
Given IV
다른 이름들:
Given IV
다른 이름들:
Undergo ECHO
다른 이름들:
Undergo CT or PET/CT
다른 이름들:
Undergo PET/CT
다른 이름들:
Given IV
다른 이름들:
Given SC
다른 이름들:
Undergo bone marrow biopsy and aspiration Undergo bone marrow biopsy and aspiration
다른 이름들:
Given PO
다른 이름들:
Given SC
다른 이름들:
Undergo LP
다른 이름들:
Undergo blood and CSF sample collection
다른 이름들:
Given SC
다른 이름들:
|
|
실험적: Arm B (DA-EPOCH-R, nivolumab)
Patients receive treatment as in Arm A. Patients also receive nivolumab IV over 30 minutes on day 1. Treatment repeats every 21 days for up to 6 cycles (5 if the patient had 1 prior cycle of treatment) in the absence of disease progression or unacceptable toxicity. Patients undergo ECHO and LP for CSF collection during screening. Patients undergo ECHO during screening and as clinically indicated and LP for CSF collection optionally during screening. Patients also undergo CT or PET/CT throughout the trial. Additionally, patients undergo bone marrow biopsy and aspiration optionally during screening and as clinically indicated on study. Patients undergo blood sample collection on study. |
Given IV
다른 이름들:
Given IV
다른 이름들:
Given PO
다른 이름들:
Given IV
다른 이름들:
Given IV
다른 이름들:
Undergo ECHO
다른 이름들:
Given IV
다른 이름들:
Undergo CT or PET/CT
다른 이름들:
Undergo PET/CT
다른 이름들:
Given IV
다른 이름들:
Given SC
다른 이름들:
Undergo bone marrow biopsy and aspiration Undergo bone marrow biopsy and aspiration
다른 이름들:
Given PO
다른 이름들:
Given SC
다른 이름들:
Undergo LP
다른 이름들:
Undergo blood and CSF sample collection
다른 이름들:
Given SC
다른 이름들:
|
|
활성 비교기: Arm C (R-CHOP)
Patients receive prednisone or prednisolone PO QD on days 1-5 and rituximab IV or rituximab and hyaluronidase human SC over 5 minutes on day 1 or 5. Patients also receive cyclophosphamide IV over 30-60 minutes, doxorubicin hydrochloride IV over 1-15 minutes or up to 60 minutes, and vincristine sulfate IV over 1 or up to 60 minutes on day 1. Treatment repeats every 21 days for up to 6 cycles (5 if the patient had 1 prior cycle of treatment) in the absence of disease progression or unacceptable toxicity. Patients undergo ECHO during screening and as clinically indicated and LP for CSF collection optionally during screening. Patients also undergo CT or PET/CT throughout the trial. Additionally, patients undergo bone marrow biopsy and aspiration optionally during screening and as clinically indicated on study. Patients undergo blood sample collection on study. |
Given IV
다른 이름들:
Given IV
다른 이름들:
Given PO
다른 이름들:
Given IV
다른 이름들:
Given IV
다른 이름들:
Undergo ECHO
다른 이름들:
Undergo CT or PET/CT
다른 이름들:
Undergo PET/CT
다른 이름들:
Undergo bone marrow biopsy and aspiration Undergo bone marrow biopsy and aspiration
다른 이름들:
Given PO
다른 이름들:
Undergo LP
다른 이름들:
Undergo blood and CSF sample collection
다른 이름들:
Given SC
다른 이름들:
|
|
실험적: Arm D (R-CHOP, nivolumab)
Patients receive treatment as in Arm C. Patients also receive nivolumab IV over 30 minutes on day 1. Treatment repeats every 21 days for up to 6 cycles (5 if the patient had 1 prior cycle of treatment) in the absence of disease progression or unacceptable toxicity. Patients undergo ECHO during screening and as clinically indicated and LP for CSF collection optionally during screening. Patients also undergo CT or PET/CT throughout the trial. Additionally, patients undergo bone marrow biopsy and aspiration optionally during screening and as clinically indicated on study. Patients undergo blood sample collection on study. |
Given IV
다른 이름들:
Given IV
다른 이름들:
Given PO
다른 이름들:
Given IV
다른 이름들:
Given IV
다른 이름들:
Undergo ECHO
다른 이름들:
Given IV
다른 이름들:
Undergo CT or PET/CT
다른 이름들:
Undergo PET/CT
다른 이름들:
Undergo bone marrow biopsy and aspiration Undergo bone marrow biopsy and aspiration
다른 이름들:
Given PO
다른 이름들:
Undergo LP
다른 이름들:
Undergo blood and CSF sample collection
다른 이름들:
Given SC
다른 이름들:
|
|
활성 비교기: Arm E (R-CHOP, radiation therapy)
Patients receive treatment as in Arm C. Within 6-8 weeks after completion of chemotherapy, patients undergo radiation therapy over 25 fractions. Patients undergo ECHO during screening and as clinically indicated and LP for CSF collection optionally during screening. Patients also undergo CT or PET/CT throughout the trial. Additionally, patients undergo bone marrow biopsy and aspiration optionally during screening and as clinically indicated on study. Patients undergo blood sample collection on study. |
Given IV
다른 이름들:
Given IV
다른 이름들:
Given PO
다른 이름들:
Given IV
다른 이름들:
Given IV
다른 이름들:
Undergo ECHO
다른 이름들:
Undergo CT or PET/CT
다른 이름들:
Undergo PET/CT
다른 이름들:
Undergo bone marrow biopsy and aspiration Undergo bone marrow biopsy and aspiration
다른 이름들:
Undergo radiation therapy
다른 이름들:
Given PO
다른 이름들:
Undergo LP
다른 이름들:
Undergo blood and CSF sample collection
다른 이름들:
Given SC
다른 이름들:
|
|
실험적: Arm F (R-CHOP, nivolumab, radiation therapy)
Patients receive treatment as in Arm D. Within 6-8 weeks after completion of chemotherapy, patients undergo radiation therapy over 25 fractions. Patients undergo ECHO during screening and as clinically indicated and LP for CSF collection optionally during screening. Patients also undergo CT or PET/CT throughout the trial. Additionally, patients undergo bone marrow biopsy and aspiration optionally during screening and as clinically indicated on study. Patients undergo blood sample collection on study. |
Given IV
다른 이름들:
Given IV
다른 이름들:
Given PO
다른 이름들:
Given IV
다른 이름들:
Undergo ECHO
다른 이름들:
Given IV
다른 이름들:
Undergo CT or PET/CT
다른 이름들:
Undergo PET/CT
다른 이름들:
Undergo bone marrow biopsy and aspiration Undergo bone marrow biopsy and aspiration
다른 이름들:
Undergo radiation therapy
다른 이름들:
Given PO
다른 이름들:
Undergo LP
다른 이름들:
Undergo blood and CSF sample collection
다른 이름들:
Given SC
다른 이름들:
|
연구는 무엇을 측정합니까?
주요 결과 측정
결과 측정 |
측정값 설명 |
기간 |
|---|---|---|
|
Progression-free survival (PFS)
기간: From enrollment on the study to first occurrence of relapse/progression or death, assessed up to 7 years
|
The primary analysis will be a one-sided Log-rank test stratified by choice of backbone and radiation therapy and whether the patient had a cycle of therapy prior to enrolling. |
From enrollment on the study to first occurrence of relapse/progression or death, assessed up to 7 years
|
2차 결과 측정
결과 측정 |
측정값 설명 |
기간 |
|---|---|---|
|
Efficacy-related event-free survival
기간: Up to 7 years
|
Will be analyzed using a one-sided stratified Log-rank test at alpha = 0.05 or 0.025, as appropriate, with events defined as progression, change in therapy due to a finding that led to concern about efficacy, biopsy + disease after 6 cycles of therapy, and death. |
Up to 7 years
|
|
Therapy-related event-free survival
기간: Up to 7 years
|
Will be analyzed using a one-sided stratified Log-rank test at alpha = 0.05 or 0.025, as appropriate, with events defined as progression, change in therapy due to a finding that led to concern about efficacy, biopsy + disease after 6 cycles of therapy, and death. |
Up to 7 years
|
|
Overall survival
기간: Up to 7 years
|
Will be analyzed using a one-sided stratified Log-rank test at alpha = 0.05 or 0.025, as appropriate, with events defined as only death. |
Up to 7 years
|
|
Proportion of positive positron emission tomography (PET) scans
기간: Up to 6 cycle (1 cycle = 21 days)
|
Will be analyzed descriptively with a point estimate and Clopper-Pearson 95% confidence interval in the trial overall and in each treatment arm separately. The prognostic significance of positive PET after 6 cycles of therapy will be evaluated using a Cox proportional hazards regression on PFS with PET result (positive versus [vs.] negative), choice of backbone (rituximab [R]-cyclophosphamide, doxorubicin, vincristine, and prednisone [CHOP] + radiation therapy [RT] regardless of end-of-therapy imaging vs. R-CHOP without RT unless biopsy positive at end-of-therapy vs. dose-adjusted [DA]-etoposide, prednisone, vincristine, cyclophosphamide, and doxorubicin [EPOCH]-R without RT unless biopsy positive at end of therapy), and assignment to nivolumab (yes vs. no) as covariates. |
Up to 6 cycle (1 cycle = 21 days)
|
기타 결과 측정
결과 측정 |
측정값 설명 |
기간 |
|---|---|---|
|
Immune profile of patients treated with nivolumab + chemo-immunotherapy
기간: Up to 7 years
|
Analysis will be by paired t-test (for pre- vs. post-treatment measurements) or two-sample equal-variance t-test (for comparisons of nivolumab vs. non-nivolumab or responders [complete response/partial response] vs. non-responders [stable disease/progressive disease]). |
Up to 7 years
|
|
Complete response rate
기간: At the completion of initial planned therapy
|
Will be described using point estimates and Clopper-Pearson 95% confidence intervals for the complete response rate overall and in each treatment arm separately. |
At the completion of initial planned therapy
|
공동 작업자 및 조사자
수사관
- 수석 연구원: Lisa G Roth, Children's Oncology Group
연구 기록 날짜
연구 주요 날짜
연구 시작 (실제)
기본 완료 (추정된)
연구 완료 (추정된)
연구 등록 날짜
최초 제출
QC 기준을 충족하는 최초 제출
처음 게시됨 (실제)
연구 기록 업데이트
마지막 업데이트 게시됨 (실제)
QC 기준을 충족하는 마지막 업데이트 제출
마지막으로 확인됨
추가 정보
이 연구와 관련된 용어
추가 관련 MeSH 약관
- 펩타이드
- 아미노산, 펩티드 및 단백질
- 단백질
- 유기 화학 물질
- 이종 사이 클릭 화합물
- 이종 사이 클릭 화합물, 2- 링
- 이종 사이 클릭 화합물, 융합 링
- 조사 기술
- 치료학
- 임상 실험실 기술
- 진단 기술 및 절차
- 진단
- 구멍
- 수술 절차, 수술
- 세포 학적 기술
- 세포 진단
- 탄화수소
- 탄화수소, 순환
- 생물학적 요인
- 탄수화물
- 물리적 현상
- 알칼로이드
- 다 환식 방향족 탄화수소
- 탄화수소, 방향족
- 다 환식 화합물
- 글리코 사이드
- 글리코 사이드 가수 분해 효소
- 가수 분해 효소
- 효소
- 효소 및 코엔자임
- 다당류-리아제
- 탄소 산소 리아제
- Lyases
- 인돌
- 항체, 모노클로 날, 인간화
- 항체, 모노클로 날
- 항체
- 면역 글로불린
- 면역 단백질
- 혈액 단백질
- 혈청 글로불린
- 글로불린
- Pretadienes
- 임신
- 스테로이드
- 융합 링 화합물
- 진단 기술, 수술
- 화학 기술, 분석
- 스펙트럼 분석
- 포스 포 아미드 머스타드
- 질소 머스타드 화합물
- 겨자 화합물
- 탄화수소, 할로겐화
- 포스 포 아미드
- 유기 인 화합물
- 세포 간 신호 전달 펩티드 및 단백질
- Pregnadienetriols
- Pregnadienediols
- Vinca 알칼로이드
- Secologanin Tryptamine 알칼로이드
- 인돌 알칼로이드
- 인돌리 지딘
- 인도인
- 안트라 사이클린
- 나프 타센
- 아미노 글리코 시드
- 당 단백질
- Glycoconjugates
- 항체, 모노클로 날, 뮤린 유래
- Daunorubicin
- 진단 기술, 신경계
- 식민지 자극 요인
- 조혈 세포 성장 인자
- 사이토 카인
- 니볼루맙
- 리툭시맙
- 프레드니손
- 프레드니솔론
- 시클로포스파미드
- 독소루비신
- 빈크리스틴
- 메틸프레드니솔론
- 방사선 요법
- 히알루로 노노 글루코 사미니다 제
- 방사
- 생검
- 시편 처리
- 자기 공명 분광법
- 척추 천자
- CT-P10
- 육아 세포 콜로니 자극 인자
- 필 그라 스트 im
- Deltacortene
- 프레드 닐리 덴
- Pegfilgrastim
- 에토 포 시드 포스페이트
- 페 길화 된 과립구 콜로니-자극 인자
기타 연구 ID 번호
- NCI-2021-01071
- U10CA180886 (미국 NIH 보조금/계약)
- NCI-2021-01071 (레지스트리 식별자: CTRP (Clinical Trial Reporting Program))
- ANHL1931 (기타 식별자: CTEP)
- ANHL1931 (기타 식별자: Children's Oncology Group)
개별 참가자 데이터(IPD) 계획
개별 참가자 데이터(IPD)를 공유할 계획입니까?
IPD 계획 설명
NCI is committed to sharing data in accordance with NIH policy. For more details on how clinical trial data is shared, access the link to the NIH data sharing policy page.
약물 및 장치 정보, 연구 문서
미국 FDA 규제 의약품 연구
미국 FDA 규제 기기 제품 연구
이 정보는 변경 없이 clinicaltrials.gov 웹사이트에서 직접 가져온 것입니다. 귀하의 연구 세부 정보를 변경, 제거 또는 업데이트하도록 요청하는 경우 register@clinicaltrials.gov. 문의하십시오. 변경 사항이 clinicaltrials.gov에 구현되는 즉시 저희 웹사이트에도 자동으로 업데이트됩니다. .