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Kombinasjonskjemoterapi med eller uten autolog stamcelletransplantasjon ved behandling av pasienter med B-celle lymfom i sentralnervesystemet

31. august 2026 oppdatert av: Alliance for Clinical Trials in Oncology

En randomisert fase II-studie av myeloablativ versus ikke-myeloablativ konsolideringskjemoterapi for nylig diagnostisert primær CNS B-celle lymfom

The purpose of this study is to find out what effects (good and/or bad) treatment with chemotherapy and stem cell transplant compared with chemotherapy alone will have on primary CNS B-cell lymphoma. Currently the best treatment for patients with primary CNS B-cell lymphoma is not known.

Studieoversikt

Status

Fullført

Forhold

Intervensjon / Behandling

Detaljert beskrivelse

Primary Objective:

To compare the two-year progression-free survival (PFS) of patients treated with the myeloablative consolidation treatment strategy of HDT/ASCT versus those treated with non-myeloablative consolidation chemotherapy with cytarabine and etoposide

Secondary Objectives:

  1. To compare the two-year event-free survival (EFS) of patients treated with consolidation HDT/ASCT versus those treated with consolidation chemotherapy consisting of etoposide and cytarabine
  2. To compare the overall survival (OS) of patients treated with the consolidation HDT/ASCT versus those treated with consolidation chemotherapy consisting of etoposide and cytarabine
  3. To assess the toxicities associated with consolidation HDT/ASCT versus consolidation consisting of etoposide and cytarabine
  4. To determine diffusion MRI metrics (ADCmini, ADC25%, and ADCmean) prior to induction chemotherapy, after one full induction chemotherapy cycle, and at the end of induction chemotherapy as a predictor of response and outcome (CALGB 581101)
  5. To determine brain FDG-PET metrics (tumor SUV and tumor versus background SUV) prior to induction chemotherapy, after one full induction chemotherapy cycle, and at the end of induction chemotherapy as a predictor of response and outcome (CALGB 581101)
  6. To determine whether low baseline ADC measurements are associated with shorter PFS and OS (CALGB 581101)
  7. To determine whether reduction in tumor SUV by > 25% on brain FDG-PET/CT after one cycle of induction therapy is associated with improved PFS and OS (CALGB 581101)
  8. To determine which IHC-based biomarkers are predictive of an adverse prognosis (CALGB 151113)
  9. To determine which IHC-based biomarkers are predictive of a favorable prognosis (CALGB 151113) for BCL6 (B-cell CLL/lymphoma 6), and STAT 6 (signal transducer and activator of transcription 6, interleukin-4 induced)
  10. To analyze tumor tissue for gene expression profiles, and to correlate these profiles with treatment outcomes (CALGB 151113)
  11. To determine whether CSF proteome is a predictor of outcomes (prognostic marker) irrespective of treatment arm (CALGB 151113) for (IL-10 (interleukin 10) and C3 (complement component 3)
  12. To assess the neurocognitive function of patients treated with consolidation HDT/ASCT versus those treated with consolidation chemotherapy (etoposide and cytarabine) as measured by serial administration of the International PCNSL Collaborative Group (IPCG) neurocognitive battery and evaluate the long-term survivorship differences between the two arms (CALGB 71105)

Studietype

Intervensjonell

Registrering (Faktiske)

113

Fase

  • Fase 2

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiesteder

  • Forente stater
    • Alaska
      • Anchorage, Alaska, Forente stater, 98508
        • Anchorage Associates in Radiation Medicine
      • Anchorage, Alaska, Forente stater, 99508
        • Alaska Breast Care and Surgery LLC
      • Anchorage, Alaska, Forente stater, 99508
        • Alaska Oncology and Hematology LLC
      • Anchorage, Alaska, Forente stater, 99508
        • Alaska Women's Cancer Care
      • Anchorage, Alaska, Forente stater, 99508
        • Anchorage Oncology Centre
      • Anchorage, Alaska, Forente stater, 99508
        • Katmai Oncology Group
      • Anchorage, Alaska, Forente stater, 99508
        • Providence Alaska Medical Center
      • Anchorage, Alaska, Forente stater, 99504
        • Anchorage Radiation Therapy Center
    • California
      • Burbank, California, Forente stater, 91505
        • Providence Saint Joseph Medical Center/Disney Family Cancer Center
      • La Jolla, California, Forente stater, 92093
        • UC San Diego Moores Cancer Center
      • Sacramento, California, Forente stater, 95817
        • University of California Davis Comprehensive Cancer Center
      • San Francisco, California, Forente stater, 94115
        • UCSF Medical Center-Mount Zion
      • San Francisco, California, Forente stater, 94143
        • UCSF Medical Center-Parnassus
    • Connecticut
      • New Haven, Connecticut, Forente stater, 06520
        • Yale University
    • Florida
      • Tampa, Florida, Forente stater, 33612
        • Moffitt Cancer Center
    • Georgia
      • Atlanta, Georgia, Forente stater, 30322
        • Emory University/Winship Cancer Institute
    • Idaho
      • Boise, Idaho, Forente stater, 83712
        • Saint Luke's Mountain States Tumor Institute
      • Fruitland, Idaho, Forente stater, 83619
        • Saint Luke's Mountain States Tumor Institute - Fruitland
      • Meridian, Idaho, Forente stater, 83642
        • Saint Luke's Mountain States Tumor Institute - Meridian
      • Nampa, Idaho, Forente stater, 83686
        • Saint Luke's Mountain States Tumor Institute - Nampa
      • Twin Falls, Idaho, Forente stater, 83301
        • Saint Luke's Mountain States Tumor Institute-Twin Falls
    • Illinois
      • Chicago, Illinois, Forente stater, 60637
        • University of Chicago Comprehensive Cancer Center
      • Chicago, Illinois, Forente stater, 60612
        • University of Illinois
    • Indiana
      • Richmond, Indiana, Forente stater, 47374
        • Reid Health
    • Kansas
      • Kansas City, Kansas, Forente stater, 66160
        • University of Kansas Cancer Center
    • Kentucky
      • Crestview Hills, Kentucky, Forente stater, 41017
        • Oncology Hematology Care Inc-Crestview
    • Louisiana
      • New Orleans, Louisiana, Forente stater, 70112
        • Tulane University Health Sciences Center
    • Maryland
      • Baltimore, Maryland, Forente stater, 21287
        • Johns Hopkins University/Sidney Kimmel Cancer Center
    • Massachusetts
      • Boston, Massachusetts, Forente stater, 02215
        • Dana-Farber Cancer Institute
      • Boston, Massachusetts, Forente stater, 02115
        • Brigham and Women's Hospital
      • Boston, Massachusetts, Forente stater, 02114
        • Massachusetts General Hospital Cancer Center
    • Michigan
      • Battle Creek, Michigan, Forente stater, 49017
        • Bronson Battle Creek
      • Grand Rapids, Michigan, Forente stater, 49503
        • Spectrum Health at Butterworth Campus
      • Grand Rapids, Michigan, Forente stater, 49503
        • Mercy Health Saint Mary's
      • Kalamazoo, Michigan, Forente stater, 49007
        • West Michigan Cancer Center
      • Kalamazoo, Michigan, Forente stater, 49007
        • Bronson Methodist Hospital
      • Kalamazoo, Michigan, Forente stater, 49001
        • Borgess Medical Center
      • Muskegon, Michigan, Forente stater, 49444
        • Mercy Health Mercy Campus
      • Niles, Michigan, Forente stater, 49120
        • Lakeland Community Hospital
      • Reed City, Michigan, Forente stater, 49677
        • Spectrum Health Reed City Hospital
      • Saint Joseph, Michigan, Forente stater, 49085
        • Marie Yeager Cancer Center
      • Saint Joseph, Michigan, Forente stater, 49085
        • Lakeland Hospital
      • Traverse City, Michigan, Forente stater, 49684
        • Munson Medical Center
      • Wyoming, Michigan, Forente stater, 49519
        • Metro Health Hospital
    • Minnesota
      • Rochester, Minnesota, Forente stater, 55905
        • Mayo Clinic
    • Missouri
      • St Louis, Missouri, Forente stater, 63110
        • Washington University School of Medicine
    • Nebraska
      • Omaha, Nebraska, Forente stater, 68198
        • University of Nebraska Medical Center
    • New York
      • New York, New York, Forente stater, 10065
        • Weill Medical College of Cornell University
      • Rochester, New York, Forente stater, 14642
        • University of Rochester
      • Stony Brook, New York, Forente stater, 11794
        • Stony Brook University Medical Center
      • Syracuse, New York, Forente stater, 13210
        • State University of New York Upstate Medical University
    • North Carolina
      • Durham, North Carolina, Forente stater, 27710
        • Duke University Medical Center
    • Ohio
      • Centerville, Ohio, Forente stater, 45459
        • Dayton Physicians LLC-Miami Valley South
      • Cincinnati, Ohio, Forente stater, 45242
        • Oncology Hematology Care Inc-Blue Ash
      • Cincinnati, Ohio, Forente stater, 45202
        • Oncology Hematology Care Inc-Eden Park
      • Cincinnati, Ohio, Forente stater, 45211
        • Oncology Hematology Care Inc-Mercy West
      • Cincinnati, Ohio, Forente stater, 45236
        • Oncology Hematology Care Inc-Kenwood
      • Cincinnati, Ohio, Forente stater, 45230
        • Oncology Hematology Care Inc - Anderson
      • Dayton, Ohio, Forente stater, 45406
        • Good Samaritan Hospital - Dayton
      • Dayton, Ohio, Forente stater, 45409
        • Miami Valley Hospital
      • Dayton, Ohio, Forente stater, 45415
        • Dayton Physicians LLC-Samaritan North
      • Dayton, Ohio, Forente stater, 45415
        • Samaritan North Health Center
      • Dayton, Ohio, Forente stater, 45420
        • Dayton NCI Community Oncology Research Program
      • Fairfield, Ohio, Forente stater, 45014
        • Oncology Hematology Care Inc-Healthplex
      • Findlay, Ohio, Forente stater, 45840
        • Blanchard Valley Hospital
      • Findlay, Ohio, Forente stater, 45840
        • Armes Family Cancer Center
      • Findlay, Ohio, Forente stater, 45840
        • Orion Cancer Care
      • Franklin, Ohio, Forente stater, 45005-1066
        • Atrium Medical Center-Middletown Regional Hospital
      • Franklin, Ohio, Forente stater, 45005
        • Dayton Physicians LLC-Atrium
      • Greenville, Ohio, Forente stater, 45331
        • Wayne Hospital
      • Greenville, Ohio, Forente stater, 45331
        • Dayton Physicians LLC-Wayne
      • Kettering, Ohio, Forente stater, 45429
        • Kettering Medical Center
      • Kettering, Ohio, Forente stater, 45409
        • Greater Dayton Cancer Center
      • Middletown, Ohio, Forente stater, 45042
        • Dayton Physicians LLC-Signal Point
      • Sidney, Ohio, Forente stater, 45365
        • Dayton Physicians LLC-Wilson
      • Springfield, Ohio, Forente stater, 45505
        • Springfield Regional Medical Center
      • Springfield, Ohio, Forente stater, 45504
        • Springfield Regional Cancer Center
      • Troy, Ohio, Forente stater, 45373
        • Upper Valley Medical Center
      • Troy, Ohio, Forente stater, 45373
        • Dayton Physicians LLC-Upper Valley
    • Oklahoma
      • Tulsa, Oklahoma, Forente stater, 74136
        • Surgical Associates Inc
      • Tulsa, Oklahoma, Forente stater, 74146
        • Warren Clinic Oncology-Tulsa
    • Oregon
      • Bend, Oregon, Forente stater, 97701
        • Saint Charles Health System
      • Clackamas, Oregon, Forente stater, 97015
        • Clackamas Radiation Oncology Center
      • Clackamas, Oregon, Forente stater, 97015
        • Providence Oncology and Hematology Care Southeast
      • Coos Bay, Oregon, Forente stater, 97420
        • Bay Area Hospital
      • Milwaukie, Oregon, Forente stater, 97222
        • Providence Milwaukie Hospital
      • Newberg, Oregon, Forente stater, 97132
        • Providence Newberg Medical Center
      • Oregon City, Oregon, Forente stater, 97045
        • Providence Willamette Falls Medical Center
      • Portland, Oregon, Forente stater, 97213
        • Providence Portland Medical Center
      • Portland, Oregon, Forente stater, 97225
        • Providence Saint Vincent Medical Center
    • Pennsylvania
      • Danville, Pennsylvania, Forente stater, 17822
        • Geisinger Medical Center
      • Lewistown, Pennsylvania, Forente stater, 17044
        • Lewistown Hospital
      • Pittsburgh, Pennsylvania, Forente stater, 15232
        • University of Pittsburgh Cancer Institute (UPCI)
    • Utah
      • Salt Lake City, Utah, Forente stater, 84112
        • Huntsman Cancer Institute/University of Utah
    • Vermont
      • Berlin Corners, Vermont, Forente stater, 05602
        • Central Vermont Medical Center/National Life Cancer Treatment
      • Burlington, Vermont, Forente stater, 05401
        • University of Vermont Medical Center
      • Burlington, Vermont, Forente stater, 05405
        • University of Vermont College of Medicine
    • Virginia
      • Richmond, Virginia, Forente stater, 23298
        • Virginia Commonwealth University/Massey Cancer Center
    • Washington
      • Aberdeen, Washington, Forente stater, 98520
        • Providence Regional Cancer System-Aberdeen
      • Anacortes, Washington, Forente stater, 98221
        • Cancer Care Center at Island Hospital
      • Bellevue, Washington, Forente stater, 98005
        • Swedish Cancer Institute-Eastside Oncology Hematology
      • Bellingham, Washington, Forente stater, 98225
        • PeaceHealth Saint Joseph Medical Center
      • Centralia, Washington, Forente stater, 98531
        • Providence Regional Cancer System-Centralia
      • Edmonds, Washington, Forente stater, 98026
        • Swedish Medical Center-Edmonds
      • Everett, Washington, Forente stater, 98201
        • Providence Regional Cancer Partnership
      • Issaquah, Washington, Forente stater, 98029
        • Swedish Cancer Institute-Issaquah
      • Lacey, Washington, Forente stater, 98503
        • Providence Regional Cancer System-Lacey
      • Longview, Washington, Forente stater, 98632
        • PeaceHealth Saint John Medical Center
      • Seattle, Washington, Forente stater, 98109
        • Fred Hutchinson Cancer Research Center
      • Seattle, Washington, Forente stater, 98109
        • Seattle Cancer Care Alliance
      • Seattle, Washington, Forente stater, 98195
        • University of Washington Medical Center
      • Seattle, Washington, Forente stater, 98107
        • Swedish Medical Center-Ballard Campus
      • Seattle, Washington, Forente stater, 98104
        • Minor and James Medical PLLC
      • Seattle, Washington, Forente stater, 98104
        • Pacific Gynecology Specialists
      • Seattle, Washington, Forente stater, 98112
        • Group Health Cooperative-Seattle
      • Seattle, Washington, Forente stater, 98122-4307
        • Swedish Medical Center-First Hill
      • Shelton, Washington, Forente stater, 98584
        • Providence Regional Cancer System-Shelton
      • Spokane, Washington, Forente stater, 99204
        • Rockwood Cancer Treatment Center-DHEC-Downtown
      • Spokane Valley, Washington, Forente stater, 99216
        • Rockwood Clinic Cancer Treatment Center-Valley
      • Vancouver, Washington, Forente stater, 98664
        • PeaceHealth Southwest Medical Center
      • Vancouver, Washington, Forente stater, 98684
        • Compass Oncology Vancouver
      • Walla Walla, Washington, Forente stater, 99362
        • Providence Saint Mary Regional Cancer Center
      • Yakima, Washington, Forente stater, 98902
        • North Star Lodge Cancer Center at Yakima Valley Memorial Hospital
      • Yelm, Washington, Forente stater, 98597
        • Providence Regional Cancer System-Yelm
    • Wisconsin
      • La Crosse, Wisconsin, Forente stater, 54601
        • Mayo Clinic Health System-Franciscan Healthcare
      • Madison, Wisconsin, Forente stater, 53792
        • University of Wisconsin Hospital and Clinics

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

18 år til 75 år (Voksen, Eldre voksen)

Tar imot friske frivillige

Nei

Kjønn som er kvalifisert for studier

Alle

Beskrivelse

  1. Documentation of Disease: Diagnosis of primary CNS diffuse large B-cell lymphoma confirmed by one of the following: brain biopsy or resection, cerebrospinal fluid and vitreous fluid.
  2. Other Lymphomas: Patients must have no evidence or history of non-Hodgkin lymphoma (NHL) outside of CNS.
  3. Previous Treatment: Patients must have no prior chemotherapy or radiation therapy for lymphoma.
  4. Age- Patients must be between the ages of 18 and 75 years.
  5. Karnofsky Performance Scale - Patients must measure Karnofsky Performance Scale ≥ 30 (≥ 50 for patients ages 60-70).
  6. Pregnancy and Nursing Status - Patients must be non-pregnant and non-nursing; women of childbearing potential must have a negative serum or urine pregnancy test 10-14 days prior to registration; in addition, women and men of childbearing potential must commit to use an effective form of contraception throughout their participation in this study; appropriate methods of birth control include abstinence, oral contraceptives, implantable hormonal contraceptives, or double barrier method (diaphragm plus condom)
  7. HIV - Patients must have negative HIV serology.
  8. Hepatitis - Patients must have negative HCV serology (unless HBsAb positive patient has recently received HBV vaccine, in this case HBcAb should be negative). All patients must be screened for hepatitis B infection before starting treatment. Those patients who test positive for hepatitis B should be closely monitored for evidence of active HBV infection and hepatitis during and for several months after rituximab treatment. PCNSL patients with a history of hepatitis B infection should be treated with entecavir or lamivudine (physician discretion for choice of drug) as antiviral prophylaxis to prevent hepatitis B reactivation.
  9. Organ Transplant or Immunosuppressant Therapy - Patient must have no history of organ transplantation or ongoing immunosuppressant therapy.
  10. Required Initial Laboratory Values: ANC ≥ 1500/mcL, AST and ALT < 2 x upper limit of normal (ULN), total bilirubin ≤ 3 mg/dL, creatinine clearance ≥ 50 mL/min, platelet count ≥ 100,000/mcL

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Behandling
  • Tildeling: Randomisert
  • Intervensjonsmodell: Parallell tildeling
  • Masking: Ingen (Open Label)

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Annen: Arm I

Patients undergo induction therapy for five cycles as defined in the protocol. Patients undergo stem cell transplant.
Legemiddel: G-CSF
Fremgangsmåte: stamcelletransplantasjon
Legemiddel: carmustine

Given IV

Legemiddel: thiotepa

Given IV
Annen: Arm II

Patients undergo induction therapy for five cycles as defined in the protocol. Patients undergo consolidation chemotherapy.
Legemiddel: G-CSF
Legemiddel: cytarabine

Given IV

Legemiddel: etoposide

Given IV

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Progression Free Survival
Tidsramme: 2 years

The primary endpoint is to compare the two-year progression-free survival (PFS) of patients treated with the myeloablative consolidation treatment strategy of HDT/ASCT versus those treated with non-myeloablative consolidation chemotherapy with cytarabine and etoposide.

PFS time = time from Registration to earliest date of Progression or Death due to any cause, censoring non-progressed and alive patients at the date of last disease status evaluation.

Response will be defined using the modified IPCG criteria. Progressive disease is defined as > 25% increase in contrast-enhancing CNS (brain and spine if latter abnormal at baseline) disease, appearance of any new, measurable (>/= 10mm) contrast-enhancing disease or recurrent or new ocular or CSF disease.
2 years

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Event Free Survival
Tidsramme: 2 years

To compare the two-year event-free survival (EFS) of patients treated with consolidation HDT/ASCT versus those treated with consolidation chemotherapy consisting of etoposide and cytarabine.

EFS event = same definition as PFS with non-protocol treatment also considered an event
2 years
Number of Participants With Treatment-related Adverse Events as Assessed by CTCAE v4.0
Tidsramme: 7 years

Number of patients reporting at least one adverse event at least possibly related to treatment.
7 years
Overall Survival
Tidsramme: 2 years

To compare the overall survival (OS) of patients treated with the consolidation HDT/ASCT versus those treated with consolidation chemotherapy consisting of etoposide and cytarabine.

OS event = Registration/Randomization to Death due to any cause
2 years

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Sponsor

Alliance for Clinical Trials in Oncology

Samarbeidspartnere

National Cancer Institute (NCI)

Etterforskere

  • Studiestol: Tracy Batchelor, MD, MPH, Massachusetts General Hospital

Publikasjoner og nyttige lenker

Den som er ansvarlig for å legge inn informasjon om studien leverer frivillig disse publikasjonene. Disse kan handle om alt relatert til studiet.

Generelle publikasjoner

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart

1. september 2012

Primær fullføring (Faktiske)

14. januar 2021

Studiet fullført (Faktiske)

24. februar 2022

Datoer for studieregistrering

Først innsendt

13. januar 2012

Først innsendt som oppfylte QC-kriteriene

13. januar 2012

Først lagt ut (Antatt)

18. januar 2012

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

24. september 2026

Siste oppdatering sendt inn som oppfylte QC-kriteriene

31. august 2026

Sist bekreftet

1. august 2026

Mer informasjon

Begreper knyttet til denne studien

Nøkkelord

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre

  • CALGB-51101
  • CDR0000721927 (Registeridentifikator: NCI Physician Data Query)
  • NCI-2012-00110 (Registeridentifikator: NCI Clinical Trial Reporting Program)

Denne informasjonen ble hentet direkte fra nettstedet clinicaltrials.gov uten noen endringer. Hvis du har noen forespørsler om å endre, fjerne eller oppdatere studiedetaljene dine, vennligst kontakt register@clinicaltrials.gov. Så snart en endring er implementert på clinicaltrials.gov, vil denne også bli oppdatert automatisk på nettstedet vårt. .

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