Badanie CC-486 (doustna azacytydyna) plus standardowa terapia lekowa u pacjentów w wieku 75 lat lub starszych z nowo zdiagnozowanym chłoniakiem rozlanym z dużych komórek B
Randomizowane badanie fazy II/III R-MiniCHOP z CC-486 (doustnie azacytydyną) lub bez niego u uczestników w wieku 75 lat lub starszych z nowo zdiagnozowanym rozlanym chłoniakiem z dużych komórek B, chłoniakiem grudkowym stopnia IIIB, chłoniakiem transformowanym i wysokim stopniem B - Chłoniaki komórkowe z rearanżacjami MYC I BCL2 i/lub BCL6
This phase II/III trial compares the side effects and activity of oral azacitidine in combination with the standard drug therapy (reduced dose rituximab-cyclophosphamide, doxorubicin, vincristine, and prednisone [R-miniCHOP]) versus R-miniCHOP alone in treating patients 75 years or older with newly diagnosed diffuse large B cell lymphoma. R-miniCHOP includes a monoclonal antibody (a type of protein), called rituximab, which attaches to the lymphoma cells and may help the immune system kill these cells. R-miniCHOP also includes prednisone which is an anti-inflammatory medication and a combination of 3 chemotherapy drugs, cyclophosphamide, doxorubicin, and vincristine. These 3 chemotherapy drugs, as well as oral azacitidine, 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. Combining oral azacitidine with R-miniCHOP may shrink the cancer or extend the time without disease symptoms coming back or extend patient's survival when compared to R-miniCHOP alone.
Przegląd badań
Status
Status
Warunki
Warunki
- Chłoniak limfoplazmocytowy
- Ann Arbor Stopień III Rozlany chłoniak z dużych komórek B
- Ann Arbor Stopień IV rozlany chłoniak z dużych komórek B
- Chłoniak z komórek B wysokiego stopnia z rearanżacjami MYC i BCL2 lub BCL6
- Chłoniak z komórek B wysokiego stopnia z rearanżacjami MYC, BCL2 i BCL6
- Chłoniak grudkowy stopnia 3b
- Rozlany chłoniak z dużych komórek B, nie określony inaczej
- EBV-dodatni chłoniak rozlany z dużych komórek B, nie określony inaczej
- Chłoniak z komórek B wysokiego stopnia, nie określony inaczej
- Rozlany chłoniak z dużych komórek B związany z przewlekłym stanem zapalnym
- Pierwotny rozlany chłoniak skóry z dużych komórek B, typ nogi
- Przekształcony chłoniak grudkowy w rozlanego chłoniaka z dużych komórek B
- Wewnątrznaczyniowy chłoniak z dużych komórek B
- Chłoniak z dużych komórek B bogaty w komórki T/histiocyty
- Chłoniak z komórek B wysokiego stopnia z rearanżacjami MYC i BCL2 i/lub BCL6
- Rozlany chłoniak z dużych komórek B aktywowany przez komórki B
- Rozlany chłoniak z dużych limfocytów B typu centrum rozrodczego komórek B
- HHV8-dodatni rozlany chłoniak z dużych komórek B, nie określony inaczej
- Przekształcony chłoniak strefy brzeżnej w rozlanego chłoniaka z dużych komórek B
- Ann Arbor Stadium IIX (objętościowe) Rozlany chłoniak z dużych komórek B
- Chłoniak z komórek B z przewagą limfocytów guzkowych
Interwencja / Leczenie
Interwencja / Leczenie
- Lek: Cyclophosphamide
- Lek: Doxorubicin Hydrochloride
- Lek: Prednisone
- Procedura: Biospecimen Collection
- Biologiczny: Rituximab
- Lek: Vincristine Sulfate
- Inny: Questionnaire Administration
- Procedura: Echocardiography Test
- Procedura: Multigated Acquisition Scan
- Procedura: Positron Emission Tomography
- Biologiczny: Rituximab and Hyaluronidase Human
- Procedura: Computed Tomography
- Lek: Oral Azacitidine
Szczegółowy opis
PRIMARY OBJECTIVES:
I. To determine if the addition of CC-486 (oral azacitidine) to R-miniCHOP results in excess toxicity compared to R-miniCHOP alone that would preclude the combination from being studied further. (Safety run-in) II. To determine if the CC-486 + R-miniCHOP regimen should be tested further (Phase III) against the control R-miniCHOP alone based on progression-free survival (PFS). (Phase II component) III. To compare the overall survival (OS) between CC-486 + R-miniCHOP and R-miniCHOP alone. (Phase III component)
SECONDARY OBJECTIVES:
I. To assess the feasibility of delivering at least 4 cycles of CC-486 with R-miniCHOP in this population.
II. To assess toxicity for CC-486 + R-miniCHOP and for R-miniCHOP. III. To compare complete response rates, as defined by Lugano 2014 classification, between CC-486 + R-miniCHOP and R-miniCHOP alone.
INTEGRATED CORRELATIVE GERIATRIC ASSESSMENTS:
I. To compare functioning as assessed by the S1918 Comprehensive Geriatric Assessment (S1918 CGA) between participants treated with CC-486 + R-miniCHOP versus R-miniCHOP alone.
II. To evaluate if frailty status (fit/unfit versus [vs] frail/superfrail) as assessed by the FIL tool is associated with OS.
III. To evaluate if frailty as measured by the FIL tool correlates with the summary frailty index as measured using components of the S1918 CGA.
BANKING OBJECTIVE:
I. To bank specimens for future correlative studies.
OUTLINE:
Beginning 7 days prior to starting [protocol treatment, all patients receive vincristine sulfate intravenously (IV) on day 1, and prednisone orally (PO) daily on days 1-7.
Patients are then randomized to 1 of 2 arms.
ARM I: Patients receive CC-486 PO for 7 days prior to cycle 1. Patients then receive CC-486 PO on days 8-21. Treatment repeats every 21 days for cycles 1-5 in the absence of disease progression or unacceptable toxicity. Patients also receive rituximab IV (or rituximab and hyaluronidase human subcutaneously [SC] for cycles 2-6), cyclophosphamide IV, doxorubicin hydrochloride IV, and vincristine sulfate IV on day 1, and prednisone PO on days 1-5. Treatment repeats every 21 days for cycles 1-6 (6 cycles total) in the absence of disease progression or unacceptable toxicity. Patients undergo echocardiography (ECHO) or multigated acquisition scan (MUGA) at screening and undergo positron emission tomography (PET)-computed tomography (CT) and blood sample collection throughout the study.
ARM II: Patients receive rituximab IV (or rituximab and hyaluronidase human SC for cycles 2-6), cyclophosphamide IV, doxorubicin hydrochloride IV, and vincristine sulfate IV on day 1, and prednisone PO on days 1-5. Treatment repeats every 21 days for up to 6 cycles in the absence of disease progression or unacceptable toxicity. Patients undergo ECHO or MUGA at screening and undergo PET-CT and blood sample collection throughout the study.
After completion of study treatment, patients are followed up periodically until 5 years from the date of registration.
Typ studiów
Typ studiów
Zapisy (Szacowany)
Zapisy
Faza
Faza
- Faza 2
- Faza 3
Kontakty i lokalizacje
Lokalizacje studiów
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Arizona
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Tucson, Arizona, Stany Zjednoczone, 85719
- Banner University Medical Center - Tucson
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Tucson, Arizona, Stany Zjednoczone, 85719
- University of Arizona Cancer Center-North Campus
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Arkansas
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Little Rock, Arkansas, Stany Zjednoczone, 72205
- University of Arkansas for Medical Sciences
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California
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Anaheim, California, Stany Zjednoczone, 92806
- Kaiser Permanente-Anaheim
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Baldwin Park, California, Stany Zjednoczone, 91706
- Kaiser Permanente-Baldwin Park
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Bellflower, California, Stany Zjednoczone, 90706
- Kaiser Permanente-Bellflower
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Beverly Hills, California, Stany Zjednoczone, 90211
- Tower Cancer Research Foundation
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Costa Mesa, California, Stany Zjednoczone, 92627
- UC Irvine Health Cancer Center-Newport
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Duarte, California, Stany Zjednoczone, 91010
- City of Hope Comprehensive Cancer Center
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Fontana, California, Stany Zjednoczone, 92335
- Kaiser Permanente-Fontana
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Harbor City, California, Stany Zjednoczone, 90710
- Kaiser Permanente South Bay
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Huntington Beach, California, Stany Zjednoczone, 92648
- City of Hope Seacliff
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Irvine, California, Stany Zjednoczone, 92618
- Kaiser Permanente-Irvine
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Irvine, California, Stany Zjednoczone, 92618
- City of Hope at Irvine Lennar
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Lancaster, California, Stany Zjednoczone, 93534
- City of Hope Antelope Valley
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Long Beach, California, Stany Zjednoczone, 90822
- Tibor Rubin VA Medical Center
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Long Beach, California, Stany Zjednoczone, 90813
- City of Hope at Long Beach Elm
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Los Angeles, California, Stany Zjednoczone, 90048
- Cedars-Sinai Medical Center
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Los Angeles, California, Stany Zjednoczone, 90027
- Kaiser Permanente Los Angeles Medical Center
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Los Angeles, California, Stany Zjednoczone, 90034
- Kaiser Permanente West Los Angeles
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Newport Beach, California, Stany Zjednoczone, 92660
- City of Hope Newport Beach
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Ontario, California, Stany Zjednoczone, 91761
- Kaiser Permanente-Ontario
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Orange, California, Stany Zjednoczone, 92868
- UC Irvine Health/Chao Family Comprehensive Cancer Center
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Palo Alto, California, Stany Zjednoczone, 94304
- Stanford Cancer Institute Palo Alto
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Panorama City, California, Stany Zjednoczone, 91402
- Kaiser Permanente - Panorama City
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Riverside, California, Stany Zjednoczone, 92505
- Kaiser Permanente-Riverside
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San Diego, California, Stany Zjednoczone, 92120
- Kaiser Permanente-San Diego Zion
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San Marcos, California, Stany Zjednoczone, 92078
- Kaiser Permanente-San Marcos
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San Mateo, California, Stany Zjednoczone, 94402
- UCSF Cancer Center - San Mateo
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South Pasadena, California, Stany Zjednoczone, 91030
- City of Hope South Pasadena
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Torrance, California, Stany Zjednoczone, 90503
- City of Hope South Bay
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Upland, California, Stany Zjednoczone, 91786
- City of Hope Upland
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Woodland Hills, California, Stany Zjednoczone, 91367
- Kaiser Permanente-Woodland Hills
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Colorado
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Golden, Colorado, Stany Zjednoczone, 80401
- Lutheran Hospital - Cancer Centers of Colorado
-
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Delaware
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Newark, Delaware, Stany Zjednoczone, 19713
- Helen F Graham Cancer Center
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Newark, Delaware, Stany Zjednoczone, 19713
- Delaware Clinical and Laboratory Physicians PA
-
Newark, Delaware, Stany Zjednoczone, 19713
- Medical Oncology Hematology Consultants PA
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Florida
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Miami, Florida, Stany Zjednoczone, 33136
- University of Miami Miller School of Medicine-Sylvester Cancer Center
-
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Georgia
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Atlanta, Georgia, Stany Zjednoczone, 30308
- Emory University Hospital Midtown
-
Atlanta, Georgia, Stany Zjednoczone, 30322
- Emory University Hospital/Winship Cancer Institute
-
Atlanta, Georgia, Stany Zjednoczone, 30342
- Emory Saint Joseph's Hospital
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Augusta, Georgia, Stany Zjednoczone, 30912
- Augusta University Medical Center
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Hawaii
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Honolulu, Hawaii, Stany Zjednoczone, 96813
- Queen's Medical Center
-
Honolulu, Hawaii, Stany Zjednoczone, 96813
- Hawaii Cancer Care Inc - Waterfront Plaza
-
Honolulu, Hawaii, Stany Zjednoczone, 96813
- Queen's Cancer Cenrer - POB I
-
Honolulu, Hawaii, Stany Zjednoczone, 96813
- Straub Clinic and Hospital
-
Honolulu, Hawaii, Stany Zjednoczone, 96817
- Queen's Cancer Center - Kuakini
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‘Aiea, Hawaii, Stany Zjednoczone, 96701
- Hawaii Cancer Care - Westridge
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‘Aiea, Hawaii, Stany Zjednoczone, 96701
- Pali Momi Medical Center
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Illinois
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Centralia, Illinois, Stany Zjednoczone, 62801
- Centralia Oncology Clinic
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Chicago, Illinois, Stany Zjednoczone, 60611
- Northwestern University
-
Chicago, Illinois, Stany Zjednoczone, 60637
- University of Chicago Comprehensive Cancer Center
-
Chicago, Illinois, Stany Zjednoczone, 60612
- University of Illinois
-
Danville, Illinois, Stany Zjednoczone, 61832
- Carle at The Riverfront
-
DeKalb, Illinois, Stany Zjednoczone, 60115
- Northwestern Medicine Cancer Center Kishwaukee
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Decatur, Illinois, Stany Zjednoczone, 62526
- Decatur Memorial Hospital
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Decatur, Illinois, Stany Zjednoczone, 62526
- Cancer Care Specialists of Illinois - Decatur
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Effingham, Illinois, Stany Zjednoczone, 62401
- Crossroads Cancer Center
-
Effingham, Illinois, Stany Zjednoczone, 62401
- Carle Physician Group-Effingham
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Evanston, Illinois, Stany Zjednoczone, 60201
- NorthShore University HealthSystem-Evanston Hospital
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Geneva, Illinois, Stany Zjednoczone, 60134
- Northwestern Medicine Cancer Center Delnor
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Glenview, Illinois, Stany Zjednoczone, 60026
- NorthShore University HealthSystem-Glenbrook Hospital
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Glenview, Illinois, Stany Zjednoczone, 60026
- Northwestern Medicine Glenview Outpatient Center
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Grayslake, Illinois, Stany Zjednoczone, 60030
- Northwestern Medicine Grayslake Outpatient Center
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Highland Park, Illinois, Stany Zjednoczone, 60035
- NorthShore University HealthSystem-Highland Park Hospital
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Lake Forest, Illinois, Stany Zjednoczone, 60045
- Northwestern Medicine Lake Forest Hospital
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Mattoon, Illinois, Stany Zjednoczone, 61938
- Carle Physician Group-Mattoon/Charleston
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New Lenox, Illinois, Stany Zjednoczone, 60451
- UC Comprehensive Cancer Center at Silver Cross
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O'Fallon, Illinois, Stany Zjednoczone, 62269
- Cancer Care Center of O'Fallon
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Orland Park, Illinois, Stany Zjednoczone, 60462
- University of Chicago Medicine-Orland Park
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Orland Park, Illinois, Stany Zjednoczone, 60462
- Northwestern Medicine Orland Park
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Peoria, Illinois, Stany Zjednoczone, 61615
- Illinois CancerCare-Peoria
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Shiloh, Illinois, Stany Zjednoczone, 62269
- Memorial Hospital East
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Urbana, Illinois, Stany Zjednoczone, 61801
- Carle Cancer Center
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Warrenville, Illinois, Stany Zjednoczone, 60555
- Northwestern Medicine Cancer Center Warrenville
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Iowa
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Ames, Iowa, Stany Zjednoczone, 50010
- McFarland Clinic - Ames
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Ankeny, Iowa, Stany Zjednoczone, 50023
- UI Health Care Mission Cancer and Blood - Ankeny Clinic
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Clive, Iowa, Stany Zjednoczone, 50325
- UI Health Care Mission Cancer and Blood - West Des Moines Clinic
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Des Moines, Iowa, Stany Zjednoczone, 50309
- Iowa Methodist Medical Center
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Des Moines, Iowa, Stany Zjednoczone, 50309
- UI Health Care Mission Cancer and Blood - Des Moines Clinic
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Des Moines, Iowa, Stany Zjednoczone, 50314
- UI Health Care Mission Cancer and Blood - Laurel Clinic
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Louisiana
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Monroe, Louisiana, Stany Zjednoczone, 71202
- Ochsner LSU Health Monroe Medical Center
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Shreveport, Louisiana, Stany Zjednoczone, 71103
- LSU Health Sciences Center at Shreveport
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Massachusetts
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Boston, Massachusetts, Stany Zjednoczone, 02111
- Tufts Medical Center
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Michigan
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Ann Arbor, Michigan, Stany Zjednoczone, 48106
- Trinity Health Saint Joseph Mercy Hospital Ann Arbor
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Brighton, Michigan, Stany Zjednoczone, 48114
- Trinity Health IHA Medical Group Hematology Oncology - Brighton
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Brighton, Michigan, Stany Zjednoczone, 48114
- Trinity Health Medical Center - Brighton
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Canton, Michigan, Stany Zjednoczone, 48188
- Trinity Health IHA Medical Group Hematology Oncology - Canton
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Canton, Michigan, Stany Zjednoczone, 48188
- Trinity Health Medical Center - Canton
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Chelsea, Michigan, Stany Zjednoczone, 48118
- Trinity Health IHA Medical Group Hematology Oncology - Chelsea Hospital
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Chelsea, Michigan, Stany Zjednoczone, 48118
- Chelsea Hospital
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Livonia, Michigan, Stany Zjednoczone, 48154
- Trinity Health Saint Mary Mercy Livonia Hospital
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Livonia, Michigan, Stany Zjednoczone, 48154
- Hope Cancer Clinic
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Ypsilanti, Michigan, Stany Zjednoczone, 48197
- Trinity Health IHA Medical Group Hematology Oncology Ann Arbor Campus
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Ypsilanti, Michigan, Stany Zjednoczone, 48106
- Huron Gastroenterology PC
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Minnesota
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Deer River, Minnesota, Stany Zjednoczone, 56636
- Essentia Health - Deer River Clinic
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Duluth, Minnesota, Stany Zjednoczone, 55805
- Essentia Health Cancer Center
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Hibbing, Minnesota, Stany Zjednoczone, 55746
- Essentia Health Hibbing Clinic
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Sandstone, Minnesota, Stany Zjednoczone, 55072
- Essentia Health Sandstone
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Virginia, Minnesota, Stany Zjednoczone, 55792
- Essentia Health Virginia Clinic
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Mississippi
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Oxford, Mississippi, Stany Zjednoczone, 38655
- Baptist Memorial Hospital and Cancer Center-Oxford
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Southhaven, Mississippi, Stany Zjednoczone, 38671
- Baptist Memorial Hospital and Cancer Center-Desoto
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Missouri
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Cape Girardeau, Missouri, Stany Zjednoczone, 63703
- Saint Francis Medical Center
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Chesterfield, Missouri, Stany Zjednoczone, 63017
- Saint Luke's Hospital
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City of Saint Peters, Missouri, Stany Zjednoczone, 63376
- Siteman Cancer Center at Saint Peters Hospital
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Creve Coeur, Missouri, Stany Zjednoczone, 63141
- Siteman Cancer Center at West County Hospital
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Saint Joseph, Missouri, Stany Zjednoczone, 64506
- Heartland Regional Medical Center
-
St Louis, Missouri, Stany Zjednoczone, 63110
- Washington University School of Medicine
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St Louis, Missouri, Stany Zjednoczone, 63129
- Siteman Cancer Center-South County
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St Louis, Missouri, Stany Zjednoczone, 63136
- Siteman Cancer Center at Christian Hospital
-
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Nebraska
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Lincoln, Nebraska, Stany Zjednoczone, 68516
- Cancer Partners of Nebraska
-
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New Jersey
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Basking Ridge, New Jersey, Stany Zjednoczone, 07920
- Memorial Sloan Kettering Basking Ridge
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Englewood, New Jersey, Stany Zjednoczone, 07631
- Englewood Hospital and Medical Center
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Lakewood, New Jersey, Stany Zjednoczone, 08701
- Monmouth Medical Center Southern Campus
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Long Branch, New Jersey, Stany Zjednoczone, 07740
- Monmouth Medical Center
-
Middletown, New Jersey, Stany Zjednoczone, 07748
- Memorial Sloan Kettering Monmouth
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Montvale, New Jersey, Stany Zjednoczone, 07645
- Memorial Sloan Kettering Bergen
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New Brunswick, New Jersey, Stany Zjednoczone, 08903
- Rutgers Cancer Institute of New Jersey
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Newark, New Jersey, Stany Zjednoczone, 07112
- Newark Beth Israel Medical Center
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Toms River, New Jersey, Stany Zjednoczone, 08755
- Community Medical Center
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New York
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Buffalo, New York, Stany Zjednoczone, 14263
- Roswell Park Cancer Institute
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Commack, New York, Stany Zjednoczone, 11725
- Memorial Sloan Kettering Commack
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Glens Falls, New York, Stany Zjednoczone, 12801
- Glens Falls Hospital
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Harrison, New York, Stany Zjednoczone, 10604
- Memorial Sloan Kettering Westchester
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Mineola, New York, Stany Zjednoczone, 11501
- NYU Langone Hospital - Long Island
-
New York, New York, Stany Zjednoczone, 10065
- Memorial Sloan Kettering Cancer Center
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New York, New York, Stany Zjednoczone, 10032
- NYP/Columbia University Medical Center/Herbert Irving Comprehensive Cancer Center
-
New York, New York, Stany Zjednoczone, 10065
- NYP/Weill Cornell Medical Center
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New York, New York, Stany Zjednoczone, 10016
- Laura and Isaac Perlmutter Cancer Center at NYU Langone
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Oswego, New York, Stany Zjednoczone, 13126
- Upstate Cancer Center at Oswego
-
Syracuse, New York, Stany Zjednoczone, 13210
- State University of New York Upstate Medical University
-
Uniondale, New York, Stany Zjednoczone, 11553
- Memorial Sloan Kettering Nassau
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Verona, New York, Stany Zjednoczone, 13478
- Upstate Cancer Center at Verona
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North Carolina
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Chapel Hill, North Carolina, Stany Zjednoczone, 27599
- UNC Lineberger Comprehensive Cancer Center
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Ohio
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Cleveland, Ohio, Stany Zjednoczone, 44195
- Cleveland Clinic Foundation
-
Cleveland, Ohio, Stany Zjednoczone, 44111
- Cleveland Clinic Cancer Center/Fairview Hospital
-
Columbus, Ohio, Stany Zjednoczone, 43210
- Ohio State University Comprehensive Cancer Center
-
Dayton, Ohio, Stany Zjednoczone, 45415
- Dayton Physician LLC - Englewood
-
Independence, Ohio, Stany Zjednoczone, 44131
- Cleveland Clinic Cancer Center Independence
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Kettering, Ohio, Stany Zjednoczone, 45409
- Greater Dayton Cancer Center
-
Mansfield, Ohio, Stany Zjednoczone, 44906
- Cleveland Clinic Cancer Center Mansfield
-
Mayfield Heights, Ohio, Stany Zjednoczone, 44124
- Hillcrest Hospital Cancer Center
-
Sandusky, Ohio, Stany Zjednoczone, 44870
- North Coast Cancer Care
-
Strongsville, Ohio, Stany Zjednoczone, 44136
- Cleveland Clinic Cancer Center Strongsville
-
Warrensville Heights, Ohio, Stany Zjednoczone, 44122
- South Pointe Hospital
-
Wooster, Ohio, Stany Zjednoczone, 44691
- Cleveland Clinic Wooster Family Health and Surgery Center
-
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Oklahoma
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Lawton, Oklahoma, Stany Zjednoczone, 73505
- Cancer Centers of Southwest Oklahoma Research
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Oklahoma City, Oklahoma, Stany Zjednoczone, 73104
- University of Oklahoma Health Sciences Center
-
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Oregon
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Portland, Oregon, Stany Zjednoczone, 97225
- Providence Saint Vincent Medical Center
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Portland, Oregon, Stany Zjednoczone, 97239
- Portland VA Medical Center
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South Carolina
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Charleston, South Carolina, Stany Zjednoczone, 29425
- Medical University of South Carolina
-
Greenville, South Carolina, Stany Zjednoczone, 29607
- Saint Francis Cancer Center
-
Greenville, South Carolina, Stany Zjednoczone, 29601
- Saint Francis Hospital
-
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Tennessee
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Memphis, Tennessee, Stany Zjednoczone, 38120
- Baptist Memorial Hospital and Cancer Center-Memphis
-
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Utah
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Salt Lake City, Utah, Stany Zjednoczone, 84112
- Huntsman Cancer Institute/University of Utah
-
Salt Lake City, Utah, Stany Zjednoczone, 84148
- George E Wahlen Department of Veterans Affairs Medical Center
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Virginia
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Charlottesville, Virginia, Stany Zjednoczone, 22908
- University of Virginia Cancer Center
-
Fairfax, Virginia, Stany Zjednoczone, 22031
- Inova Schar Cancer Institute
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Richmond, Virginia, Stany Zjednoczone, 23298
- VCU Massey Comprehensive Cancer Center
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Washington
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Bellevue, Washington, Stany Zjednoczone, 98004
- FHCC Overlake
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Kirkland, Washington, Stany Zjednoczone, 98034
- FHCC at EvergreenHealth
-
Seattle, Washington, Stany Zjednoczone, 98133
- FHCC at Northwest Hospital
-
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West Virginia
-
Charleston, West Virginia, Stany Zjednoczone, 25304
- Vandalia Health/CAMC Institute for Academic Medicine
-
-
Wisconsin
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Ashland, Wisconsin, Stany Zjednoczone, 54806
- Duluth Clinic Ashland
-
Eau Claire, Wisconsin, Stany Zjednoczone, 54701
- Marshfield Medical Center-EC Cancer Center
-
Green Bay, Wisconsin, Stany Zjednoczone, 54301
- Saint Vincent Hospital Cancer Center Green Bay
-
Green Bay, Wisconsin, Stany Zjednoczone, 54303
- Saint Vincent Hospital Cancer Center at Saint Mary's
-
La Crosse, Wisconsin, Stany Zjednoczone, 54601
- Gundersen Lutheran Medical Center
-
Marshfield, Wisconsin, Stany Zjednoczone, 54449
- Marshfield Medical Center-Marshfield
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Minocqua, Wisconsin, Stany Zjednoczone, 54548
- Marshfield Medical Center - Minocqua
-
Oconto Falls, Wisconsin, Stany Zjednoczone, 54154
- Saint Vincent Hospital Cancer Center at Oconto Falls
-
Rice Lake, Wisconsin, Stany Zjednoczone, 54868
- Marshfield Medical Center-Rice Lake
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Sheboygan, Wisconsin, Stany Zjednoczone, 53081
- Saint Vincent Hospital Cancer Center at Sheboygan
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Stevens Point, Wisconsin, Stany Zjednoczone, 54482
- Marshfield Medical Center-River Region at Stevens Point
-
Sturgeon Bay, Wisconsin, Stany Zjednoczone, 54235-1495
- Saint Vincent Hospital Cancer Center at Sturgeon Bay
-
Weston, Wisconsin, Stany Zjednoczone, 54476
- Marshfield Medical Center - Weston
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Kryteria uczestnictwa
Kryteria kwalifikacji
Kryteria kwalifikacji
Wiek uprawniający do nauki
Akceptuje zdrowych ochotników
Płeć kwalifikująca się do nauki
Opis
Inclusion Criteria:
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Participants must have histologically or cytologically confirmed diffuse large B-cell lymphoma (DLBCL), Ann Arbor Stage IIX (bulky), III or IV. Participants with DLBCL transformed from follicular lymphoma (FL) or marginal zone lymphoma (MZL, including mucosa-associated lymphoid tissue [MALT] lymphomas), lymphoplasmacytic lymphoma (LPL), or nodular lymphocyte-predominant Hodgkin Lymphoma (NLPHL) are eligible. Participants with Grade IIIB follicular lymphoma (FL) or high-grade B-cell lymphomas with MYC and BCL2 and/or BCL6 rearrangements are also eligible. Participants with DLBCL that arose from prior CLL (Richter's transformation) are not eligible.
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As defined by the World Health Organization (WHO), eligible lymphoma subtypes include the following:
- DLBCL, not otherwise specified (NOS)
- DLBCL, germinal-center B-cell type (GCB)
- DLBCL, activated B-cell type (ABC)
- T-cell histiocyte-rich B-cell lymphomas (THRBCL)
- Primary cutaneous DLBCL, leg type
- Intravascular large B cell lymphoma
- EBV+ DLBCL, NOS
- DLBCL associated with chronic inflammation
- HHV8+ DLBCL, NOS
- High-grade B-cell lymphoma with MYC and BCL2 and/or BCL6 rearrangements
- High grade B-cell lymphoma, NOS
- Follicular lymphoma grade 3b
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Participants must have staging imaging performed within 28 days prior to registration, as follows. PET-CT baseline scans are strongly preferred; diagnostic quality magnetic resonance imaging (MRI), contrast-enhanced CT, or contrast-enhanced MRI scans are also acceptable if PET-CT is not feasible at baseline. Note: PET-CT will be required at end of treatment (EOT) and progression for response assessment. Participants must have measurable disease (at least one lesion with longest diameter ≥ 1.5 cm). All measurable lesions (longest diameter >= 1.5 cm) must be assessed within 28 days prior to registration. Tests to assess non-measurable disease must be performed within 42 days prior to registration.
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Participants with known human immunodeficiency virus (HIV)-infection are eligible providing they are on effective anti-retroviral therapy and have undetectable viral load at their most recent viral load test (must be within 26 weeks prior to registration). Participants with known HIV must have a CD4 count checked within 28 days prior to registration, but may proceed with therapy regardless of CD4 count.
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All participants must be screened for chronic hepatitis B virus (HBV) within 28 days prior to registration. Participants with known HBV infection (positive serology) must also have a HBV viral load performed within 28 days prior to registration, and participants must have an undetectable HBV viral load on suppressive therapy within 28 days prior to registration. Participants found to be HBV carriers during screening are eligible and must receive standard of care prophylaxis. Participants with active hepatitis B (HBV viral load > 500 IU/mL) within 28 days prior to registration are not eligible
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Participants with a known history of hepatitis C virus (HCV) infection must have an undetectable HCV viral load within in 28 days prior to registration
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Participants must not have known lymphomatous involvement of the central nervous system (CNS)
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Participants must not have active inflammatory bowel disease (such as, Crohn's disease, ulcerative colitis), celiac disease (i.e., sprue), prior gastrectomy or upper bowel removal, or any other gastrointestinal disorder or defect that would interfere with the absorption, distribution, metabolism, or excretion of the study drug and/or predispose the subject to an increased risk of gastrointestinal toxicity
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Participants must not have a history of acute leukemia having been treated with intensive induction therapy. Participants with a prior or concurrent malignancy whose natural history or treatment does not have the potential to interfere with the safety or efficacy assessment of the investigational regimen are eligible for this trial
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Participants must not have received any prior cytotoxic chemotherapy or rituximab for treatment of the newly diagnosed DLBCL except for the pre-phase treatment (within specified dose range) that may have either started before or may start after registration to S1918. Inhaled, nasal, and topical steroid use is allowed. Prior cytotoxic chemotherapy and/or antibody therapy for an indolent lymphoma prior to transformation is allowed. Up to 4 doses of intrathecal (IT) chemotherapy administered for central nervous system (CNS) prophylaxis is allowed in addition to protocol therapy. High-dose intravenous methotrexate is not allowed.
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Participants must not have received more than a cumulative of dose 250 mg/m^2 of prior doxorubicin (or equivalent dose of another anthracycline, such as epirubicin) therapy (at any time prior to registration).
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Participants must not currently be receiving any other investigational agents
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Participant must not have a history of allergic reactions attributed to azacitidine, mannitol, or other hypomethylating agents
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Participants must be age ≥ 75
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Participants must have a Zubrod performance status of 0-2
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Participants must have adequate renal function, as demonstrated by a creatinine clearance, calculated by the Cockcroft and Gault formula, of >= 30 ml/min that was obtained within 28 days prior to registration
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Aspartate aminotransferase (AST) =< 2.5 x institutional upper limit of normal (IULN), alanine aminotransferase (ALT) =< 2.5 x IULN (within 28 days prior to registration)
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Total bilirubin =< 2 x institutional upper limit of normal (IULN), unless due to Gilbert's disease, hemolysis, or lymphomatous involvement of liver (within 28 days prior to registration). Note: If total bilirubin is elevated, and direct bilirubin is subsequently performed (within 28 days prior to registration) and resulted to be =< 2 x IULN, the participant will be considered eligible
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Absolute neutrophil count (ANC) >= 1000/mcL (within 28 days prior to registration)
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Platelets >= 75,000/mcL (within 28 days prior to registration)
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Hemoglobin (Hgb) >= 8 g/ dL (within 28 days prior to registration)
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If there is a documented lymphomatous involvement of the bone marrow, bone marrow function within 28 days prior to registration, as evidenced by:
- ANC >= 500/mcL
- Platelets >= 50,000/mcL
- Hgb >= 8 g/ dL
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Participants must have a left ventricular ejection (LVEF) fraction >= 45% as measured by echocardiogram or radionuclide (multigated acquisition scan [MUGA]) ventriculography within 56 days prior to registration
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For the duration of the study treatment period and for at least 4 months following the last dose of study drug, male participants must agree to use effective contraceptive methods during sexual contact with a female of childbearing potential (FCBP) and must agree to refrain from semen or sperm donation during the same timeframe. Effective contraceptive methods include a history of vasectomy, use of hormonal contraception or an intrauterine device (IUD) by the female partner, or use of condoms
- A FCBP is a sexually mature woman who: 1) has not undergone a hysterectomy or bilateral oophorectomy; or 2) has not been naturally postmenopausal for at least 24 consecutive months (i.e., has had menses at any time in the preceding 24 consecutive months)
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Participants must not have active infection (systemic fungal, bacterial, or viral infection) that is not controlled (defined as ongoing signs/symptoms related the infection without improvement despite appropriate antibiotics, antiviral therapy, and/or other treatment)
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Participants must not have active cardiac disease within 26 weeks prior to registration, including: symptomatic congestive heart failure (New York Heart Association [NYHA] class 4), unstable angina pectoris, hemodynamically unstable cardiac arrhythmia, or myocardial infarction
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Participants must not have >= grade 2 neuropathy, by Common Terminology Criteria for Adverse Events (CTCAE) version (v.) 5.0, within 28 days prior to registration
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Participants must not have any other known uncontrolled intercurrent illness including, but not limited to ongoing psychiatric illness/social situations that would limit compliance with study requirements
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Participants must not have a concurrent primary malignancy undergoing active therapy. Exceptions: participants may have non-melanomatous skin cancers requiring only surgical intervention. Participants may have a history of early stage breast cancer or prostate cancer in remission after surgical and/or radiation therapy on adjuvant hormonal therapy only
Plan studiów
Jak projektuje się badanie?
Szczegóły projektu
- Główny cel: Leczenie
- Przydział: Randomizowane
- Model interwencyjny: Przydział równoległy
- Maskowanie: Brak (otwarta etykieta)
Liczba ramion
Broń i interwencje
Grupa uczestników / ArmGrupa uczestników / Arm |
Interwencja / LeczenieInterwencja / Leczenie |
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Eksperymentalny: Arm I (oral azacitidine, R-miniCHOP)
Patients receive CC-486 PO for 7 days prior to cycle 1. Patients then receive CC-486 PO on days 8-21. Treatment repeats every 21 days for cycles 1-5 in the absence of disease progression or unacceptable toxicity. Patients also receive rituximab IV (or rituximab and hyaluronidase human SC for cycles 2-6), cyclophosphamide IV, doxorubicin hydrochloride IV, and vincristine sulfate IV on day 1, and prednisone PO on days 1-5. Treatment repeats every 21 days for cycles 1-6 (6 cycles total) in the absence of disease progression or unacceptable toxicity. Patients undergo ECHO or MUGA at screening and undergo PET-CT and blood sample collection throughout the study. |
Given IV
Inne nazwy:
Given IV
Inne nazwy:
Given PO
Inne nazwy:
Undergo blood sample collection
Inne nazwy:
Given IV
Inne nazwy:
Given IV
Inne nazwy:
Ancillary studies Undergo ECHO
Inne nazwy:
Undergo MUGA
Inne nazwy:
Undergo PET-CT
Inne nazwy:
Given SC
Inne nazwy:
Undergo PET-CT
Inne nazwy:
Given PO
Inne nazwy:
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Aktywny komparator: Arm II (R-miniCHOP)
Patients receive rituximab IV (or rituximab and hyaluronidase human SC for cycles 2-6), cyclophosphamide IV, doxorubicin hydrochloride IV, and vincristine sulfate IV on day 1, and prednisone PO on days 1-5. Treatment repeats every 21 days for up to 6 cycles in the absence of disease progression or unacceptable toxicity. Patients undergo ECHO or MUGA at screening and undergo PET-CT and blood sample collection throughout the study. |
Given IV
Inne nazwy:
Given IV
Inne nazwy:
Given PO
Inne nazwy:
Undergo blood sample collection
Inne nazwy:
Given IV
Inne nazwy:
Given IV
Inne nazwy:
Ancillary studies Undergo ECHO
Inne nazwy:
Undergo MUGA
Inne nazwy:
Undergo PET-CT
Inne nazwy:
Given SC
Inne nazwy:
Undergo PET-CT
Inne nazwy:
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Co mierzy badanie?
Podstawowe miary wyniku
Podstawowe miary wyniku
Miara wyniku |
Opis środka |
Ramy czasowe |
|---|---|---|
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Excess toxicity as a result of adding oral azacitidine (CC-486) to reduced dose rituximab-cyclophosphamide, doxorubicin, vincristine, and prednisone (R-miniCHOP) (Safety run-in)
Ramy czasowe: Up to completion of cycle 6
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Will determine if the addition of CC-486 to R-miniCHOP results in excess toxicity compared to R-miniCHOP alone that would preclude the combination from being studied further. |
Up to completion of cycle 6
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Progression-free survival (PFS) (Phase II)
Ramy czasowe: From date of registration to date of first observation of progressive disease according to the 2014 Lugano classification, or death due to any cause, assessed up to 1 year
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Will determine if the CC-486 + R-miniCHOP regimen should be tested further (Phase III) against the control R-miniCHOP alone based on PFS. After accruing 130 patients (65 per arm, 21 months of accrual and potentially pausing accrual for 6 months follow-up to reach a target 63 events across arms), a one-sided stratified .10 log-rank test will inform a go/no-go decision based on sufficient evidence of efficacy to continue to the Phase III portion of the study. |
From date of registration to date of first observation of progressive disease according to the 2014 Lugano classification, or death due to any cause, assessed up to 1 year
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Overall survival (Phase III)
Ramy czasowe: From date of registration to date of death due to any cause, assessed up to 2 years
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Will compare overall survival in the control arm of R-miniCHOP to the experimental arm of CC-486 (oral azacitidine) + R-miniCHOP. Will be evaluated using a 1-sided .025 level stratified logrank test. |
From date of registration to date of death due to any cause, assessed up to 2 years
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Miary wyników drugorzędnych
Miary wyników drugorzędnych
Miara wyniku |
Opis środka |
Ramy czasowe |
|---|---|---|
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Metabolic complete response (CR)
Ramy czasowe: Up to end of cycle 6 or end of treatment
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Will be defined using 2014 Lugano classification. Fisher's exact test will be used to compare CR rates between the experimental arm of CC-486 + R-miniCHOP and the control arm of R-miniCHOP alone. |
Up to end of cycle 6 or end of treatment
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Incidence of adverse events
Ramy czasowe: Until disease progression, assessed up to 5 years
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Will be assessed using Common Terminology Criteria for Adverse Events version 5. The maximum Grade for each toxicity will be recorded for each patient, and frequency tables will be reviewed to determine toxicity patterns. Treatment-related toxicities between arms will be compared using Fisher's exact test. |
Until disease progression, assessed up to 5 years
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Overall survival (Phase III)
Ramy czasowe: From date of registration to date of death due to any cause, assessed up to 5 years
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An additional secondary analysis of overall survival of the Phase III comparison will adjust for patients with identified double-hit phenotype in addition to the pre-specified stratification factors. Will also prospectively collect the number of days between diagnostic biopsy and cycle 1 day 1 of therapy for a pre-planned secondary analysis. |
From date of registration to date of death due to any cause, assessed up to 5 years
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Inne miary wyników
Inne miary wyników
Miara wyniku |
Opis środka |
Ramy czasowe |
|---|---|---|
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Changes in function (Integrated Correlative Geriatric Assessments Substudy)
Ramy czasowe: From time of randomization up to 24 months after date of registration
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Will be assessed by a Comprehensive Geriatric Assessment (Carolina Frailty Index [CFI] Score) between patients treated with CC-486 + R-miniCHOP and those treated with R-miniCHOP alone. Linear regression will be used for each examination, adjusting for the stratification factors from the clinical study and the baseline score (for the examination of change from 12 to 24 months, the 12-month score will be considered the baseline score). Although the number of timepoints is limited to 3, longitudinal assessments of the CFI Score over time will also be conducted using linear mixed models, adjusting for the stratification factors and the baseline score, with patient considered a random effect. |
From time of randomization up to 24 months after date of registration
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Frailty status (fit/unfit vs frail) (Integrated Correlative Geriatric Assessments Substudy)
Ramy czasowe: Baseline
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Will evaluate if frailty status (fit/unfit versus frail) as assessed by the Italian Lymphoma Foundation (FIL) tool is associated with overall survival. Multivariable Cox regression will be conducted, adjusting for the stratification variables and the randomized treatment arm as covariates. Will also examine whether randomization to CC-486 + R-miniCHOP is associated with better overall survival compared to treatment with R-miniCHOP alone in the subset of fit and unfit patients. Multivariable Cox regression will be conducted, adjusting for the stratification variables as covariates. |
Baseline
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Frailty status (Integrated Correlative Geriatric Assessments Substudy)
Ramy czasowe: Up to 24 months after date of registration
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Will evaluate if frailty status (fit/unfit versus frail) as assessed by the FIL tool correlates with the summary frailty indexed as measured by the S1918 Comprehensive Geriatric Assessment (CGA). In particular, agreement between the FIL and CGA will measured using an unweighted Kappa statistic; moderate or better agreement is defined as a Kappa coefficient of >= 0.41. |
Up to 24 months after date of registration
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Współpracownicy i badacze
Sponsor
Sponsor
Śledczy
Śledczy
- Główny śledczy: Elizabeth A Brem, SWOG Cancer Research Network
Publikacje i pomocne linki
Daty zapisu na studia
Główne daty studiów
Rozpoczęcie studiów (Rzeczywisty)
Rozpoczęcie studiów
Zakończenie podstawowe (Szacowany)
Zakończenie podstawowe
Ukończenie studiów (Szacowany)
Ukończenie studiów
Daty rejestracji na studia
Pierwszy przesłany
Pierwszy przesłany
Pierwszy przesłany, który spełnia kryteria kontroli jakości
Pierwszy przesłany, który spełnia kryteria kontroli jakości
Pierwszy wysłany (Rzeczywisty)
Pierwszy wysłany
Aktualizacje rekordów badań
Ostatnia wysłana aktualizacja (Rzeczywisty)
Ostatnia wysłana aktualizacja
Ostatnia przesłana aktualizacja, która spełniała kryteria kontroli jakości
Ostatnia przesłana aktualizacja, która spełniała kryteria kontroli jakości
Ostatnia weryfikacja
Ostatnia weryfikacja
Więcej informacji
Terminy związane z tym badaniem
Dodatkowe istotne warunki MeSH
- Nowotwory
- Choroby układu odpornościowego
- Nowotwory według typu histologicznego
- Choroby limfatyczne
- Zaburzenia limfoproliferacyjne
- Zaburzenia immunoproliferacyjne
- Chłoniak nieziarniczy
- Chłoniak z komórek B
- Chłoniak
- Choroby hemowe i limfatyczne
- Chłoniak, duże komórki B, rozlany
- Chłoniak, komórki B, strefa brzeżna
- Aminokwasy, peptydy i białka
- Białka
- Organiczne chemikalia
- Związki heterocykliczne, 1-ring
- Związki heterocykliczne
- Związki heterocykliczne, 2-ring
- Związki heterocykliczne, sterowanie stopieniem
- Techniki śledcze
- Techniki laboratoryjne kliniczne
- Techniki i procedury diagnostyczne
- Diagnoza
- Kwasy nukleinowe, nukleotydy i nukleozydy
- Węglowodory
- Węglowodory, cykliczne
- Węglowodany
- Alkaloidy
- Policykliczne aromatyczne węglowodory
- Węglowodory, aromatyczne
- Związki policykliczne
- Glikozydy
- Hydrolazy glikozydowe
- Hydrolazy
- Enzymy
- Enzymy i koenzymy
- Polisacharyd-Lyaza
- Lyaza z tlenkiem węgla
- Lyazy
- Indole
- Przeciwciała, monoklonalne
- Przeciwciała
- Immunoglobuliny
- Immunoproteiny
- Białka krwi
- Globuliny w surowicy
- Globuliny
- Cytydyna
- Nukleozydy pirymidynowe
- Pirymidyn
- Ciąży
- Ciężarne
- Steroidy
- Związki sterownika
- Techniki chemii, analityczne
- Analiza widma
- Mostki fosforamidu
- Związki musztardy azotu
- Związki musztardy
- Węglowodory, uboczne
- Fosforamidy
- Związki okorosfosforowe
- Związki AZA
- Nukleozydy
- Rybonukleozydy
- Ciąży
- Vinca alkaloidy
- Sesologanina alkaloidy tryptaminy
- Alkaloidy indole
- Indolizicyny
- Indolizyny
- Antracykliny
- Naftaceny
- Aminoglikozydy
- Przeciwciała, monoklonalne, mysie
- Daunorubicyna
- Rytuksymab
- Prednizon
- Cyklofosfamid
- Azacytydyna
- Doksorubicyna
- Winkrystyna
- Hialuronoglukozaminidaza
- Prowadzenie okazów
- Spektroskopia rezonansu magnetycznego
- CC-486
- CT-P10
- Deltacortene
- prednielidene
Inne numery identyfikacyjne badania
Inne numery identyfikacyjne badania
- NCI-2020-01256
- U10CA180888 (Grant/umowa NIH USA)
- NCI-2020-01256 (Identyfikator rejestru: CTRP (Clinical Trial Reporting Program))
- S1918 (Inny identyfikator: CTEP)
- S1918 (Inny identyfikator: SWOG)
Plan dla danych uczestnika indywidualnego (IPD)
Planujesz udostępniać dane poszczególnych uczestników (IPD)?
Opis planu IPD
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.
Informacje o lekach i urządzeniach, dokumenty badawcze
Bada produkt leczniczy regulowany przez amerykańską FDA
Bada produkt urządzenia regulowany przez amerykańską FDA
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