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- Ensaio Clínico NCT00110006
Positron Emission Tomography Using Fludeoxyglucose F 18 in Predicting Response to Treatment in Patients Who Are Receiving Rituximab and Combination Chemotherapy for Newly Diagnosed Non-Hodgkin's Lymphoma
Prognostic Significance of Early Positron Emission Tomography (PET) With Fluorine-18 Fluorodeoxyglucose ([18F] FDG) in Intermediate and High Grade Non-Hodgkin's Lymphoma
RATIONALE: Diagnostic procedures, such as positron emission tomography (PET) using fludeoxyglucose F 18, may help in learning how well chemotherapy works to kill cancer cells and allow doctors to plan better treatment. Comparing results of diagnostic procedures done before, during, and after chemotherapy may help doctors predict a patient's response to treatment and help plan the best treatment.
PURPOSE: This clinical trial is studying positron emission tomography using fludeoxyglucose F 18 to see how well it works in predicting response to treatment in patients who are receiving rituximab and combination chemotherapy for newly diagnosed non-Hodgkin's lymphoma.
Visão geral do estudo
Status
Condições
Descrição detalhada
OBJECTIVES:
- Determine the positive and negative predictive values of early positron emission tomography (PET) scanning using fludeoxyglucose F 18 in terms of the probability of patients with newly diagnosed intermediate- or high-grade non-Hodgkin's lymphoma who achieve or do not achieve complete remission, after treatment with 1 course of rituximab and combination chemotherapy comprising cyclophosphamide, doxorubicin, vincristine, and prednisone.
- Determine event free and overall survival of patients with an early positive and negative PET scan treated with this regimen.
- Determine the predictive value of early PET scan response ratio as a continuous variable in terms of response to therapy (assessed at the end of therapy), disease-free survival, and overall survival, in patients treated with this regimen.
- Correlate International Prognostic Index score at presentation with early PET scan results and overall outcome in patients treated with this regimen.
- Correlate the degree of neutropenia 7 to 10 days after the first course of treatment with rituximab and combination chemotherapy with PET scan response and pre-treatment blood CD34-positive cell concentration in these patients.
OUTLINE: This is a multicenter study.
Patients receive fludeoxyglucose F 18 (^18FDG) IV. Beginning 1 hour later, patients undergo whole-body positron emission tomography (PET) scanning. Patients also undergo conventional radiographic staging of their disease.
Patients then receive standard R-CHOP (or an alternative regimen) comprising rituximab IV over 3-6 hours, cyclophosphamide IV over 30 minutes, doxorubicin IV over 5 minutes, and vincristine IV over 5 minutes on day 1 and oral prednisone once daily on days 1-5. Treatment repeats every 14-21 days for up to 4 courses in the absence of unacceptable toxicity.
Patients undergo repeat ^18FDG-PET scanning between days 7-10 of course 1, between courses 3 and 4, and then at the completion of R-CHOP. Patients also undergo radiographic restaging of their disease between courses 3 and 4 and at the completion of R-CHOP.
After completion of study treatment, patients are followed every 3-4 months for 2 years, every 6 months for 1 year, and then annually for 3 years.
PROJECTED ACCRUAL: A total of 30 patients will be accrued for this study within 2 years.
Tipo de estudo
Estágio
- Não aplicável
Critérios de participação
Critérios de elegibilidade
Idades elegíveis para estudo
Aceita Voluntários Saudáveis
Gêneros Elegíveis para o Estudo
Descrição
DISEASE CHARACTERISTICS:
Histologically confirmed newly diagnosed non-Hodgkin's lymphoma (NHL)
- Intermediate- or high-grade disease
- Stage I-IV disease
Any of the following subtypes are allowed:
- Diffuse large B-cell lymphoma
- Anaplastic large cell lymphoma
- Mantle cell lymphoma
- Grade 3 follicular lymphoma
- Mediastinal B-cell lymphoma
The following subtypes are not allowed:
- Lymphoblastic lymphoma
- Mycosis fungoides/Sézary's syndrome
- HTLV-1 associated T-cell leukemia or lymphoma
- Primary CNS lymphoma
- HIV-associated lymphoma
- Transformed lymphoma
- Burkitt's lymphoma
Adequate staging of lymphoma by any of the following methods:
- CT scan or MRI of affected sites
- Unilateral or bilateral bone marrow biopsy
- Positive pre-treatment positron emission tomography (PET) scan
- Lumbar puncture
- Radiographically measurable disease by PET scan
- Any International Prognostic Index risk category allowed
- No prior diagnosis of another hematologic malignancy NOTE: A new classification scheme for adult non-Hodgkin's lymphoma has been adopted by PDQ. The terminology of "indolent" or "aggressive" lymphoma will replace the former terminology of "low", "intermediate", or "high" grade lymphoma. However, this protocol uses the former terminology.
PATIENT CHARACTERISTICS:
Age
- 18 and over
Performance status
- Not specified
Life expectancy
- Not specified
Hematopoietic
- Absolute neutrophil count > 1,000/mm^3*
- Platelet count ≥ 75,000/mm^3* NOTE: *Unless due to NHL
Hepatic
- Bilirubin ≤ 2.0 mg/dL* (excluding Gilbert's disease) NOTE: *Unless due to NHL
Renal
- Creatinine ≤ 2.0 mg/dL (unless due to NHL)
Cardiovascular
- Ejection fraction ≥ 45% by echocardiogram or MUGA
Other
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective contraception
- HIV negative
- No other malignancy within the past 5 years except superficial nonmelanoma skin cancer or carcinoma in situ of the cervix
- No other serious co-morbid disease that would preclude study participation
PRIOR CONCURRENT THERAPY:
Biologic therapy
- No prior rituximab for NHL
- No concurrent filgrastim [G-CSF] during course 1 of study treatment except for patients > 70 years of age OR patients with active infection
Chemotherapy
- No prior chemotherapy for NHL
Endocrine therapy
- No prior steroids for NHL
Radiotherapy
- No prior radiotherapy for NHL
- Concurrent consolidation radiotherapy to sites of bulky disease allowed at the discretion of the attending physician
Surgery
- Not specified
Other
- No other prior treatment for NHL
Plano de estudo
Como o estudo é projetado?
Detalhes do projeto
- Finalidade Principal: Diagnóstico
- Alocação: N / D
- Modelo Intervencional: Atribuição de grupo único
- Mascaramento: Nenhum (rótulo aberto)
O que o estudo está medindo?
Medidas de resultados primários
Medida de resultado |
Prazo |
---|---|
Complete remission as measured by positron emission tomography (PET) at 7-10 days after R-CHOP, and after completion of study treatment
Prazo: at 7-10 days after R-CHOP, and after completion of study treatment
|
at 7-10 days after R-CHOP, and after completion of study treatment
|
Overall survival at 7-10 days after R-CHOP, and after completion of study treatment
Prazo: at 7-10 days after R-CHOP, and after completion of study treatment
|
at 7-10 days after R-CHOP, and after completion of study treatment
|
Disease-free survival at 7-10 days after R-CHOP, and after completion of study treatment
Prazo: at 7-10 days after R-CHOP, and after completion of study treatment
|
at 7-10 days after R-CHOP, and after completion of study treatment
|
Colaboradores e Investigadores
Patrocinador
Colaboradores
Investigadores
- Cadeira de estudo: Panayiotis Savvides, MD, Ireland Cancer Center at University Hospitals Case Medical Center, Case Comprehensive Cancer Center
Datas de registro do estudo
Datas Principais do Estudo
Início do estudo
Datas de inscrição no estudo
Enviado pela primeira vez
Enviado pela primeira vez que atendeu aos critérios de CQ
Primeira postagem (Estimativa)
Atualizações de registro de estudo
Última Atualização Postada (Estimativa)
Última atualização enviada que atendeu aos critérios de controle de qualidade
Última verificação
Mais Informações
Termos relacionados a este estudo
Palavras-chave
- linfoma difuso de grandes células do adulto estágio III
- linfoma folicular grau 3 estágio IV
- linfoma difuso de grandes células do adulto estágio IV
- linfoma folicular grau 3 estágio III
- linfoma de células do manto estágio III
- linfoma de células do manto estágio IV
- linfoma anaplásico de grandes células
- linfoma de células do manto estágio II contíguo
- linfoma de células do manto estágio II não contíguo
- linfoma difuso de grandes células adulto estágio II não contíguo
- linfoma folicular não contíguo estágio II grau 3
- linfoma de células do manto estágio I
- linfoma folicular contíguo estágio II grau 3
- linfoma folicular grau 3 estágio I
- linfoma difuso de grandes células adulto estágio II contíguo
- linfoma difuso de grandes células do adulto estágio I
Termos MeSH relevantes adicionais
- Doenças do sistema imunológico
- Neoplasias por Tipo Histológico
- Neoplasias
- Distúrbios Linfoproliferativos
- Doenças Linfáticas
- Distúrbios imunoproliferativos
- Linfoma
- Linfoma Não-Hodgkin
- Efeitos Fisiológicos das Drogas
- Mecanismos Moleculares de Ação Farmacológica
- Inibidores Enzimáticos
- Antiinflamatórios
- Agentes Antirreumáticos
- Agentes Antineoplásicos
- Agentes imunossupressores
- Fatores imunológicos
- Moduladores de Tubulina
- Agentes Antimitóticos
- Moduladores de Mitose
- Glicocorticóides
- Hormônios
- Hormônios, Substitutos Hormonais e Antagonistas Hormonais
- Agentes Antineoplásicos Hormonais
- Agentes Antineoplásicos Alquilantes
- Agentes Alquilantes
- Agonistas Mieloablativos
- Agentes Antineoplásicos Fitogênicos
- Inibidores da Topoisomerase II
- Inibidores da Topoisomerase
- Agentes Antineoplásicos Imunológicos
- Radiofármacos
- Antibióticos, Antineoplásicos
- Ciclofosfamida
- Fluorodesoxiglicose F18
- Rituximabe
- Prednisona
- Doxorrubicina
- Doxorrubicina lipossomal
- Vincristina
Outros números de identificação do estudo
- CASE2404
- P30CA043703 (Concessão/Contrato do NIH dos EUA)
- CASE-CWRU-2404 (Outro identificador: Case Comprehensive Cancer Center)
- CWRU-100401
Essas informações foram obtidas diretamente do site clinicaltrials.gov sem nenhuma alteração. Se você tiver alguma solicitação para alterar, remover ou atualizar os detalhes do seu estudo, entre em contato com register@clinicaltrials.gov. Assim que uma alteração for implementada em clinicaltrials.gov, ela também será atualizada automaticamente em nosso site .
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