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Testar CC-486 (oral azacitidin) plus standardläkemedelsterapi hos patienter 75 år eller äldre med nyligen diagnostiserat diffust stort B-cellslymfom

10 november 2026 uppdaterad av: National Cancer Institute (NCI)

En randomiserad fas II/III studie av R-MiniCHOP med eller utan CC-486 (oral azacitidin) hos deltagare i åldern 75 år eller äldre med nyligen diagnostiserat diffust storcellslymfom, follikulärt lymfom av grad IIIB, transformerat lymfom och höggradigt B -Cellymfom med MYC OCH BCL2 och/eller BCL6 omarrangemang

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.

Studieöversikt

Status

Aktiv, inte rekryterande

Betingelser

Intervention / Behandling

Detaljerad beskrivning

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.

Studietyp

Interventionell

Inskrivning (Beräknad)

422

Fas

  • Fas 2
  • Fas 3

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studieorter

  • Förenta staterna
    • Arizona
      • Tucson, Arizona, Förenta staterna, 85719
        • Banner University Medical Center - Tucson
      • Tucson, Arizona, Förenta staterna, 85719
        • University of Arizona Cancer Center-North Campus
    • Arkansas
      • Little Rock, Arkansas, Förenta staterna, 72205
        • University of Arkansas for Medical Sciences
    • California
      • Anaheim, California, Förenta staterna, 92806
        • Kaiser Permanente-Anaheim
      • Baldwin Park, California, Förenta staterna, 91706
        • Kaiser Permanente-Baldwin Park
      • Bellflower, California, Förenta staterna, 90706
        • Kaiser Permanente-Bellflower
      • Beverly Hills, California, Förenta staterna, 90211
        • Tower Cancer Research Foundation
      • Costa Mesa, California, Förenta staterna, 92627
        • UC Irvine Health Cancer Center-Newport
      • Duarte, California, Förenta staterna, 91010
        • City of Hope Comprehensive Cancer Center
      • Fontana, California, Förenta staterna, 92335
        • Kaiser Permanente-Fontana
      • Harbor City, California, Förenta staterna, 90710
        • Kaiser Permanente South Bay
      • Huntington Beach, California, Förenta staterna, 92648
        • City of Hope Seacliff
      • Irvine, California, Förenta staterna, 92618
        • Kaiser Permanente-Irvine
      • Irvine, California, Förenta staterna, 92618
        • City of Hope at Irvine Lennar
      • Lancaster, California, Förenta staterna, 93534
        • City of Hope Antelope Valley
      • Long Beach, California, Förenta staterna, 90822
        • Tibor Rubin VA Medical Center
      • Long Beach, California, Förenta staterna, 90813
        • City of Hope at Long Beach Elm
      • Los Angeles, California, Förenta staterna, 90048
        • Cedars-Sinai Medical Center
      • Los Angeles, California, Förenta staterna, 90027
        • Kaiser Permanente Los Angeles Medical Center
      • Los Angeles, California, Förenta staterna, 90034
        • Kaiser Permanente West Los Angeles
      • Newport Beach, California, Förenta staterna, 92660
        • City of Hope Newport Beach
      • Ontario, California, Förenta staterna, 91761
        • Kaiser Permanente-Ontario
      • Orange, California, Förenta staterna, 92868
        • UC Irvine Health/Chao Family Comprehensive Cancer Center
      • Palo Alto, California, Förenta staterna, 94304
        • Stanford Cancer Institute Palo Alto
      • Panorama City, California, Förenta staterna, 91402
        • Kaiser Permanente - Panorama City
      • Riverside, California, Förenta staterna, 92505
        • Kaiser Permanente-Riverside
      • San Diego, California, Förenta staterna, 92120
        • Kaiser Permanente-San Diego Zion
      • San Marcos, California, Förenta staterna, 92078
        • Kaiser Permanente-San Marcos
      • San Mateo, California, Förenta staterna, 94402
        • UCSF Cancer Center - San Mateo
      • South Pasadena, California, Förenta staterna, 91030
        • City of Hope South Pasadena
      • Torrance, California, Förenta staterna, 90503
        • City of Hope South Bay
      • Upland, California, Förenta staterna, 91786
        • City of Hope Upland
      • Woodland Hills, California, Förenta staterna, 91367
        • Kaiser Permanente-Woodland Hills
    • Colorado
      • Golden, Colorado, Förenta staterna, 80401
        • Lutheran Hospital - Cancer Centers of Colorado
    • Delaware
      • Newark, Delaware, Förenta staterna, 19713
        • Helen F Graham Cancer Center
      • Newark, Delaware, Förenta staterna, 19713
        • Delaware Clinical and Laboratory Physicians PA
      • Newark, Delaware, Förenta staterna, 19713
        • Medical Oncology Hematology Consultants PA
    • Florida
      • Miami, Florida, Förenta staterna, 33136
        • University of Miami Miller School of Medicine-Sylvester Cancer Center
    • Georgia
      • Atlanta, Georgia, Förenta staterna, 30308
        • Emory University Hospital Midtown
      • Atlanta, Georgia, Förenta staterna, 30322
        • Emory University Hospital/Winship Cancer Institute
      • Atlanta, Georgia, Förenta staterna, 30342
        • Emory Saint Joseph's Hospital
      • Augusta, Georgia, Förenta staterna, 30912
        • Augusta University Medical Center
    • Hawaii
      • Honolulu, Hawaii, Förenta staterna, 96813
        • Queen's Medical Center
      • Honolulu, Hawaii, Förenta staterna, 96813
        • Hawaii Cancer Care Inc - Waterfront Plaza
      • Honolulu, Hawaii, Förenta staterna, 96813
        • Queen's Cancer Cenrer - POB I
      • Honolulu, Hawaii, Förenta staterna, 96813
        • Straub Clinic and Hospital
      • Honolulu, Hawaii, Förenta staterna, 96817
        • Queen's Cancer Center - Kuakini
      • ‘Aiea, Hawaii, Förenta staterna, 96701
        • Hawaii Cancer Care - Westridge
      • ‘Aiea, Hawaii, Förenta staterna, 96701
        • Pali Momi Medical Center
    • Illinois
      • Centralia, Illinois, Förenta staterna, 62801
        • Centralia Oncology Clinic
      • Chicago, Illinois, Förenta staterna, 60611
        • Northwestern University
      • Chicago, Illinois, Förenta staterna, 60637
        • University of Chicago Comprehensive Cancer Center
      • Chicago, Illinois, Förenta staterna, 60612
        • University of Illinois
      • Danville, Illinois, Förenta staterna, 61832
        • Carle at The Riverfront
      • DeKalb, Illinois, Förenta staterna, 60115
        • Northwestern Medicine Cancer Center Kishwaukee
      • Decatur, Illinois, Förenta staterna, 62526
        • Decatur Memorial Hospital
      • Decatur, Illinois, Förenta staterna, 62526
        • Cancer Care Specialists of Illinois - Decatur
      • Effingham, Illinois, Förenta staterna, 62401
        • Crossroads Cancer Center
      • Effingham, Illinois, Förenta staterna, 62401
        • Carle Physician Group-Effingham
      • Evanston, Illinois, Förenta staterna, 60201
        • NorthShore University HealthSystem-Evanston Hospital
      • Geneva, Illinois, Förenta staterna, 60134
        • Northwestern Medicine Cancer Center Delnor
      • Glenview, Illinois, Förenta staterna, 60026
        • NorthShore University HealthSystem-Glenbrook Hospital
      • Glenview, Illinois, Förenta staterna, 60026
        • Northwestern Medicine Glenview Outpatient Center
      • Grayslake, Illinois, Förenta staterna, 60030
        • Northwestern Medicine Grayslake Outpatient Center
      • Highland Park, Illinois, Förenta staterna, 60035
        • NorthShore University HealthSystem-Highland Park Hospital
      • Lake Forest, Illinois, Förenta staterna, 60045
        • Northwestern Medicine Lake Forest Hospital
      • Mattoon, Illinois, Förenta staterna, 61938
        • Carle Physician Group-Mattoon/Charleston
      • New Lenox, Illinois, Förenta staterna, 60451
        • UC Comprehensive Cancer Center at Silver Cross
      • O'Fallon, Illinois, Förenta staterna, 62269
        • Cancer Care Center of O'Fallon
      • Orland Park, Illinois, Förenta staterna, 60462
        • University of Chicago Medicine-Orland Park
      • Orland Park, Illinois, Förenta staterna, 60462
        • Northwestern Medicine Orland Park
      • Peoria, Illinois, Förenta staterna, 61615
        • Illinois CancerCare-Peoria
      • Shiloh, Illinois, Förenta staterna, 62269
        • Memorial Hospital East
      • Urbana, Illinois, Förenta staterna, 61801
        • Carle Cancer Center
      • Warrenville, Illinois, Förenta staterna, 60555
        • Northwestern Medicine Cancer Center Warrenville
    • Iowa
      • Ames, Iowa, Förenta staterna, 50010
        • McFarland Clinic - Ames
      • Ankeny, Iowa, Förenta staterna, 50023
        • UI Health Care Mission Cancer and Blood - Ankeny Clinic
      • Clive, Iowa, Förenta staterna, 50325
        • UI Health Care Mission Cancer and Blood - West Des Moines Clinic
      • Des Moines, Iowa, Förenta staterna, 50309
        • Iowa Methodist Medical Center
      • Des Moines, Iowa, Förenta staterna, 50309
        • UI Health Care Mission Cancer and Blood - Des Moines Clinic
      • Des Moines, Iowa, Förenta staterna, 50314
        • UI Health Care Mission Cancer and Blood - Laurel Clinic
    • Louisiana
      • Monroe, Louisiana, Förenta staterna, 71202
        • Ochsner LSU Health Monroe Medical Center
      • Shreveport, Louisiana, Förenta staterna, 71103
        • LSU Health Sciences Center at Shreveport
    • Massachusetts
      • Boston, Massachusetts, Förenta staterna, 02111
        • Tufts Medical Center
    • Michigan
      • Ann Arbor, Michigan, Förenta staterna, 48106
        • Trinity Health Saint Joseph Mercy Hospital Ann Arbor
      • Brighton, Michigan, Förenta staterna, 48114
        • Trinity Health IHA Medical Group Hematology Oncology - Brighton
      • Brighton, Michigan, Förenta staterna, 48114
        • Trinity Health Medical Center - Brighton
      • Canton, Michigan, Förenta staterna, 48188
        • Trinity Health IHA Medical Group Hematology Oncology - Canton
      • Canton, Michigan, Förenta staterna, 48188
        • Trinity Health Medical Center - Canton
      • Chelsea, Michigan, Förenta staterna, 48118
        • Trinity Health IHA Medical Group Hematology Oncology - Chelsea Hospital
      • Chelsea, Michigan, Förenta staterna, 48118
        • Chelsea Hospital
      • Livonia, Michigan, Förenta staterna, 48154
        • Trinity Health Saint Mary Mercy Livonia Hospital
      • Livonia, Michigan, Förenta staterna, 48154
        • Hope Cancer Clinic
      • Ypsilanti, Michigan, Förenta staterna, 48197
        • Trinity Health IHA Medical Group Hematology Oncology Ann Arbor Campus
      • Ypsilanti, Michigan, Förenta staterna, 48106
        • Huron Gastroenterology PC
    • Minnesota
      • Deer River, Minnesota, Förenta staterna, 56636
        • Essentia Health - Deer River Clinic
      • Duluth, Minnesota, Förenta staterna, 55805
        • Essentia Health Cancer Center
      • Hibbing, Minnesota, Förenta staterna, 55746
        • Essentia Health Hibbing Clinic
      • Sandstone, Minnesota, Förenta staterna, 55072
        • Essentia Health Sandstone
      • Virginia, Minnesota, Förenta staterna, 55792
        • Essentia Health Virginia Clinic
    • Mississippi
      • Oxford, Mississippi, Förenta staterna, 38655
        • Baptist Memorial Hospital and Cancer Center-Oxford
      • Southhaven, Mississippi, Förenta staterna, 38671
        • Baptist Memorial Hospital and Cancer Center-Desoto
    • Missouri
      • Cape Girardeau, Missouri, Förenta staterna, 63703
        • Saint Francis Medical Center
      • Chesterfield, Missouri, Förenta staterna, 63017
        • Saint Luke's Hospital
      • City of Saint Peters, Missouri, Förenta staterna, 63376
        • Siteman Cancer Center at Saint Peters Hospital
      • Creve Coeur, Missouri, Förenta staterna, 63141
        • Siteman Cancer Center at West County Hospital
      • Saint Joseph, Missouri, Förenta staterna, 64506
        • Heartland Regional Medical Center
      • St Louis, Missouri, Förenta staterna, 63110
        • Washington University School of Medicine
      • St Louis, Missouri, Förenta staterna, 63129
        • Siteman Cancer Center-South County
      • St Louis, Missouri, Förenta staterna, 63136
        • Siteman Cancer Center at Christian Hospital
    • Nebraska
      • Lincoln, Nebraska, Förenta staterna, 68516
        • Cancer Partners of Nebraska
    • New Jersey
      • Basking Ridge, New Jersey, Förenta staterna, 07920
        • Memorial Sloan Kettering Basking Ridge
      • Englewood, New Jersey, Förenta staterna, 07631
        • Englewood Hospital and Medical Center
      • Lakewood, New Jersey, Förenta staterna, 08701
        • Monmouth Medical Center Southern Campus
      • Long Branch, New Jersey, Förenta staterna, 07740
        • Monmouth Medical Center
      • Middletown, New Jersey, Förenta staterna, 07748
        • Memorial Sloan Kettering Monmouth
      • Montvale, New Jersey, Förenta staterna, 07645
        • Memorial Sloan Kettering Bergen
      • New Brunswick, New Jersey, Förenta staterna, 08903
        • Rutgers Cancer Institute of New Jersey
      • Newark, New Jersey, Förenta staterna, 07112
        • Newark Beth Israel Medical Center
      • Toms River, New Jersey, Förenta staterna, 08755
        • Community Medical Center
    • New York
      • Buffalo, New York, Förenta staterna, 14263
        • Roswell Park Cancer Institute
      • Commack, New York, Förenta staterna, 11725
        • Memorial Sloan Kettering Commack
      • Glens Falls, New York, Förenta staterna, 12801
        • Glens Falls Hospital
      • Harrison, New York, Förenta staterna, 10604
        • Memorial Sloan Kettering Westchester
      • Mineola, New York, Förenta staterna, 11501
        • NYU Langone Hospital - Long Island
      • New York, New York, Förenta staterna, 10065
        • Memorial Sloan Kettering Cancer Center
      • New York, New York, Förenta staterna, 10032
        • NYP/Columbia University Medical Center/Herbert Irving Comprehensive Cancer Center
      • New York, New York, Förenta staterna, 10065
        • NYP/Weill Cornell Medical Center
      • New York, New York, Förenta staterna, 10016
        • Laura and Isaac Perlmutter Cancer Center at NYU Langone
      • Oswego, New York, Förenta staterna, 13126
        • Upstate Cancer Center at Oswego
      • Syracuse, New York, Förenta staterna, 13210
        • State University of New York Upstate Medical University
      • Uniondale, New York, Förenta staterna, 11553
        • Memorial Sloan Kettering Nassau
      • Verona, New York, Förenta staterna, 13478
        • Upstate Cancer Center at Verona
    • North Carolina
      • Chapel Hill, North Carolina, Förenta staterna, 27599
        • UNC Lineberger Comprehensive Cancer Center
    • Ohio
      • Cleveland, Ohio, Förenta staterna, 44195
        • Cleveland Clinic Foundation
      • Cleveland, Ohio, Förenta staterna, 44111
        • Cleveland Clinic Cancer Center/Fairview Hospital
      • Columbus, Ohio, Förenta staterna, 43210
        • Ohio State University Comprehensive Cancer Center
      • Dayton, Ohio, Förenta staterna, 45415
        • Dayton Physician LLC - Englewood
      • Independence, Ohio, Förenta staterna, 44131
        • Cleveland Clinic Cancer Center Independence
      • Kettering, Ohio, Förenta staterna, 45409
        • Greater Dayton Cancer Center
      • Mansfield, Ohio, Förenta staterna, 44906
        • Cleveland Clinic Cancer Center Mansfield
      • Mayfield Heights, Ohio, Förenta staterna, 44124
        • Hillcrest Hospital Cancer Center
      • Sandusky, Ohio, Förenta staterna, 44870
        • North Coast Cancer Care
      • Strongsville, Ohio, Förenta staterna, 44136
        • Cleveland Clinic Cancer Center Strongsville
      • Warrensville Heights, Ohio, Förenta staterna, 44122
        • South Pointe Hospital
      • Wooster, Ohio, Förenta staterna, 44691
        • Cleveland Clinic Wooster Family Health and Surgery Center
    • Oklahoma
      • Lawton, Oklahoma, Förenta staterna, 73505
        • Cancer Centers of Southwest Oklahoma Research
      • Oklahoma City, Oklahoma, Förenta staterna, 73104
        • University of Oklahoma Health Sciences Center
    • Oregon
      • Portland, Oregon, Förenta staterna, 97225
        • Providence Saint Vincent Medical Center
      • Portland, Oregon, Förenta staterna, 97239
        • Portland VA Medical Center
    • South Carolina
      • Charleston, South Carolina, Förenta staterna, 29425
        • Medical University of South Carolina
      • Greenville, South Carolina, Förenta staterna, 29607
        • Saint Francis Cancer Center
      • Greenville, South Carolina, Förenta staterna, 29601
        • Saint Francis Hospital
    • Tennessee
      • Memphis, Tennessee, Förenta staterna, 38120
        • Baptist Memorial Hospital and Cancer Center-Memphis
    • Utah
      • Salt Lake City, Utah, Förenta staterna, 84112
        • Huntsman Cancer Institute/University of Utah
      • Salt Lake City, Utah, Förenta staterna, 84148
        • George E Wahlen Department of Veterans Affairs Medical Center
    • Virginia
      • Charlottesville, Virginia, Förenta staterna, 22908
        • University of Virginia Cancer Center
      • Fairfax, Virginia, Förenta staterna, 22031
        • Inova Schar Cancer Institute
      • Richmond, Virginia, Förenta staterna, 23298
        • VCU Massey Comprehensive Cancer Center
    • Washington
      • Bellevue, Washington, Förenta staterna, 98004
        • FHCC Overlake
      • Kirkland, Washington, Förenta staterna, 98034
        • FHCC at EvergreenHealth
      • Seattle, Washington, Förenta staterna, 98133
        • FHCC at Northwest Hospital
    • West Virginia
      • Charleston, West Virginia, Förenta staterna, 25304
        • Vandalia Health/CAMC Institute for Academic Medicine
    • Wisconsin
      • Ashland, Wisconsin, Förenta staterna, 54806
        • Duluth Clinic Ashland
      • Eau Claire, Wisconsin, Förenta staterna, 54701
        • Marshfield Medical Center-EC Cancer Center
      • Green Bay, Wisconsin, Förenta staterna, 54301
        • Saint Vincent Hospital Cancer Center Green Bay
      • Green Bay, Wisconsin, Förenta staterna, 54303
        • Saint Vincent Hospital Cancer Center at Saint Mary's
      • La Crosse, Wisconsin, Förenta staterna, 54601
        • Gundersen Lutheran Medical Center
      • Marshfield, Wisconsin, Förenta staterna, 54449
        • Marshfield Medical Center-Marshfield
      • Minocqua, Wisconsin, Förenta staterna, 54548
        • Marshfield Medical Center - Minocqua
      • Oconto Falls, Wisconsin, Förenta staterna, 54154
        • Saint Vincent Hospital Cancer Center at Oconto Falls
      • Rice Lake, Wisconsin, Förenta staterna, 54868
        • Marshfield Medical Center-Rice Lake
      • Sheboygan, Wisconsin, Förenta staterna, 53081
        • Saint Vincent Hospital Cancer Center at Sheboygan
      • Stevens Point, Wisconsin, Förenta staterna, 54482
        • Marshfield Medical Center-River Region at Stevens Point
      • Sturgeon Bay, Wisconsin, Förenta staterna, 54235-1495
        • Saint Vincent Hospital Cancer Center at Sturgeon Bay
      • Weston, Wisconsin, Förenta staterna, 54476
        • Marshfield Medical Center - Weston

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

75 år och äldre (Äldre vuxen)

Tar emot friska volontärer

Nej

Kön som är behöriga för studier

Allt

Beskrivning

Inclusion Criteria:

  • 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.

  • 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

  • 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.

  • 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.

  • 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

  • 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

  • Participants must not have known lymphomatous involvement of the central nervous system (CNS)

  • 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

  • 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

  • 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.

  • 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).

  • Participants must not currently be receiving any other investigational agents

  • Participant must not have a history of allergic reactions attributed to azacitidine, mannitol, or other hypomethylating agents

  • Participants must be age ≥ 75

  • Participants must have a Zubrod performance status of 0-2

  • 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

  • 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)

  • 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

  • Absolute neutrophil count (ANC) >= 1000/mcL (within 28 days prior to registration)

  • Platelets >= 75,000/mcL (within 28 days prior to registration)

  • Hemoglobin (Hgb) >= 8 g/ dL (within 28 days prior to registration)

  • 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

  • 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

  • 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)

  • 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)

  • 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

  • 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

  • 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

  • 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

Studieplan

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Behandling
  • Tilldelning: Randomiserad
  • Interventionsmodell: Parallellt uppdrag
  • Maskning: Ingen (Open Label)

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Experimentell: 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.
Läkemedel: Cyclophosphamide

Given IV

Andra namn:
  • Cytoxan
  • CTX
  • (-)-cyklofosfamid
  • 2H-1,3,2-oxazafosforin, 2-[bis(2-kloretyl)amino]tetrahydro-, 2-oxid, monohydrat
  • Carloxan
  • Ciclofosfamida
  • Ciklofosfamid
  • Cicloxal
  • Clafen
  • Claphene
  • CP monohydrat
  • CYKLO-cell
  • Cykloblastin
  • Cyklofosfam
  • Cyklofosfamidmonohydrat
  • Cyclophosphamidum
  • Cyklofosfan
  • Cyklofosfanum
  • Cyclostin
  • Cyklostin
  • Cytofosfan
  • Fosfaseron
  • Genoxal
  • Genuxal
  • Ledoxina
  • Mitoxan
  • Neosar
  • Revimmune
  • Syklofosfamid
  • WR- 138719
  • Asta B 518
  • B-518
  • WR-138719
  • B 518
  • B518
  • WR 138719
  • WR138719
  • Frindovyx
Läkemedel: Doxorubicin Hydrochloride

Given IV

Andra namn:
  • Adriamycin
  • 5,12-naftacendion, 10-[(3-amino-2,3,6-trideoxi-alfa-L-lyxo-hexopyranosyl)oxi]-7,8, 9,10-tetrahydro-6,8,11-trihydroxi -8-(hydroxiacetyl)-1-metoxi-, hydroklorid, (8S-cis)- (9Cl)
  • ADM
  • Adriacin
  • Adriamycinhydroklorid
  • Adriamycin PFS
  • Adriamycin RDF
  • ADRIAMYCIN, HYDROKLORID
  • Adriblastina
  • Adriblastin
  • Adrimedac
  • Chloridrato de Doxorrubicina
  • DOX
  • DOXO-CELL
  • Doxolem
  • Doxorubicin HCl
  • Doxorubicin.HCl
  • Doxorubin
  • Farmiblastina
  • FI 106
  • FI-106
  • hydroxidaunorubicin
  • Rubex
  • FI106
Läkemedel: Prednisone

Given PO

Andra namn:
  • Deltasone
  • Orasone
  • 61-kortison
  • 1,2-dehydrokortison
  • Adasone
  • Cortancyl
  • Dacortin
  • DeCortin
  • Decortisyl
  • Decorton
  • Delta 1-kortison
  • Delta-Dome
  • Deltacortene
  • Deltakortison
  • Deltadehydrokortison
  • Deltison
  • Delta
  • Econosone
  • Lisacort
  • Meprosona-F
  • Metakortandracin
  • Meticorten
  • Ofisolona
  • Panafcort
  • Panasol-S
  • Paracort
  • Perrigo Prednison
  • PRED
  • Predicor
  • Predicorten
  • Prednicen-M
  • Prednicort
  • Prednidib
  • Prednilonga
  • Prediment
  • Prednison Intensol
  • Prednisonum
  • Predniton
  • Promifen
  • Rayos
  • Servisone
  • SK-Prednison
Procedur: Biospecimen Collection

Undergo blood sample collection

Andra namn:
  • Biologisk provsamling
  • Bioprov insamlat
  • Provsamling
  • Provuppsamling
Biologisk: Rituximab

Given IV

Andra namn:
  • Rituxan
  • MabThera
  • ABP 798
  • BI 695500
  • C2B8 monoklonal antikropp
  • Chimär anti-CD20-antikropp
  • CT-P10
  • IDEC-102
  • IDEC-C2B8
  • IDEC-C2B8 monoklonal antikropp
  • Monoklonal antikropp IDEC-C2B8
  • PF-05280586
  • Riabni
  • Rituximab ABBS
  • Rituximab ARRX
  • Rituximab Biosimilar ABP 798
  • Rituximab Biosimilar BI 695500
  • Rituximab Biosimilar CT-P10
  • Rituximab Biosimilar GB241
  • Rituximab Biosimilar IBI301
  • Rituximab Biosimilar JHL1101
  • Rituximab Biosimilar PF-05280586
  • Rituximab Biosimilar RTXM83
  • Rituximab Biosimilar SAIT101
  • Rituximab Biosimilar SIBP-02
  • rituximab biosimilar TQB2303
  • Rituximab PVVR
  • Rituximab-arrx
  • Rituximab-pvvr
  • RTXM83
  • Ruxience
  • Truxima
  • Rixathon
  • Ikgdar
  • Mabtas
  • Rituximab-abbs
  • BI-695500
  • BI695500
  • Blitzima
  • IDEC 102
  • IDEC102
  • PF 05280586
  • PF05280586
  • Ritemvia
  • Rituximab-blit
  • Rituximab-rit
  • Rituximab-rixa
  • Rituximab-rixi
  • Riximyo
  • RTXM 83
  • RTXM-83
  • ABP-798
  • ABP798
  • CT P10
  • CTP10
  • GP 2013
  • GP-2013
  • GP2013
  • Rituximab Biosimilar GP2013
Läkemedel: Vincristine Sulfate

Given IV

Andra namn:
  • Oncovin
  • Kyocristine
  • Leurocristine Sulfate
  • Leurocristine, sulfat
  • Vincasar
  • Vincosid
  • Vincrex
  • Vinkristin, sulfat
Övrig: Questionnaire Administration

Ancillary studies

Procedur: Echocardiography Test

Undergo ECHO

Andra namn:
  • Ekokardiografi
  • EC
Procedur: Multigated Acquisition Scan

Undergo MUGA

Andra namn:
  • Blood Pool Scan
  • Jämviktsradionuklidangiografi
  • Gated Blood Pool Imaging
  • MUGA
  • Radionuklidventrikulografi
  • RNVG
  • SYMA-skanning
  • Synchronized Multigated Acquisition Scanning
  • MUGA Scan
  • Multi-Gated Acquisition Scan
  • Radionuklid Ventrikulogram Scan
  • Gated Heart Pool Scan
  • RNV Scan
Procedur: Positron Emission Tomography

Undergo PET-CT

Andra namn:
  • Medicinsk avbildning, Positron Emission Tomografi
  • SÄLLSKAPSDJUR
  • Djur Scan
  • Positron Emission Tomography Scan
  • Positronemissionstomografi
  • PT
  • Positronemissionstomografi (förfarande)
Biologisk: Rituximab and Hyaluronidase Human

Given SC

Andra namn:
  • Rituxan Hycela
  • Rituximab Plus Hyaluronidas
  • Rituximab/Hyaluronidas
  • Rituximab/Hyaluronidase Human
Procedur: Computed Tomography

Undergo PET-CT

Andra namn:
  • CT
  • KATT
  • Datortomografi
  • Beräknad axiell tomografi
  • Datoriserad axialtomografi
  • tomografi
  • Datoriserad axiell tomografi (förfarande)
  • Datortomografi (CT) skanning
  • Diagnostisk kattskanning
  • Diagnostisk kattskanningstjänsttyp
Läkemedel: Oral Azacitidine

Given PO

Andra namn:
  • Onureg
  • CC-486
  • Azacitidin Oral
  • CC 486
  • CC486
Aktiv 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.
Läkemedel: Cyclophosphamide

Given IV

Andra namn:
  • Cytoxan
  • CTX
  • (-)-cyklofosfamid
  • 2H-1,3,2-oxazafosforin, 2-[bis(2-kloretyl)amino]tetrahydro-, 2-oxid, monohydrat
  • Carloxan
  • Ciclofosfamida
  • Ciklofosfamid
  • Cicloxal
  • Clafen
  • Claphene
  • CP monohydrat
  • CYKLO-cell
  • Cykloblastin
  • Cyklofosfam
  • Cyklofosfamidmonohydrat
  • Cyclophosphamidum
  • Cyklofosfan
  • Cyklofosfanum
  • Cyclostin
  • Cyklostin
  • Cytofosfan
  • Fosfaseron
  • Genoxal
  • Genuxal
  • Ledoxina
  • Mitoxan
  • Neosar
  • Revimmune
  • Syklofosfamid
  • WR- 138719
  • Asta B 518
  • B-518
  • WR-138719
  • B 518
  • B518
  • WR 138719
  • WR138719
  • Frindovyx
Läkemedel: Doxorubicin Hydrochloride

Given IV

Andra namn:
  • Adriamycin
  • 5,12-naftacendion, 10-[(3-amino-2,3,6-trideoxi-alfa-L-lyxo-hexopyranosyl)oxi]-7,8, 9,10-tetrahydro-6,8,11-trihydroxi -8-(hydroxiacetyl)-1-metoxi-, hydroklorid, (8S-cis)- (9Cl)
  • ADM
  • Adriacin
  • Adriamycinhydroklorid
  • Adriamycin PFS
  • Adriamycin RDF
  • ADRIAMYCIN, HYDROKLORID
  • Adriblastina
  • Adriblastin
  • Adrimedac
  • Chloridrato de Doxorrubicina
  • DOX
  • DOXO-CELL
  • Doxolem
  • Doxorubicin HCl
  • Doxorubicin.HCl
  • Doxorubin
  • Farmiblastina
  • FI 106
  • FI-106
  • hydroxidaunorubicin
  • Rubex
  • FI106
Läkemedel: Prednisone

Given PO

Andra namn:
  • Deltasone
  • Orasone
  • 61-kortison
  • 1,2-dehydrokortison
  • Adasone
  • Cortancyl
  • Dacortin
  • DeCortin
  • Decortisyl
  • Decorton
  • Delta 1-kortison
  • Delta-Dome
  • Deltacortene
  • Deltakortison
  • Deltadehydrokortison
  • Deltison
  • Delta
  • Econosone
  • Lisacort
  • Meprosona-F
  • Metakortandracin
  • Meticorten
  • Ofisolona
  • Panafcort
  • Panasol-S
  • Paracort
  • Perrigo Prednison
  • PRED
  • Predicor
  • Predicorten
  • Prednicen-M
  • Prednicort
  • Prednidib
  • Prednilonga
  • Prediment
  • Prednison Intensol
  • Prednisonum
  • Predniton
  • Promifen
  • Rayos
  • Servisone
  • SK-Prednison
Procedur: Biospecimen Collection

Undergo blood sample collection

Andra namn:
  • Biologisk provsamling
  • Bioprov insamlat
  • Provsamling
  • Provuppsamling
Biologisk: Rituximab

Given IV

Andra namn:
  • Rituxan
  • MabThera
  • ABP 798
  • BI 695500
  • C2B8 monoklonal antikropp
  • Chimär anti-CD20-antikropp
  • CT-P10
  • IDEC-102
  • IDEC-C2B8
  • IDEC-C2B8 monoklonal antikropp
  • Monoklonal antikropp IDEC-C2B8
  • PF-05280586
  • Riabni
  • Rituximab ABBS
  • Rituximab ARRX
  • Rituximab Biosimilar ABP 798
  • Rituximab Biosimilar BI 695500
  • Rituximab Biosimilar CT-P10
  • Rituximab Biosimilar GB241
  • Rituximab Biosimilar IBI301
  • Rituximab Biosimilar JHL1101
  • Rituximab Biosimilar PF-05280586
  • Rituximab Biosimilar RTXM83
  • Rituximab Biosimilar SAIT101
  • Rituximab Biosimilar SIBP-02
  • rituximab biosimilar TQB2303
  • Rituximab PVVR
  • Rituximab-arrx
  • Rituximab-pvvr
  • RTXM83
  • Ruxience
  • Truxima
  • Rixathon
  • Ikgdar
  • Mabtas
  • Rituximab-abbs
  • BI-695500
  • BI695500
  • Blitzima
  • IDEC 102
  • IDEC102
  • PF 05280586
  • PF05280586
  • Ritemvia
  • Rituximab-blit
  • Rituximab-rit
  • Rituximab-rixa
  • Rituximab-rixi
  • Riximyo
  • RTXM 83
  • RTXM-83
  • ABP-798
  • ABP798
  • CT P10
  • CTP10
  • GP 2013
  • GP-2013
  • GP2013
  • Rituximab Biosimilar GP2013
Läkemedel: Vincristine Sulfate

Given IV

Andra namn:
  • Oncovin
  • Kyocristine
  • Leurocristine Sulfate
  • Leurocristine, sulfat
  • Vincasar
  • Vincosid
  • Vincrex
  • Vinkristin, sulfat
Övrig: Questionnaire Administration

Ancillary studies

Procedur: Echocardiography Test

Undergo ECHO

Andra namn:
  • Ekokardiografi
  • EC
Procedur: Multigated Acquisition Scan

Undergo MUGA

Andra namn:
  • Blood Pool Scan
  • Jämviktsradionuklidangiografi
  • Gated Blood Pool Imaging
  • MUGA
  • Radionuklidventrikulografi
  • RNVG
  • SYMA-skanning
  • Synchronized Multigated Acquisition Scanning
  • MUGA Scan
  • Multi-Gated Acquisition Scan
  • Radionuklid Ventrikulogram Scan
  • Gated Heart Pool Scan
  • RNV Scan
Procedur: Positron Emission Tomography

Undergo PET-CT

Andra namn:
  • Medicinsk avbildning, Positron Emission Tomografi
  • SÄLLSKAPSDJUR
  • Djur Scan
  • Positron Emission Tomography Scan
  • Positronemissionstomografi
  • PT
  • Positronemissionstomografi (förfarande)
Biologisk: Rituximab and Hyaluronidase Human

Given SC

Andra namn:
  • Rituxan Hycela
  • Rituximab Plus Hyaluronidas
  • Rituximab/Hyaluronidas
  • Rituximab/Hyaluronidase Human
Procedur: Computed Tomography

Undergo PET-CT

Andra namn:
  • CT
  • KATT
  • Datortomografi
  • Beräknad axiell tomografi
  • Datoriserad axialtomografi
  • tomografi
  • Datoriserad axiell tomografi (förfarande)
  • Datortomografi (CT) skanning
  • Diagnostisk kattskanning
  • Diagnostisk kattskanningstjänsttyp

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
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)
Tidsram: Up to completion of cycle 6

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
Progression-free survival (PFS) (Phase II)
Tidsram: 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

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
Overall survival (Phase III)
Tidsram: From date of registration to date of death due to any cause, assessed up to 2 years

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

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Metabolic complete response (CR)
Tidsram: Up to end of cycle 6 or end of treatment

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
Incidence of adverse events
Tidsram: Until disease progression, assessed up to 5 years

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
Overall survival (Phase III)
Tidsram: From date of registration to date of death due to any cause, assessed up to 5 years

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

Andra resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Changes in function (Integrated Correlative Geriatric Assessments Substudy)
Tidsram: From time of randomization up to 24 months after date of registration

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
Frailty status (fit/unfit vs frail) (Integrated Correlative Geriatric Assessments Substudy)
Tidsram: Baseline

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
Frailty status (Integrated Correlative Geriatric Assessments Substudy)
Tidsram: Up to 24 months after date of registration

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

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Sponsor

National Cancer Institute (NCI)

Utredare

  • Huvudutredare: Elizabeth A Brem, SWOG Cancer Research Network

Publikationer och användbara länkar

Den som ansvarar för att lägga in information om studien tillhandahåller frivilligt dessa publikationer. Dessa kan handla om allt som har med studien att göra.

Allmänna publikationer

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart (Faktisk)

20 maj 2021

Primärt slutförande (Beräknad)

1 mars 2027

Avslutad studie (Beräknad)

1 mars 2027

Studieregistreringsdatum

Först inskickad

13 mars 2021

Först inskickad som uppfyllde QC-kriterierna

13 mars 2021

Första postat (Faktisk)

16 mars 2021

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

12 november 2026

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

10 november 2026

Senast verifierad

1 oktober 2026

Mer information

Termer relaterade till denna studie

Ytterligare relevanta MeSH-villkor

Andra studie-ID-nummer

  • NCI-2020-01256
  • U10CA180888 (U.S.S. NIH-anslag/kontrakt)
  • NCI-2020-01256 (Registeridentifierare: CTRP (Clinical Trial Reporting Program))
  • S1918 (Annan identifierare: CTEP)
  • S1918 (Annan identifierare: SWOG)

Plan för individuella deltagardata (IPD)

Planerar du att dela individuella deltagardata (IPD)?

JA

IPD-planbeskrivning

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.

Läkemedels- och apparatinformation, studiedokument

Studerar en amerikansk FDA-reglerad läkemedelsprodukt

Ja

Studerar en amerikansk FDA-reglerad produktprodukt

Nej

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