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The Response Study of Yt90-Zevalin in Patients With Diffuse Large B-cell Lymphoma After 6 Cycles of CHOP

This study is ongoing, but not recruiting participants.
Sponsor:
Collaborator:
Bayer
Information provided by (Responsible Party):
Mahidol University
ClinicalTrials.gov Identifier:
NCT00440583
First received: February 26, 2007
Last updated: October 4, 2011
Last verified: October 2011
History of Changes
  Purpose

The purpose of this study is to determine the effective of Yt90-Zevalin therapy in patients with diffuse large B-cell lymphoma that have achieved at least an unconfirmed partial remission after 6 cycles of CHOP therapy.


Condition Intervention Phase
Patients With Diffuse Large B-cell Lymphoma Who Achieved at Least Unconfirmed Partial Remission After 6 Cycles of CHOP Therapy.
 Drug: Ibritumomab tiuxetan (Zevalin)
Drug: Yttrium 90
 Phase 2

Study Type: Interventional
Study Design: Allocation: Non-Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: Yt90 Zevalin & Combination Chemotherapy in Treating Patients With Stage II,Stage III,or Stage IV Diffuse Large B-cell Lymphoma

Resource links provided by NLM:

MedlinePlus related topics: Lymphoma
U.S. FDA Resources

Further study details as provided by Mahidol University:

Primary Outcome Measures:
  • - Determine the 2-years progression-free survival of consolidation therapy with Yt90-Zevalin. [ Time Frame: 2 year ] [ Designated as safety issue: Yes ]

Secondary Outcome Measures:
  • Determine the response duration(time to progression)after therapy. [ Time Frame: 2 year ] [ Designated as safety issue: Yes ]
  • Determine safety and tolerability of Yt90-Zevalin consolidation therapy. [ Time Frame: 2 year ] [ Designated as safety issue: Yes ]

Estimated Enrollment: 30
Study Start Date: September 2006
Estimated Study Completion Date: March 2012
Primary Completion Date: September 2011 (Final data collection date for primary outcome measure)
Detailed Description:

Diffuse large B-cell lymphomas (DLBCL) are the most common lymphoid neoplasm and account for 30% to 40% of adult non-Hodgkin lymphomas (NHL). DLCBL is a potentially curable disease. The ultimate goals of introducing new modality treatments such as monoclonal antibody (Ab)-targeted therapy are to increase complete remission (CR) rate and prolong event-free survival and overall survival.In phase II trials, it was shown that in DLBL the addition of rituximab to CHOP was feasible, with an increase in ORR, including CR and an increase in the OS and PFS in patients with DLBL.2 The benefit of R-CHOP was consistent across all subgroups of patients tested, including good and poor risks according to IPI and independent of younger than 70 years and older than 70 years of age.

Recently, new radiolabeled monoclonal antibodies have been established in the therapy of malignant lymphoma which can induce high remission rates. Radiolabeled antibodies are particularly effective as lymphoma cells are highly sensitive to radiation. In addition, the local emission of radiolabeled antibodies is able to destroy cells in close proximity to the bound antibody (bystander effect) therefore circumventing the problem of limited perfusion of bulky or poorly vascularized tumors.Ibritumomab is covalently linked to the tiuxetan chelate and radiolabeled with Yt90, producing Yt90-ibritumomab tiuxetan (Yt90-Zevalin). To optimize biodistribution, Rituximab is given prior to the radiolabeled antibody. Yt90-ibritumomab-tiuxetan-treatment was compared to a standard course of Rituximab. ORR in the Yt90-ibritumomab tiuxetan group was significantly higher than ORR in the Rituximab group (80% vs. 56% according to International Workshop Response criteria or 73% vs. 47% according to protocol-defined evaluation of response).

Since radioimmunotherapy represents a significant advance over unlabeled immunotherapy for the treatment of patients with B-cell non-Hodgkin's lymphoma, it is worthwhile to study the consolidation therapy with Yt90-ibritumomab tiuxetan (Yt90-Zevalin) in patients who achieved at least unconfirmed partial remission after 6 cycles of CHOP therapy.

  Eligibility

Ages Eligible for Study:   18 Years to 75 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Histologically confirmed, CD 20 positive diffuse large B-cell lymphoma, meeting 1 of the following stage criteria: Bulky stage II disease, Stage III disease, Stage IV disease at the initial diagnosis.
  • Bidimensionally measurable disease
  • Age 18 - 75 Years
  • Performance status Zubrod 0-2
  • Less than 20,000/mcL circulating lymphoid cells on WBC differential count
  • Adequate sections AND a paraffin block OR ≥ 10 unstained sections from the original diagnostic specimen available
  • Needle aspiration or cytology are not considered adequate
  • No clinical evidence of CNS involvement by lymphoma
  • No prior diagnosis of indolent lymphoma
  • No histologic transformation
  • Life expectancy : Not specified
  • Hepatic : Not specified
  • Renal : Not specified

  • Cardiovascular

    • Ejection fraction ≥ 45% by MUGA OR
    • No significant abnormalities by echocardiogram
  • Pulmonary : No requirement for continuous supplemental oxygen

  • Other

    • All adult patients of reproductive potential must use contraception during and for 6 months after completion of study treatment
    • No other malignancy within the past 5 years except adequately treated basal cell or squamous cell skin cancer, stage I or II cancer in complete remission, or carcinoma in situ of the cervix
    • No known HIV positive
  • Written informed consent

  • PRIOR CONCURRENT THERAPY:

    • Biologic therapy : No prior antibody therapy for lymphoma
    • Chemotherapy : 6 cycles of CHOP
    • Endocrine therapy : Not specified
    • Radiotherapy : No prior radiotherapy for lymphoma
    • Surgery : No prior solid organ transplantation

Exclusion Criteria:

  • Previous antineoplastic treatment other than the 6 cycles of CHOP for the initial treatment of DLBCL
  • Positive HIV serology
  • Positive serology of HCV with the presence of HCV RNA of chronic hepatitis
  • Positive serology of HBV with the presence of HBV RNA of chronic hepatitis
  • Serum creatinine or bilirubin > 2.5 x upper limit of normal
  • Active uncontrolled infection
  • Concurrent severe and/or uncontrolled medical disease which could compromise the participation in the study
  • Patients in whom more than 25% of the bone marrow has been infiltrated by lymphoma cells
  • Patients with platelet counts <100,000/µl or neutrophil counts < 1500/µl
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00440583

Locations
Thailand
Siriraj Hospital, Mahidol University
Bangkoknoi, Bangkok, Thailand, 10700
Sponsors and Collaborators
Mahidol University
Bayer
Investigators
Principal Investigator: Surapol Issaragrisil, M.D. Siriraj Hospital
  More Information

No publications provided

Responsible Party: Mahidol University
ClinicalTrials.gov Identifier: NCT00440583     History of Changes
Other Study ID Numbers: TH011101
Study First Received: February 26, 2007
Last Updated: October 4, 2011
Health Authority: Thailand: Food and Drug Administration

Keywords provided by Mahidol University:
CHOP-Z

Additional relevant MeSH terms:
Lymphoma
Lymphoma, B-Cell
Lymphoma, Large B-Cell, Diffuse
Neoplasms by Histologic Type
Neoplasms
Lymphoproliferative Disorders
Lymphatic Diseases
 Immunoproliferative Disorders
Immune System Diseases
Lymphoma, Non-Hodgkin
Antibodies, Monoclonal
Immunologic Factors
Physiological Effects of Drugs
Pharmacologic Actions

ClinicalTrials.gov processed this record on May 23, 2013