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Y90 Ibritumomab Tiuxetan Post R-CHOP Chemotherapy for Advanced Stage Follicular Lymphoma (ZEVISS)

This study has been completed.
Information provided by (Responsible Party):
Dr. Neil Berinstein, Sunnybrook Health Sciences Centre Identifier:
First received: August 11, 2011
Last updated: June 15, 2016
Last verified: June 2016
The primary objective of this study is to establish in a prospective phase II study the efficacy of 90Yttrium ibritumomab tiuxetan (90Y-RIT) after first line induction immuno-chemotherapy with R-CHOP in patients with high-risk advanced stage follicular non-Hodgkin's lymphoma, as assessed by the complete response rate.

Condition Intervention Phase
Follicular Lymphoma
Biological: Y90 Ibritumomab Tiuxetan RIT
Phase 2

Study Type: Interventional
Study Design: Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: Phase II Trial of Y90 Ibritumomab Tiuxetan Post Rituximab-Cyclophosphamide, Doxobrubicn, Vincristine and Prednisone (R-CHOP) Chemotherapy for Newly Diagnosed Patients With Advanced Stage Follicular Lymphoma

Resource links provided by NLM:

Further study details as provided by Sunnybrook Health Sciences Centre:

Primary Outcome Measures:
  • The primary endpoint for this study is the complete response rate measured 3 months after the dose of 90Y-RIT [ Time Frame: 3 months after the dose of 90Y-RIT ]
    The primary endpoint for the study is the final complete response (CR) rate, defined according to International Working Group criteria 24, and measured 3 months after completion of the treatment (measured from day 1 of the 90Y-RIT therapy). Hence, CR implies the elimination of all lymphoma manifestations including complete disappearance of all detectable clinical and radiographic evidence of disease and all disease-related symptoms if present before therapy.

Secondary Outcome Measures:
  • toxicities [ Time Frame: entry into trial until 6 weeks post 90Y ibritumomab tiuxetan treatment (week 30) ]
    Toxicity associated with R-CHOP induction and 90Y ibritumomab tiuxetan treatment will be assessed by monitoring the incidence, severity, and type of adverse events. Adverse events will be recorded according to the NCI CTCAE . In addition, changes in physical examination findings, vital signs, and clinical laboratory results (complete blood count, differential, and chemistry) will be documented.

  • Conversion of partial responses to complete responses [ Time Frame: 6 weeks post 90Y ibritumomab tiuxetan treatment ]
    CTT assessment before and after 90Y ibritumomab tiuxetan treatment - Bone marrow aspiration and biopsies in those patients with positive Bone marrows prior to 90Y ibritumomab tiuxetan treatment.

  • Minimal residual disease [ Time Frame: For two years post study entry ]
    Peripheral blood will be assessed every 6 months for the two years from entry into the trial and subjected to PCR analysis for evidence of lymphoma cells with the t(14;18)

  • Time to treatment failure [ Time Frame: Two years of the study duration ]
    Evidence of progression will be assessed every 6 months for two years from study entry clinically and radiologically to determine the date of disease progression

  • Overall survival [ Time Frame: two years of study duration ]
    Survival will be assessed continually throughout the two year study period

Enrollment: 34
Study Start Date: May 2007
Study Completion Date: May 2016
Primary Completion Date: May 2016 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Y90 Ibritumomab Tiuxetan
Addition of Y90 Ibritumomab Tiuxetan RIT to CHOP-R treatment for follicular lymphoma-patients also receive maintenance Rituximab every 3 months for 2 years after the Y90 Ibritumomab Tiuxetan
Biological: Y90 Ibritumomab Tiuxetan RIT
40 mCi/kg
Other Name: Zevalin

  Show Detailed Description


Ages Eligible for Study:   18 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Age greater than or equal to 18 years.
  • Biopsy demonstration of a CD20+ follicular non-Hodgkin's lymphoma diagnosed according to the World Health Organization (WHO) classification (grade I, II, or IIIa).
  • Staging demonstration of advanced stage disease (stage III or IV) according to the Ann Arbor staging system.
  • Intermediate or high-risk prognostic score (2-5 points) according to the follicular lymphoma international prognostic index (FLIPI).
  • Adequate performance status (less than or equal to 2) according to the Eastern Cooperative Oncology Group (ECOG) (Zubrod) scale.
  • No prior radiotherapy or systemic therapy, including chemotherapy or immunotherapy (rituximab).
  • Bi-dimensional measurable disease by physical examination or radiographic evaluation (disease measurements at least 1.5 cm x 1.5 cm) or assessable disease on bone marrow evaluation.
  • Clinical criteria for therapeutic intervention, as previously reported by Hiddeman, including one of: the presence of B-symptoms, bulky disease (mediastinal lymphomas >7.5 cm or other lymphomas >5 cm in maximal diameter), an impairment of normal hematopoesis with hemoglobin <10g/mm3, granulocytes <1500/mm3, or platelets <100,000/mm3, and/or a rapidly progressive disorder.
  • Patient consent must be obtained according to the Sunnybrook Health Sciences Centre Research Ethics Board requirements. A sample consent form is given in Appendix I. The patient must sign the consent form prior to registration.
  • Patients must be accessible for treatment and follow up. Patients registered on this trial must complete their therapy with 90Y Ibritumomab Tiuxetan at the participating centre. Induction chemotherapy with R-CHOP should also be completed at the participating centre, but exceptions can be made according to the discretion of the centre's primary investigator.
  • Protocol treatment is to begin within 5 working days of patient registration

Exclusion Criteria:

  • Pregnancy or women who intend to breast-feed during the study period.
  • Follicular non-Hodgkin's lymphoma grade IIIb histology, according to the World Health Organization (WHO) classification.
  • Known human immunodeficiency virus infection or hepatitis B viral infection.
  • Life expectancy less than or equal to 3 months, according to physician judgement.
  • Evidence of left ventricular (LV) dysfunction (ejection fraction less than or equal to 50%). Demonstration of LV function is required in patients over the age of 60 or in patients with a prior history of hypertension, congestive heart failure, peripheral vascular disease, cerebrovascular disease, coronary artery disease, or cardiac arrhythmia.
  • Serum creatinine, alkaline phosphatase, or total bilirubin >2.5 times the upper limit of the normal value, unless clearly related to lymphoma.
  • Concurrent uncontrolled medical disease, including severe congestive heart failure, myocardial infarction within 6 months prior to enrollment, severe chronic renal failure, or active infection, with the severity of disease judged according to the discretion of the treating physician.
  • Patients with a history of other malignancies, except: (1) adequately treated non-melanoma skin cancer, curatively treated in-situ cancer of the cervix, or (2) other solid tumours curatively treated with no evidence of disease for > 5 years
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Please refer to this study by its identifier: NCT01446562

Canada, Ontario
Sunnybrook Health Sciences Centre, Odette Cancer Centre
Toronto, Ontario, Canada, M4N 3M5
Sponsors and Collaborators
Sunnybrook Health Sciences Centre
Principal Investigator: Neil L Berinstein, MD, FRCP(C) Sunnybrook Health Sciences Centre, Odette Cancer Centre
  More Information

Responsible Party: Dr. Neil Berinstein, Medical Oncologist, Sunnybrook Health Sciences Centre Identifier: NCT01446562     History of Changes
Other Study ID Numbers: ZEVISS
Study First Received: August 11, 2011
Last Updated: June 15, 2016

Additional relevant MeSH terms:
Lymphoma, Follicular
Neoplasms by Histologic Type
Lymphoproliferative Disorders
Lymphatic Diseases
Immunoproliferative Disorders
Immune System Diseases
Lymphoma, Non-Hodgkin
Antibodies, Monoclonal
Immunologic Factors
Physiological Effects of Drugs processed this record on April 21, 2017