Dose-Adjusted EPOCH Chemotherapy and Rituximab (CD20+) in Previously Untreated Aggressive Non-Hodgkin's Lymphoma
Diffuse Large B-Cell Lymphoma (DLBCL)
Primary Mediastinal Large B-cell Lymphoma
Anaplastic Large-Cell Lymphoma
Gray Zone Lymphoma
|Study Design:||Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
|Official Title:||Dose-Adjusted EPOCH Chemotherapy and Rituximab (CD20+) in Adults and Children With Previously Untreated Patients With Aggressive Non-Hodgkin's Lymphoma|
- Overall response and PFS [ Time Frame: Time of progression ]
|Study Start Date:||April 1993|
|Estimated Study Completion Date:||March 2022|
|Estimated Primary Completion Date:||March 2019 (Final data collection date for primary outcome measure)|
Experimental: Arm A
EPOCH-R every 3 weeks for 6 cycles.
Combination chemotherapy given with Rituximab (EPOCH-R) IV every 3 weeks for 6 cycles.Biological: Rituximab
Rituximab given on Day 1 of combination chemotherapy (EPOCH-R) every 3 weeks for 6 cycles.
The treatment of the intermediate and aggressive non-Hodgkin's lymphomas in adults and children commonly induces complete responses in a sizable fraction of the treated population, and about 2/3 of the complete responders appear to have prolonged disease-free survival.
The present study assesses the activity and tolerability in previously untreated patients of a regimen of EPOCH infusional chemotherapy given intensively with G-CSF support.
Assess complete response (CR) and progression-free survival (PFS) of dose-adjusted EPOCH-Rituximab (DA-EPOCH-R) with G-CSF in agressive B-cell lymphomas.
Non-Hodgkin's lymphomas in the following categories: diffuse large B-cell to include
gray zone lymphoma and follicular center cell grade IIIB, anaplastic large cell, aggressive
T-cell lymphomas and Burkitt Lymphoma.
Patients greater than or equal to 12 years old.
Stages II, III, IV for all subtypes, and Stage I for bulky (> 5 cm) primary mediastinal
lymphomas or Burkitt Lymphoma.
No prior systemic chemotherapy.
This study will estimate the complete response rate of a group of previously untreated patients and the extent to which EPOCH infusional drug delivery accompanied by a hematopoietic growth factor can increase the dose intensity of treatment.
Patients receive prednisone orally for 5 days, a 96 hour infusion of vincristine, doxorubicin, and etoposide, and a bolus of cyclophosphamide on day 5.
Cycles are repeated every 21 days for a total of 6-8 cycles.
Patients with CD20 expressing tumors (i.e. mature B-cell lymphomas) will also receive rituximab, the humanized monoclonal antibody against the CD20 receptor on day 1 of each cycle.
A total of 348 patients will be enrolled on this protocol.
Please refer to this study by its ClinicalTrials.gov identifier: NCT00001337
|United States, Maryland|
|National Institutes of Health Clinical Center, 9000 Rockville Pike|
|Bethesda, Maryland, United States, 20892|
|Principal Investigator:||Wyndham H Wilson, M.D.||National Cancer Institute (NCI)|