Lymphoma Clinical Trial
Official title:
A Phase II Trial of Oxaliplatin, Cytosine Arabinoside, Dexamethasone With Rituxan (ROAD) in Patients With Relapsed CD20+ B-Cell Non-Hodgkins Lymphoma
The goals of this protocol are to determine the effect of oxaliplatin, cytosine arabinoside, and dexamethasone with Rituxan (ROAD) as treatment for patients with relapsed CD20+ B-cell non-Hodgkins lymphoma (NHL).
Patients with B-cell NHL that comes back after chemotherapy are typically treated with
cisplatin, high-dose cytosine arabinoside and dexamethasone (DHAP) or other platinum-based
treatments. Recent studies have shown a 37% response rate in patients with large cell
lymphoma to immunotherapy with Rituxan. Patients <75 years old and in otherwise good health
may be candidates for high dose therapy with stem cell rescue if they have disease that
remains sensitive to chemotherapy. Typically, patients are administered 2 cycles of DHAP or
ICE (ifosfamide, carboplatin, and etoposide) and, if the disease responds, they proceed to
high-dose therapy with stem cell support. Even patients not considered transplant candidates
are also often treated with DHAP or ICE or other salvage regimens. It is likely that the
response rate with DHAP alone in patients eligible for transplant is <59%. Recent studies
have attempted to improve on the results from DHAP or ICE by combining them with rituxan.
NCCTG has just completed a phase II trial of R-DHAP. Preliminary results of the R-ICE
protocol indicate a higher response rate and longer time to progression than traditional ICE.
The problem with DHAP and ICE is that they are associated with significant side effects and
specifically, with DHAP the cisplatin often causes kidney problems. In fact, some patients
who are considered transplant eligible before DHAP may become transplant ineligible simply by
the kidney side effects. Clearly, there is a need to improve the quality of life of patients
undergoing treatment and to avoid the kidney problems.
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