Lymphoma Clinical Trial
Official title:
Phase II Trial Of Yttrium-90-Ibritumomab Tiuxetan (Zevalin®) Radioimmunotherapy After Cytoreduction With ESHAP Chemotherapy In Patients With Relapsed Follicular Non-Hodgkin's Lymphoma
RATIONALE: Drugs used in chemotherapy work in different ways to stop the growth of cancer
cells, either by killing the cells or by stopping them from dividing. Monoclonal antibodies,
such as rituximab, can block cancer growth in different ways. Some block the ability of
cancer cells to grow and spread. Others find cancer cells and help kill them or carry
cancer-killing substances to them. Radiolabeled monoclonal antibodies, such as yttrium Y 90
ibritumomab tiuxetan, can find cancer cells and carry cancer-killing substances to them
without harming normal cells. Giving combination chemotherapy together with rituximab and
yttrium Y 90 ibritumomab tiuxetan may kill more cancer cells.
PURPOSE: This phase II trial is studying giving combination chemotherapy followed by
rituximab and yttrium Y 90 ibritumomab tiuxetan to see how well it works in treating patients
with relapsed stage II, stage III, or stage IV follicular non-Hodgkin lymphoma.
OBJECTIVES:
Primary
- To evaluate the 1-year progression-free survival of patients with relapsed stage II-IV
follicular non-Hodgkin lymphoma treated with ESHAP chemotherapy for cytoreduction
followed by yttrium Y 90 ibritumomab tiuxetan radioimmunotherapy.
- To evaluate the median time to progression in these patients.
Secondary
- To evaluate the overall and complete response rates in patients treated with this
regimen.
OUTLINE:
- ESHAP chemotherapy: Patients receive ESHAP chemotherapy comprising etoposide IV over 1
hour, methylprednisolone IV, cisplatin IV on days 1-4, and cytarabine IV over 2 hours on
day 1. Treatment repeats every 28 days for 2 courses in the absence of disease
progression or unacceptable toxicity.
- Radioimmunotherapy: Between 4-6 weeks after completion of ESHAP chemotherapy, patients
receive rituximab IV followed by indium In 111 ibritumomab tiuxetan IV over 10 minutes
on day 1. Patients with < 25% bone marrow involvement and expected biodistribution
proceed to treatment. Patients receive rituximab IV followed by yttrium Y 90 ibritumomab
tiuxetan IV over 10 minutes on day 7, 8, or 9.
After completion of study treatment, patients are followed periodically.
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