Lymphoma Clinical Trial
Official title:
A Phase II Study of Dose Augmented Rituximab and Ice for Patients With Primary Refractory and Poor Risk Relapsed Aggressive B-Cell Non-Hodgkin's Lymphoma Undergoing Second-Line Therapy Prior to Stem Cell Transplantation
The purpose of this research is to study a treatment program for patients with aggressive
lymphoma that has come back after initial or first therapy (called relapsed) or that has not
responded to first therapy (called refractory). Since 1993, we have used a combination of
chemotherapy known as ICE (Ifosfamide, Carboplatin, and Etoposide) for your type of
lymphoma. In many patients, this treatment helps the disease to shrink before giving
high-dose therapy and autologous stem cell transplant (ASCT). Only patients who respond to
these types of treatments have a chance of their disease going away (remission) with an
ASCT. In 1999, we studied the same treatment but added another medicine for your type of
lymphoma, Rituximab (Rituxan), to the ICE treatment (RICE). More patients had lymphoma
shrinkage from this treatment (chemosensitive disease) than with ICE alone. These patients
then received high dose therapy and autologous stem cell transplant and have an improved
chance of having a remission.
ICE chemotherapy is standard chemotherapy used at Memorial Sloan-Kettering Cancer Center.
However, it is different in this study because of the higher doses. We are testing higher
doses of RICE treatment for patients in this study.
In our current study in Hodgkin's lymphoma, we are giving these higher doses of ICE (called
augmented ICE) to patients who also have higher risk. We hope to show in this study that by
using Rituximab and augmented ICE that we can improve your ability to achieve a remission
(that is, to have the disease go away).
The purpose of this study is to determine if dose escalation of the rituximab-ICE (RICEesc)
program can improve the overall response rate of patients with primary refractory or poor
risk relapsed aggressive B cell lymphoma. R-ICEesc will be administered for 2 cycles with
peripheral blood progenitor cells (PBPCs) collected after cycle 2.
A two-stage design will be employed, such that the study will be terminated if in the first
cohort of patients it appears that the overall response rate is <50% or if >25% patients
fail to mobilize at least 2 x 106 CD34+ cells/kg.
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Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
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