Diffuse Large-Cell Lymphoma Clinical Trial
Official title:
Randomized Study of ACVBP Plus Rituximab Versus CHOP Plus Rituximab in Patients Aged From 18 to 59 Years With Diffuse Large B-cell Lymphoma and a Age-adjusted IPI of 1.
This study is a multicentric randomized trial evaluating the efficacy of the combination ACVBP+rituximab compared to the combination of CHOP+rituximab in patients aged from 18 to 59 years with diffuse large B-cell lymphoma and one factor of the age-adjusted international prognostic index (IPI).
This phase III multicentric open label randomized study is based on the results of previous
LNH 93-5 and LNH98-5 studies.
The LNH93-5 study has shown that the ACVBP regimen gave a longer EFS (39% vs 29% at 5 years,
p=0.005) and a longer overall survival (46% vs 38% at 5 years, p=0.036) than CHOP in
patients aged between 61 and 69 with an IPI score ≥1. However ACVBP had a more important
toxicity and a higher treatment related mortality (13% vs 7%, p<0.01), specially after 65
years. In younger patients ACVBP is better tolerated.
The addition of Rituximab to standard CHOP (R-CHOP) has been shown in LNH98-5 study to
improve complete remission rate (CR), event-free survival (EFS) and overall survival (OS) in
elderly patients with B-DLCL. Considering only patients with an aa-IPI score of 1, the 2
year EFS was 75% in the R-CHOP group as compared with 42% in the CHOP group.
This study is designed to test whether addition of rituximab to ACVBP is better than R-CHOP
in patients younger than 60. Primary endpoint is event-free survival, we expect a gain in 2
years-EFS of 10% in R-ACVBP group as compared with R-CHOP group.
This study is a multicentric, phase III open-label, randomized trial evaluating the efficacy
of ACVBP+rituximab compared to CHOP+rituximab in patients aged from 18 to 59 years with non
previously treated diffuse large B-cell lymphoma and one factor of the age-adjusted
international prognostic index
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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