Lymphoma Clinical Trial
Official title:
Phase II Trial of Rituximab in Combination With CHOP Chemotherapy in Patients With Previously Untreated Intermediate or High Grade Non-Hodgkin's Lymphoma
RATIONALE: Monoclonal antibodies such as rituximab can locate cancer cells and either kill
them or deliver cancer-killing substances to them without harming normal cells. Drugs used
in chemotherapy use different ways to stop cancer cells from dividing so they stop growing
or die. Combining more than one chemotherapy drug with rituximab may kill more cancer cells.
PURPOSE: Phase II trial to study the effectiveness of rituximab plus combination
chemotherapy in treating patients who have intermediate-grade or high-grade non-Hodgkin's
lymphoma.
OBJECTIVES: I. Determine the rate of complete response and partial response in patients with
intermediate or high grade non-Hodgkin's lymphoma treated with rituximab plus
cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP). II. Determine the
toxicity of this regimen in these patients. III. Determine the disease-free and overall
survival, time to response, and time to disease progression in patients treated with this
regimen.
OUTLINE: This is a multicenter study. Patients are stratified according to the number of
risk factors (0-2 vs 3-5). Risk factors include age (no greater than 60 vs greater than 60),
tumor stage (II vs III or IV), number of extranodal sites (no more than 1 vs more than 1),
performance status (0-1 vs 2-4), and serum LDH level (no greater than normal vs greater than
normal). Patients receive rituximab IV on day 1; cyclophosphamide, doxorubicin, and
vincristine IV on day 3; and oral prednisone on days 3-7. Patients over 60 also receive
filgrastim (G-CSF) subcutaneously beginning on day 4 and continuing until blood counts
recover (all other patients receive G-CSF as secondary prophylaxis). Treatment continues
every 3 weeks for 4 courses in the absence of disease progression or unacceptable toxicity.
Patients who respond receive 2 more courses. Patients who have no measurable disease after 6
courses receive rituximab IV once weekly for 4 consecutive weeks. This treatment continues
every 6 months for 4 courses in the absence of disease progression or unacceptable toxicity.
Patients who have measurable disease after 6 courses of chemotherapy receive 2 more courses
for a maximum of 8 courses of CHOP, followed by maintenance therapy with rituximab (as
described above). Patients are followed every 6 months for 2 years.
PROJECTED ACCRUAL: Approximately 100 patients will be accrued for this study.
;
Primary Purpose: Treatment
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