Lymphoma Clinical Trial
Official title:
Rituximab and Combination Chemotherapy in Treating Patients With Newly Diagnosed Stage II, Stage III, or Stage IV Hodgkin's Lymphoma
RATIONALE: 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. 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. Giving rituximab together with combination chemotherapy may kill more
cancer cells.
PURPOSE: This phase II trial is studying how well giving rituximab together with combination
chemotherapy works in treating patients with newly diagnosed stage II, stage III, or stage IV
Hodgkin's lymphoma.
OBJECTIVES:
Primary
- Investigate plasma DNA biomarkers, including plasma clonal immunoglobulin DNA, tumor
suppressor gene methylation, and Epstein-Barr virus DNA, in patients receiving rituximab
and doxorubicin hydrochloride, bleomycin, vinblastine, and dacarbazine (ABVD) for newly
diagnosed stage II-IV classical Hodgkin's lymphoma.
- Characterize the impact of rituximab on these markers.
- Characterize the relationship between marker detection and clinical outcome.
Secondary
- Estimate the event-free survival of patients with newly diagnosed Hodgkin's lymphoma
treated with rituximab and ABVD.
- Assess the presence of Hodgkin's lymphoma stem cells in peripheral blood mononuclear
cells at baseline, after treatment with rituximab, and after treatment with ABVD.
- Assess whether plasma DNA biomarkers add information to fludeoxyglucose F 18 positron
emission tomography (FDG-PET) in assessing tumor response.
OUTLINE: Patients receive doxorubicin hydrochloride IV, vinblastine IV, bleomycin IV, and
dacarbazine IV (ABVD) on days 1 and 15 of all courses. Patients also receive rituximab IV on
days -6, 1, 8, 15, and 22 of ABVD course 1 and on day 1 only of ABVD courses 2, 4, and 6.
Treatment repeats every 28 days for 6-8 courses in the absence of disease progression or
unacceptable toxicity.
Patients with bulky disease may undergo radiotherapy.
Plasma samples are obtained during treatment for investigation of tumor markers (e.g.,
immunoglobulin rearrangement, patterns of DNA methylation, and the presence of Epstein-Barr
virus DNA). Patients undergo fludeoxyglucose F18 positron emission tomography periodically
during the study.
PROJECTED ACCRUAL: A total of 35 patients will be accrued for this study.
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