Stage IV Adult Diffuse Large Cell Lymphoma Clinical Trial
Official title:
Standard Dose Cyclophosphamide, Doxorubicin, Vincristine, Prednisone (CHOP) and Rituximab, or Rituximab and G3139 Phosphorothioate Oligonucleotide (BCL-2 Antisense - NSC-683428) Therapy for Young Patients (< Age 60) With Advanced Stage Diffuse Large B-Cell NHL of Low and Low-Intermediate IPI Risk
This randomized phase II trial is studying rituximab and combination chemotherapy to see how well they work compared to oblimersen, rituximab, and combination chemotherapy in treating patients with advanced diffuse large B-cell non-Hodgkin's lymphoma. 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, such as cyclophosphamide, doxorubicin, vincristine, and prednisone, work in different ways to stop cancer cells from dividing so they stop growing or die. Oblimersen may increase the effectiveness of anticancer drugs by making cancer cells more sensitive to the drugs. Combining rituximab and combination chemotherapy with oblimersen may kill more cancer cells
PRIMARY OBJECTIVES:
I. To estimate the 1-year progression-free survival probability rate in younger patients
with low and low-intermediate IPI risk advanced stage diffuse large B-cell NHL treated with
8-cycles of CHOP-rituximab. (The CHOP-rituximab arm of this study was permanently closed,
effective 10/15/04.) II. To estimate the 1-year progression-free survival probability rate
in younger patients with low and low-intermediate IPI risk advanced stage diffuse large
B-cell NHL treated with 8 cycles of CHOP-rituximab-G3139.
III. To evaluate response (complete, complete unconfirmed, and partial) and toxicity for
these regimens in this patient population. (The CHOP-rituximab arm of this study was
permanently closed, effective 10/15/04.) IV. To estimate the 1-year progression-free
survival and response rate in the subset of patients overexpressing bcl-2 protein.
OUTLINE: This is a randomized, multicenter study. Patients are stratified according to
age-adjusted International Prognostic Index (0 vs 1). Patients are randomized to 1 of 2
treatment arms. (Arm I closed to accrual as of 9/21/04.)
ARM I (closed to accrual as of 9/21/04): Patients receive rituximab IV over 6 hours,
cyclophosphamide IV over 15-45 minutes, doxorubicin IV over 5-20 minutes, and vincristine IV
over 5-15 minutes on day 1 and oral prednisone on days 1-5.
ARM II: Patients receive oblimersen IV continuously on days 1-7; rituximab IV over 6 hours,
cyclophosphamide IV over 15-45 minutes, doxorubicin IV over 5-20 minutes, and vincristine IV
over 5-15 minutes on day 5; and oral prednisone on days 5-10.
In both arms, treatment repeats every 21 days for up to 8 courses in the absence of disease
progression or unacceptable toxicity.
Patients are followed every 3 months for 1 year, every 6 months for 1 year, and then
annually for up to 5 years.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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