LymphomaPhase 3NCT00053768
Combination Chemotherapy Followed By Radiation Therapy in Treating Patients With Aggressive Non-Hodgkin's Lymphoma
A Phase 3 study testing filgrastim, EPOCH regimen and cyclophosphamide in people with Lymphoma, run by German High-Grade Non-Hodgkin's Lymphoma Study Group at 175 sites in 2 countries.
Trial summary
RATIONALE: Drugs used in chemotherapy use different ways to stop cancer cells from dividing so they stop growing or die. Combining more than one drug and giving the drugs in different ways may kill more cancer cells. Radiation therapy uses high-energy x-rays to damage cancer cells. Read more about this study
- Who is it for?
- Ages 18 to 60 years
- Conditions the study is for
- Lymphoma
- What is being tested?
- filgrastim, EPOCH regimen and cyclophosphamide
- Type of treatment
- Injection or infusion, Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 392 participants
- Where
- 175 sitesin 2 countries
- Study dates
- Apr 2002to 5 Dec 2006
- Phase
- Phase 3
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 60 years
- All sexes
- No healthy volunteers
- Adult
DISEASE CHARACTERISTICS:
- Histologically confirmed aggressive non-Hodgkin's lymphoma
- Previously untreated disease
- Favorable prognosis
- International Prognostic Index score of 0-1
- No more than 25% marrow involvement
PATIENT CHARACTERISTICS:
Age
- 18 to 60
Performance status
- ECOG 0-3 OR
- Karnofsky 40-100%
Life expectancy
- Not specified
Hematopoietic
- Platelet count at least 100,000/mm^3
- WBC at least 2,500/mm^3
Hepatic
- No active hepatitis infection
Renal
- Not specified
Other
- HIV negative
- Not pregnant or nursing
- No relevant accompanying disease
- No other concurrent malignancy
- No contraindications to any study medications
- No prior noncompliance by patient
PRIOR CONCURRENT THERAPY:
Biologic therapy
- Not specified
Chemotherapy
- No prior chemotherapy
Endocrine therapy
- Not specified
Radiotherapy
- No prior radiotherapy
Surgery
- Not specified
Other
- No other concurrent participation in another treatment study
Trial locations and contacts
175 sites in 2 countries.
175 sites in 2 countries
Germany173 sites
Haematologisch Onkologische Praxis
Aachen, 52070
Klinikum St. Marien
Amberg, D-92224
Gemeinschaftspraxis Fuer Innere Medizin, Haematologie Und Internistische Onkologie
Ansbach, D-91522
Specialist Practice for Oncology
Aschaffenburg, 63739
II. Medizinische Klinik
Aschaffenburg, D-63739
Haematologische Praxis
Augsburg, 86150
Hamatologische/Onkologische Gemeinschaftspraxis - Augsburg
Augsburg, 86150
Klinikum Augsburg
Augsburg, D-86156
Kreiskrankenhaus Aurich
Aurich, D-26603
Kreiskrankenhaus
Bad Hersfeld, D-36251
Humaine - Clinic
Bad Saarow, D-15526
Krankenhaus Hohe Warte Mediziniche Klinik
Bayreuth, D-95445
Onkolog - Haematolog Schwerpunktpraxis
Berlin, 13357
Charite - Campus Charite Mitte
Berlin, D-13125
Hospital Complex Bernburg
Bernburg, D-06406
Krankenhaus Bietigheim
Bietigheim, D-74319
Saint Agnes Hospital
Bocholt, D-46397
Saint Josef Hospital
Bochum, D-44791
Knappschaft Krankenhaus
Bochum, D-44892
Medizinische Poliklinik
Bonn, D-53111
Rheinische Friedrich-Wilhelms-Universitat
Bonn, D-53113
DIAKO Ev. Diakonie Krankenhaus gGmbH
Bremen, D-28239
Medizinische Klinik Am Lukas - Krankenhaus
Bünde, D-32257
General Hospital
Celle, D-29223
Hospital Kuchwald Chemnitz
Chemnitz, D-09113
Praxis Fuer Haematologie Internistische Onkologie
Cologne, D-50677
Medizinische Universitaetsklinik I at the University of Cologne
Cologne, D-50924
Study site
Cologne-Kalk, D-51105
Carl - Thiem - Klinkum Cottbus
Cottbus, D-03048
Klinikum Darmstadt
Darmstadt, D-64283
Saint Johannes Hospital Dortmund
Dortmund, D-44137
Universitatsklinikum Carl Gustav Carus
Dresden, D-01307
St. Johannes Hospital - Medical Klinik II
Duisburg, D-47166
Franz Hospital Dulmen
Dülmen, D-48249
Florence-Nightingale-Krankenhause, Deaconess Kaiserswerth
Düsseldorf, D-40489
Hans - Susemihl - Krankenhaus
Emden, D-26721
Klinikum Erfurt
Erfurt, 99089
St. Antonius Hospital
Eschweiler, 52249
Universitaetsklinikum Essen
Essen, D-45147
Evangelisches Krankenhaus Essen-Werden
Essen, D-45239
Krankenhaus Nordwest
Frankfurt, 60488
Klinikum Frankfurt (Oder) GmbH
Frankfurt (Oder), 15236
Evang. Deaconess Hospital Freiburg
Freiburg im Breisgau, D-79110
Municipal Hospital Complex
Fulda, 36043
Robert - Koch Hospital
Gehrden, 30989
Centre for Internal Medicine Gießen
Giessen, D-35392
Universitaetsklinikum Göttingen
Göttingen, D-37075
Klinik Fuer Innere Medizin, Hematology/Oncology, Ernst Moritz Armdt Universitaet
Greifswald, D-17489
Staedtisches Klinikum Guetersloh
Gütersloh, 33332
St. Marien Hospital - Katholisches Krankenhaus Hagen gGmbH
Hagen, 58095
Allgemeines Krankenhaus Hagen
Hagen, D-58095
Krankenhaus St. Elisabeth und St. Barbara
Halle, 06110
Krankenhaus Martha-Maria Halle-Doelau gGmbH
Halle, 06120
Universitaetsklinikum Halle
Halle, D-06097
Study site
Hamburg, 20095
Universitaetsklinikum Hamburg-Eppendorf
Hamburg, D-20251
Asklepios Klinik Nord Heidberg
Hamburg, D-22413
Allgemeines Krankenhaus Altona
Hamburg, D-22763
Haematologisch-Onkologische Praxis Altona
Hamburg, D-22767
Evangelische Krankenhaus Hamm
Hamm, D-59063
Study site
Hanover, 30159
Krankenhaus Siloah - Medizinische Klinik II
Hanover, 30449
Henriettenstiftung Krankenhaus
Hanover, 30559
Medizinische Hochschule Hannover
Hanover, 30625
Oncology Specialists Clinic
Harrislee, D-24955
Medizinische Universitaetsklinik und Poliklinik
Heidelberg, 69115
Thoraxklinik Heidelberg
Heidelberg, D-69126
Regional Hospital Heidenheim
Heidenheim, 89522
Regional Hospital Am Plattenwald - Bad Friedrichhall
Heilbronn, D-74172
Klinikum Herford
Herford, 32049
Marienhospital at Ruhr University Bochum
Herne, 44625
Privatklinik Dr. R. Schindlbeck GmbH & Co. KG
Herrsching am Ammersee, D-82211
Onkologische Schwerpunktpraxis
Hildesheim, 31134
Evang. Hospital
Holzminden, D-37603
Medical University Hospital Homburg
Homburg, 66421
Universitaetsklinikum des Saarlandes
Homburg, D-66424
Hospital Complex Hoyerswerda
Hoyerswerda, D-02977
Gemeinschaftspraxis Innere Medizin
Jena, D-07743
Klinikum der Friedrich-Schiller Universitaet Jena
Jena, D-07747
Municipal Hospital Complex of the University
Kaiserslautern, D-67655
Staedtisches Klinikum Karlsruhe gGmbH
Karlsruhe, D-76133
Red Cross Hospital Kassel
Kassel, D-34121
Staedtisches Krankenhaus Kiel
Kiel, D-23116
Praxis fuer Haematologie und Onkologie
Koblenz, D-56068
Stiftungsklinikum Mittelrhein - Gesundheitszentrum Evangelisches Stift Sankt Martin Koblenz gGmbH
Koblenz, D-56068
Kliniken der Stadt Koeln gGmbH - Krankenhaus Merheim
Koln-Merheim, D-51109
Leonardis Clinic
Kornwestheim, D-70806
Klinikum Krefeld GmbH
Krefeld, D-47805
Frankenwald Klinik
Kronach, D-96317
Caritas - Krakenhaus Lebach
Lebach, D-66822
Medizinische Klinik und Poliklinik III - Universitaetsklinikum Leipzig
Leipzig, D-04103
University Leipzig Clinic of Internal Medicine
Leipzig, D-04103
Study site
Leipzig, D-04103
Staedtisches Klinikum "St. Georg" Leipzig
Leipzig, D-04129
Klinikum Lippe - Lemgo
Lemgo, D-32657
St. Vincenz Hospital Limburg
Limburg, D-65549
St. Bonifatius Hospital Lingen
Lingen, D-49808
Dreifaltigkeits Hospital
Lippstadt, D-59555
Universitaetsklinikum Schleswig-Holstein - Campus Luebeck
Lübeck, D-23538
Klinikum Ludwigsburg
Ludwigsburg, D-71460
Klinikum der Stadt Ludwigshafen am Rhein
Ludwigshafen, D-67063
St. Marien Hospital Ludwighafen
Ludwigshafen, D-67067
Staedtisches Klinikum Magdeburg - Altstadt
Magdeburg, D-39104
Universitaetsklinkum Magdeburg der Otto-von-Guericke-Universitaet Magdeburg
Magdeburg, D-39120
Johannes Gutenberg University
Mainz, D-55131
German CML Study Group
Manheim, D-68305
Study site
Marburg, D-35037
Philipps-Universitaet Marburg Klinikum
Marburg, D-35043
Regional Hospital Mayen
Mayen, D-56727
Klinikum Minden
Minden, D-32423
Study site
Minden, D-32427
Ev. Hospital Bethesda
Monchenglabach, D-41061
Hospital Maria-Hilf II
Mönchengladbach, D-41063
Study site
Monchenglasbach/Rheydt, D-41239
Evangelisches Krankenhaus - Mülheim
Mülheim, D-45466
St. Marien Hospital - Muelheim an der Ruhr
Mülheim, D-45468
Kreiskrankenhaus Muenchberg
Münchberg, D-95213
Munich Oncologic Practice at Elisenhof
München, D-80335
Klinikum der Universitaet Muenchen - Innenstadt Campus
München, D-80336
Krankenhaus Muenchen Schwabing
Munich, D-80804
Klinikum der Universitaet Muenchen - Grosshadern Campus
Munich, D-81377
Medizinische Klinik und Poliklinik A - Universitaetsklinikum Muenster
Münster, D-48129
Regional Hospital Neumarkt
Neumarkt, D-92318
Staedtisches Klinikum Neunkirchen gGmbH
Neunkirchen, D-66538
Lukaskrankenhaus Neuss
Neuss, D-41464
Klinikum Nuernberg - Klinikum Nord
Nuremberg, D-90340
Klinikum Offenburg
Offenburg, D-77654
Hematologische Praxis
Oldenburg, D-26121
Ev. Hospital Oldenburg
Oldenburg, D-26122
Klinikum Oldenburg
Oldenburg, D-26133
Paracelsus - Klinik Osnabrück
Osnabrück, D-49076
Municipal Hospital Complex
Pforzheim, D-49 7231 9690
Klinikum Ernst Von Bergmann
Potsdam, D-14467
Kreiskrankenhaus Radebeul
Radebeul, D-01445
Krankenhaus St. Elisabeth - Ravensburg
Ravensburg, D-88212
Klinikum der Universitaet Regensburg
Regensburg, D-93042
Hematologische Onkologische Praxis
Regensburg, D-93047
Krankenhaus Barmherzige Brueder Regensburg
Regensburg, D-93049
Jakobi Krankenhaus
Rheine, D-48431
Klinik und Poliklinik fuer Innere Medizin - Universitaet Rostock
Rostock, D-18057
Klinik und Poliklinik fuer Strahlentherapie - Universitaetsklinikum Rostock
Rostock, D-18057
Study site
Rostock, D-18257
Caritasklinik St. Theresia
Saarbrücken, D-66113
Schwerpunktpraxis fuer Haematologie und Onkologie
Saarbrücken, D-66113
St. Elizabeth-Klinik Saarlouis
Saarlouis, D-66713
Martin - Luther Hospital
Schleswig, D-24837
Deaconess Hospital
Schwäbisch Hall, D-74523
Leopoldina - Krankenhaus
Schweinfurt, D-97422
Evang. Jung-Stilling Hospital
Siegen, D-57074
St. Lukas - Clinic Solingen
Solingen, D-42697
Klinik fuer Onkologie - Katharinenhospital Stuttgart
Stuttgart, D-70174
Diakonie Klinikum Stuttgart
Stuttgart, D-70176
Klinikum Stuttgart - Buergerhospital
Stuttgart, D-70191
Hospital Bad Cannstatt
Stuttgart, D-70374
Robert-Bosch-Krankenhaus
Stuttgart, D-70376
St. Elisabeth Hospital Thuine
Thuine, D-49832
Regional Hospital Traunstein
Traunstein, D-83278
Krankenanstalt Mutterhaus der Borromaerinnen
Trier, D-54290
Study site
Trier, D-54290
Krankenhaus Der Barmherzigen Brueder
Trier, D-54292
Hospital Tutzing
Tutzing, D-82327
Comprehensive Cancer Center Ulm at Universitaetsklinikum Ulm
Ulm, D-89081
Ev. Hospital Unna
Unna, D-59403
St. Marienhospital - Vechta
Vechta, D-49377
Klinikum Der Stadt Villingen - Schwenningen
Villingen-Schwenningen, D-78045
Regional Hospital Waldbrol
Waldbröl, D-51545
Hospital Wetzler
Wetzlar, D-35578
Deutsche Klinik fuer Diagnostik
Wiesbaden, D-65191
Dr. Horst-Schmidt-Kliniken
Wiesbaden, D-65199
Ev. Hospital Witten-Herdecke
Witten, D-58455
Kliniken St. Antonius
Wuppertal, D-42283
University Wurzburg
Würzburg, D-97070
Municipal Hospital Complex Zwickau
Zwickau, D-08060
Switzerland2 sites
UniversitaetsSpital Zuerich
Zurich, CH-8091
City Hospital Triemli
Zurich, D-8063
About this study
Official title: Randomised Trial Comparing Chemotherapy Mit CHOEP (Cyclophosphamid, Doxorubicin, Vincristin, Etoposid Und Prednison) In 21-Day Intervals In Standard And Escalated Doses In Patients Aged 18-60 Years Of Age With Aggresive Non-Hodgkin-Lymphomas Favourable Prognoses
RATIONALE: Drugs used in chemotherapy use different ways to stop cancer cells from dividing so they stop growing or die. Combining more than one drug and giving the drugs in different ways may kill more cancer cells. Radiation therapy uses high-energy x-rays to damage cancer cells. It is not yet known which combination chemotherapy regimen followed by radiation therapy is more effective in treating aggressive non-Hodgkin's lymphoma.
PURPOSE: This randomized phase III trial is studying two combination chemotherapy regimens followed by radiation therapy to compare how well they work in treating patients with aggressive non-Hodgkin's lymphoma.
Read the detailed description
OBJECTIVES:
- Compare the efficacy of standard-dose vs high-dose cyclophosphamide, doxorubicin, vincristine, etoposide, and prednisone followed by radiotherapy, in terms of time to treatment failure, in patients with aggressive non-Hodgkin's lymphoma.
- Compare the acute and long-term toxic effects of these regimens in these patients.
- Compare the complete response rate, survival and tumor control, and disease-free survival in patients treated with these regimens.
- Analyze the time to relapse after radiotherapy in these patients.
OUTLINE: This is a randomized, open-label, multicenter study. Patients are stratified according to LDH levels (no greater than upper limit of normal [ULN] vs greater than ULN), initial bulky disease (yes vs no), stage (I or II vs II or IV), ECOG performance status (0 or 1 vs 2 or 3), and participating center. Patients are randomized to 1 of 2 treatment arms as follows:
- Arm I (Standard dose): Patients receive cyclophosphamide IV, doxorubicin IV, and vincristine IV on day 1; etoposide IV on days 1-3; and oral prednisone on days 1-5 (CHOEP) in standard doses.
- Arm II (Escalated dose): Patients receive high-dose CHOEP as in arm I. Patients also receive filgrastim (G-CSF) subcutaneously on days 6-12.
In both arms, treatment repeats every 21 days for up to 6 courses in the absence of disease progression or unacceptable toxicity.
After completion of CHOEP chemotherapy, patients with initial bulky disease or extranodal involvement undergo radiotherapy 5 days a week for 4 weeks.
Patients who undergo radiotherapy are followed at 2 months after radiotherapy. All patients (including those who undergo radiotherapy) are followed every 3 months for 2 years and then every 6 months for 3 years.
PROJECTED ACCRUAL: A total of 389 patients were accrued for this study.
- Conditions
- Lymphoma
- Being tested
- filgrastim, EPOCH regimen, cyclophosphamide, doxorubicin hydrochloride, etoposide
- Keywords
- contiguous stage II grade 3 follicular lymphoma, noncontiguous stage II grade 3 follicular lymphoma, stage I grade 3 follicular lymphoma, stage III grade 3 follicular lymphoma, stage IV grade 3 follicular lymphoma, contiguous stage II adult diffuse mixed cell lymphoma, noncontiguous stage II adult diffuse mixed cell lymphoma, stage I adult diffuse mixed cell lymphoma, stage III adult diffuse mixed cell lymphoma, stage IV adult diffuse mixed cell lymphoma, contiguous stage II adult diffuse large cell lymphoma, contiguous stage II adult Burkitt lymphoma, noncontiguous stage II adult diffuse large cell lymphoma, noncontiguous stage II adult Burkitt lymphoma, stage I adult diffuse large cell lymphoma, stage I adult Burkitt lymphoma, stage III adult diffuse large cell lymphoma, stage III adult Burkitt lymphoma, stage IV adult diffuse large cell lymphoma, stage IV adult Burkitt lymphoma
- Medical subject headings
- Lymphoma, Lymphoma, Follicular, Lymphoma, Non-Hodgkin, Lymphoma, Large B-Cell, Diffuse, Burkitt Lymphoma, Lymphoma, Large-Cell, Immunoblastic, Precursor Cell Lymphoblastic Leukemia-Lymphoma, Lymphoma, Mantle-Cell
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
filgrastimBiological
EPOCH regimenDrug
cyclophosphamideDrug
etoposideDrug
prednisoneDrug
radiation therapyRadiation
| Study group | Role | What they receive |
|---|---|---|
| CHOEP-21 | Active comparator | CHOEP-21-Schema:
Cyclophosphamid (750 mg/m2 i.v. d1), Doxorubicin (50 mg/m2 i.v. d1), Vincristin (2 mg i.v. d1), Etoposid (100 mg/m² i.v. d1-3), Prednison (100 mg p.o. d1-5) Receives: Biological: filgrastim; Drug: EPOCH regimen; Drug: cyclophosphamide; Drug: doxorubicin hydrochloride; Drug: etoposide; Drug: prednisone; Drug: vincristine sulfate; Radiation: radiation therapy |
| high CHOEP-21 | Experimental | High-CHOEP-21-Schema:
Cyclophosphamid (1400 mg/m2 i.v. d1), Doxorubicin (32,5 mg/m2 i.v. d1+2), Vincristin (2 mg i.v. d1), Etoposid (175 mg/m² i.v. d1-3), Prednison (100 mg p.o. d1-5) Receives: Biological: filgrastim; Drug: EPOCH regimen; Drug: cyclophosphamide; Drug: doxorubicin hydrochloride; Drug: etoposide; Drug: prednisone; Drug: vincristine sulfate; Radiation: radiation therapy |
What is being measured
The primary outcome is the main question the study is designed to answer.
Time to treatment failure (TTF) at first relapse
Time to Treatment failure using the Kaplan_Meier-Method
Measured: 3 years within study and periodically after study completion
Secondary outcomes (4)
Complete response rate at first relapse
Number of complete remission (CR) and unconfirmed complete Remission (CRu)
Measured: 3 years within study and periodically after study completion
Survival time
Time till death (whatever cause)
Measured: 3 years within study and periodically after study completion
Tumor control
Calcution of treatment Duration using the Kaplan-Meier method
Measured: thought the treatment
Disease-free survival
Time of disease-free survivial
Measured: 3 years within study and periodically after study completion
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted6 Feb 2003 (estimated)
- Study startApr 2002
- Primary completion5 Dec 2006
- Study completion5 Dec 2006
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (2)Papers the sponsor has linked to this study.
- Other trials for LymphomaStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 3
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 392 participants (actual)
Sponsor and investigators
- Lead sponsor
- German High-Grade Non-Hodgkin's Lymphoma Study Group
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Michael G.M. Pfreundschuh, MD, Study chair, Universitaetsklinikum des Saarlandes
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT00053768
- Sponsor's protocol ID
- CDR0000269371
- Other IDs
- DSHNHL-1999-2, EU-20242
- Status last verified
- May 2021
- First submitted
- 5 Feb 2003
- Last updated
- 18 May 2021
- Results posted
- No
Publications
Trumper L, Zwick C, Ziepert M, Hohloch K, Schmits R, Mohren M, Liersch R, Bentz M, Graeven U, Wruck U, Hoffmann M, Metzner B, Hasenclever D, Loeffler M, Pfreundschuh M; German High-Grade Non-Hodgkin's Lymphoma Study Group (DSHNHL). Dose-escalated CHOEP for the treatment of young patients with aggressive non-Hodgkin's lymphoma: I. A randomized dose escalation and feasibility study with bi- and tri-weekly regimens. Ann Oncol. 2008 Mar;19(3):538-44. doi: 10.1093/annonc/mdm497. Epub 2008 Jan 22.
PubMed 18212092Pfreundschuh M, Zwick C, Zeynalova S, Duhrsen U, Pfluger KH, Vrieling T, Mesters R, Mergenthaler HG, Einsele H, Bentz M, Lengfelder E, Trumper L, Rube C, Schmitz N, Loeffler M; German High-Grade Non-Hodgkin's Lymphoma Study Group (DSHNHL). Dose-escalated CHOEP for the treatment of young patients with aggressive non-Hodgkin's lymphoma: II. Results of the randomized high-CHOEP trial of the German High-Grade Non-Hodgkin's Lymphoma Study Group (DSHNHL). Ann Oncol. 2008 Mar;19(3):545-52. doi: 10.1093/annonc/mdm514. Epub 2007 Dec 6.
PubMed 18065407
Study at a glance
From the registry record, last updated by the sponsor on 18 May 2021. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Randomised Trial Comparing Chemotherapy Mit CHOEP (Cyclophosphamid, Doxorubicin, Vincristin, Etoposid Und Prednison) In 21-Day Intervals In Standard And Escalated Doses In Patients Aged 18-60 Years Of Age With Aggresive Non-Hodgkin-Lymphomas Favourable Prognoses
- ClinicalTrials.gov ID
- NCT00053768
- Acronym / sponsor ID
- CDR0000269371
- Conditions
- Lymphoma
- Keywords
- contiguous stage II grade 3 follicular lymphoma, noncontiguous stage II grade 3 follicular lymphoma, stage I grade 3 follicular lymphoma, stage III grade 3 follicular lymphoma, stage IV grade 3 follicular lymphoma, contiguous stage II adult diffuse mixed cell lymphoma, noncontiguous stage II adult diffuse mixed cell lymphoma, stage I adult diffuse mixed cell lymphoma
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 392 participants (actual)
- Lead sponsor
- German High-Grade Non-Hodgkin's Lymphoma Study GroupUniversity, hospital or other
- Study start
- Apr 2002
- Primary completion
- 5 Dec 2006 (actual)
- Study completion
- 5 Dec 2006 (actual)
- First posted
- 6 Feb 2003 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
RATIONALE: Drugs used in chemotherapy use different ways to stop cancer cells from dividing so they stop growing or die. Combining more than one drug and giving the drugs in different ways may kill more cancer cells. Radiation therapy uses high-energy x-rays to damage cancer cells. It is not yet known which combination chemotherapy regimen followed by radiation therapy is more effective in treating aggressive non-Hodgkin's lymphoma.
PURPOSE: This randomized phase III trial is studying two combination chemotherapy regimens followed by radiation therapy to compare how well they work in treating patients with aggressive non-Hodgkin's lymphoma.
Detailed description
OBJECTIVES:
- Compare the efficacy of standard-dose vs high-dose cyclophosphamide, doxorubicin, vincristine, etoposide, and prednisone followed by radiotherapy, in terms of time to treatment failure, in patients with aggressive non-Hodgkin's lymphoma.
- Compare the acute and long-term toxic effects of these regimens in these patients.
- Compare the complete response rate, survival and tumor control, and disease-free survival in patients treated with these regimens.
- Analyze the time to relapse after radiotherapy in these patients.
OUTLINE: This is a randomized, open-label, multicenter study. Patients are stratified according to LDH levels (no greater than upper limit of normal [ULN] vs greater than ULN), initial bulky disease (yes vs no), stage (I or II vs II or IV), ECOG performance status (0 or 1 vs 2 or 3), and participating center. Patients are randomized to 1 of 2 treatment arms as follows:
- Arm I (Standard dose): Patients receive cyclophosphamide IV, doxorubicin IV, and vincristine IV on day 1; etoposide IV on days 1-3; and oral prednisone on days 1-5 (CHOEP) in standard doses.
- Arm II (Escalated dose): Patients receive high-dose CHOEP as in arm I. Patients also receive filgrastim (G-CSF) subcutaneously on days 6-12.
In both arms, treatment repeats every 21 days for up to 6 courses in the absence of disease progression or unacceptable toxicity.
After completion of CHOEP chemotherapy, patients with initial bulky disease or extranodal involvement undergo radiotherapy 5 days a week for 4 weeks.
Patients who undergo radiotherapy are followed at 2 months after radiotherapy. All patients (including those who undergo radiotherapy) are followed every 3 months for 2 years and then every 6 months for 3 years.
PROJECTED ACCRUAL: A total of 389 patients were accrued for this study.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| CHOEP-21 | Active comparator | Biological: filgrastim, Drug: EPOCH regimen, Drug: cyclophosphamide, Drug: doxorubicin hydrochloride, Drug: etoposide, Drug: prednisone, Drug: vincristine sulfate, Radiation: radiation therapyCHOEP-21-Schema: Cyclophosphamid (750 mg/m2 i.v. d1), Doxorubicin (50 mg/m2 i.v. d1), Vincristin (2 mg i.v. d1), Etoposid (100 mg/m² i.v. d1-3), Prednison (100 mg p.o. d1-5) |
| high CHOEP-21 | Experimental | Biological: filgrastim, Drug: EPOCH regimen, Drug: cyclophosphamide, Drug: doxorubicin hydrochloride, Drug: etoposide, Drug: prednisone, Drug: vincristine sulfate, Radiation: radiation therapyHigh-CHOEP-21-Schema: Cyclophosphamid (1400 mg/m2 i.v. d1), Doxorubicin (32,5 mg/m2 i.v. d1+2), Vincristin (2 mg i.v. d1), Etoposid (175 mg/m² i.v. d1-3), Prednison (100 mg p.o. d1-5) |
Who may qualify
- Ages
- 18 to 60 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| filgrastim | Biological | CHOEP-21, high CHOEP-21 |
| EPOCH regimen | Drug | CHOEP-21, high CHOEP-21 |
| cyclophosphamide | Drug | CHOEP-21, high CHOEP-21 |
| doxorubicin hydrochloride | Drug | CHOEP-21, high CHOEP-21 |
| etoposide | Drug | CHOEP-21, high CHOEP-21 |
| prednisone | Drug | CHOEP-21, high CHOEP-21 |
| vincristine sulfate | Drug | CHOEP-21, high CHOEP-21 |
| radiation therapy | Radiation | CHOEP-21, high CHOEP-21 |
Primary outcome
Time to treatment failure (TTF) at first relapse
Time frame: 3 years within study and periodically after study completion
Time to Treatment failure using the Kaplan_Meier-Method
4 secondary outcomes
Complete response rate at first relapse
Time frame: 3 years within study and periodically after study completion
Survival time
Time frame: 3 years within study and periodically after study completion
Tumor control
Time frame: thought the treatment
Disease-free survival
Time frame: 3 years within study and periodically after study completion
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 18 May 2021.
- Background: PubMed 18212092Trumper L, Zwick C, Ziepert M, Hohloch K, Schmits R, Mohren M, Liersch R, Bentz M, Graeven U, Wruck U, Hoffmann M, Metzner B, Hasenclever D, Loeffler M, Pfreundschuh M; German High-Grade Non-Hodgkin's Lymphoma Study Group (DSHNHL). Dose-escalated CHOEP for the treatment of young patients with aggressive non-Hodgkin's lymphoma: I. A randomized dose escalation and feasibility study with bi- and tri-weekly regimens. Ann Oncol. 2008 Mar;19(3):538-44. doi: 10.1093/annonc/mdm497. Epub 2008 Jan 22.
- Results publication: PubMed 18065407Pfreundschuh M, Zwick C, Zeynalova S, Duhrsen U, Pfluger KH, Vrieling T, Mesters R, Mergenthaler HG, Einsele H, Bentz M, Lengfelder E, Trumper L, Rube C, Schmitz N, Loeffler M; German High-Grade Non-Hodgkin's Lymphoma Study Group (DSHNHL). Dose-escalated CHOEP for the treatment of young patients with aggressive non-Hodgkin's lymphoma: II. Results of the randomized high-CHOEP trial of the German High-Grade Non-Hodgkin's Lymphoma Study Group (DSHNHL). Ann Oncol. 2008 Mar;19(3):545-52. doi: 10.1093/annonc/mdm514. Epub 2007 Dec 6.
Related trials for Lymphoma
RecruitingPhase 2
Tafasitamab With Acalabrutinib and Venetoclax for the Treatment of Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma
Chronic Lymphocytic Leukemia, Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma
RecruitingPhase 2
Ibrutinib Combination Therapy in Transplant Ineligible Individuals With Newly Diagnosed Primary CNS Lymphoma
Non-hodgkin Lymphoma
RecruitingObservational study
Blood, Urine, and Tissue Collection for Cutaneous Lymphoma, Eczema, and Atopic Dermatitis Research
Cutaneous T-cell Lymphoma, Sezary Syndrome
Not yet recruitingPhase 1
Testing the Addition of an Anti-Cancer Drug, Glofitamab, to the Usual Chemotherapy Treatment (Alternating R-CHOP/R-DHAP) for Previously Untreated Mantle Cell Lymphoma
Ann Arbor Stage II Mantle Cell Lymphoma, Ann Arbor Stage III Mantle Cell Lymphoma
Active, not recruitingPhase 2
Brentuximab Vedotin and Combination Chemotherapy in Treating Patients With CD30-Positive Peripheral T-cell Lymphoma
Adult T-Cell Leukemia/Lymphoma, Anaplastic Large Cell Lymphoma, ALK-Negative
Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Michael G.M. Pfreundschuh, MD study chair
Universitaetsklinikum des Saarlandes
175 sites in 2 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing filgrastim, EPOCH regimen and cyclophosphamide in people with Lymphoma, run by German High-Grade Non-Hodgkin's Lymphoma Study Group at 175 sites in 2 countries.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 18 May 2021. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 175 sites in Germany, Switzerland. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Time to treatment failure (TTF) at first relapse (time frame: 3 years within study and periodically after study completion). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT00053768, which also lists 2 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 18 May 2021.