LymphomaPhase 2NCT00060346
Rituximab and Combination Chemotherapy in Treating Patients With Newly Diagnosed Waldenstrom's Macroglobulinemia
A Phase 2 study testing rituximab, cyclophosphamide and Doxorubicin in people with Lymphoma, run by Eastern Cooperative Oncology Group at 153 sites in United States.
Trial summary
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 work in different ways to stop cancer cells from dividing so they stop growing or die. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Lymphoma
- What is being tested?
- rituximab, cyclophosphamide and Doxorubicin
- Type of treatment
- Pill or oral medicine, Injection or infusion
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 16 participants
- Where
- 153 sitesUnited States
- Study dates
- 5 Oct 2004to Aug 2012
- Phase
- Phase 2
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
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 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Diagnosis of Waldenstrom's macroglobulinemia confirmed by the presence of the following:
- Bone marrow lymphoplasmacytosis with: > 10% lymphoplasmacytic cells OR aggregates or sheets of one of the following: lymphocytes, plasma cells or lymphoplasmacytic cells on the bone marrow biopsy (measured within 4 weeks prior to registration)
- Measurable disease defined as a quantitative immunoglobulin M (IgM) monoclonal protein of > 1,000 mg/dL obtained within 4 weeks prior to registration
- Cluster of differentiation 20 (CD20) positive stain of bone marrow or lymph node samples obtained < 8 weeks prior to registration
- Impaired bone marrow function due to infiltration by lymphoplasmacytic lymphoma, defined by 1 of the following:
- Hemoglobin no greater than 11 g/dL
Show all 24Show fewer
- Serum viscosity level relative to water of at least 4.0 centipoise
- Absolute neutrophil count at least 1,000/mm^3
- Platelet count at least 75,000/mm^3
- Bilirubin no greater than 3.0 mg/dL
- Aspartate aminotransferase (AST) no greater than 3 times upper limit of normal
- Creatinine no greater than 3.0 mg/dL
- Age of 18 and over
- ECOG (Eastern Cooperative Oncology Group) performance status 0-1
- Must be symptomatic with 1 of the following:
- Clinically significant anemia (hemoglobin no greater than 11 g/dL)
- Bulky lymphadenopathy
- Symptoms attributable to hyperviscosity (e.g., nose bleeding, gingival bleeding, or retinal hemorrhage)
- History of heart disease allowed only if 1 of the following is demonstrated by echocardiography, multigated acquisition scan (MUGA), exercise MUGA, or coronary catheterization:
- Ejection fraction of at least 45%
- Normal fractional shortening of the left ventricle
- Must have been tested for hepatitis B surface antigen within 2 weeks of registration
- Negative pregnancy test
- Fertile patients must use effective contraception
Who cannot join
- Prior treatment for Waldenstrom's macroglobulinemia
- Prior anti-CD20 therapy
- Concurrent steroids exceeding 10 mg prednisone (or equivalent) per day
- Prior irradiation if less than 4 weeks had elapsed prior to registration and the date of last treatment
- Prior anthracyclines
- Prior malignancy except curatively treated basal cell or squamous cell carcinoma of the skin, carcinoma in situ of the cervix, or other cancer curatively treated with surgery alone and from which patient has been disease free for at least 5 years
Show all 11Show fewer
- Active heart disease
- Pregnant or nursing
- Myocardial infarction within the past 3 months
- Congestive heart failure
- Symptomatic ventricular arrhythmia
Trial locations and contacts
153 sites in 1 country.
153 sites in 1 country
United States153 sites
McFarland Clinic, PC
Ames, Iowa, 50010
AnMed Cancer Center
Anderson, South Carolina, 29621
Rush-Copley Cancer Care Center
Aurora, Illinois, 60507
Battle Creek Health System Cancer Care Center
Battle Creek, Michigan, 49017
St. Francis Hospital and Health Centers - Beech Grove Campus
Beech Grove, Indiana, 46107
MeritCare Bemidji
Bemidji, Minnesota, 56601
Mecosta County Medical Center
Big Rapids, Michigan, 49307
CCOP - Montana Cancer Consortium
Billings, Montana, 59101
Hematology-Oncology Centers of the Northern Rockies - Billings
Billings, Montana, 59101
Northern Rockies Radiation Oncology Center
Billings, Montana, 59101
St. Vincent Healthcare Cancer Care Services
Billings, Montana, 59101
Billings Clinic Cancer Center
Billings, Montana, 59107-5100
Billings Clinic - Downtown
Billings, Montana, 59107-7000
Bozeman Deaconess Cancer Center
Bozeman, Montana, 59715
Fairview Ridges Hospital
Burnsville, Minnesota, 55337
St. James Healthcare Cancer Care
Butte, Montana, 59701
Aultman Cancer Center at Aultman Hospital
Canton, Ohio, 44710-1799
Cancer Center of Kansas, PA - Chanute
Chanute, Kansas, 66720
Cleveland Clinic Taussig Cancer Center
Cleveland, Ohio, 44195
Mercy and Unity Cancer Center at Mercy Hospital
Coon Rapids, Minnesota, 55433
Geisinger Medical Center
Danville, Pennsylvania, 17822-0001
Danville Regional Medical Center
Danville, Virginia, 24541
Genesis Regional Cancer Center at Genesis Medical Center
Davenport, Iowa, 52803
Genesis Medical Center - West Campus
Davenport, Iowa, 52804
Grandview Hospital
Dayton, Ohio, 45405
Good Samaritan Hospital
Dayton, Ohio, 45406
David L. Rike Cancer Center at Miami Valley Hospital
Dayton, Ohio, 45409
Samaritan North Cancer Care Center
Dayton, Ohio, 45415
Veterans Affairs Medical Center - Dayton
Dayton, Ohio, 45428
CCOP - Dayton
Dayton, Ohio, 45429
Mercy Capitol Hospital
Des Moines, Iowa, 50307
CCOP - Iowa Oncology Research Association
Des Moines, Iowa, 50309
John Stoddard Cancer Center at Iowa Methodist Medical Center
Des Moines, Iowa, 50309
Medical Oncology and Hematology Associates at John Stoddard Cancer Center
Des Moines, Iowa, 50309
Medical Oncology and Hematology Associates at Mercy Cancer Center
Des Moines, Iowa, 50314
Mercy Cancer Center at Mercy Medical Center - Des Moines
Des Moines, Iowa, 50314
John Stoddard Cancer Center
Des Moines, Iowa, 50316-2301
Cancer Center of Kansas, PA - Dodge City
Dodge City, Kansas, 67801
Fairview Southdale Hospital
Edina, Minnesota, 55435
Cancer Center of Kansas, PA - El Dorado
El Dorado, Kansas, 67042
Elkhart General Hospital
Elkhart, Indiana, 46515
Union Hospital Cancer Program at Union Hospital
Elkton, Maryland, 21921
CCOP - MeritCare Hospital
Fargo, North Dakota, 58122
MeritCare Broadway
Fargo, North Dakota, 58122
Hunterdon Regional Cancer Center at Hunterdon Medical Center
Flemington, New Jersey, 08822
Brooke Army Medical Center
Fort Sam Houston, Texas, 78234
Mercy and Unity Cancer Center at Unity Hospital
Fridley, Minnesota, 55432
Wayne Memorial Hospital, Incorporated
Goldsboro, North Carolina, 27534
Wayne Radiation Oncology
Goldsboro, North Carolina, 27534
CCOP - Grand Rapids
Grand Rapids, Michigan, 49503
Lacks Cancer Center at Saint Mary's Health Care
Grand Rapids, Michigan, 49503
Spectrum Health Hospital - Butterworth Campus
Grand Rapids, Michigan, 49503
Metro Health Hospital
Grand Rapids, Michigan, 49506
Great Falls Clinic - Main Facility
Great Falls, Montana, 59405
Great Falls Clinic
Great Falls, Montana, 59405
St. Peter's Hospital
Helena, Montana, 59601
Penn State Cancer Institute at Milton S. Hershey Medical Center
Hershey, Pennsylvania, 17033-0850
Holland Community Hospital
Holland, Michigan, 49423
Hutchinson Area Health Care
Hutchinson, Minnesota, 55350
Community Oncology Group at Cleveland Clinic Cancer Center
Independence, Ohio, 44131
Indiana University Melvin and Bren Simon Cancer Center
Indianapolis, Indiana, 46202-5289
William N. Wishard Memorial Hospital
Indianapolis, Indiana, 46202
Joliet Oncology-Hematology Associates, Limited - West
Joliet, Illinois, 60435
Borgess Medical Center
Kalamazoo, Michigan, 49001
West Michigan Cancer Center
Kalamazoo, Michigan, 49007-3731
Bronson Methodist Hospital
Kalamazoo, Michigan, 49007
Glacier Oncology, PLLC
Kalispell, Montana, 59901
Kalispell Medical Oncology at KRMC
Kalispell, Montana, 59901
Kalispell Regional Medical Center
Kalispell, Montana, 59901
Charles F. Kettering Memorial Hospital
Kettering, Ohio, 45429
Cancer Center of Kansas, PA - Kingman
Kingman, Kansas, 67068
Howard Community Hospital
Kokomo, Indiana, 46904
Gundersen Lutheran Cancer Center at Gundersen Lutheran Medical Center
La Crosse, Wisconsin, 54601
Center for Cancer Therapy at LaPorte Hospital and Health Services
La Porte, Indiana, 46350
Wilford Hall Medical Center
Lackland Air Force Base, Texas, 78236
Beebe Medical Center
Lewes, Delaware, 19958
Lewistown Hospital
Lewistown, Pennsylvania, 17044
Southwest Medical Center
Liberal, Kansas, 67901
St. Rita's Medical Center
Lima, Ohio, 45801
Meeker County Memorial Hospital
Litchfield, Minnesota, 55355
Arkansas Cancer Research Center at University of Arkansas for Medical Sciences
Little Rock, Arkansas, 72205
HealthEast Cancer Care at St. John's Hospital
Maplewood, Minnesota, 55109
Minnesota Oncology Hematology, PA - Maplewood
Maplewood, Minnesota, 55109
Fox Chase Virtua Health Cancer Program at Virtua Memorial Hospital Marlton
Marlton, New Jersey, 08053
Mercy Cancer Center at Mercy Medical Center - North Iowa
Mason City, Iowa, 50401
Saint Anthony Memorial Health Centers
Michigan City, Indiana, 46360
Middletown Regional Hospital
Middletown, Ohio, 45044
Virginia Piper Cancer Institute at Abbott - Northwestern Hospital
Minneapolis, Minnesota, 55407
Hennepin County Medical Center - Minneapolis
Minneapolis, Minnesota, 55415
Community Medical Center
Missoula, Montana, 59801
Guardian Oncology and Center for Wellness
Missoula, Montana, 59804
Montana Cancer Specialists at Montana Cancer Center
Missoula, Montana, 59807-7877
Montana Cancer Center at St. Patrick Hospital and Health Sciences Center
Missoula, Montana, 59807
Hackley Hospital
Muskegon, Michigan, 49442
CCOP - Christiana Care Health Services
Newark, Delaware, 19713
Cancer Center of Kansas, PA - Newton
Newton, Kansas, 67114
Cancer Center of Kansas, PA - Parsons
Parsons, Kansas, 67357
Cancer Center of Kansas, PA - Pratt
Pratt, Kansas, 67124
Reid Hospital & Health Care Services, Incorporated
Richmond, Indiana, 47374
Hubert H. Humphrey Cancer Center at North Memorial Outpatient Center
Robbinsdale, Minnesota, 55422-2900
Mayo Clinic Cancer Center
Rochester, Minnesota, 55905
Interlakes Oncology/Hematology PC
Rochester, New York, 14623
James P. Wilmot Cancer Center at University of Rochester Medical Center
Rochester, New York, 14642
Rutherford Hospital
Rutherfordton, North Carolina, 28139
Lakeland Regional Cancer Care Center - St. Joseph
Saint Joseph, Michigan, 49085
CCOP - Metro-Minnesota
Saint Louis Park, Minnesota, 55416
Park Nicollet Cancer Center
Saint Louis Park, Minnesota, 55416
Regions Hospital Cancer Care Center
Saint Paul, Minnesota, 55101
HealthEast Cancer Care at St. Joseph's Hospital
Saint Paul, Minnesota, 55102
United Hospital
Saint Paul, Minnesota, 55102
Cancer Center of Kansas, PA - Salina
Salina, Kansas, 67042
Tammy Walker Cancer Center at Salina Regional Health Center
Salina, Kansas, 67401
St. Francis Cancer Center at St. Francis Medical Center
Shakopee, Minnesota, 55379
Welch Cancer Center at Sheridan Memorial Hospital
Sheridan, Wyoming, 82801
Siouxland Hematology-Oncology Associates, LLP
Sioux City, Iowa, 51101
Mercy Medical Center - Sioux City
Sioux City, Iowa, 51104
St. Luke's Regional Medical Center
Sioux City, Iowa, 51104
Avera Cancer Institute
Sioux Falls, South Dakota, 57105
Medical X-Ray Center, PC
Sioux Falls, South Dakota, 57105
Sanford Cancer Center at Sanford USD Medical Center
Sioux Falls, South Dakota, 57117-5039
CCOP - Northern Indiana CR Consortium
South Bend, Indiana, 46601
Memorial Hospital of South Bend
South Bend, Indiana, 46601
Saint Joseph Regional Medical Center
South Bend, Indiana, 46617
CCOP - Upstate Carolina
Spartanburg, South Carolina, 29303
Gibbs Regional Cancer Center at Spartanburg Regional Medical Center
Spartanburg, South Carolina, 29303
Saint Louis University Cancer Center
St Louis, Missouri, 63110
Geisinger Medical Group - Scenery Park
State College, Pennsylvania, 16801
Mount Nittany Medical Center
State College, Pennsylvania, 16803
CCOP - Scott and White Hospital
Temple, Texas, 76508
Our Lady of Mercy Medical Center Comprehensive Cancer Center
The Bronx, New York, 10466
Cotton-O'Neil Cancer Center
Topeka, Kansas, 66604
St. Francis Comprehensive Cancer Center
Topeka, Kansas, 66606
Munson Medical Center
Traverse City, Michigan, 49684
UVMC Cancer Care Center at Upper Valley Medical Center
Troy, Ohio, 45373-1300
Carle Cancer Center at Carle Foundation Hospital
Urbana, Illinois, 61801
CCOP - Carle Cancer Center
Urbana, Illinois, 61801
Cancer Institute of New Jersey at Cooper - Voorhees
Voorhees Township, New Jersey, 08043
Fox Chase Virtua Health Cancer Program at Virtua West Jersey
Voorhees Township, New Jersey, 08043
Ridgeview Medical Center
Waconia, Minnesota, 55387
Cancer Center of Kansas, PA - Wellington
Wellington, Kansas, 67152
Medical Oncology and Hematology Associates - West Des Moines
West Des Moines, Iowa, 50266
Associates in Womens Health, PA - North Review
Wichita, Kansas, 67203
Cancer Center of Kansas, PA - Medical Arts Tower
Wichita, Kansas, 67208
Cancer Center of Kansas, PA - Wichita
Wichita, Kansas, 67214
CCOP - Wichita
Wichita, Kansas, 67214
Via Christi Cancer Center at Via Christi Regional Medical Center
Wichita, Kansas, 67214
Frank M. and Dorothea Henry Cancer Center at Geisinger Wyoming Valley Medical Center
Wilkes-Barre, Pennsylvania, 18711
Wilson Medical Center
Wilson, North Carolina, 27893-3428
Cancer Center of Kansas, PA - Winfield
Winfield, Kansas, 67156
HealthEast Cancer Care at Woodwinds Health Campus
Woodbury, Minnesota, 55125
Minnesota Oncology Hematology, PA - Woodbury
Woodbury, Minnesota, 55125
Cleveland Clinic - Wooster
Wooster, Ohio, 44691
Ruth G. McMillan Cancer Center at Greene Memorial Hospital
Xenia, Ohio, 45385
About this study
Official title: Phase II Pilot Study Of Rituximab Plus CHOP In Patients With Newly Diagnosed Waldenstrom's Macroglobulinemia
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 work in different ways to stop cancer cells from dividing so they stop growing or die. Combining rituximab 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 Waldenstrom's macroglobulinemia.
Read the detailed description
OBJECTIVES:
- Determine the response rate of patients with newly diagnosed Waldenstrom's macroglobulinemia treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone.
- Determine the associated toxic effects of this regimen, specifically the frequency of febrile neutropenia, in these patients.
- Determine the progression-free survival of patients treated with this regimen.
- Correlate baseline cytogenetic features and gene expression profiles with response in patients treated with this regimen.
OUTLINE: This is a pilot, multicenter study.
Patients receive rituximab intravenously (IV) over approximately 4 hours, cyclophosphamide IV over 5-30 minutes, doxorubicin IV over 5-15 minutes, and vincristine IV over 1 minute on day 1. Patients also receive oral prednisone on days 1-5. Treatment repeats every 21 days for up to 6 courses in the absence of disease progression or unacceptable toxicity.
Patients are followed every 3 months for 2 years, every 6 months for 3 years, and then annually for 5 years.
ACTUAL ACCRUAL: A total of 16 patients were accrued for this study.
- Conditions
- Lymphoma
- Being tested
- rituximab, cyclophosphamide, Doxorubicin, Prednisone, Vincristine
- Keywords
- Waldenstrom macroglobulinemia, Rituximab, CHOP
- Medical subject headings
- Lymphoma, Waldenstrom Macroglobulinemia
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
rituximabBiological
Also called IDEC-C2B8, Chimeric anti-CD20 monoclonal antibody, Rituxan, NSC# 687451
Rituximab is given intravenously. The initial rate is 50 mg/hr for the 1st hour. If no toxicity, the rate may be escalated in 50 mg/hr increments at 30-minute intervals to a maximum of 400 mg/hr. If the first dose is well tolerated, the initial rate for subsequent dose is 100 mg/hr, increased in 100 mg/hr increments at 30-minute intervals, not to exceed 400 mg/hr. If the patient experiences fever and rigors, the antibody infusion is discontinued. The severity of the side effects should be evaluated. If the symptoms improve, the infusion is continued initially at half the previous rate. Following the antibody infusion, the intravenous line should be maintained for medications as needed. If there are no complications after one hour of observation, the intravenous line may be discontinued.
cyclophosphamideDrug
Also called Cytoxan, CTX, CPM, Neosar
Cyclophosphamide will be given at a dosage of 750 mg/m² intravenously on day 1 of each cycle (1 cycle =21 days) for 6 cycles. Dose is based on surface area calculated based on actual body weight.
The drug should be administered as a rapid IV infusion over 5 to 30 minutes.
DoxorubicinDrug
Also called Adriamycin, Rubex, Adriamycin RDF, Adriamycin PFS
Doxorubicin will be given intravenously at a dosage of 50 mg/m² on day 1 of each cycle for 6 cycles (1 cycle =21 days). Dose is based on surface area calculated based on actual body weight.
Doxorubicin should be administered as a continuous infusion into tubing of a freely flowing intravenous line for 5 -15 minutes. Avoid extravasation.
PrednisoneDrug
Also called Deltasone, Orasone, Medicortone, Panasol-S
Prednisone will be administered at 100 mg/m² orally, days 1-5 of each cycle for 6 cycles (1 cycle =21 days). Dose is based on surface area calculated based on actual body weight.
VincristineDrug
Also called Vinsacar PFS, vincristine sulfate, VCR, leucocristine
Vincristine will be administered 1.4 mg/m² intravenously (Maximum dose = 2.0 mg) on day 1 of each cycle for 6 cycles (1 cycle =21 days). Dose is based on surface area calculated based on actual body weight.
Given as IV push over 1 minute, using extravasation precautions.
| Study group | Role | What they receive |
|---|---|---|
| Rituximab + CHOP | Experimental | Rituximab 375 mg/m2 day 1 of a 21-day cycle, followed by:
Cyclophosphamide 750 mg/m2 Doxorubicin 50 mg/m2 Vincristine 1.4 mg/m2 and Prednisone 100 mg/m2 daily Receives: Biological: rituximab; Drug: cyclophosphamide; Drug: Doxorubicin; Drug: Prednisone; Drug: Vincristine |
What is being measured
The primary outcome is the main question the study is designed to answer.
Objective Response to Treatment
Objective response assessed using standard myeloma response criteria. Objective response is defined as a > 50% reduction in the quantitative IgM or M-Spike levels from baseline levels. Response must be documented by two measurements separated by at least 3 weeks.
Measured: Every 3 months if patient is < 2 years from study entry, every 6 months if patient is 2-5 years from study entry, every 12 months if patient is 6-10 years from study entry
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted7 May 2003 (estimated)
- Study start5 Oct 2004
- Primary completionDec 2011
- Study completionAug 2012
Why it stopped: slow accrual
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (1)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 2
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Enrolment
- 16 participants (actual)
Sponsor and investigators
- Lead sponsor
- Eastern Cooperative Oncology Group
- Sponsor type
- Research network
- Collaborators
- National Cancer Institute (NCI)
- Responsible party
- Sponsor
- Investigators
- Rafat Abonour, MD, Study chair, Indiana University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT00060346
- Sponsor's protocol ID
- CDR0000301634
- Other IDs
- U10CA021115, E1A02
- Status last verified
- Jun 2023
- First submitted
- 6 May 2003
- Last updated
- 29 Jun 2023
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- No
Publications
Abonour R, Zhang LA, Rajkumar V, et al.: Phase II pilot study of rituximab + CHOP in patients with newly diagnosed Waldenstroms macroglobulinemia, an Eastren Cooperative Oncology Group trial (study E1A02). [Abstract] Blood 110 (11): A-3616, 2007.
Study at a glance
From the registry record, last updated by the sponsor on 29 Jun 2023. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Phase II Pilot Study Of Rituximab Plus CHOP In Patients With Newly Diagnosed Waldenstrom's Macroglobulinemia
- ClinicalTrials.gov ID
- NCT00060346
- Acronym / sponsor ID
- CDR0000301634
- Conditions
- Lymphoma
- Keywords
- Waldenstrom macroglobulinemia, Rituximab, CHOP
- Phase
- Phase 2
- Study type
- Interventional
- Recruitment status
- TerminatedReason stopped: slow accrual
- Enrolment
- 16 participants (actual)
- Lead sponsor
- Eastern Cooperative Oncology GroupResearch network
- Collaborators
- National Cancer Institute (NCI)
- Study start
- 5 Oct 2004 (actual)
- Primary completion
- Dec 2011 (actual)
- Study completion
- Aug 2012 (actual)
- First posted
- 7 May 2003 (estimated)
- Results
- Posted 12 Feb 2013
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
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 work in different ways to stop cancer cells from dividing so they stop growing or die. Combining rituximab 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 Waldenstrom's macroglobulinemia.
Detailed description
OBJECTIVES:
- Determine the response rate of patients with newly diagnosed Waldenstrom's macroglobulinemia treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone.
- Determine the associated toxic effects of this regimen, specifically the frequency of febrile neutropenia, in these patients.
- Determine the progression-free survival of patients treated with this regimen.
- Correlate baseline cytogenetic features and gene expression profiles with response in patients treated with this regimen.
OUTLINE: This is a pilot, multicenter study.
Patients receive rituximab intravenously (IV) over approximately 4 hours, cyclophosphamide IV over 5-30 minutes, doxorubicin IV over 5-15 minutes, and vincristine IV over 1 minute on day 1. Patients also receive oral prednisone on days 1-5. Treatment repeats every 21 days for up to 6 courses in the absence of disease progression or unacceptable toxicity.
Patients are followed every 3 months for 2 years, every 6 months for 3 years, and then annually for 5 years.
ACTUAL ACCRUAL: A total of 16 patients were accrued for this study.
Study design
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| Rituximab + CHOP | Experimental | Biological: rituximab, Drug: cyclophosphamide, Drug: Doxorubicin, Drug: Prednisone, Drug: VincristineRituximab 375 mg/m2 day 1 of a 21-day cycle, followed by: Cyclophosphamide 750 mg/m2 Doxorubicin 50 mg/m2 Vincristine 1.4 mg/m2 and Prednisone 100 mg/m2 daily |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (24 listed)
- Diagnosis of Waldenstrom's macroglobulinemia confirmed by the presence of the following:
- Impaired bone marrow function due to infiltration by lymphoplasmacytic lymphoma, defined by 1 of the following:
- Absolute neutrophil count at least 1,000/mm^3
- Platelet count at least 75,000/mm^3
- Bilirubin no greater than 3.0 mg/dL
Key exclusion criteria (11 listed)
- Prior treatment for Waldenstrom's macroglobulinemia
- Prior anti-CD20 therapy
- Concurrent steroids exceeding 10 mg prednisone (or equivalent) per day
- Prior irradiation if less than 4 weeks had elapsed prior to registration and the date of last treatment
- Prior anthracyclines
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 |
|---|---|---|
| rituximabAlso: IDEC-C2B8, Chimeric anti-CD20 monoclonal antibody, Rituxan, NSC# 687451Rituximab is given intravenously. The initial rate is 50 mg/hr for the 1st hour. If no toxicity, the rate may be escalated in 50 mg/hr increments at 30-minute intervals to a maximum of 400 mg/hr. If the first dose is well tolerated, the initial rate for subsequent dose is 100 mg/hr, increased in 100 mg/hr increments at 30-minute intervals, not to exceed 400 mg/hr. If the patient experiences fever and rigors, the antibody infusion is discontinued. The severity of the side effects should be evaluated. If the symptoms improve, the infusion is continued initially at half the previous rate. Following the antibody infusion, the intravenous line should be maintained for medications as needed. If there are no complications after one hour of observation, the intravenous line may be discontinued. | Biological | Rituximab + CHOP |
| cyclophosphamideAlso: Cytoxan, CTX, CPM, NeosarCyclophosphamide will be given at a dosage of 750 mg/m² intravenously on day 1 of each cycle (1 cycle =21 days) for 6 cycles. Dose is based on surface area calculated based on actual body weight. The drug should be administered as a rapid IV infusion over 5 to 30 minutes. | Drug | Rituximab + CHOP |
| DoxorubicinAlso: Adriamycin, Rubex, Adriamycin RDF, Adriamycin PFSDoxorubicin will be given intravenously at a dosage of 50 mg/m² on day 1 of each cycle for 6 cycles (1 cycle =21 days). Dose is based on surface area calculated based on actual body weight. Doxorubicin should be administered as a continuous infusion into tubing of a freely flowing intravenous line for 5 -15 minutes. Avoid extravasation. | Drug | Rituximab + CHOP |
| PrednisoneAlso: Deltasone, Orasone, Medicortone, Panasol-SPrednisone will be administered at 100 mg/m² orally, days 1-5 of each cycle for 6 cycles (1 cycle =21 days). Dose is based on surface area calculated based on actual body weight. | Drug | Rituximab + CHOP |
| VincristineAlso: Vinsacar PFS, vincristine sulfate, VCR, leucocristineVincristine will be administered 1.4 mg/m² intravenously (Maximum dose = 2.0 mg) on day 1 of each cycle for 6 cycles (1 cycle =21 days). Dose is based on surface area calculated based on actual body weight. Given as IV push over 1 minute, using extravasation precautions. | Drug | Rituximab + CHOP |
Primary outcome
Objective Response to Treatment
Time frame: Every 3 months if patient is < 2 years from study entry, every 6 months if patient is 2-5 years from study entry, every 12 months if patient is 6-10 years from study entry
Objective response assessed using standard myeloma response criteria. Objective response is defined as a > 50% reduction in the quantitative IgM or M-Spike levels from baseline levels. Response must be documented by two measurements separated by at least 3 weeks.
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 29 Jun 2023.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Results publicationAbonour R, Zhang LA, Rajkumar V, et al.: Phase II pilot study of rituximab + CHOP in patients with newly diagnosed Waldenstroms macroglobulinemia, an Eastren Cooperative Oncology Group trial (study E1A02). [Abstract] Blood 110 (11): A-3616, 2007.
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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.
Rafat Abonour, MD study chair
Indiana University
153 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 2 study testing rituximab, cyclophosphamide and Doxorubicin in people with Lymphoma, run by Eastern Cooperative Oncology Group at 153 sites in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 24 inclusion and 11 exclusion criteria. 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: stopped early, as of the sponsor's last update on 29 Jun 2023. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 153 sites in United States. 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 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
Yes. Results are posted in the registry (first posted 12 Feb 2013). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
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?
Objective Response to Treatment (time frame: Every 3 months if patient is < 2 years from study entry, every 6 months if patient is 2-5 years from study entry, every 12 months if patient is 6-10 years from study entry). 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 NCT00060346, which also lists 1 linked publication.
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 29 Jun 2023.