LymphomaPhase 2NCT00770224
S0801 Iodine I 131 Tositumomab, Rituximab, and Combination Chemotherapy in Previously Untreated Stage II, Stage III, or Stage IV Follicular Non-Hodgkin Lymphoma
A Phase 2 study testing rituximab, tositumomab and cyclophosphamide in people with Lymphoma, run by SWOG Cancer Research Network at 114 sites in United States.
Trial summary
RATIONALE: Radiolabeled monoclonal antibodies, such as iodine I 131 tositumomab, can find cancer cells and carry cancer-killing substances to them without harming normal cells. Monoclonal antibodies, such as rituximab, can block cancer growth in different ways. 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, tositumomab 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
- 87 participants
- Where
- 114 sitesUnited States
- Study dates
- Apr 2009to Aug 2019
- 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
DISEASE CHARACTERISTICS:
- Histologically confirmed* grade 1, 2, or 3 follicular B-cell non-Hodgkin lymphoma meeting the following criteria:
- Bulky stage II or stage III or IV disease
- Diffuse large cell component must be < 25% of the biopsy
- Confirmed cluster of differentiation antigen 20 (CD20) antigen-positive disease NOTE: *Needle aspiration or cytology are not considered adequate for pathology review
- Patient must have unilateral or bilateral bone marrow aspirate and biopsy performed within 42 days
- Positive biopsy performed > 42 days but < 6 months allowed
- Previously untreated disease
- Bidimensionally measurable disease
- No clinical evidence of central nervous system (CNS) involvement by lymphoma
PATIENT CHARACTERISTICS:
- Zubrod performance status 0-2
- Cardiac ejection fraction ≥ 45% by multigated acquisition scan (MUGA) or ECHO
- No significant cardiac abnormalities
- No known HIV positivity
- No requirement for continuous supplemental oxygen therapy
- No other malignancy within the past 5 years except adequately treated basal cell or squamous cell skin cancer, carcinoma in situ of the cervix, or adequately treated stage I or II cancer from which the patient is currently in complete remission
- Not pregnant or nursing
- Fertile patients must use effective contraception during and for 12 months after completion of maintenance therapy
PRIOR CONCURRENT THERAPY:
- No prior chemotherapy, radiotherapy, or antibody therapy for lymphoma
- No prior solid organ transplantation
Trial locations and contacts
114 sites in 1 country.
114 sites in 1 country
United States114 sites
Saint Anthony's Hospital at Saint Anthony's Health Center
Alton, Illinois, 62002
AnMed Cancer Center
Anderson, South Carolina, 29621
Alvin and Lois Lapidus Cancer Institute at Sinai Hospital
Baltimore, Maryland, 21215
Battle Creek Health System Cancer Care Center
Battle Creek, Michigan, 49017
St. Francis Hospital and Health Centers - Beech Grove Campus
Beech Grove, Indiana, 46107
Mary Rutan Hospital
Bellefontaine, Ohio, 43311
St. Joseph Cancer Center
Bellingham, Washington, 98225
Mecosta County Medical Center
Big Rapids, Michigan, 49307
CCOP - Montana Cancer Consortium
Billings, Montana, 59101
St. Vincent Healthcare Cancer Care Services
Billings, Montana, 59101
Hematology-Oncology Centers of the Northern Rockies - Billings
Billings, Montana, 59102
Billings Clinic - Downtown
Billings, Montana, 59107-7000
Bozeman Deaconess Cancer Center
Bozeman, Montana, 59715
Olympic Hematology and Oncology
Bremerton, Washington, 98310
St. James Healthcare Cancer Care
Butte, Montana, 59701
Saint Francis Medical Center
Cape Girardeau, Missouri, 63703
Rocky Mountain Oncology
Casper, Wyoming, 82609
Cancer Center of Kansas, PA - Chanute
Chanute, Kansas, 66720
Adena Regional Medical Center
Chillicothe, Ohio, 45601
Riverside Methodist Hospital Cancer Care
Columbus, Ohio, 43214-3998
CCOP - Columbus
Columbus, Ohio, 43215
Grant Medical Center Cancer Care
Columbus, Ohio, 43215
Mount Carmel Health - West Hospital
Columbus, Ohio, 43222
Doctors Hospital at Ohio Health
Columbus, Ohio, 43228
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
CCOP - Dayton
Dayton, Ohio, 45420
Cancer Care Center of Decatur
Decatur, Illinois, 62526
Decatur Memorial Hospital Cancer Care Institute
Decatur, Illinois, 62526
Grady Memorial Hospital
Delaware, Ohio, 43015
Cancer Center of Kansas, PA - Dodge City
Dodge City, Kansas, 67801
Crossroads Cancer Center
Effingham, Illinois, 62401
Cancer Center of Kansas, PA - El Dorado
El Dorado, Kansas, 67042
Falck Cancer Center at Arnot Ogden Medical Center
Elmira, New York, 14905
Blanchard Valley Medical Associates
Findlay, Ohio, 45840
Cancer Center of Kansas - Fort Scott
Fort Scott, Kansas, 66701
Middletown Regional Hospital
Franklin, Ohio, 45005-1066
Wayne Memorial Hospital, Incorporated
Goldsboro, North Carolina, 27534
Butterworth Hospital at Spectrum Health
Grand Rapids, Michigan, 49503
CCOP - Grand Rapids
Grand Rapids, Michigan, 49503
Lacks Cancer Center at Saint Mary's Health Care
Grand Rapids, Michigan, 49503
Great Falls Clinic - Main Facility
Great Falls, Montana, 59405
Sletten Cancer Institute at Benefis Healthcare
Great Falls, Montana, 59405
Wayne Hospital
Greenville, Ohio, 45331
Northern Montana Hospital
Havre, Montana, 59501
St. Peter's Hospital
Helena, Montana, 59601
Cancer Center of Kansas-Independence
Independence, Kansas, 67301
University of Mississippi Cancer Clinic
Jackson, Mississippi, 39216
Glacier Oncology, PLLC
Kalispell, Montana, 59901
Kalispell Medical Oncology at KRMC
Kalispell, Montana, 59901
Kalispell Regional Medical Center
Kalispell, Montana, 59901
Columbia Basin Hematology
Kennewick, Washington, 99336
Charles F. Kettering Memorial Hospital
Kettering, Ohio, 45429
Cancer Center of Kansas, PA - Kingman
Kingman, Kansas, 67068
U.T. Medical Center Cancer Institute
Knoxville, Tennessee, 37920-6999
Fairfield Medical Center
Lancaster, Ohio, 43130
Lawrence Memorial Hospital
Lawrence, Kansas, 66044
Strecker Cancer Center at Marietta Memorial Hospital
Marietta, Ohio, 45750
Cardinal Bernardin Cancer Center at Loyola University Medical Center
Maywood, Illinois, 60153
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
Providence Cancer Center at Providence Hospital
Mobile, Alabama, 36608
Good Samaritan Regional Health Center
Mount Vernon, Illinois, 62864
Knox Community Hospital
Mount Vernon, Ohio, 43050
Skagit Valley Hospital Cancer Care Center
Mount Vernon, Washington, 98273
Mercy General Health Partners
Muskegon, Michigan, 49443
Licking Memorial Cancer Care Program at Licking Memorial Hospital
Newark, Ohio, 43055
Cancer Center of Kansas, PA - Newton
Newton, Kansas, 67114
Cancer Center of Kansas, PA - Parsons
Parsons, Kansas, 67357
Harrison Poulsbo Hematology and Onocology
Poulsbo, Washington, 98370
Cancer Center of Kansas, PA - Pratt
Pratt, Kansas, 67124
Reid Hospital & Health Care Services
Richmond, Indiana, 47374
James P. Wilmot Cancer Center at University of Rochester Medical Center
Rochester, New York, 14642
Rutherford Hospital
Rutherfordton, North Carolina, 28139
Cancer Center of Kansas, PA - Salina
Salina, Kansas, 67401
Tammy Walker Cancer Center at Salina Regional Health Center
Salina, Kansas, 67401
Huntsman Cancer Institute at University of Utah
Salt Lake City, Utah, 84112
Harborview Medical Center
Seattle, Washington, 98104
Minor and James Medical, PLLC
Seattle, Washington, 98104
Fred Hutchinson Cancer Research Center
Seattle, Washington, 98109
Group Health Central Hospital
Seattle, Washington, 98112
Swedish Cancer Institute at Swedish Medical Center - First Hill Campus
Seattle, Washington, 98122-4307
Polyclinic First Hill
Seattle, Washington, 98122
University Cancer Center at University of Washington Medical Center
Seattle, Washington, 98195
Welch Cancer Center at Sheridan Memorial Hospital
Sheridan, Wyoming, 82801
CCOP - Upstate Carolina
Spartanburg, South Carolina, 29303
Gibbs Regional Cancer Center at Spartanburg Regional Medical Center
Spartanburg, South Carolina, 29303
Cancer Care Northwest - Spokane South
Spokane, Washington, 99202
Evergreen Hematology and Oncology, PS
Spokane, Washington, 99218
Regional Cancer Center at Memorial Medical Center
Springfield, Illinois, 62781-0001
Community Hospital of Springfield and Clark County
Springfield, Ohio, 45505
Midwest Hematology Oncology Group, Incorporated
St Louis, Missouri, 63109
CCOP - St. Louis-Cape Girardeau
St Louis, Missouri, 63141
David C. Pratt Cancer Center at St. John's Mercy
St Louis, Missouri, 63141
Cotton-O'Neil 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
Arizona Cancer Center at University of Arizona Health Sciences Center
Tucson, Arizona, 85724-5024
Cancer Center of Kansas, PA - Wellington
Wellington, Kansas, 67152
Wenatchee Valley Medical Center
Wenatchee, Washington, 98801-2028
Mount Carmel St. Ann's Cancer Center
Westerville, Ohio, 43081
Associates in Womens Health, PA - North Review
Wichita, Kansas, 67208
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
Wesley Medical Center
Wichita, Kansas, 67214
Clinton Memorial Hospital
Wilmington, Ohio, 45177
Cancer Center of Kansas, PA - Winfield
Winfield, Kansas, 67156
Metro Health Hospital
Wyoming, Michigan, 49519
Ruth G. McMillan Cancer Center at Greene Memorial Hospital
Xenia, Ohio, 45385
Genesis - Good Samaritan Hospital
Zanesville, Ohio, 43701
About this study
Official title: A Phase II Study of Iodine-131-Labeled Tositumomab in Combination With Cyclophosphamide, Doxorubicin, Vincristine, Prednisone and Rituximab Therapy for Patients With Advanced Stage Follicular Non-Hodgkin's Lymphoma
RATIONALE: Radiolabeled monoclonal antibodies, such as iodine I 131 tositumomab, can find cancer cells and carry cancer-killing substances to them without harming normal cells. 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, such as cyclophosphamide, doxorubicin, vincristine, and prednisone, work in different ways to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Giving a radiolabeled monoclonal antibody together with rituximab and combination chemotherapy may kill more cancer cells.
PURPOSE: This phase II trial is studying the side effects of giving iodine I 131 tositumomab together with rituximab and combination chemotherapy and to see how well it works in treating patients with previously untreated stage II, stage III, or stage IV follicular non-Hodgkin lymphoma.
Read the detailed description
OBJECTIVES:
- To evaluate the response rate in patients with previously untreated stage II-IV follicular non-Hodgkin lymphoma treated with rituximab, cyclophosphamide, doxorubicin hydrochloride, vincristine sulfate, and prednisone (R-CHOP) in combination with iodine I 131 tositumomab.
- To evaluate the toxicity of this regimen in these patients.
- To estimate the 3-year progression-free survival rate in patients treated with this regimen.
- To estimate the 5-year progression-free and overall survival rate in patients treated with this regimen.
- To assess the safety profile of this regimen in these patients.
OUTLINE: This is a multicenter study.
- Induction therapy: Patients receive R-CHOP* comprising rituximab IV, cyclophosphamide IV, doxorubicin hydrochloride IV, and vincristine sulfate IV on day 1 and oral prednisone once daily on days 1-5. Treatment repeats every 21 days for up to 6 courses in the absence of disease progression or unacceptable toxicity. Patients with at least stable disease then proceed to consolidation therapy.
NOTE: *Patients receive R-CHOP in courses 1-4 and CHOP alone in courses 5 and 6.
- Consolidation therapy: Within 12 weeks after completion of induction therapy, patients receive tositumomab IV over 1 hour followed by a dosimetric dose of iodine I 131 tositumomab IV over 20 minutes. Patients then undergo whole body gamma camera scans over a 1-week period to determine the rate of total body clearance of radioactivity and the therapeutic dose of iodine I 131 tositumomab. Within 7-14 days after the dosimetric dose, patients receive tositumomab IV over 1 hour followed by a therapeutic dose of iodine I 131 tositumomab IV over 20 minutes. Patients with at least stable disease then proceed to maintenance therapy.
- Maintenance therapy: Beginning approximately 1 year after study entry and no more than 28 days after restaging, patients receive rituximab IV every 3 months for up to 4 years (16 courses) in the absence of disease progression or unacceptable toxicity.
After completion of maintenance therapy, patients are followed annually for up to 7 years. Patients who do not complete maintenance therapy are followed every 6 months for 2 years and then annually for up to 7 years.
- Conditions
- Lymphoma
- Being tested
- rituximab, tositumomab, cyclophosphamide, doxorubicin, prednisone
- Keywords
- contiguous stage II grade 1 follicular lymphoma, contiguous stage II grade 2 follicular lymphoma, contiguous stage II grade 3 follicular lymphoma, noncontiguous stage II grade 1 follicular lymphoma, noncontiguous stage II grade 2 follicular lymphoma, noncontiguous stage II grade 3 follicular lymphoma, stage III grade 1 follicular lymphoma, stage III grade 2 follicular lymphoma, stage III grade 3 follicular lymphoma, stage IV grade 1 follicular lymphoma, stage IV grade 2 follicular lymphoma, stage IV grade 3 follicular lymphoma
- Medical subject headings
- Lymphoma, Lymphoma, Follicular
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
rituximabBiological
tositumomabBiological
cyclophosphamideDrug
doxorubicinDrug
prednisoneDrug
vincristineDrug
tositumomabRadiation
Also called iodine I 131 tositumomab
| Study group | Role | What they receive |
|---|---|---|
| R-CHOP, tositumomab and rituximab | Experimental | Cyclophosphamide 750 mg/m2 IV Day 1 Doxorubicin 50 mg/m2 IV Day 1 Vincristine 1.4 mg/m2 IV Day 1 Prednisone 100 mg PO Days 1-5 Rituximab 375 mg/m2 IV Day 1 Q 21 Days x 6 Cycles
Patients are restaged by CT scan. Unlabeled tositumomab antibody 450 mg IV within 12 after Cycle 6 of CHOP. Dosimetric dose 35 mg IV after infusion of unlabeled tositumomab antibody. Unlabeled tositumomab antibody 450 mg IV 7-14 days after dosimetric dose. Therapeutic dose 35 mg IV after infusion of unlabeled tositumomab antibody.
Rituximab 375 mg/m2 IV q 3 months x 4 years beginning 1 year after registration. Receives: Biological: rituximab; Biological: tositumomab; Drug: cyclophosphamide; Drug: doxorubicin; Drug: prednisone; Drug: vincristine; Radiation: tositumomab |
What is being measured
The primary outcome is the main question the study is designed to answer.
Percentage of Participants With 3-year Progression-free Survival (PFS)
Measured from date of registration to date of first observation of progressive disease or death due to any cause. Progressive disease is ≥ 50% increase in the sum of products of greatest diameters (SPD) of target measurable nodal lesions over the smallest sum observed (over baseline if no decrease during therapy), or ≥ 50% increase in the greatest transverse diameter (GTD) of any node > 1 cm in shortest axis, or ≥ 50% increase in the SPD of other target measurable lesions (e.g., splenic or hepatic nodules) over the smallest sum observed. Appearance of any new bone marrow involvement; appearance of a new lesion/site; lymph nodes with the long axis is > 1.5 cm, or if the both the long and short axes are > 1 cm; in patients with no pretreatment PET scan or when the PET scan was positive before therapy, lesions should be PET positive; or death due to disease without prior documentation of progression.
Measured: 0-3 years
Secondary outcomes (4)
5-year Progression-free Survival
Measured from date of registration to date of first observation of progressive disease or death due to any cause. Progressive disease is ≥ 50% increase in the sum of products of greatest diameters (SPD) of target measurable nodal lesions over the smallest sum observed (over baseline if no decrease during therapy), or ≥ 50% increase in the greatest transverse diameter (GTD) of any node > 1 cm in shortest axis, or ≥ 50% increase in the SPD of other target measurable lesions (e.g., splenic or hepatic nodules) over the smallest sum observed. Appearance of any new bone marrow involvement; appearance of a new lesion/site; lymph nodes with the long axis is > 1.5 cm, or if the both the long and short axes are > 1 cm; in patients with no pretreatment PET scan or when the PET scan was positive before therapy, lesions should be PET positive; or death due to disease without prior documentation of progression.
Measured: 0-5 years
5-year Overall Survival
Measured from date of registration to date of death due to any cause. Patients last known to be alive and are censored at date of last contact.
Measured: 0-5 years
Response Rate
Complete (CR), complete unconfirmed (CRU) and partial responses (PR). CR is complete disappearance of all measurable and non-measurable disease with the exception of the following. Positron emission tomography (PET) must be negative if no pre-treatment PET scan or when the PET was positive before therapy. If the PET scan was negative before therapy, all nodal masses must have regressed. no new lesions; previously enlarged organs must have regressed in size; and if bone marrow positive at baseline, it must be negative. PR is ≥ 50% decrease in sum of products of greatest diameters (SPD) for up to six identified dominant lesions identified at baseline; no new lesions; no increase in the size of liver, spleen or other nodes; and splenic and hepatic nodules must have regressed in size by at least 50% in SPD. In patients with no pre-treatment PET scan or when the PET scan was positive before therapy, PET should be positive in at least one previously involved site.
Measured: up to 5 years (1 year induction + 4 years maintenance therapy) or time of disease progression
Number of Patients With Grade 3 Through Grade 5 Adverse Events That Are Related to Study Drug
Adverse Events (AEs) are reported by the NCI Common Terminology Criteria for Adverse Events (CTCAE) version 4.0. For each patient, worst grade of each event type is reported. Grade 3 = Severe, Grade 4 = Life-threatening, Grade 5 = Fatal.
Measured: up to 5 years (1 year induction + 4 years maintenance therapy) or time of disease progression.
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted9 Oct 2008 (estimated)
- Study startApr 2009
- Primary completionApr 2017
- Study completionAug 2019
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 (2)Papers the sponsor has linked to this study.
- Other trials for LymphomaStudies of the same condition, open and under way.
- More trials run by SWOG Cancer Research NetworkThe sponsor's other registered studies.
- 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
- 87 participants (actual)
Sponsor and investigators
- Lead sponsor
- SWOG Cancer Research Network
- Sponsor type
- Research network
- Collaborators
- National Cancer Institute (NCI)
- Responsible party
- Sponsor
- Investigators
- Jonathan W. Friedberg, MD, Study chair, James P. Wilmot Cancer CenterOliver W. Press, MD, PhD, Study chair, Fred Hutchinson Cancer CenterLisa Rimsza, MD, Study chair, University of Arizona
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT00770224
- Sponsor's protocol ID
- CDR0000615104
- Other IDs
- S0801, U10CA032102
- Status last verified
- Aug 2019
- First submitted
- 8 Oct 2008
- Last updated
- 28 Aug 2019
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- No
Publications
Rutherford SC, Yin J, Pederson L, Perez Burbano G, LaPlant B, Shadman M, Li H, LeBlanc ML, Kenkre VP, Hong F, Blum KA, Dockter T, Martin P, Jung SH, Grant B, Rosenbaum C, Ujjani C, Barr PM, Unger JM, Cheson BD, Bartlett NL, Kahl B, Friedberg JW, Mandrekar SJ, Leonard JP. Relevance of Bone Marrow Biopsies for Response Assessment in US National Cancer Institute National Clinical Trials Network Follicular Lymphoma Clinical Trials. J Clin Oncol. 2023 Jan 10;41(2):336-342. doi: 10.1200/JCO.21.02301. Epub 2022 Jul 5.
PubMed 35787017Barr PM, Li H, Burack WR, LeBlanc M, Smith SM, Gopal AK, Floyd JD, Persky DO, Press OW, Fisher RI, Friedberg JW. R-CHOP, radioimmunotherapy, and maintenance rituximab in untreated follicular lymphoma (SWOG S0801): a single-arm, phase 2, multicentre study. Lancet Haematol. 2018 Mar;5(3):e102-e108. doi: 10.1016/S2352-3026(18)30001-2. Epub 2018 Jan 26.
PubMed 29396094
Study at a glance
From the registry record, last updated by the sponsor on 28 Aug 2019. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Phase II Study of Iodine-131-Labeled Tositumomab in Combination With Cyclophosphamide, Doxorubicin, Vincristine, Prednisone and Rituximab Therapy for Patients With Advanced Stage Follicular Non-Hodgkin's Lymphoma
- ClinicalTrials.gov ID
- NCT00770224
- Acronym / sponsor ID
- CDR0000615104
- Conditions
- Lymphoma
- Keywords
- contiguous stage II grade 1 follicular lymphoma, contiguous stage II grade 2 follicular lymphoma, contiguous stage II grade 3 follicular lymphoma, noncontiguous stage II grade 1 follicular lymphoma, noncontiguous stage II grade 2 follicular lymphoma, noncontiguous stage II grade 3 follicular lymphoma, stage III grade 1 follicular lymphoma, stage III grade 2 follicular lymphoma
- Phase
- Phase 2
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 87 participants (actual)
- Lead sponsor
- SWOG Cancer Research NetworkResearch network
- Collaborators
- National Cancer Institute (NCI)
- Study start
- Apr 2009
- Primary completion
- Apr 2017 (actual)
- Study completion
- Aug 2019 (actual)
- First posted
- 9 Oct 2008 (estimated)
- Results
- Posted 15 Nov 2018
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
RATIONALE: Radiolabeled monoclonal antibodies, such as iodine I 131 tositumomab, can find cancer cells and carry cancer-killing substances to them without harming normal cells. 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, such as cyclophosphamide, doxorubicin, vincristine, and prednisone, work in different ways to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Giving a radiolabeled monoclonal antibody together with rituximab and combination chemotherapy may kill more cancer cells.
PURPOSE: This phase II trial is studying the side effects of giving iodine I 131 tositumomab together with rituximab and combination chemotherapy and to see how well it works in treating patients with previously untreated stage II, stage III, or stage IV follicular non-Hodgkin lymphoma.
Detailed description
OBJECTIVES:
- To evaluate the response rate in patients with previously untreated stage II-IV follicular non-Hodgkin lymphoma treated with rituximab, cyclophosphamide, doxorubicin hydrochloride, vincristine sulfate, and prednisone (R-CHOP) in combination with iodine I 131 tositumomab.
- To evaluate the toxicity of this regimen in these patients.
- To estimate the 3-year progression-free survival rate in patients treated with this regimen.
- To estimate the 5-year progression-free and overall survival rate in patients treated with this regimen.
- To assess the safety profile of this regimen in these patients.
OUTLINE: This is a multicenter study.
- Induction therapy: Patients receive R-CHOP* comprising rituximab IV, cyclophosphamide IV, doxorubicin hydrochloride IV, and vincristine sulfate IV on day 1 and oral prednisone once daily on days 1-5. Treatment repeats every 21 days for up to 6 courses in the absence of disease progression or unacceptable toxicity. Patients with at least stable disease then proceed to consolidation therapy.
NOTE: *Patients receive R-CHOP in courses 1-4 and CHOP alone in courses 5 and 6.
- Consolidation therapy: Within 12 weeks after completion of induction therapy, patients receive tositumomab IV over 1 hour followed by a dosimetric dose of iodine I 131 tositumomab IV over 20 minutes. Patients then undergo whole body gamma camera scans over a 1-week period to determine the rate of total body clearance of radioactivity and the therapeutic dose of iodine I 131 tositumomab. Within 7-14 days after the dosimetric dose, patients receive tositumomab IV over 1 hour followed by a therapeutic dose of iodine I 131 tositumomab IV over 20 minutes. Patients with at least stable disease then proceed to maintenance therapy.
- Maintenance therapy: Beginning approximately 1 year after study entry and no more than 28 days after restaging, patients receive rituximab IV every 3 months for up to 4 years (16 courses) in the absence of disease progression or unacceptable toxicity.
After completion of maintenance therapy, patients are followed annually for up to 7 years. Patients who do not complete maintenance therapy are followed every 6 months for 2 years and then annually for up to 7 years.
Study design
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| R-CHOP, tositumomab and rituximab | Experimental | Biological: rituximab, Biological: tositumomab, Drug: cyclophosphamide, Drug: doxorubicin, Drug: prednisone, Drug: vincristine, Radiation: tositumomabCyclophosphamide 750 mg/m2 IV Day 1 Doxorubicin 50 mg/m2 IV Day 1 Vincristine 1.4 mg/m2 IV Day 1 Prednisone 100 mg PO Days 1-5 Rituximab 375 mg/m2 IV Day 1 Q 21 Days x 6 Cycles Patients are restaged by CT scan. Unlabeled tositumomab antibody 450 mg IV within 12 after Cycle 6 of CHOP. Dosimetric dose 35 mg IV after infusion of unlabeled tositumomab antibody. Unlabeled tositumomab antibody 450 mg IV 7-14 days after dosimetric dose. Therapeutic dose 35 mg IV after infusion of unlabeled tositumomab antibody. Rituximab 375 mg/m2 IV q 3 months x 4 years beginning 1 year after registration. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older 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 |
|---|---|---|
| rituximab | Biological | R-CHOP, tositumomab and rituximab |
| tositumomab | Biological | R-CHOP, tositumomab and rituximab |
| cyclophosphamide | Drug | R-CHOP, tositumomab and rituximab |
| doxorubicin | Drug | R-CHOP, tositumomab and rituximab |
| prednisone | Drug | R-CHOP, tositumomab and rituximab |
| vincristine | Drug | R-CHOP, tositumomab and rituximab |
| tositumomabAlso: iodine I 131 tositumomab | Radiation | R-CHOP, tositumomab and rituximab |
Primary outcome
Percentage of Participants With 3-year Progression-free Survival (PFS)
Time frame: 0-3 years
Measured from date of registration to date of first observation of progressive disease or death due to any cause. Progressive disease is ≥ 50% increase in the sum of products of greatest diameters (SPD) of target measurable nodal lesions over the smallest sum observed (over baseline if no decrease during therapy), or ≥ 50% increase in the greatest transverse diameter (GTD) of any node > 1 cm in shortest axis, or ≥ 50% increase in the SPD of other target measurable lesions (e.g., splenic or hepatic nodules) over the smallest sum observed. Appearance of any new bone marrow involvement; appearance of a new lesion/site; lymph nodes with the long axis is > 1.5 cm, or if the both the long and short axes are > 1 cm; in patients with no pretreatment PET scan or when the PET scan was positive before therapy, lesions should be PET positive; or death due to disease without prior documentation of progression.
4 secondary outcomes
5-year Progression-free Survival
Time frame: 0-5 years
5-year Overall Survival
Time frame: 0-5 years
Response Rate
Time frame: up to 5 years (1 year induction + 4 years maintenance therapy) or time of disease progression
Number of Patients With Grade 3 Through Grade 5 Adverse Events That Are Related to Study Drug
Time frame: up to 5 years (1 year induction + 4 years maintenance therapy) or time of disease progression.
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 28 Aug 2019.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Derived from this study: PubMed 35787017Rutherford SC, Yin J, Pederson L, Perez Burbano G, LaPlant B, Shadman M, Li H, LeBlanc ML, Kenkre VP, Hong F, Blum KA, Dockter T, Martin P, Jung SH, Grant B, Rosenbaum C, Ujjani C, Barr PM, Unger JM, Cheson BD, Bartlett NL, Kahl B, Friedberg JW, Mandrekar SJ, Leonard JP. Relevance of Bone Marrow Biopsies for Response Assessment in US National Cancer Institute National Clinical Trials Network Follicular Lymphoma Clinical Trials. J Clin Oncol. 2023 Jan 10;41(2):336-342. doi: 10.1200/JCO.21.02301. Epub 2022 Jul 5.
- Derived from this study: PubMed 29396094Barr PM, Li H, Burack WR, LeBlanc M, Smith SM, Gopal AK, Floyd JD, Persky DO, Press OW, Fisher RI, Friedberg JW. R-CHOP, radioimmunotherapy, and maintenance rituximab in untreated follicular lymphoma (SWOG S0801): a single-arm, phase 2, multicentre study. Lancet Haematol. 2018 Mar;5(3):e102-e108. doi: 10.1016/S2352-3026(18)30001-2. Epub 2018 Jan 26.
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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.
Jonathan W. Friedberg, MD study chair
James P. Wilmot Cancer Center
Oliver W. Press, MD, PhD study chair
Fred Hutchinson Cancer Center
Lisa Rimsza, MD study chair
University of Arizona
114 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, tositumomab and cyclophosphamide in people with Lymphoma, run by SWOG Cancer Research Network at 114 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?
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 28 Aug 2019. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 114 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 15 Nov 2018). 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?
Percentage of Participants With 3-year Progression-free Survival (PFS) (time frame: 0-3 years). 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 NCT00770224, 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 28 Aug 2019.