LymphomaPhase 2NCT01132807
Chemotherapy Based on Positron Emission Tomography Scan in Treating Patients With Stage I or Stage II Hodgkin Lymphoma
A Phase 2 study testing Bleomycin Sulfate, Doxorubicin Hydrochloride and Procarbazine Hydrochloride in people with Lymphoma, run by Alliance for Clinical Trials in Oncology at 95 sites in United States.
Trial summary
This phase II trial studies how well chemotherapy based on positron emission tomography (PET) scan works in treating patients with stage I or stage II Hodgkin lymphoma. Drugs used in chemotherapy work in different ways to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Read more about this study
- Who is it for?
- Ages 18 to 60 years
- Conditions the study is for
- Lymphoma
- What is being tested?
- Bleomycin Sulfate, Doxorubicin Hydrochloride and Procarbazine Hydrochloride
- Type of treatment
- Injection or infusion, Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 164 participants
- Where
- 95 sitesUnited States
- Study dates
- May 2010to Jan 2018
- 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 to 60 years
- All sexes
- No healthy volunteers
- Adult
DISEASE CHARACTERISTICS:
- Histologically confirmed* Hodgkin lymphoma
- Clinical stage IA, IB, IIA, or IIB disease according to the modified Ann Arbor Staging Classification system
- Subclassified according to the WHO modification of the Rye Classification
- "E" extension allowed provided all other criteria have been met NOTE: *Pathology materials must be submitted within 60 days of study registration. Core-needle biopsies are acceptable provided they contain adequate tissue for primary diagnosis and immunophenotyping. Fine-needle aspirates not allowed. If multiple specimens are available, submit the most recent.
- No nodular lymphocyte-predominant Hodgkin lymphoma
- No mediastinal mass > 0.33 maximum intrathoracic diameter by standing postero-anterior chest x-ray or peripheral or retroperitoneal adenopathy > 10 cm in its largest diameter
- Measurable disease by physical examination or imaging studies
- Any tumor mass measurable in two dimensions and > 1 cm (or 1.5 cm if 0.5 cm slices are used, as in spiral CT scans) allowed
- Lesions that are considered intrinsically non-measurable include:
- Bone lesions
- Leptomeningeal disease
- Ascites
- Pleural/pericardial effusion
- Lymphangitis cutis/pulmonis
- Abdominal masses that are not confirmed and followed by imaging techniques
- Cystic lesions
- Lesions that are situated in a previously irradiated area
PATIENT CHARACTERISTICS:
- Performance status 0-2
- ANC ≥ 1,000/μL
- Platelet count ≥ 100,000/μL
- Serum creatinine ≤ 2 mg/dL
- Bilirubin ≤ 2 mg/dL
- AST ≤ 2 times upper limit of normal
- LVEF normal by ECHO or MUGA
- DLCO ≥ 60% with no symptomatic pulmonary disease
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective contraception
- Patients with known HIV allowed provided they have CD4 counts ≥ 350/mcL
- Patients must not have multi-drug resistant HIV infections (i.e., concurrent AIDS-defining conditions)
- An HIV test is required for patients with a history of IV drug abuse or any behavior associated with an increased risk of HIVinfection
- No "currently active" second malignancy other than nonmelanoma skin cancers
- Patients are not considered to have a "currently active" malignancy provided they have completed therapy and are considered by their physician to be at < 30% risk of relapse
PRIOR CONCURRENT THERAPY:
- See Disease Characteristics
- No prior chemotherapy or radiotherapy for Hodgkin lymphoma
- 1 course of ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine) allowed and will be considered the first course
Trial locations and contacts
95 sites in 1 country.
95 sites in 1 country
United States95 sites
Kapiolani Medical Center at Pali Momi
‘Aiea, Hawaii, 96701
Oncare Hawaii, Incorporated - Pali Momi
‘Aiea, Hawaii, 96701
Hickman Cancer Center at Bixby Medical Center
Adrian, Michigan, 49221
Harrington Cancer Center
Amarillo, Texas, 79106
McFarland Clinic, PC
Ames, Iowa, 50010
Saint Joseph Mercy Cancer Center
Ann Arbor, Michigan, 48106-0995
MBCCOP - Medical College of Georgia Cancer Center
Augusta, Georgia, 30912
Greenebaum Cancer Center at University of Maryland Medical Center
Baltimore, Maryland, 21201
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
Baltimore, Maryland, 21231-2410
CancerCare of Maine at Eastern Maine Medical Center
Bangor, Maine, 04401
Mary Bird Perkins Cancer Center - Baton Rouge
Baton Rouge, Louisiana, 70809
Mountainview Medical
Berlin Corners, Vermont, 05602
Billings Clinic - Downtown
Billings, Montana, 59107-7000
Dana-Farber/Harvard Cancer Center at Dana-Farber Cancer Institute
Boston, Massachusetts, 02115
Fletcher Allen Health Care - University Health Center Campus
Burlington, Vermont, 05401
Blumenthal Cancer Center at Carolinas Medical Center
Charlotte, North Carolina, 28232-2861
Presbyterian Cancer Center at Presbyterian Hospital
Charlotte, North Carolina, 28233-3549
Mount Sinai Hospital Medical Center
Chicago, Illinois, 60608
Robert H. Lurie Comprehensive Cancer Center at Northwestern University
Chicago, Illinois, 60611-3013
John H. Stroger, Jr. Hospital of Cook County
Chicago, Illinois, 60612-3785
University of Chicago Cancer Research Center
Chicago, Illinois, 60637-1470
Louis A. Weiss Memorial Hospital
Chicago, Illinois, 60640
Case Comprehensive Cancer Center
Cleveland, Ohio, 44106-5065
Cleveland Clinic Taussig Cancer Center
Cleveland, Ohio, 44195
Arthur G. James Cancer Hospital and Richard J. Solove Research Institute at Ohio State University Comprehensive Cancer Center
Columbus, Ohio, 43210-1240
Simmons Comprehensive Cancer Center at University of Texas Southwestern Medical Center - Dallas
Dallas, Texas, 75390
Geisinger Cancer Institute at Geisinger Health
Danville, Pennsylvania, 17822-0001
Decatur Memorial Hospital Cancer Care Institute
Decatur, Illinois, 62526
City of Hope Comprehensive Cancer Center
Duarte, California, 91010-3000
CCOP - Duluth
Duluth, Minnesota, 55805
Center for Cancer Treatment & Prevention at Sacred Heart Hospital
Eau Claire, Wisconsin, 54701
Union Hospital of Cecil County
Elkton, Maryland, 21921
Evanston Hospital
Evanston, Illinois, 60201-1781
Wayne Memorial Hospital, Incorporated
Goldsboro, North Carolina, 27534
Bon Secours St. Francis Health System
Greenville, South Carolina, 29601
OnCare Hawaii, Incorporated - Lusitana
Honolulu, Hawaii, 96813
Queen's Cancer Institute at Queen's Medical Center
Honolulu, Hawaii, 96813
Straub Clinic and Hospital, Incorporated
Honolulu, Hawaii, 96813
OnCare Hawaii, Incorporated - Kuakini
Honolulu, Hawaii, 96817-3169
Kuakini Medical Center
Honolulu, Hawaii, 96817
Kapiolani Medical Center for Women and Children
Honolulu, Hawaii, 96826
West Tennessee Cancer Center at Jackson-Madison County General Hospital
Jackson, Tennessee, 38301
Castle Medical Center
Kailua, Hawaii, 96734
West Michigan Cancer Center
Kalamazoo, Michigan, 49007-3731
Gundersen Lutheran Center for Cancer and Blood
La Crosse, Wisconsin, 54601
Monter Cancer Center of the North Shore-LIJ Health System
Lake Success, New York, 11042
University Medical Center of Southern Nevada
Las Vegas, Nevada, 89102
Norris Cotton Cancer Center at Dartmouth-Hitchcock Medical Center
Lebanon, New Hampshire, 03756-0002
Lucille P. Markey Cancer Center at University of Kentucky
Lexington, Kentucky, 40536-0093
Kauai Medical Clinic
Lihue, Hawaii, 96766
Louisville Oncology at Norton Cancer Institute - Louisville
Louisville, Kentucky, 40202
Norton Suburban Hospital
Louisville, Kentucky, 40207
University of Wisconsin Paul P. Carbone Comprehensive Cancer Center
Madison, Wisconsin, 53792-6164
CCOP - North Shore University Hospital
Manhasset, New York, 11030
Don Monti Comprehensive Cancer Center at North Shore University Hospital
Manhasset, New York, 11030
Marshfield Clinic - Marshfield Center
Marshfield, Wisconsin, 54449
Saint Joseph's Hospital
Marshfield, Wisconsin, 54449
Cardinal Bernardin Cancer Center at Loyola University Medical Center
Maywood, Illinois, 60153
Marshfield Clinic - Lakeland Center
Minocqua, Wisconsin, 54548
Mary Babb Randolph Cancer Center at West Virginia University Hospitals
Morgantown, West Virginia, 26506
Vanderbilt-Ingram Cancer Center
Nashville, Tennessee, 37232-6838
Yale Cancer Center
New Haven, Connecticut, 06520-8028
Long Island Jewish Medical Center
New Hyde Park, New York, 11040
MBCCOP - LSU Health Sciences Center
New Orleans, Louisiana, 70112
Medical Center of Louisiana - New Orleans
New Orleans, Louisiana, 70112
New York Weill Cornell Cancer Center at Cornell University
New York, New York, 10021
Memorial Sloan-Kettering Cancer Center
New York, New York, 10065
CCOP - Christiana Care Health Services
Newark, Delaware, 19713
UNMC Eppley Cancer Center at the University of Nebraska Medical Center
Omaha, Nebraska, 68198-6805
St. Charles Mercy Hospital
Oregon, Ohio, 43616
M.D. Anderson Cancer Center at Orlando
Orlando, Florida, 32806
Fox Chase Cancer Center CCOP Research Base
Philadelphia, Pennsylvania, 19140
Ministry Medical Group at Saint Mary's Hospital
Rhinelander, Wisconsin, 54501
Marshfield Clinic - Indianhead Center
Rice Lake, Wisconsin, 54868
Virginia Commonwealth University Massey Cancer Center
Richmond, Virginia, 23298-0037
Humphrey Cancer Center at North Memorial Outpatient Center
Robbinsdale, Minnesota, 55422-2900
James P. Wilmot Cancer Center at University of Rochester Medical Center
Rochester, New York, 14642
Regions Hospital Cancer Care Center
Saint Paul, Minnesota, 55101
University Cancer Center at University of Washington Medical Center
Seattle, Washington, 98195
Siouxland Hematology-Oncology Associates, LLP
Sioux City, Iowa, 51101
CCOP - Upstate Carolina
Spartanburg, South Carolina, 29303
Gibbs Regional Cancer Center at Spartanburg Regional Medical Center
Spartanburg, South Carolina, 29303
Siteman Cancer Center at Barnes-Jewish Hospital - Saint Louis
St Louis, Missouri, 63110
Missouri Baptist Cancer Center
St Louis, Missouri, 63131
Iredell Memorial Hospital
Statesville, North Carolina, 28677
Saint Michael's Hospital Cancer Center
Stevens Point, Wisconsin, 54481
SUNY Upstate Medical University Hospital
Syracuse, New York, 13210
Toledo Clinic, Incorporated - Main Clinic
Toledo, Ohio, 43623
Arizona Cancer Center at University of Arizona Health Sciences Center
Tucson, Arizona, 85724-5024
Lombardi Comprehensive Cancer Center at Georgetown University Medical Center
Washington D.C., District of Columbia, 20007
Diagnostic and Treatment Center
Weston, Wisconsin, 54476
CCOP - Wichita
Wichita, Kansas, 67214
Frank M. and Dorothea Henry Cancer Center at Geisinger Wyoming Valley Medical Center
Wilkes-Barre, Pennsylvania, 18711
Wake Forest University Comprehensive Cancer Center
Winston-Salem, North Carolina, 27157-1096
UMASS Memorial Cancer Center - University Campus
Worcester, Massachusetts, 01655
About this study
Official title: Phase II Trial of Response-Adapted Chemotherapy Based on Positron Emission Tomography for Non-Bulky Stage I and II Hodgkin Lymphoma
This phase II trial studies how well chemotherapy based on positron emission tomography (PET) scan works in treating patients with stage I or stage II Hodgkin lymphoma. Drugs used in chemotherapy work in different ways to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Giving more than one drug (combination chemotherapy) may kill more cancer cells. Radiation therapy uses high energy x-rays to kill cancer cells. Giving combination chemotherapy together with radiation therapy may kill more cancer cells and allow doctors to save the part of the body where the cancer started. Comparing results of diagnostic procedures, such as PET scan, done before, during, and after chemotherapy may help doctors predict a patient's response to treatment and help plan the best treatment.
Read the detailed description
PRIMARY OBJECTIVES:
- To determine the progression-free survival (PFS) from enrollment for patients with non-bulky stage I and II Hodgkin lymphoma.
II. To compare the PFS of patients who are PET positive versus PET negative following 2 cycles of doxorubicin hydrochloride, bleomycin, vinblastine, and dacarbazine (ABVD).
SECONDARY OBJECTIVES:
- To evaluate the complete response (CR) rate of patients diagnosed with non-bulky stage I and II Hodgkin lymphoma following PET response-adapted chemotherapy with or without radiation therapy.
II. To determine the predictive value of fludeoxyglucose (FDG) uptake using various semi-quantitative approaches, at baseline, after 2 cycles of AVBD and at completion of therapy.
III. To determine the predictive value of volumetric changes on computed tomography (CT) vs 2-dimensional (2-D) analyses after 2 cycles and 4 cycles and compare with PET parameters with and without combination analyses (PET + dedicated CT data).
IV. To compare the predictive value of metabolic parameters/changes that are measured both visually and semi-quantitatively, International Harmonization Project (IHP) criteria, 2-D and volumetric CT changes, molecular parameters, and conventional parameters, including International Prognostic Score (IPS).
- To assess whether elevated baseline circulating markers of inflammation (including soluble cluster of differentiation CD30 [sCD]30, soluble CD 163 [CD163], interleukin-10 (IL10), chemokine (C-C motif) ligand 17 (CCL17), and chemokine (C-C motif) ligand 22 [CCL22]) correlate with clinical response and PFS and PET scan results.
VI. To assess whether persistent or recurrent elevated serial circulating markers of inflammation (including soluble CD30 [sCD30], soluble CD163 [sCD163], IL10, CCL17, or CCL22) correlate with relapse/progression or PET scan results.
VII. To confirm independently useful tissue biomarkers for risk stratification in patients with non-bulky stage I and II Hodgkin lymphoma treated with this regimen.
VIII. To compare mediastinal bulk on standing posterior-anterior (PA) and lateral chest x-ray (> 0.33 maximum chest diameter) with chest CT (mass > 10 cm).
OUTLINE:
ABVD CHEMOTHERAPY: Patients receive doxorubicin hydrochloride intravenously (IV) over 3-5 minutes, bleomycin sulfate IV over 3-5 minutes, vinblastine IV over 3-5 minutes, and dacarbazine IV over 30 minutes on days 1 and 15. Treatment repeats every 28 days for 2 courses. Patients then undergo PET scan. Patients achieving complete response (CR), partial response (PR), or stable disease (SD) with a negative PET scan receive 2 additional courses of ABVD chemotherapy in the absence of disease progression or unacceptable toxicity. Patients achieving CR, PR, or SD with a positive PET scan proceed to escalated BEACOPP chemotherapy.
ESCALATED BEACOPP* CHEMOTHERAPY: Patients receive doxorubicin hydrochloride IV over 3-5 minutes and cyclophosphamide IV over 60 minutes on day 1, etoposide IV over 45-60 minutes on days 1-3, procarbazine orally (PO) on days 1-7, prednisone PO on days 1-14, and bleomycin sulfate IV and vincristine IV on day 8. Treatment repeats every 21 days for 2 courses in the absence of disease progression or unacceptable toxicity. Within 4-6 weeks after completion of BEACOPP chemotherapy, patients undergo involved-field radiotherapy (IFRT) 5 days a week for 3½ weeks.
NOTE: * HIV-positive patients receive standard BEACOPP instead of escalated BEACOPP.
Patients undergo fludeoxyglucose F^18 PET/CT scan at baseline, and within 8-10 days after completion of chemotherapy. Patients also undergo additional PET/CT scans within 3-4 weeks after completion of ABVD or within 12 weeks after completion of BEACOPP and IFRT. Patients with a negative PET scan proceed to follow up. Patients with a positive PET scan undergo biopsy**. Patients with a negative biopsy proceed to follow up, and patients with a positive biopsy are treated at the discretion of the investigator.
NOTE: ** Patients for whom biopsy is neither clinically appropriate nor medically feasible proceed to follow-up. Patients for whom biopsy is neither clinically indicated nor medically appropriate undergo a repeat PET/CT scan after 3 months. If PET/CT scan remains positive, patients undergo biopsy as above.
After completion of study therapy, patients are followed up every 3 months for 1 year, every 6 months for 2-3 years, and then annually for a maximum of 5 years.
- Conditions
- Lymphoma
- Being tested
- Bleomycin Sulfate, Doxorubicin Hydrochloride, Procarbazine Hydrochloride, Vinblastine Sulfate, Dacarbazine
- Keywords
- stage I adult Hodgkin lymphoma, stage II adult Hodgkin lymphoma
- Medical subject headings
- Lymphoma, Hodgkin Disease
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Bleomycin SulfateBiological
Given IV
Given IV
Procarbazine HydrochlorideDrug
Given PO
Vinblastine SulfateDrug
Given IV
DacarbazineDrug
Given IV
CyclophosphamideDrug
Given IV
Etoposide phosphateDrug
Given IV
prednisoneDrug
Given PO
Radiation TherapyDrug
Undergo radiation therapy
Fludeoxyglucose F-18Radiation
Undergo FDG PET/CT
computed tomographyProcedure or surgery
Undergo FDG PET/CT
Positron Emission TomographyProcedure or surgery
Undergo FDG PET/CT
| Study group | Role | What they receive |
|---|---|---|
| Treatment (chemotherapy and F-18 PET/CT) | Experimental | See Detailed Description Receives: Biological: Bleomycin Sulfate; Drug: Doxorubicin Hydrochloride; Drug: Procarbazine Hydrochloride; Drug: Vinblastine Sulfate; Drug: Dacarbazine; Drug: Cyclophosphamide; Drug: Etoposide phosphate; Drug: prednisone; Drug: Radiation Therapy; Radiation: Fludeoxyglucose F-18; Procedure: computed tomography; Procedure: Positron Emission Tomography |
What is being measured
The primary outcome is the main question the study is designed to answer.
Progression-Free Survival (PFS) at 36-Months for Patients Who Received 4 Cycles of ABVD
The primary objective of this trial is to estimate the 3 year PFS in patients who received 4 cycles of ABVD. PFS for each patient is measured as the time from registration on trial to the first incident of death or progression. The PFS at 36 months is calculated as the number of patients who have a progression-free survival time greater than 36 months divided by the total number of patients that started treatment. For this endpoint, all patients that received 4 cycles of doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) are included.
Measured: 36 Months
36 Month Progression Free Survival Rate of Patients Receiving 4 Cycles of ABVD Versus Patients Receiving 2 Cycles of ABVD and 2 Cycles of BEACOPP and Radiation.
All patients received an initial 2-28 day cycles of doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) on Days 1 and 15. After the first 2 cycles of ABVD, PET/CT was performed and submitted for central review (cycle 2, days 23-25) and determined whether patients would receive 2 cycles of escalated BEACOPP and involved-field RT (IFRT) or an additional 2 cycles of ABVD. PFS for each patient is measured as the time from registration on trial to the first incident of death or progression. The PFS rate at 36 months is calculated as the number of patients who have a progression-free survival time greater than 36 months divided by the total number of patients that started treatment. For this endpoint, we compare the PFS rate between patients who received 4 cycles of ABVD and patients who received 2 cycles of ABVD and 2 cycles of IFRT.
Measured: at 36 months
Secondary outcomes (1)
Complete Response Rate
A Complete Response (CR) was defined as having the following conditions: 1. A complete disappearance of all detectable clinical evidence of disease and disease-related symptoms if present before therapy. 2. In patients with a PET scan that was positive before therapy, a post-treatment residual mass of any size is permitted as long as it is PET-negative. A Complete Response rate was defined as the number of patients who achieved a CR divided by the number of patients that were eligible for analysis in each group. The CR rate was calculated for patients that completed 4 cycles of ABVD and for patients that completed 2 cycles of ABVD and 2 cycles of BEACOPP and IFRT.
Measured: Up to 5 years
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted28 May 2010 (estimated)
- Study startMay 2010
- Primary completionFeb 2016
- Study completionJan 2018
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 Alliance for Clinical Trials in OncologyThe 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
- 164 participants (actual)
Sponsor and investigators
- Lead sponsor
- Alliance for Clinical Trials in Oncology
- Sponsor type
- University, hospital or other
- Collaborators
- National Cancer Institute (NCI)
- Responsible party
- Sponsor
- Investigators
- David J. Straus, MD, Principal investigator, Memorial Sloan Kettering Cancer Center
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT01132807
- Sponsor's protocol ID
- CALGB-50604
- Other IDs
- CALGB-50604, NCI-2011-02042, U10CA180821, CDR0000672913
- Status last verified
- Jun 2021
- First submitted
- 27 May 2010
- Last updated
- 14 Jun 2021
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- No
Publications
Kreuzberger N, Goldkuhle M, von Tresckow B, Kobe C, Sickinger MT, Monsef I, Skoetz N. Positron emission tomography-adapted therapy for first-line treatment in adults with Hodgkin lymphoma. Cochrane Database Syst Rev. 2025 Mar 26;3(3):CD010533. doi: 10.1002/14651858.CD010533.pub3.
PubMed 40135712Straus DJ, Jung SH, Pitcher B, Kostakoglu L, Grecula JC, Hsi ED, Schoder H, Popplewell LL, Chang JE, Moskowitz CH, Wagner-Johnston N, Leonard JP, Friedberg JW, Kahl BS, Cheson BD, Bartlett NL. CALGB 50604: risk-adapted treatment of nonbulky early-stage Hodgkin lymphoma based on interim PET. Blood. 2018 Sep 6;132(10):1013-1021. doi: 10.1182/blood-2018-01-827246. Epub 2018 Jul 26.
PubMed 30049811
Study at a glance
From the registry record, last updated by the sponsor on 14 Jun 2021. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Phase II Trial of Response-Adapted Chemotherapy Based on Positron Emission Tomography for Non-Bulky Stage I and II Hodgkin Lymphoma
- ClinicalTrials.gov ID
- NCT01132807
- Acronym / sponsor ID
- CALGB-50604
- Conditions
- Lymphoma
- Keywords
- stage I adult Hodgkin lymphoma, stage II adult Hodgkin lymphoma
- Phase
- Phase 2
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 164 participants (actual)
- Lead sponsor
- Alliance for Clinical Trials in OncologyUniversity, hospital or other
- Collaborators
- National Cancer Institute (NCI)
- Study start
- May 2010
- Primary completion
- Feb 2016 (actual)
- Study completion
- Jan 2018 (actual)
- First posted
- 28 May 2010 (estimated)
- Results
- Posted 14 Jun 2021
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This phase II trial studies how well chemotherapy based on positron emission tomography (PET) scan works in treating patients with stage I or stage II Hodgkin lymphoma. Drugs used in chemotherapy work in different ways to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Giving more than one drug (combination chemotherapy) may kill more cancer cells. Radiation therapy uses high energy x-rays to kill cancer cells. Giving combination chemotherapy together with radiation therapy may kill more cancer cells and allow doctors to save the part of the body where the cancer started. Comparing results of diagnostic procedures, such as PET scan, done before, during, and after chemotherapy may help doctors predict a patient's response to treatment and help plan the best treatment.
Detailed description
PRIMARY OBJECTIVES:
- To determine the progression-free survival (PFS) from enrollment for patients with non-bulky stage I and II Hodgkin lymphoma.
II. To compare the PFS of patients who are PET positive versus PET negative following 2 cycles of doxorubicin hydrochloride, bleomycin, vinblastine, and dacarbazine (ABVD).
SECONDARY OBJECTIVES:
- To evaluate the complete response (CR) rate of patients diagnosed with non-bulky stage I and II Hodgkin lymphoma following PET response-adapted chemotherapy with or without radiation therapy.
II. To determine the predictive value of fludeoxyglucose (FDG) uptake using various semi-quantitative approaches, at baseline, after 2 cycles of AVBD and at completion of therapy.
III. To determine the predictive value of volumetric changes on computed tomography (CT) vs 2-dimensional (2-D) analyses after 2 cycles and 4 cycles and compare with PET parameters with and without combination analyses (PET + dedicated CT data).
IV. To compare the predictive value of metabolic parameters/changes that are measured both visually and semi-quantitatively, International Harmonization Project (IHP) criteria, 2-D and volumetric CT changes, molecular parameters, and conventional parameters, including International Prognostic Score (IPS).
- To assess whether elevated baseline circulating markers of inflammation (including soluble cluster of differentiation CD30 [sCD]30, soluble CD 163 [CD163], interleukin-10 (IL10), chemokine (C-C motif) ligand 17 (CCL17), and chemokine (C-C motif) ligand 22 [CCL22]) correlate with clinical response and PFS and PET scan results.
VI. To assess whether persistent or recurrent elevated serial circulating markers of inflammation (including soluble CD30 [sCD30], soluble CD163 [sCD163], IL10, CCL17, or CCL22) correlate with relapse/progression or PET scan results.
VII. To confirm independently useful tissue biomarkers for risk stratification in patients with non-bulky stage I and II Hodgkin lymphoma treated with this regimen.
VIII. To compare mediastinal bulk on standing posterior-anterior (PA) and lateral chest x-ray (> 0.33 maximum chest diameter) with chest CT (mass > 10 cm).
OUTLINE:
ABVD CHEMOTHERAPY: Patients receive doxorubicin hydrochloride intravenously (IV) over 3-5 minutes, bleomycin sulfate IV over 3-5 minutes, vinblastine IV over 3-5 minutes, and dacarbazine IV over 30 minutes on days 1 and 15. Treatment repeats every 28 days for 2 courses. Patients then undergo PET scan. Patients achieving complete response (CR), partial response (PR), or stable disease (SD) with a negative PET scan receive 2 additional courses of ABVD chemotherapy in the absence of disease progression or unacceptable toxicity. Patients achieving CR, PR, or SD with a positive PET scan proceed to escalated BEACOPP chemotherapy.
ESCALATED BEACOPP* CHEMOTHERAPY: Patients receive doxorubicin hydrochloride IV over 3-5 minutes and cyclophosphamide IV over 60 minutes on day 1, etoposide IV over 45-60 minutes on days 1-3, procarbazine orally (PO) on days 1-7, prednisone PO on days 1-14, and bleomycin sulfate IV and vincristine IV on day 8. Treatment repeats every 21 days for 2 courses in the absence of disease progression or unacceptable toxicity. Within 4-6 weeks after completion of BEACOPP chemotherapy, patients undergo involved-field radiotherapy (IFRT) 5 days a week for 3½ weeks.
NOTE: * HIV-positive patients receive standard BEACOPP instead of escalated BEACOPP.
Patients undergo fludeoxyglucose F^18 PET/CT scan at baseline, and within 8-10 days after completion of chemotherapy. Patients also undergo additional PET/CT scans within 3-4 weeks after completion of ABVD or within 12 weeks after completion of BEACOPP and IFRT. Patients with a negative PET scan proceed to follow up. Patients with a positive PET scan undergo biopsy**. Patients with a negative biopsy proceed to follow up, and patients with a positive biopsy are treated at the discretion of the investigator.
NOTE: ** Patients for whom biopsy is neither clinically appropriate nor medically feasible proceed to follow-up. Patients for whom biopsy is neither clinically indicated nor medically appropriate undergo a repeat PET/CT scan after 3 months. If PET/CT scan remains positive, patients undergo biopsy as above.
After completion of study therapy, patients are followed up every 3 months for 1 year, every 6 months for 2-3 years, and then annually for a maximum of 5 years.
Study design
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| Treatment (chemotherapy and F-18 PET/CT) | Experimental | Biological: Bleomycin Sulfate, Drug: Doxorubicin Hydrochloride, Drug: Procarbazine Hydrochloride, Drug: Vinblastine Sulfate, Drug: Dacarbazine, Drug: Cyclophosphamide, Drug: Etoposide phosphate, Drug: prednisone, Drug: Radiation Therapy, Radiation: Fludeoxyglucose F-18, Procedure: computed tomography, Procedure: Positron Emission TomographySee Detailed Description |
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 |
|---|---|---|
| Bleomycin SulfateGiven IV | Biological | Treatment (chemotherapy and F-18 PET/CT) |
| Doxorubicin HydrochlorideGiven IV | Drug | Treatment (chemotherapy and F-18 PET/CT) |
| Procarbazine HydrochlorideGiven PO | Drug | Treatment (chemotherapy and F-18 PET/CT) |
| Vinblastine SulfateGiven IV | Drug | Treatment (chemotherapy and F-18 PET/CT) |
| DacarbazineGiven IV | Drug | Treatment (chemotherapy and F-18 PET/CT) |
| CyclophosphamideGiven IV | Drug | Treatment (chemotherapy and F-18 PET/CT) |
| Etoposide phosphateGiven IV | Drug | Treatment (chemotherapy and F-18 PET/CT) |
| prednisoneGiven PO | Drug | Treatment (chemotherapy and F-18 PET/CT) |
| Radiation TherapyUndergo radiation therapy | Drug | Treatment (chemotherapy and F-18 PET/CT) |
| Fludeoxyglucose F-18Undergo FDG PET/CT | Radiation | Treatment (chemotherapy and F-18 PET/CT) |
| computed tomographyUndergo FDG PET/CT | Procedure or surgery | Treatment (chemotherapy and F-18 PET/CT) |
| Positron Emission TomographyUndergo FDG PET/CT | Procedure or surgery | Treatment (chemotherapy and F-18 PET/CT) |
Primary outcome
Progression-Free Survival (PFS) at 36-Months for Patients Who Received 4 Cycles of ABVD
Time frame: 36 Months
The primary objective of this trial is to estimate the 3 year PFS in patients who received 4 cycles of ABVD. PFS for each patient is measured as the time from registration on trial to the first incident of death or progression. The PFS at 36 months is calculated as the number of patients who have a progression-free survival time greater than 36 months divided by the total number of patients that started treatment. For this endpoint, all patients that received 4 cycles of doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) are included.
36 Month Progression Free Survival Rate of Patients Receiving 4 Cycles of ABVD Versus Patients Receiving 2 Cycles of ABVD and 2 Cycles of BEACOPP and Radiation.
Time frame: at 36 months
All patients received an initial 2-28 day cycles of doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) on Days 1 and 15. After the first 2 cycles of ABVD, PET/CT was performed and submitted for central review (cycle 2, days 23-25) and determined whether patients would receive 2 cycles of escalated BEACOPP and involved-field RT (IFRT) or an additional 2 cycles of ABVD. PFS for each patient is measured as the time from registration on trial to the first incident of death or progression. The PFS rate at 36 months is calculated as the number of patients who have a progression-free survival time greater than 36 months divided by the total number of patients that started treatment. For this endpoint, we compare the PFS rate between patients who received 4 cycles of ABVD and patients who received 2 cycles of ABVD and 2 cycles of IFRT.
1 secondary outcome
Complete Response Rate
Time frame: Up to 5 years
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 14 Jun 2021.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Derived from this study: PubMed 40135712Kreuzberger N, Goldkuhle M, von Tresckow B, Kobe C, Sickinger MT, Monsef I, Skoetz N. Positron emission tomography-adapted therapy for first-line treatment in adults with Hodgkin lymphoma. Cochrane Database Syst Rev. 2025 Mar 26;3(3):CD010533. doi: 10.1002/14651858.CD010533.pub3.
- Derived from this study: PubMed 30049811Straus DJ, Jung SH, Pitcher B, Kostakoglu L, Grecula JC, Hsi ED, Schoder H, Popplewell LL, Chang JE, Moskowitz CH, Wagner-Johnston N, Leonard JP, Friedberg JW, Kahl BS, Cheson BD, Bartlett NL. CALGB 50604: risk-adapted treatment of nonbulky early-stage Hodgkin lymphoma based on interim PET. Blood. 2018 Sep 6;132(10):1013-1021. doi: 10.1182/blood-2018-01-827246. Epub 2018 Jul 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.
David J. Straus, MD principal investigator
Memorial Sloan Kettering Cancer Center
95 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 Bleomycin Sulfate, Doxorubicin Hydrochloride and Procarbazine Hydrochloride in people with Lymphoma, run by Alliance for Clinical Trials in Oncology at 95 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 14 Jun 2021. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 95 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 14 Jun 2021). 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?
Progression-Free Survival (PFS) at 36-Months for Patients Who Received 4 Cycles of ABVD (time frame: 36 Months). The study lists 2 primary outcomes in all. 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 NCT01132807, 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 14 Jun 2021.