LymphomaPhase 2NCT01412879
S1106 Rituximab With Combination Chemotherapy or Bendamustine Hydrochloride Followed by Consolidation Chemotherapy and Stem Cell Transplantation in Older Patients With Previously Untreated Mantle Cell Lymphoma
A Phase 2 study testing rituximab, bendamustine hydrochloride and cyclophosphamide in people with Lymphoma, run by SWOG Cancer Research Network at 204 sites in United States.
Trial summary
RATIONALE: Monoclonal antibodies, such as rituximab, can block cancer growth in different ways. Some find cancer cells and help kill them or carry cancer-killing substances to them. Others interfere with the ability of cancer cells to grow and spread. Read more about this study
- Who is it for?
- Ages 18 to 65 years
- Conditions the study is for
- Lymphoma
- What is being tested?
- rituximab, bendamustine hydrochloride and cyclophosphamide
- Type of treatment
- Pill or oral medicine, Injection or infusion
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 53 participants
- Where
- 204 sitesUnited States
- Study dates
- Nov 2011to Mar 2021
- 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 65 years
- All sexes
- No healthy volunteers
- Adult, Older adult
DISEASE CHARACTERISTICS:
- All patients must have previously untreated stage III, IV, or bulky stage II mantle cell lymphoma (MCL)
- A diagnosis of MCL must be confirmed by histopathological diagnosis including immunohistochemistry and flow cytometry documenting both of the following phenotypes:
- CD19+ or CD20+
- Cyclin D1+ or evidence of the t(11;14) translocation by cytogenetics or FISH
- Adequate sections from the original diagnostic specimen must be available for submission for central review
- An adequate biopsy requires sufficient tissue to establish the architecture and a WHO histologic subtype with certainty
- Core biopsies, especially multiple core biopsies, MAY be adequate, but needle aspirations or cytologies are not adequate
- Bone marrow core biopsy or clot sections (not aspirates) may be used as diagnostic material if it is significantly involved and are the only diagnostic material available
- All patients must have bidimensional measurable disease documented on the Lymphoma Baseline Tumor Assessment Form (Form #48031)
- Patients who also have non-measurable disease in addition to measurable disease must have all nonmeasurable disease assessed within 28 days prior to registration
- Patients must not have clinical evidence of central nervous system (CNS) involvement by lymphoma
- Any laboratory or radiographic tests performed prior to registration to assess CNS involvement must be negative
- Patients must have a unilateral/bilateral bone marrow aspirate and biopsy for staging performed within 42 days prior to registration
- If the biopsy cannot be performed but the aspirate is unequivocally consistent with mantle cell lymphoma, this will be considered adequate for staging purposes
- Patients must be eligible for stem cell transplantation by institutional guidelines with the plan that transplant will be conducted at a cooperative group-approved transplant center
- Patients must be planning to undergo stem cell transplantation within 84 days after day 1 of the last induction course
- Patients must have had at least 1.5 X 10^6 CD34^+ cells/kg collected and stored prior to second registration for stem cell transplantation
PATIENT CHARACTERISTICS:
- Zubrod performance status of 0-2
- Bilirubin ≤ 3 times upper limit of normal (ULN)
- Serum creatinine ≤ 2.0 times ULN
- Alanine Aminotransferase (ALT) and Aspartate Aminotransferase (AST) ≤ 2.5 times ULN
- Alkaline phosphatase ≤ 2.5 times ULN
- Platelet count ≥ 100,000/mcL, unless due to bone marrow infiltration by lymphoma
- All patients ≥ 45 years of age must have an echocardiogram (ECHO) or Multi Gated Acquisition Scan (MUGA )scan within 42 days prior to registration (whichever method is used at baseline must be used at restaging)
- Patients < 45 years of age should have ECHO/MUGA only if clinically indicated
- Patients with an ejection fraction < institutional lower limit of normal (ILLN) are not eligible
- Serum Lactate dehydrogenase (LDH) and a Complete Blood Count (CBC with differential must be measured within 28 days prior to registration
- Patients known to be HIV positive, or who have a history of solid organ transplantation, are ineligible
- No active hepatitis
- No other prior malignancy is allowed except for the following: adequately treated basal cell or squamous cell skin cancer; in situ cervical cancer; adequately treated Stage I or II cancer from which the patient is currently in complete remission; or any other cancer from which the patient has been disease-free for 5 years
- Pregnant or nursing women may not participate
- Women or men of reproductive potential may not participate unless they have agreed to use an effective contraceptive method
PRIOR CONCURRENT THERAPY:
- See Disease Characteristics
Trial locations and contacts
204 sites in 1 country.
204 sites in 1 country
United States204 sites
Hickman Cancer Center at Bixby Medical Center
Adrian, Michigan, 49221
McFarland Clinic, PC
Ames, Iowa, 50010
Island Hospital Cancer Care Center at Island Hospital
Anacortes, Washington, 98221
Aurora Presbyterian Hospital
Aurora, Colorado, 80012
St. Francis Hospital and Health Centers - Beech Grove Campus
Beech Grove, Indiana, 46107
Overlake Cancer Center at Overlake Hospital Medical Center
Bellevue, Washington, 98004
St. Joseph Cancer Center
Bellingham, Washington, 98225
Illinois CancerCare - Bloomington
Bloomington, Illinois, 61701
Boulder Community Hospital
Boulder, Colorado, 80301-9019
Olympic Hematology and Oncology
Bremerton, Washington, 98310
Highline Medical Center Cancer Center
Burien, Washington, 98166
Fairview Ridges Hospital
Burnsville, Minnesota, 55337
Graham Hospital
Canton, Illinois, 61520
Illinois CancerCare - Canton
Canton, Illinois, 61520
Illinois CancerCare - Carthage
Carthage, Illinois, 62321
Memorial Hospital
Carthage, Illinois, 62321
Providence Centralia Hospital
Centralia, Washington, 98531-9027
Cancer Center of Kansas, PA - Chanute
Chanute, Kansas, 66720
Robert H. Lurie Comprehensive Cancer Center at Northwestern University
Chicago, Illinois, 60611-3013
Hematology and Oncology Associates
Chicago, Illinois, 60611
Clackamas Radiation Oncology Center
Clackamas, Oregon, 97015
Penrose Cancer Center at Penrose Hospital
Colorado Springs, Colorado, 80933
Arthur G. James Cancer Hospital and Richard J. Solove Research Institute at Ohio State University Comprehensive Cancer Center
Columbus, Ohio, 43210-1240
Mercy and Unity Cancer Center at Mercy Hospital
Coon Rapids, Minnesota, 55433
Baylor University Medical Center - Dallas
Dallas, Texas, 75246
Geisinger Cancer Institute at Geisinger Health
Danville, Pennsylvania, 17822-0001
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
Decatur Memorial Hospital Cancer Care Institute
Decatur, Illinois, 62526
St. Anthony Central Hospital
Denver, Colorado, 80204
Porter Adventist Hospital
Denver, Colorado, 80210
Presbyterian - St. Luke's Medical Center
Denver, Colorado, 80218
St. Joseph Hospital
Denver, Colorado, 80218
Rose Medical Center
Denver, Colorado, 80220
CCOP - Colorado Cancer Research Program
Denver, Colorado, 80222
Barbara Ann Karmanos Cancer Institute
Detroit, Michigan, 48201-1379
Cancer Center of Kansas, PA - Dodge City
Dodge City, Kansas, 67801
City of Hope Comprehensive Cancer Center
Duarte, California, 91010-3000
Fairview Southdale Hospital
Edina, Minnesota, 55435
Cancer Center of Kansas, PA - El Dorado
El Dorado, Kansas, 67042
Union Hospital of Cecil County
Elkton, Maryland, 21921
Community Cancer Center
Elyria, Ohio, 44035
Hematology Oncology Center
Elyria, Ohio, 44035
Swedish Medical Center
Englewood, Colorado, 80110
Eureka Community Hospital
Eureka, Illinois, 61530
Illinois CancerCare - Eureka
Eureka, Illinois, 61530
Providence Regional Cancer Partnership
Everett, Washington, 98201
St. Francis Hospital
Federal Way, Washington, 98003
Blanchard Valley Medical Associates
Findlay, Ohio, 45840
Cancer Center of Kansas - Fort Scott
Fort Scott, Kansas, 66701
Middletown Regional Hospital
Franklin, Ohio, 45005-1066
Fredericksburg Oncology, Incorporated
Fredericksburg, Virginia, 22401
Mercy and Unity Cancer Center at Unity Hospital
Fridley, Minnesota, 55432
Galesburg Clinic, PC
Galesburg, Illinois, 61401
Illinois CancerCare - Galesburg
Galesburg, Illinois, 61401
North Colorado Medical Center
Greeley, Colorado, 80631
Wayne Hospital
Greenville, Ohio, 45331
Cancer Centers of the Carolinas - Faris Road
Greenville, South Carolina, 29605
Cancer Centers of the Carolinas - Grove Commons
Greenville, South Carolina, 29605
Greenville Hospital Cancer Center
Greenville, South Carolina, 29605
CCOP - Greenville
Greenville, South Carolina, 29615
Cancer Centers of the Carolinas - Greer Medical Oncology
Greer, South Carolina, 29650
Cancer Institute of New Jersey at Hamilton
Hamilton, New Jersey, 08690
Illinois CancerCare - Havana
Havana, Illinois, 62644
Mason District Hospital
Havana, Illinois, 62644
Geisinger Hazleton Cancer Center
Hazleton, Pennsylvania, 18201
Kellogg Cancer Care Center
Highland Park, Illinois, 60035
Hutchinson Area Health Care
Hutchinson, Minnesota, 55350
Cancer Center of Kansas-Independence
Independence, Kansas, 67301
Swedish Medical Center - Issaquah Campus
Issaquah, Washington, 98029
Provena St. Mary's Regional Cancer Center - Kankakee
Kankakee, Illinois, 60901
Columbia Basin Hematology
Kennewick, Washington, 99336
Charles F. Kettering Memorial Hospital
Kettering, Ohio, 45429
Illinois CancerCare - Kewanee Clinic
Kewanee, Illinois, 61443
Cancer Center of Kansas, PA - Kingman
Kingman, Kansas, 67068
Gundersen Lutheran Center for Cancer and Blood
La Crosse, Wisconsin, 54601
Lawrence Memorial Hospital
Lawrence, Kansas, 66044
Tunnell Cancer Center at Beebe Medical Center
Lewes, Delaware, 19958
St. Joseph Regional Medical Center
Lewiston, Idaho, 83501
Lucille P. Markey Cancer Center at University of Kentucky
Lexington, Kentucky, 40536-0093
Cancer Center of Kansas, PA - Liberal
Liberal, Kansas, 67901
North Shore Oncology and Hematology Associates, Limited - Libertyville
Libertyville, Illinois, 60048
Lima Memorial Hospital
Lima, Ohio, 45804
Littleton Adventist Hospital
Littleton, Colorado, 80122
Sky Ridge Medical Center
Lone Tree, Colorado, 80124
Hope Cancer Care Center at Longmont United Hospital
Longmont, Colorado, 80501
McKee Medical Center
Loveland, Colorado, 80539
Illinois CancerCare - Macomb
Macomb, Illinois, 61455
McDonough District Hospital
Macomb, Illinois, 61455
HealthEast Cancer Care at St. John's Hospital
Maplewood, Minnesota, 55109
Minnesota Oncology - Maplewood
Maplewood, Minnesota, 55109
Northwest Ohio Oncology Center
Maumee, Ohio, 43537-1839
Cardinal Bernardin Cancer Center at Loyola University Medical Center
Maywood, Illinois, 60153
Cancer Center of Kansas, PA - McPherson
McPherson, Kansas, 67460
Medical College of Wisconsin Cancer Center
Milwaukee, Wisconsin, 53226
Providence Milwaukie Hospital
Milwaukie, Oregon, 97222
Virginia Piper Cancer Institute at Abbott - Northwestern Hospital
Minneapolis, Minnesota, 55407
Hennepin County Medical Center - Minneapolis
Minneapolis, Minnesota, 55415
Illinois CancerCare - Monmouth
Monmouth, Illinois, 61462
Mercy Memorial Hospital - Monroe
Monroe, Michigan, 48162
Mary Babb Randolph Cancer Center at West Virginia University Hospitals
Morgantown, West Virginia, 26506
Skagit Valley Hospital Cancer Care Center
Mount Vernon, Washington, 98274
Cancer Institute of New Jersey at UMDNJ - Robert Wood Johnson Medical School
New Brunswick, New Jersey, 08903
New Ulm Medical Center
New Ulm, Minnesota, 56073
CCOP - Christiana Care Health Services
Newark, Delaware, 19713
Providence Newberg Medical Center
Newberg, Oregon, 97132
Cancer Center of Kansas, PA - Newton
Newton, Kansas, 67114
Cancer Care and Hematology Specialists of Chicagoland - Niles
Niles, Illinois, 60714
BroMenn Regional Medical Center
Normal, Illinois, 61761
Community Cancer Center
Normal, Illinois, 61761
Illinois CancerCare - Community Cancer Center
Normal, Illinois, 61761
Providence St. Peter Hospital Regional Cancer Center
Olympia, Washington, 98506-5166
St. Charles Mercy Hospital
Oregon, Ohio, 43616
Willamette Falls Hospital
Oregon City, Oregon, 97045
Florida Hospital Cancer Institute at Florida Hospital Orlando
Orlando, Florida, 32803-1273
Community Hospital of Ottawa
Ottawa, Illinois, 61350
Oncology Hematology Associates of Central Illinois, PC - Ottawa
Ottawa, Illinois, 61350
Parker Adventist Hospital
Parker, Colorado, 80138
Cancer Center of Kansas, PA - Parsons
Parsons, Kansas, 67357
Cancer Treatment Center at Pekin Hospital
Pekin, Illinois, 61554
Illinois CancerCare - Pekin
Pekin, Illinois, 61603
Proctor Hospital
Peoria, Illinois, 61614
CCOP - Illinois Oncology Research Association
Peoria, Illinois, 61615
Oncology Hematology Associates of Central Illinois, PC - Peoria
Peoria, Illinois, 61615
Methodist Medical Center of Illinois
Peoria, Illinois, 61636
Illinois CancerCare - Peru
Peru, Illinois, 61354
Illinois Valley Community Hospital
Peru, Illinois, 61354
Providence Cancer Center at Providence Portland Medical Center
Portland, Oregon, 97213-2967
CCOP - Columbia River Oncology Program
Portland, Oregon, 97225
Providence St. Vincent Medical Center
Portland, Oregon, 97225
Harrison Poulsbo Hematology and Onocology
Poulsbo, Washington, 98370
Cancer Center of Kansas, PA - Pratt
Pratt, Kansas, 67124
Illinois CancerCare - Princeton
Princeton, Illinois, 61356
Perry Memorial Hospital
Princeton, Illinois, 61356
St. Mary - Corwin Regional Medical Center
Pueblo, Colorado, 81004
Good Samaritan Cancer Center
Puyallup, Washington, 98372
Reid Hospital & Health Care Services
Richmond, Indiana, 47374
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
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
United Hospital
Saint Paul, Minnesota, 55102
Cancer Center of Kansas, PA - Salina
Salina, Kansas, 67401
North Coast Cancer Care, Incorporated
Sandusky, Ohio, 44870
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
North Puget Oncology at United General Hospital
Sedro-Woolley, Washington, 98284
Cancer Centers of the Carolinas - Seneca
Seneca, South Carolina, 29672
St. Francis Cancer Center at St. Francis Medical Center
Shakopee, Minnesota, 55379
Siouxland Hematology-Oncology Associates, LLP
Sioux City, Iowa, 51101
Mercy Medical Center - Sioux City
Sioux City, Iowa, 51102
St. Luke's Regional Medical Center
Sioux City, Iowa, 51104
Hematology Oncology Associates - Skokie
Skokie, Illinois, 60076
Cancer Centers of the Carolinas - Spartanburg
Spartanburg, South Carolina, 29307
Cancer Care Northwest - Spokane South
Spokane, Washington, 99202
Evergreen Hematology and Oncology, PS
Spokane, Washington, 99218
Illinois CancerCare - Spring Valley
Spring Valley, Illinois, 61362
Regional Cancer Center at Memorial Medical Center
Springfield, Illinois, 62781-0001
Saint Louis University Cancer Center
St Louis, Missouri, 63110
Siteman Cancer Center at Barnes-Jewish Hospital - Saint Louis
St Louis, Missouri, 63110
Geisinger Medical Group - Scenery Park
State College, Pennsylvania, 16801
Lakeview Hospital
Stillwater, Minnesota, 55082
Flower Hospital Cancer Center
Sylvania, Ohio, 43560
SUNY Upstate Medical University Hospital
Syracuse, New York, 13210
Franciscan Cancer Center at St. Joseph Medical Center
Tacoma, Washington, 98405-3004
Allenmore Hospital
Tacoma, Washington, 98405
CCOP - Northwest
Tacoma, Washington, 98405
MultiCare Regional Cancer Center at Tacoma General Hospital
Tacoma, Washington, 98405
St. Clare Hospital
Tacoma, Washington, 98499
Mercy Hospital of Tiffin
Tiffin, Ohio, 44883
Toledo Hospital
Toledo, Ohio, 43606
St. Vincent Mercy Medical Center
Toledo, Ohio, 43608
Medical University of Ohio Cancer Center
Toledo, Ohio, 43614
CCOP - Toledo Community Hospital
Toledo, Ohio, 43617
St. Anne Mercy Hospital
Toledo, Ohio, 43623
Toledo Clinic, Incorporated - Main Clinic
Toledo, Ohio, 43623
UVMC Cancer Care Center at Upper Valley Medical Center
Troy, Ohio, 45373-1300
Southwest Washington Medical Center Cancer Center
Vancouver, Washington, 98664
Northwest Cancer Specialists at Vancouver Cancer Center
Vancouver, Washington, 98684
Cancer Institute of New Jersey at Cooper - Voorhees
Voorhees Township, New Jersey, 08043
Ridgeview Medical Center
Waconia, Minnesota, 55387
Fulton County Health Center
Wauseon, Ohio, 43567
Cancer Center of Kansas, PA - Wellington
Wellington, Kansas, 67152
Wenatchee Valley Medical Center
Wenatchee, Washington, 98801-2028
Exempla Lutheran Medical Center
Wheat Ridge, Colorado, 80033
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
Frank M. and Dorothea Henry Cancer Center at Geisinger Wyoming Valley Medical Center
Wilkes-Barre, Pennsylvania, 18711
Willmar Cancer Center at Rice Memorial Hospital
Willmar, Minnesota, 56201
Cancer Center of Kansas, PA - Winfield
Winfield, Kansas, 67156
Minnesota Oncology - Woodbury
Woodbury, Minnesota, 55125
Ruth G. McMillan Cancer Center at Greene Memorial Hospital
Xenia, Ohio, 45385
About this study
Official title: A Randomized Phase II Trial of R-HCVAD/MTX/ARA-C Induction Followed by Consolidation With an Autologous Stem Cell Transplant Vs. R-Bendamustine Induction Followed by Consolidation With an Autologous Stem Cell Transplant for Patients ≤ 65 Years of Age With Previously Untreated Mantle Cell Lymphoma
RATIONALE: Monoclonal antibodies, such as rituximab, can block cancer growth in different ways. Some find cancer cells and help kill them or carry cancer-killing substances to them. Others interfere with the ability of cancer cells to grow and spread. Drugs used in chemotherapy also work in different ways to kill more cancer cells or stop them from growing. It is not yet known whether rituximab is more effective with combination chemotherapy or bendamustine hydrochloride in treating patients with mantle cell lymphoma undergoing peripheral blood stem cell transplantation.
PURPOSE: This randomized phase II trial studies how well giving rituximab together with combination chemotherapy or bendamustine hydrochloride followed by consolidation chemotherapy and peripheral blood stem cell transplantation works in treating older patients with previously untreated mantle cell lymphoma.
Read the detailed description
OBJECTIVES:
- To estimate the 2-year progression-free survival (PFS) of patients with newly diagnosed mantle cell lymphoma (MCL) treated with rituximab, cyclophosphamide, doxorubicin hydrochloride, vincristine sulfate, dexamethasone (RHCVAD), methotrexate and cytarabine (MTX/Ara-C), and autologous stem cell transplant (ASCT) or rituximab and bendamustine (R-bendamustine) and autologous stem cell transplant and to select a regimen for further development.
- To assess the response rate and overall survival of patients with newly diagnosed MCL treated with R-HCVAD/MTX/Ara-C and ASCT or R-bendamustine and ASCT.
- To assess the toxicity and tolerability of R-HCVAD/MTX/Ara-C and ASCT or R-bendamustine and ASCT in patients with newly diagnosed MCL.
- To determine the prognostic value of quantitative minimal-residual disease (MRD) monitoring in the peripheral blood of MCL patients after induction therapy and serially after high-dose chemotherapy and ASCT on treatment outcome.
- To bank diagnostic tissue sections for future translational research studies.
OUTLINE: This is a multicenter study. Patients are stratified according to risk classification by Mantle Cell Lymphoma International prognostic Index (MIPI) score (low risk vs intermediate/high risk). Patients are randomized to 1 of 2 treatment arms.
- Arm I (induction therapy):
- Courses 1 and 3: Patients receive induction therapy comprising rituximab IV on day 1; cyclophosphamide IV over 3 hours every 12 hours on days 2-4; doxorubicin hydrochloride IV over 72 hours on days 5-7; vincristine sulfate IV on days 5 and 12; and dexamethasone IV or orally (PO) once daily (QD) on days 2-5 and 12-15. Patients with responsive disease after course 1 proceed to course 2.
- Course 2 and 4: Patients receive rituximab IV on day 1; methotrexate IV over 2-22 hours on day 2; cytarabine IV over 2 hours every 12 hours on days 3-4; and leucovorin calcium PO or IV on days 3-6. Patients undergo stem cell collection after completion of course 2.
- Each course is 21 days long and continues in the absence of disease progression or unacceptable toxicity.
- Arm II (induction therapy):
- Course 1-6: Patients receive rituximab IV on day 1 and bendamustine hydrochloride IV over 30 minutes on days 1-2. Treatment repeats every 28 days for 4 courses in the absence of disease progression or unacceptable toxicity. Beginning 3-4 weeks later, patients with responsive disease receive 2 additional courses of treatment.
- Stem cell mobilization: Beginning within 8 weeks, patients receive rituximab IV and cyclophosphamide IV over 1 hour on day 1. Patients then undergo stem cell collection about 26 days later.
Consolidation therapy: Patients receive one of the following preparative regimens.
- BCV* chemotherapy: Carmustine IV over 2 hours on days -6 to -4; etoposide IV over 4 hours on day -4; and cyclophosphamide IV over 1 hour on day -2.
- BEAM* chemotherapy: Carmustine IV over 4 hours on days -7 and -6; etoposide IV over 1 hour twice daily and cytarabine IV over 2 hours twice daily on days -5 to -2, and melphalan IV on day -1.
- TBI, etoposide, cyclophosphamide: Patients undergo total-body irradiation (TBI)** twice daily on days -8 to -5. Patients also receive etoposide IV on day -4 and cyclophosphamide IV over 1 hour on day -2.
- NOTE: * Patients 61 years of age or older receive either BCV or BEAM.
- NOTE: * *TBI may not be used for patients 61 years of age and older. Stem cell transplantation: Patients then undergo autologous peripheral blood stem cell transplantation on day 0.
After completion of study treatment, patients are followed up every 3 months for 1 year, every 6 months for 2 years, and then annually for up to 8 years from registration.
- Conditions
- Lymphoma
- Being tested
- rituximab, bendamustine hydrochloride, cyclophosphamide, cytarabine, dexamethasone
- Keywords
- contiguous stage II mantle cell lymphoma, noncontiguous stage II mantle cell lymphoma, stage III mantle cell lymphoma, stage IV mantle cell lymphoma
- Medical subject headings
- Lymphoma, Lymphoma, Mantle-Cell
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
rituximabBiological
Given IV
bendamustine hydrochlorideDrug
Given IV
cyclophosphamideDrug
Given IV
cytarabineDrug
Given IV
dexamethasoneDrug
Given PO or IV
Given IV
Given PO or IV
methotrexateDrug
Given IV
Given IV
| Study group | Role | What they receive |
|---|---|---|
| Arm I | Experimental | Course 1 and 3: Patients receive induction therapy comprising rituximab IV on day 1; cyclophosphamide IV over 3 hours every 12 hours on days 2-4; doxorubicin hydrochloride IV over 72 hours on days 5-7; vincristine sulfate IV on days 5 and 12; and dexamethasone IV or orally (PO) once daily (QD) on days 2-5 and 12-15. Patients with responsive disease after course 1 proceed to course 2. Course 2 and 4: Patients receive rituximab IV on day 1; methotrexate IV over 2-22 hours on day 2; cytarabine IV over 2 hours every 12 hours on days 3-4; and leucovorin calcium PO or IV on days 3-6. Patients then undergo stem cell collection after completion of course 2. Patients undergo stem cell collection after completion of course 2. Receives: Biological: rituximab; Drug: cyclophosphamide; Drug: cytarabine; Drug: dexamethasone; Drug: doxorubicin hydrochloride; Drug: leucovorin calcium; Drug: methotrexate; Drug: vincristine sulfate |
| Arm II | Experimental | Course 1-6: Patients receive rituximab IV on day 1 and bendamustine hydrochloride IV over 30 minutes on days 1-2. Treatment repeats every 28 days for 4 courses in the absence of disease progression or unacceptable toxicity. Beginning 3-4 weeks later, patients with responsive disease receive 2 additional courses of treatment. Beginning within 8 weeks, patients receive rituximab IV and cyclophosphamide IV over 1 hour on day 1. Patients then undergo stem cell collection about 26 days later. Receives: Biological: rituximab; Drug: bendamustine hydrochloride; Drug: cyclophosphamide |
What is being measured
The primary outcome is the main question the study is designed to answer.
Progression-Free Survival (PFS) at 2 Years
Disease progression is defined using the 2007 revised Cheson et al. criteria that is at least 50% increase in sum of the product of the diameters (SPD) of target measurable nodal lesions over the smallest sum observed, or >= 50% increase in greatest transverse diameter (GTD) of any nodal > 1 cm in shortest axis, or >= 50% increase in the SPD of other target measurable lesions over the smallest sum observed, any new bone marrow involvement, any new lesion, lymph node with long axis is > 1.5 cm or if both long and short axes are > 1 cm, PET positive if patients with no pretreatment PET scan or when PET scan was positive before therapy. Progression-free survival is measured from date of registration to date of first observation of progressive disease, or death due to any cause. Patients last known to be alive and progression-free are censored at date of last contact.
Measured: Up to 2 years
Secondary outcomes (3)
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 8 months (Assessed at the beginning of each cycle of treatment, at restaging, and at post transplant.)
Response Rate (Complete and Partial Response)
Complete Response (CR) is a complete disappearance of all disease with the exception of the following. If no PET scan or when the PET scan was positive before therapy, a post-treatment residual mass of any size is permitted if it is PET negative. If the PET scan was negative before therapy, all nodal masses at baseline must have regressed. No new lesions. Previously enlarged organs must have regressed and not be palpable. Bone marrow (BM) must be negative if positive at baseline. Normalization of markers. Partial Response (PR) is a 50% decrease in the sum of products of greatest diameters (SPD) for up to 6 identified dominant lesions, including spleenic and hepatic nodules from baseline. No new lesions and no increase in the size of liver, spleen or other nodes. If 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 9 months
5-year Overall Survival (OS)
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: 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 posted9 Aug 2011 (estimated)
- Study startNov 2011
- Primary completionFeb 2016
- Study completionMar 2021
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.
- 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
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 53 participants (actual)
Sponsor and investigators
- Lead sponsor
- SWOG Cancer Research Network
- Sponsor type
- Research network
- Collaborators
- National Cancer Institute (NCI)
- Responsible party
- Sponsor
- Investigators
- Steven H. Bernstein, MD, Principal investigator, James P. Wilmot Cancer Center
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT01412879
- Sponsor's protocol ID
- CDR0000707601
- Other IDs
- S1106, U10CA032102
- Status last verified
- Oct 2021
- First submitted
- 6 Aug 2011
- Last updated
- 29 Oct 2021
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- No
Study at a glance
From the registry record, last updated by the sponsor on 29 Oct 2021. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Randomized Phase II Trial of R-HCVAD/MTX/ARA-C Induction Followed by Consolidation With an Autologous Stem Cell Transplant Vs. R-Bendamustine Induction Followed by Consolidation With an Autologous Stem Cell Transplant for Patients ≤ 65 Years of Age With Previously Untreated Mantle Cell Lymphoma
- ClinicalTrials.gov ID
- NCT01412879
- Acronym / sponsor ID
- CDR0000707601
- Conditions
- Lymphoma
- Keywords
- contiguous stage II mantle cell lymphoma, noncontiguous stage II mantle cell lymphoma, stage III mantle cell lymphoma, stage IV mantle cell lymphoma
- Phase
- Phase 2
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 53 participants (actual)
- Lead sponsor
- SWOG Cancer Research NetworkResearch network
- Collaborators
- National Cancer Institute (NCI)
- Study start
- Nov 2011
- Primary completion
- Feb 2016 (actual)
- Study completion
- Mar 2021 (actual)
- First posted
- 9 Aug 2011 (estimated)
- Results
- Posted 7 Jun 2017
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 block cancer growth in different ways. Some find cancer cells and help kill them or carry cancer-killing substances to them. Others interfere with the ability of cancer cells to grow and spread. Drugs used in chemotherapy also work in different ways to kill more cancer cells or stop them from growing. It is not yet known whether rituximab is more effective with combination chemotherapy or bendamustine hydrochloride in treating patients with mantle cell lymphoma undergoing peripheral blood stem cell transplantation.
PURPOSE: This randomized phase II trial studies how well giving rituximab together with combination chemotherapy or bendamustine hydrochloride followed by consolidation chemotherapy and peripheral blood stem cell transplantation works in treating older patients with previously untreated mantle cell lymphoma.
Detailed description
OBJECTIVES:
- To estimate the 2-year progression-free survival (PFS) of patients with newly diagnosed mantle cell lymphoma (MCL) treated with rituximab, cyclophosphamide, doxorubicin hydrochloride, vincristine sulfate, dexamethasone (RHCVAD), methotrexate and cytarabine (MTX/Ara-C), and autologous stem cell transplant (ASCT) or rituximab and bendamustine (R-bendamustine) and autologous stem cell transplant and to select a regimen for further development.
- To assess the response rate and overall survival of patients with newly diagnosed MCL treated with R-HCVAD/MTX/Ara-C and ASCT or R-bendamustine and ASCT.
- To assess the toxicity and tolerability of R-HCVAD/MTX/Ara-C and ASCT or R-bendamustine and ASCT in patients with newly diagnosed MCL.
- To determine the prognostic value of quantitative minimal-residual disease (MRD) monitoring in the peripheral blood of MCL patients after induction therapy and serially after high-dose chemotherapy and ASCT on treatment outcome.
- To bank diagnostic tissue sections for future translational research studies.
OUTLINE: This is a multicenter study. Patients are stratified according to risk classification by Mantle Cell Lymphoma International prognostic Index (MIPI) score (low risk vs intermediate/high risk). Patients are randomized to 1 of 2 treatment arms.
- Arm I (induction therapy):
- Courses 1 and 3: Patients receive induction therapy comprising rituximab IV on day 1; cyclophosphamide IV over 3 hours every 12 hours on days 2-4; doxorubicin hydrochloride IV over 72 hours on days 5-7; vincristine sulfate IV on days 5 and 12; and dexamethasone IV or orally (PO) once daily (QD) on days 2-5 and 12-15. Patients with responsive disease after course 1 proceed to course 2.
- Course 2 and 4: Patients receive rituximab IV on day 1; methotrexate IV over 2-22 hours on day 2; cytarabine IV over 2 hours every 12 hours on days 3-4; and leucovorin calcium PO or IV on days 3-6. Patients undergo stem cell collection after completion of course 2.
- Each course is 21 days long and continues in the absence of disease progression or unacceptable toxicity.
- Arm II (induction therapy):
- Course 1-6: Patients receive rituximab IV on day 1 and bendamustine hydrochloride IV over 30 minutes on days 1-2. Treatment repeats every 28 days for 4 courses in the absence of disease progression or unacceptable toxicity. Beginning 3-4 weeks later, patients with responsive disease receive 2 additional courses of treatment.
- Stem cell mobilization: Beginning within 8 weeks, patients receive rituximab IV and cyclophosphamide IV over 1 hour on day 1. Patients then undergo stem cell collection about 26 days later.
Consolidation therapy: Patients receive one of the following preparative regimens.
- BCV* chemotherapy: Carmustine IV over 2 hours on days -6 to -4; etoposide IV over 4 hours on day -4; and cyclophosphamide IV over 1 hour on day -2.
- BEAM* chemotherapy: Carmustine IV over 4 hours on days -7 and -6; etoposide IV over 1 hour twice daily and cytarabine IV over 2 hours twice daily on days -5 to -2, and melphalan IV on day -1.
- TBI, etoposide, cyclophosphamide: Patients undergo total-body irradiation (TBI)** twice daily on days -8 to -5. Patients also receive etoposide IV on day -4 and cyclophosphamide IV over 1 hour on day -2.
- NOTE: * Patients 61 years of age or older receive either BCV or BEAM.
- NOTE: * *TBI may not be used for patients 61 years of age and older. Stem cell transplantation: Patients then undergo autologous peripheral blood stem cell transplantation on day 0.
After completion of study treatment, patients are followed up every 3 months for 1 year, every 6 months for 2 years, and then annually for up to 8 years from registration.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Arm I | Experimental | Biological: rituximab, Drug: cyclophosphamide, Drug: cytarabine, Drug: dexamethasone, Drug: doxorubicin hydrochloride, Drug: leucovorin calcium, Drug: methotrexate, Drug: vincristine sulfateCourse 1 and 3: Patients receive induction therapy comprising rituximab IV on day 1; cyclophosphamide IV over 3 hours every 12 hours on days 2-4; doxorubicin hydrochloride IV over 72 hours on days 5-7; vincristine sulfate IV on days 5 and 12; and dexamethasone IV or orally (PO) once daily (QD) on days 2-5 and 12-15. Patients with responsive disease after course 1 proceed to course 2. Course 2 and 4: Patients receive rituximab IV on day 1; methotrexate IV over 2-22 hours on day 2; cytarabine IV over 2 hours every 12 hours on days 3-4; and leucovorin calcium PO or IV on days 3-6. Patients then undergo stem cell collection after completion of course 2. Patients undergo stem cell collection after completion of course 2. |
| Arm II | Experimental | Biological: rituximab, Drug: bendamustine hydrochloride, Drug: cyclophosphamideCourse 1-6: Patients receive rituximab IV on day 1 and bendamustine hydrochloride IV over 30 minutes on days 1-2. Treatment repeats every 28 days for 4 courses in the absence of disease progression or unacceptable toxicity. Beginning 3-4 weeks later, patients with responsive disease receive 2 additional courses of treatment. Beginning within 8 weeks, patients receive rituximab IV and cyclophosphamide IV over 1 hour on day 1. Patients then undergo stem cell collection about 26 days later. |
Who may qualify
- Ages
- 18 to 65 years
- 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 |
|---|---|---|
| rituximabGiven IV | Biological | Arm I, Arm II |
| bendamustine hydrochlorideGiven IV | Drug | Arm II |
| cyclophosphamideGiven IV | Drug | Arm I, Arm II |
| cytarabineGiven IV | Drug | Arm I |
| dexamethasoneGiven PO or IV | Drug | Arm I |
| doxorubicin hydrochlorideGiven IV | Drug | Arm I |
| leucovorin calciumGiven PO or IV | Drug | Arm I |
| methotrexateGiven IV | Drug | Arm I |
| vincristine sulfateGiven IV | Drug | Arm I |
Primary outcome
Progression-Free Survival (PFS) at 2 Years
Time frame: Up to 2 years
Disease progression is defined using the 2007 revised Cheson et al. criteria that is at least 50% increase in sum of the product of the diameters (SPD) of target measurable nodal lesions over the smallest sum observed, or >= 50% increase in greatest transverse diameter (GTD) of any nodal > 1 cm in shortest axis, or >= 50% increase in the SPD of other target measurable lesions over the smallest sum observed, any new bone marrow involvement, any new lesion, lymph node with long axis is > 1.5 cm or if both long and short axes are > 1 cm, PET positive if patients with no pretreatment PET scan or when PET scan was positive before therapy. Progression-free survival is measured from date of registration to date of first observation of progressive disease, or death due to any cause. Patients last known to be alive and progression-free are censored at date of last contact.
3 secondary outcomes
Number of Patients With Grade 3 Through Grade 5 Adverse Events That Are Related to Study Drug
Time frame: Up to 8 months (Assessed at the beginning of each cycle of treatment, at restaging, and at post transplant.)
Response Rate (Complete and Partial Response)
Time frame: Up to 9 months
5-year Overall Survival (OS)
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 29 Oct 2021.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
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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.
Steven H. Bernstein, MD principal investigator
James P. Wilmot Cancer Center
204 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, bendamustine hydrochloride and cyclophosphamide in people with Lymphoma, run by SWOG Cancer Research Network at 204 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 29 Oct 2021. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 204 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 7 Jun 2017). 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 2 Years (time frame: Up to 2 years). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
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 Oct 2021; AzTrials last refreshed its copy on 7 Nov 2026.