HIVPhase 2CARMENNCT01516593
Short Term Intensified Chemo-immunotherapy in HIV-positive Patients With Burkitt Lymphoma
A Phase 2 study testing Induction Phase, Consolidation Phase (on day +50) and Intensification phase in people with HIV and Burkitt's Lymphoma, run by Andres J. M. Ferreri at 8 sites in Italy.
Trial summary
This is a multicenter,open-label trial to evaluate activity and safety of the investigational intensive in HIV+ patients with Burkitt's lymphoma. Experimental treatment consists of an induction phase followed by a consolidation or intensified phase according to tumor response. Read more about this study
- Who is it for?
- Ages 18 to 60 years
- Conditions the study is for
- HIV, Burkitt's Lymphoma
- What is being tested?
- Induction Phase, Consolidation Phase (on day +50) and Intensification phase
- Type of treatment
- Injection or infusion, Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 19 participants
- Where
- 8 sitesItaly
- Study dates
- Nov 2011to Aug 2015
- Phase
- Phase 2
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 60 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- Histologic diagnosis of Burkitt's lymphoma (WHO 2008)
- HIV sero-positivity
- Age ≥18 and ≤60 years
- ECOG-PS ≤3
Who cannot join
- CNS parenchymal involvement
- Absolute neutrophil count <1.000 cells/μL and platelets count <75 × 109/L (Burkitt unrelated)
- Creatinine >1,5N (Burkitt unrelated)
- SGOT and/or SGTP >2,5N (Burkitt unrelated)
- Bilirubin >2N (Burkitt unrelated)
- Severe psychiatric illness or any other clinical, social or psychological condition that could interfere with patient's adherence and compliance
- Significant cardiac disease or acute myocardial infarction in the last 12 months
- Severe active infection (except for HBV and/or HCV co-infection)
Trial locations and contacts
8 sites in 1 country.
8 sites in 1 country
Italy8 sites
Oncologia Medica A - Centro di Riferimento Oncologico
Aviano (PN)
Ematologia - A.O. Spedali Civili
Brescia
Dip. Oncoematologia - Fondazione Centro San Raffaele del Monte Tabor
Milan
S.C. Oncologia Medica - Ospedale San Paolo
Milan
S.C. Oncologia Medica 3 - IRCCS Istituto Nazionale Tumori (INT)
Milan
U.O.C. Immunodeficienze virali - I.N.M.I. L. Spallanzani
Roma
S.C. Oncoematologia - A.O. Santa Maria
Terni
U.O. Ematologia 2 - Ospedale San Giovanni Battista
Torino
About this study
Official title: Phase II Study on Safety and Activity of a Short Term Intensified Chemo-immunotherapy Combination in HIV-positive Patients Affected by Burkitt Lymphoma
This is a multicenter,open-label trial to evaluate activity and safety of the investigational intensive in HIV+ patients with Burkitt's lymphoma.
Experimental treatment consists of an induction phase followed by a consolidation or intensified phase according to tumor response.
Until recently, the immuno-compromised state of patients with concomitant HIV/AIDS and BL was thought to limit the ability to administer intensive chemotherapeutic regimens due to infection rate. However, the advent of highly active antiretroviral therapy (HAART) and evidence in diffuse large B-cell lymphomas that HIV-positive patients can tolerate standard chemotherapeutic regimens with improved outcomes have led investigators to treat HIV-positive patients with the same intensive chemotherapy regimens used to treat immuno-competent patients. Data suggest that these current approaches, along with supportive care, may result in improved patient outcomes, similar to those in the immuno-competent patient population.
Read the detailed description
The activity of feasibility of the proposed program will be assessed in HIV+ patients with Burkitt lymphoma with the aim to improve tolerability, minimize source consuming and supporting treatment and redu ce late sequels. Available combinations in this setting are really source demanding and toxic combinations showing high rates of septic complication and a treatment-related mortality of near 20%.
- Conditions
- HIV, Burkitt's Lymphoma
- Being tested
- Induction Phase, Consolidation Phase (on day +50), Intensification phase, BEAM conditioning, Consolidation radiotherapy
- Keywords
- HIV, Burkitt's lymphoma, intensive, short term, immuno-chemotherapy, HIV-positive patients with Burkitt's lymphoma
- Medical subject headings
- Burkitt Lymphoma
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Induction PhaseDrug
Also called Short-term intensive sequential chemoimmunotherapy
- dd -2 to 1: Methylprednisolone
- dd 0-1, Cyclophosphamide, associated on day 0 with Vincristine
- dd 2, Rituximab
- dd 7, Methotrexate
- dd 14, Rituximab
- dd 15, Etoposide
- dd 21, Methotrexate
- dd 29, Rituximab and Doxorubicin
- dd 36, Rituximab and VCR
At the end of this induction phase, subsequent treatment will be performed according to the objective response:
- pts in CR: consolidation phase followed by bulky site irradiation
- pts in PR: consolidation phase followed by BEAM conditioning regimen supported by ASCT and bulky irradiation
- pts with SD after induction or PD during or after induction: intensification phase followed by BEAM conditioning regimen supported by ASCT and bulky irradiation
Consolidation Phase (on day +50)Drug
Also called high-dose cytarabine; consolidation phase
- dd 1-2: cytarabine twice a day
- dd 3 and 11: rituximab
- dd 11-13: leukapheresis for PBPC collection.
Intensification phaseDrug
Also called unresponsive patients, refractory disease
- One or two courses of R-IVAC or R-ICE chemoimmunotherapy regimen, every three weeks as debulking.
- CTX (dd 1) associated with rituximab on dd 3 and 10, followed by PBPC collection (dd 11-13);
- AraC every 12 hours for four days (dd -5 to -2) supported by reinfusion of CD34+ cells (dd 0), rituximab infusion (dd -1 and +11) and second in-vivo purged PBPC collection (if needed).
BEAM conditioningDrug
Also called Conditioning regimen, autologous transplantation
BCNU on dd 1; VP-16 every 12 hours on dd 2-5 and araC every 12 hours on dd 2-5; melphalan on dd 6, followed by the reinfusion of CD34+ cells
Consolidation radiotherapyRadiation
Also called bulky irradiation; residual lesion
At the end of the whole program, patients will be evaluated for involved-field irradiation with 6-10 MeV photons and a dose of 36 Gy (2 Gy/d, five fractions a week). Three subgroups of patients will be considered for radiotherapy
| Study group | Role | What they receive |
|---|---|---|
| intensive short term immuno-chemotherapy | Experimental | Experimental treatment consists of an induction phase followed by a consolidation or intensified phase according to tumor response. Receives: Drug: Induction Phase; Drug: Consolidation Phase (on day +50); Drug: Intensification phase; Drug: BEAM conditioning; Radiation: Consolidation radiotherapy |
What is being measured
The primary outcome is the main question the study is designed to answer.
evaluation of activity of the induction phase in terms of complete remission rate
Objective lymphoma response achieved after the induction phase of the experimental treatment.
Measured: at the end of the induction phase of the investigational intensive chemotherapy, an expected average of 45 days
Secondary outcomes (4)
Feasibility and tolerability of the investigational intensive chemotherapy in terms of grade ≥4 adverse events
Assessment of incidence of grade 4 AE during experimental treatment (induction, consolidation and intensification phases as well as conditioning and autologous stem cell transplantation (if indicated)
Measured: participants will be followed for the duration of the whole experimental program, an expected average of 100 days
Feasibility and tolerability of the consolidation phase followed by BEAM conditioning and autologous stem cell transplantation in terms of prevalence of grade ≥4 adverse events
Measured: participants will be followed for the duration of the whole experimental program, an expected average of 100 days
Feasibility and tolerability of intensification phase in terms of prevalence of grade ≥4 adverse events
Participants who will not achieve a complete or partial response after induction and consolidation phases will be referred to intensification phase, which will be followed by BEAM + ASCT. These patients will be assess for tolerabbility and AE during these therapeutic phases.
Measured: participants will be followed for the duration of the whole experimental program, an expected average of 100 days
Activity of the whole investigational program in terms of complete remission rate
Participants will be assessed by conventional exams to define complete remission rate after the whole experiemntal program; that is after consolidation phase for patients who achieved complete remission after induction phase, after BEAM + ASCt for patients who achieved partial response after induction phase, and after intensification phase for patients who did not achieve an objective response after induction phase.
Measured: at the end of the whole program, an expected average of 100 days
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted25 Jan 2012 (estimated)
- Study startNov 2011
- Primary completionApr 2013
- Study completionAug 2015
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for HIVStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 2
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Enrolment
- 19 participants (actual)
Sponsor and investigators
- Lead sponsor
- Andres J. M. Ferreri
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor-investigator, Andres J. M. Ferreri, IRCCS San Raffaele
- Investigators
- Andrés JM Ferreri, MD, Study chair, San Raffaele Scientific Institute, Milano, Italy
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT01516593
- Sponsor's protocol ID
- CARMEN
- Acronym
- CARMEN
- Status last verified
- Aug 2022
- First submitted
- 6 Jan 2012
- Last updated
- 4 Aug 2022
- Results posted
- No
- Data monitoring committee
- No
Study at a glance
From the registry record, last updated by the sponsor on 4 Aug 2022. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Phase II Study on Safety and Activity of a Short Term Intensified Chemo-immunotherapy Combination in HIV-positive Patients Affected by Burkitt Lymphoma
- ClinicalTrials.gov ID
- NCT01516593
- Acronym / sponsor ID
- CARMEN / CARMEN
- Conditions
- HIV, Burkitt's Lymphoma
- Keywords
- HIV, Burkitt's lymphoma, intensive, short term, immuno-chemotherapy, HIV-positive patients with Burkitt's lymphoma
- Phase
- Phase 2
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 19 participants (actual)
- Lead sponsor
- Andres J. M. FerreriUniversity, hospital or other
- Study start
- Nov 2011
- Primary completion
- Apr 2013 (actual)
- Study completion
- Aug 2015 (actual)
- First posted
- 25 Jan 2012 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This is a multicenter,open-label trial to evaluate activity and safety of the investigational intensive in HIV+ patients with Burkitt's lymphoma.
Experimental treatment consists of an induction phase followed by a consolidation or intensified phase according to tumor response.
Until recently, the immuno-compromised state of patients with concomitant HIV/AIDS and BL was thought to limit the ability to administer intensive chemotherapeutic regimens due to infection rate. However, the advent of highly active antiretroviral therapy (HAART) and evidence in diffuse large B-cell lymphomas that HIV-positive patients can tolerate standard chemotherapeutic regimens with improved outcomes have led investigators to treat HIV-positive patients with the same intensive chemotherapy regimens used to treat immuno-competent patients. Data suggest that these current approaches, along with supportive care, may result in improved patient outcomes, similar to those in the immuno-competent patient population.
Detailed description
The activity of feasibility of the proposed program will be assessed in HIV+ patients with Burkitt lymphoma with the aim to improve tolerability, minimize source consuming and supporting treatment and redu ce late sequels. Available combinations in this setting are really source demanding and toxic combinations showing high rates of septic complication and a treatment-related mortality of near 20%.
Study design
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| intensive short term immuno-chemotherapy | Experimental | Drug: Induction Phase, Drug: Consolidation Phase (on day +50), Drug: Intensification phase, Drug: BEAM conditioning, Radiation: Consolidation radiotherapyExperimental treatment consists of an induction phase followed by a consolidation or intensified phase according to tumor response. |
Who may qualify
- Ages
- 18 to 60 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (4 listed)
- Histologic diagnosis of Burkitt's lymphoma (WHO 2008)
- HIV sero-positivity
- Age ≥18 and ≤60 years
- ECOG-PS ≤3
Key exclusion criteria (8 listed)
- CNS parenchymal involvement
- Absolute neutrophil count <1.000 cells/μL and platelets count <75 × 109/L (Burkitt unrelated)
- Creatinine >1,5N (Burkitt unrelated)
- SGOT and/or SGTP >2,5N (Burkitt unrelated)
- Bilirubin >2N (Burkitt unrelated)
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 |
|---|---|---|
| Induction PhaseAlso: Short-term intensive sequential chemoimmunotherapy* dd -2 to 1: Methylprednisolone * dd 0-1, Cyclophosphamide, associated on day 0 with Vincristine * dd 2, Rituximab * dd 7, Methotrexate * dd 14, Rituximab * dd 15, Etoposide * dd 21, Methotrexate * dd 29, Rituximab and Doxorubicin * dd 36, Rituximab and VCR At the end of this induction phase, subsequent treatment will be performed according to the objective response: 1. pts in CR: consolidation phase followed by bulky site irradiation 2. pts in PR: consolidation phase followed by BEAM conditioning regimen supported by ASCT and bulky irradiation 3. pts with SD after induction or PD during or after induction: intensification phase followed by BEAM conditioning regimen supported by ASCT and bulky irradiation | Drug | intensive short term immuno-chemotherapy |
| Consolidation Phase (on day +50)Also: high-dose cytarabine; consolidation phase* dd 1-2: cytarabine twice a day * dd 3 and 11: rituximab * dd 11-13: leukapheresis for PBPC collection. | Drug | intensive short term immuno-chemotherapy |
| Intensification phaseAlso: unresponsive patients, refractory disease1. One or two courses of R-IVAC or R-ICE chemoimmunotherapy regimen, every three weeks as debulking. 2. CTX (dd 1) associated with rituximab on dd 3 and 10, followed by PBPC collection (dd 11-13); 3. AraC every 12 hours for four days (dd -5 to -2) supported by reinfusion of CD34+ cells (dd 0), rituximab infusion (dd -1 and +11) and second in-vivo purged PBPC collection (if needed). | Drug | intensive short term immuno-chemotherapy |
| BEAM conditioningAlso: Conditioning regimen, autologous transplantationBCNU on dd 1; VP-16 every 12 hours on dd 2-5 and araC every 12 hours on dd 2-5; melphalan on dd 6, followed by the reinfusion of CD34+ cells | Drug | intensive short term immuno-chemotherapy |
| Consolidation radiotherapyAlso: bulky irradiation; residual lesionAt the end of the whole program, patients will be evaluated for involved-field irradiation with 6-10 MeV photons and a dose of 36 Gy (2 Gy/d, five fractions a week). Three subgroups of patients will be considered for radiotherapy | Radiation | intensive short term immuno-chemotherapy |
Primary outcome
evaluation of activity of the induction phase in terms of complete remission rate
Time frame: at the end of the induction phase of the investigational intensive chemotherapy, an expected average of 45 days
Objective lymphoma response achieved after the induction phase of the experimental treatment.
4 secondary outcomes
Feasibility and tolerability of the investigational intensive chemotherapy in terms of grade ≥4 adverse events
Time frame: participants will be followed for the duration of the whole experimental program, an expected average of 100 days
Feasibility and tolerability of the consolidation phase followed by BEAM conditioning and autologous stem cell transplantation in terms of prevalence of grade ≥4 adverse events
Time frame: participants will be followed for the duration of the whole experimental program, an expected average of 100 days
Feasibility and tolerability of intensification phase in terms of prevalence of grade ≥4 adverse events
Time frame: participants will be followed for the duration of the whole experimental program, an expected average of 100 days
Activity of the whole investigational program in terms of complete remission rate
Time frame: at the end of the whole program, an expected average of 100 days
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 4 Aug 2022.
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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.
Andrés JM Ferreri, MD study chair
San Raffaele Scientific Institute, Milano, Italy
8 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 Induction Phase, Consolidation Phase (on day +50) and Intensification phase in people with HIV and Burkitt's Lymphoma, run by Andres J. M. Ferreri at 8 sites in Italy.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 4 inclusion and 8 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 4 Aug 2022. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 8 sites in Italy. 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?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
evaluation of activity of the induction phase in terms of complete remission rate (time frame: at the end of the induction phase of the investigational intensive chemotherapy, an expected average of 45 days). 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 4 Aug 2022.