Trial for Patients With Newly Diagnosed Primary Central Nervous System (CNS) Lymphoma
This trial is active, not recruiting.
|Condition||central nervous system lymphoma|
|Treatments||methotrexate, ara-c, rituximab, thiotepa, radiotherapy, bcnu, apbsct|
|Sponsor||International Extranodal Lymphoma Study Group (IELSG)|
|Start date||November 2009|
|End date||December 2016|
|Trial size||126 participants|
|Trial identifier||NCT01011920, IELSG32|
This is a multicenter open label randomized phase II trial.
Enrolled Primary Central Nervous System Lymphoma (PCNSL) patients will be stratified according to the IELSG score and randomized to receive one of the follows as primary chemotherapy:
- Arm A: Methotrexate (MTX) + Cytarabine (Ara-C)
- Arm B: MTX + Ara-C + rituximab
- Arm C: MTX + Ara-C + rituximab + thiotepa.
Chemotherapy will be administered every three weeks. The maximum number of chemotherapy induction courses will be 4. Patients in Stable Disease (SD) or better after two courses will receive two more courses of the same primary chemotherapy regimen. Stem-cells harvest will be performed in the three arms after the second course. After 4 courses response assessment will be performed.
Patients who will not achieve SD or better after the 4th course, as well as those who will experience Progressive Disease (PD) at any time and those who will not achieve a sufficient stem cell harvest, will receive Whole Brain Radiation Therapy (WBRT) 36-40 Gy +/- tumor bed boost of 9 Gy.
Patients who will achieve SD or better after the 4th course will be stratified according to objective response to primary chemotherapy and to primary chemotherapy regimen and randomly allocated to receive as consolidation therapy one of the follows:
- Arm D: WBRT 36 Gy +/- boost 9 Gy
- Arm E: Carmustine (BCNU) + Thiotepa + Autologous Peripheral Blood Stem Cell Transplant (APBSCT) Patients in Complete Response (CR) after WBRT or APBSCT will remain in follow-up. Patients who will not achieve a CR after WBRT will be managed according to physician's preferences. Patients who will not achieve a CR after APBSCT will be referred to WBRT.
|United States||No locations recruiting|
|Other Countries||No locations recruiting|
|Aachen, Germany||University Hospital||no longer recruiting|
|Erlangen, Germany||Universitätsklinikum Erlangen||no longer recruiting|
|Essen, Germany||"Klinik für Hämatologie Universitätsklinikum Essen"||no longer recruiting|
|Freiburg, Germany||Uniklinik Freiburg||no longer recruiting|
|Hamburg, Germany||Universitätskrankenhaus Hamburg-Eppendorf||no longer recruiting|
|Jena, Germany||Friedrich Schiller Universitaet Jena||no longer recruiting|
|Mainz, Germany||Johannes Gutenberg Universität Mainz||no longer recruiting|
|München, Germany||Technische Universität in München||no longer recruiting|
|Ulm, Germany||Universitätsklinikum Ulm||no longer recruiting|
|Alessandria, Italy||A.O. SS. Antonio e Biagio e Cesare Arrigo||no longer recruiting|
|Brescia, Italy||Spedali Civili||no longer recruiting|
|Milan, Italy||San Raffaele H Scientific Institute||no longer recruiting|
|Nocera Inferiore, Italy||Ospedale Umberto I||no longer recruiting|
|Pescara, Italy||Ospedale Civile S.Spirito||no longer recruiting|
|Reggio Emilia, Italy||Arcispedale Santa Maria Nuova||no longer recruiting|
|Roma, Italy||Istituto Nazionale dei Tumori Regina Elena||no longer recruiting|
|Roma, Italy||Università degli Studi La Sapienza||no longer recruiting|
|Rozzano, Italy||Humanitas||no longer recruiting|
|Torino, Italy||Ospedale Maggiore S. Giovanni Battista||no longer recruiting|
|Verona, Italy||Policlinico G.B. Rossi||no longer recruiting|
|Bellinzona, Switzerland||IOSI - Oncology Institute of Southern Switzerland||no longer recruiting|
|Nottingham, United Kingdom||Nottingham City Hospital||no longer recruiting|
|Romford, United Kingdom||Queen's Hospital||no longer recruiting|
|Endpoint classification||efficacy study|
|Intervention model||parallel assignment|
response rate after primary chemotherapy and 2 years failure free survival at second randomization
time frame: 3 months, 2 years
safety, as acute and long-term toxicity
time frame: Throughout all the active treatment period
time frame: From entry onto trial until death for any cause
Male or female participants from 18 years up to 65 years old.
Inclusion Criteria: - Histological or cytological assessed diagnosis of non-Hodgkin's lymphoma. - Diagnostic sample obtained by stereotactic or surgical biopsy, Cerebrospinal Fluid (CSF) cytology examination or vitrectomy. - Disease exclusively localized into the central nervous system, CSF, cranial nerves or eyes. - At least one measurable lesion. - Previously untreated patients (previous or ongoing steroid therapy admitted). - Age 18-65 years (with ECOG Performance Status 0-3) or 66-70 (with ECOG Performance Status 0-2). - Adequate bone marrow, renal, cardiac, and hepatic function. - Sexually active patients of childbearing potential agreeing in implementing adequate contraceptive measures during study participation. - Absence of any familial, sociological or geographical condition potentially hampering compliance with the study protocol and follow-up schedule. - Patient-signed informed consent obtained before registration. Exclusion Criteria: - Patients with lymphomatous lesions outside the CNS. - Patients with a previous non-Hodgkin lymphoma at any time. - Previous or concurrent malignancies with the exception of surgically cured carcinoma in-situ of the cervix, carcinoma of the skin or other cancers without evidence of disease at least from 5 years. - HBsAg and HCV positivity. - HIV infection, previous organ transplantation or other clinically evident form of immunodeficiency. - Concurrent treatment with other experimental drugs. - Concurrent Pregnancy or lactation. - Patients not agreeing to take adequate contraceptive measures during the study. - Symptomatic coronary artery disease, cardiac arrhythmias uncontrolled with medication or myocardial infarction within the last 6 months (New York Heart Association Class III or IV heart disease).
|Official title||Randomized Phase II Trial On Primary Chemotherapy With High-Dose Methotrexate And High-Dose Cytarabine With Or Without Thiotepa, And With Or Without Rituximab, Followed By Brain Irradiation Vs. High-Dose Chemotherapy Supported By Autologous Stem Cells Transplantation For Immunocompetent Patients With Newly Diagnosed Primary CNS Lymphoma|
|Principal investigator||Emanuele Zucca, MD|
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