A Multicenter, Randomized Controlled Clinical Study of Pegaspargase Combined With P-GEMD Regimen Versus P-Gemox Regimen in the Treatment of Untreated Early-Stage Non-Upper Aerodigestive Tract or Advanced-Stage Extranodal NK/T-Cell Lymphoma.
试验速览
- 阶段
- 3 期
- 状态
- 尚未招募
- 入组人数
- 60
- 主要终点
- Complete Response (CR) Rate
研究概览
简要总结
Extranodal natural-killer (NK)/T-cell lymphoma (ENKTL) is an aggressive subtype of non-Hodgkin lymphoma with a poor prognosis. Notably, patients with advanced-stage disease or early-stage non-upper aero-digestive tract (NUAT) involvement frequently develop hemophagocytic lymphohistiocytosis (HLH), necessitating more effective therapeutic interventions. This Multicenter, Randomized Controlled Clinical Study aimed to compare the efficacy and safety of P-GEMD and P-Gemox in the treatment of newly diagnosed early NUAT or advanced-stage ENKTL.
详细描述
This Multicenter, Randomized Controlled Clinical Study aimed to compare the efficacy and safety of P-GEMD and P-Gemox in the treatment of newly diagnosed early NUAT or advanced-stage ENKTL. The P-GEMD regimen (pegaspargase; gemcitabine; etoposide; mitoxantrone hydrochlorid liposome; dexamethasone) was administered intravenously every 3 weeks until up to 6 cycles of planned therapy. The P-Gemox regimen ( Pegaspargase, Gemcitabine, and Oxaliplatin) was administered intravenously 3 weeks until up to 6 cycles of planned therapy.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Voluntarily join this study and sign the informed consent form; 2.Age ≥18 years old; 3.Expected survival time ≥ 3 months;
- •Histopathologically confirmed early non-upper aerodigestive or advanced ENKTL;
- •There must be at least one evaluable or measurable lesion that meets the Lugano2014 criteria: lymph node lesions, measurable lymph nodes need to have a long diameter > 1.5cm; non-lymph node lesions, extranodal lesions that can be measured Long diameter > 1.0cm;
- •ECOG score 0-2 points;
- •Bone marrow function: neutrophil count ≥ 1.5×109/L, platelet count ≥ 75×109/L, hemoglobin ≥ 80g/L(Restriction may be relaxed in patients with bone marrow involvement, Absolute neutrophil count (ANC) ≥1.0×109/L, Platelet count (PLT) ≥50×109/L, Hemoglobin(HB)≥ 75g/L);
- •Liver and kidney function: serum creatinine ≤ 1.5 times the upper limit of the normal value; alanine aminotransferase (AST) and aspartate aminotransferase (ALT) ≤ 2.5 times the upper limit of the normal value (for patients with liver invasion ≤ 5 times the normal value upper limit); total bilirubin ≤ 1.5 times the upper limit of normal value (for patients with liver invasion ≤ 3 times the upper limit of normal value).
排除标准
- •1.Hypersensitivity to any study drug or its components;
- •Uncontrollable systemic diseases (such as advanced infection, uncontrollable hypertension, diabetes, etc.);
- •Cardiac function and disease meet one of the following conditions : A.long QTc syndrome or QTc interval >480 ms; B.complete left bundle branch block, second-degree or third-degree atrioventricular block; C.severe, uncontrolled arrhythmia requiring drug treatment ; D.New York Society of Cardiology ≥ Grade III; E.Cardiac ejection fraction (LVEF) lower than 50%; F.Myocardial infarction, unstable angina, and severely unstable ventricular rhythm within 6 months before recruitment History of arrhythmia or any other arrhythmia requiring treatment, history of clinically severe pericardial disease, or ECG evidence of acute ischemia or active conduction system abnormalities.
- •Active hepatitis B and C infection (positive hepatitis B virus surface antigen and more than 1x103 copies/mL of hepatitis B virus DNA; more than 1x103 copies/mL of hepatitis C virus RNA);
- •Human immunodeficiency virus (HIV) infection (positive HIV antibody);
- •Previously or currently suffering from other malignant tumors (except for effectively controlled non-melanoma skin basal cell carcinoma, breast/cervix carcinoma in situ and other malignant tumors that have been effectively controlled without treatment in the past five years);
- •Central nervous system (CNS) involvement at the time of recruitment;
- •Pregnant, lactating women and patients of childbearing age who do not want to take contraceptive measures; 9.Other investigators judge that they are not suitable for participating in this study.
研究组 & 干预措施
P-GEMD
The P-GEMD regimen (pegaspargase at 3750 IU, d2; gemcitabine at 1000 mg/m2, d1; etoposide at 65 mg/m2, d2-4; mitoxantrone hydrochloride liposome at 12mg/m2, d1; dexamethasone at 40 mg/d, d1-4.) was administered intravenously every 3 weeks until up to 6 cycles of planned therapy.
干预措施: P-GEMD (Drug)
P-Gemox
The P-Gemox regimen (pegaspargase at 2000-2500 IU/m2, d2; gemcitabine at 1000 mg/m2, d1, d8; oxaliplatin at 130 mg/m2, d1) was administered intravenously every 3 weeks until up to 6 cycles of planned therapy.
干预措施: P-Gemox (Drug)
结局指标
主要结局
Complete Response (CR) Rate
时间窗: 5.5years
Response is assessed according to the lugano criteria.
次要结局
- EBV-DNA load level (before and after treatment)(5.5 years)
- Overall Response Rate (ORR)(5.5years)
- Progression-Free-Survival (PFS)(5.5years)
- Duration of Response (DOR)(5.5years)
- Overall survival (OS)(5.5years)
- Hematologic and non-hematologic toxicity.(From the first day of medication to 28 days after the last dose)