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Rituximab and Combination Chemotherapy in Treating Patients With Primary Central Nervous System Lymphoma

Registration Number
NCT00335140
Lead Sponsor
Eastern Cooperative Oncology Group
Brief Summary

RATIONALE: Monoclonal antibodies, such as rituximab, can block cancer growth in different ways. Some find cancer cells and 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, such as methotrexate, leucovorin, vincristine, procarbazine, dexamethasone, and cytarabine, work in different ways to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Giving rituximab together with combination chemotherapy may kill more cancer cells.

PURPOSE: This phase II trial is studying how well giving rituximab together with combination chemotherapy works in treating patients with primary central nervous system (CNS) lymphoma.

Detailed Description

OBJECTIVES:

Primary

* Determine the complete response rate.

Secondary

* Determine the progression-free survival of these patients.

* Determine the proportion of progression-free and overall survival in these patients.

* Determine rituximab cerebrospinal fluid pharmacokinetics (only in patients requiring intrathecal chemotherapy).

OUTLINE: This is a multicenter study.

Patients receive rituximab IV 3 times weekly in weeks 1-4; high-dose methotrexate IV over 2 hours in weeks 1, 3, 5, and 9; oral or IV leucovorin calcium every 6 hours for 12 doses beginning 24 hours after the start of methotrexate in weeks 1, 3, 5, and 9; vincristine IV in weeks 1, 3, 5, 7, and 9; oral procarbazine hydrochloride daily on days 1-7 in weeks 1, 5, and 9; oral dexamethasone daily in weeks 1-6; and cytarabine IV over 2 hours twice weekly in weeks 11 and 14.

Patients with positive cerebrospinal fluid also receive methotrexate intrathecally and oral leucovorin calcium every 12 hours for 8 doses beginning 24 hours after the start of methotrexate in weeks 2, 4, 6, 8, and 10.

After completion of study treatment, patients are followed periodically for 5 years.

PROJECTED ACCRUAL: A total of 43 patients will be accrued for this study.

Recruitment & Eligibility

Status
TERMINATED
Sex
All
Target Recruitment
26
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Rituximab + standard chemotherapyRituximabRituximab + high dose methotrexate, leucovorin, vincristine, procarbazine, dexamethasone, and cytarabine. Patients with meningeal involvement will receive additional methotrexate and leucovorin.
Rituximab + standard chemotherapyCytarabineRituximab + high dose methotrexate, leucovorin, vincristine, procarbazine, dexamethasone, and cytarabine. Patients with meningeal involvement will receive additional methotrexate and leucovorin.
Rituximab + standard chemotherapyDexamethasoneRituximab + high dose methotrexate, leucovorin, vincristine, procarbazine, dexamethasone, and cytarabine. Patients with meningeal involvement will receive additional methotrexate and leucovorin.
Rituximab + standard chemotherapyLeucovorinRituximab + high dose methotrexate, leucovorin, vincristine, procarbazine, dexamethasone, and cytarabine. Patients with meningeal involvement will receive additional methotrexate and leucovorin.
Rituximab + standard chemotherapyProcarbazineRituximab + high dose methotrexate, leucovorin, vincristine, procarbazine, dexamethasone, and cytarabine. Patients with meningeal involvement will receive additional methotrexate and leucovorin.
Rituximab + standard chemotherapyMethotrexateRituximab + high dose methotrexate, leucovorin, vincristine, procarbazine, dexamethasone, and cytarabine. Patients with meningeal involvement will receive additional methotrexate and leucovorin.
Rituximab + standard chemotherapyVincristineRituximab + high dose methotrexate, leucovorin, vincristine, procarbazine, dexamethasone, and cytarabine. Patients with meningeal involvement will receive additional methotrexate and leucovorin.
Primary Outcome Measures
NameTimeMethod
Complete Response Rate - Locally ReviewedFor the primary endpoint, complete response will be based on disease status at three weeks post the end of therapy (week 17).

Assessed by the ECOG-ACRIN data manager based upon local review of images and data sent by the local sites.

Treatment response was determined by calculating the sum of the maximal cross section in 2 separate axes using enhancing lesion(s) on CT or MRI imaging. The same imaging modality was to be used throughout assessment. Complete response was defined as the disappearance of all contrast enhancing tumor size on CT or MRI, patient was off all glucocorticoids, and resolution of all meningeal and vitreous involvement if present. Response must have lasted at least 4 weeks.

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (68)

Stanford Cancer Center

🇺🇸

Stanford, California, United States

University of Florida Shands Cancer Center

🇺🇸

Gainesville, Florida, United States

Mayo Clinic - Jacksonville

🇺🇸

Jacksonville, Florida, United States

John H. Stroger, Jr. Hospital of Cook County

🇺🇸

Chicago, Illinois, United States

Hinsdale Hematology Oncology Associates

🇺🇸

Hinsdale, Illinois, United States

McFarland Clinic, PC

🇺🇸

Ames, Iowa, United States

Siouxland Hematology-Oncology Associates, LLP

🇺🇸

Sioux City, Iowa, United States

Mercy Medical Center - Sioux City

🇺🇸

Sioux City, Iowa, United States

St. Luke's Regional Medical Center

🇺🇸

Sioux City, Iowa, United States

Hospital District Sixth of Harper County

🇺🇸

Anthony, Kansas, United States

Scroll for more (58 remaining)
Stanford Cancer Center
🇺🇸Stanford, California, United States

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