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Pixantrone, Cytarabine, Methylprednisolone, and Cisplatin in Treating Patients With Aggressive Non-Hodgkin's Lymphoma in First Relapse

Phase 2
Conditions
Lymphoma
Registration Number
NCT00069966
Lead Sponsor
Theradex
Brief Summary

RATIONALE: Drugs used in chemotherapy, such as pixantrone, cytarabine, methylprednisolone, and cisplatin, work in different ways to stop cancer cells from dividing so they stop growing or die. Combining more than one drug may kill more cancer cells.

PURPOSE: Phase II trial to study the effectiveness of combination chemotherapy in treating patients who have relapsed aggressive non-Hodgkin's lymphoma.

Detailed Description

OBJECTIVES:

* Determine the antitumor activity of pixantrone, cytarabine, methylprednisolone, and cisplatin in patients with aggressive non-Hodgkin's lymphoma in first relapse.

* Determine the safety and tolerability of this regimen in these patients.

* Determine the validity and safety of this regimen as a mobilization regimen before high-dose chemotherapy with stem cell support in these patients.

OUTLINE: This is an open-label, multicenter study.

* Salvage therapy: Patients receive pixantrone IV over 1 hour on day 1; cisplatin IV over 30 minutes on days 1-4; methylprednisolone IV over 15-30 minutes on days 1-5; and cytarabine IV over 2 hours on day 5. Treatment repeats every 21 days for 2 courses in the absence of disease progression or unacceptable toxicity.

After 2 courses of salvage therapy, patients are re-evaluated and treated as follows:

* Complete response (CR) or partial response (PR): Patients with a CR or PR who are suitable candidates for autologous stem cell transplantation (ASCT) proceed to mobilization therapy, high-dose chemotherapy, and ASCT. Patients with a CR or PR who are unsuitable candidates for ASCT continue to receive salvage therapy for up to 6 courses in the absence of disease progression or unacceptable toxicity.

* Stable disease: Patients with stable disease continue to receive salvage therapy for up to 6 courses. Patients who have a CR or PR after 3-4 courses of salvage therapy and who are suitable candidates for ASCT proceed to mobilization therapy, high-dose chemotherapy, and ASCT off study at the investigator's discretion.

* Mobilization therapy (optional regimen; regimen used for mobilization is at the investigator's discretion): Patients receive rituximab\* IV on days 1 and 7; pixantrone IV over 1 hour on day 2; cisplatin IV over 30 minutes on days 2-5; cytarabine IV over 2 hours on day 6; and methylprednisolone IV over 15-30 minutes on days 2-6. Patients also receive filgrastim (G-CSF) subcutaneously once daily beginning on day 7 and continuing until blood counts recover. Patients receive 1 or more courses of mobilization therapy during which stem cells are harvested. Patients then proceed to high-dose chemotherapy and subsequent re-infusion of harvested stem cells.

NOTE: \*If this mobilization regimen is used, patients with T-cell lymphoma do not receive rituximab

* High-dose chemotherapy and ASCT: Patients receive high-dose chemotherapy and ASCT per institutional standard practice.

Patients are followed every 3 months for 2 years.

PROJECTED ACCRUAL: A total of 75 patients will be accrued for this study.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
Not specified
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (29)

Massachusetts General Hospital Cancer Center

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Boston, Massachusetts, United States

Baylor University Medical Center

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Dallas, Texas, United States

Ireland Cancer Center at University Hospitals of Cleveland and Case Western Reserve University

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Cleveland, Ohio, United States

Cleveland Clinic Taussig Cancer Center

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Cleveland, Ohio, United States

Rocky Mountain Cancer Centers - Colorado Springs

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Colorado Springs, Colorado, United States

Hematology-Oncology Associates of Illinois

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Chicago, Illinois, United States

City of Hope Comprehensive Cancer Center

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Duarte, California, United States

UNMC Eppley Cancer Center at the University of Nebraska Medical Center

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Omaha, Nebraska, United States

Duke Comprehensive Cancer Center

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Durham, North Carolina, United States

Cancer Care Associates-West

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Oklahoma City, Oklahoma, United States

Rocky Mountain Cancer Centers - Denver Midtown

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Denver, Colorado, United States

University of Texas - MD Anderson Cancer Center

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Houston, Texas, United States

Medical College of Wisconsin Cancer Center

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Milwaukee, Wisconsin, United States

North Shore University Hospital

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Manhasset, New York, United States

USC/Norris Comprehensive Cancer Center and Hospital

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Los Angeles, California, United States

Delaware Clinical & Laboratory Physicians

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Newark, Delaware, United States

Markey Cancer Center at University of Kentucky Chandler Medical Center

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Lexington, Kentucky, United States

Pasco, Hernando Oncology Associates, P.A.

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New Port Richey, Florida, United States

Louisiana State University Health Sciences Center - Shreveport

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Shreveport, Louisiana, United States

Dana-Farber/Harvard Cancer Center at Dana Farber Cancer Institute

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Boston, Massachusetts, United States

SUNY Upstate Medical University Hospital

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Syracuse, New York, United States

Gabrail Cancer Center - Canton Office

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Canton, Ohio, United States

Penn State Cancer Institute at Milton S. Hershey Medical Center

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Hershey, Pennsylvania, United States

Cancer Centers of the Carolinas - Eastside

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Greenville, South Carolina, United States

Fairfax Northern Virginia Hematology Oncology, P.C. - Fairfax

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Fairfax, Virginia, United States

Hospital Auxilio Mutuo

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Hato Rey, Puerto Rico

Piedmont Hematology-Oncology Associates

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Winston-Salem, North Carolina, United States

Arizona Oncology Associates - Craycroft Road Offices

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Tucson, Arizona, United States

Providence Cancer Center at Providence Portland Medical Center

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Portland, Oregon, United States

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