Fludarabine, Mitoxantrone, and Dexamethasone (FND) Plus Rituximab for Lymphoma Patients
- Conditions
- Lymphoma
- Interventions
- Registration Number
- NCT00577993
- Lead Sponsor
- M.D. Anderson Cancer Center
- Brief Summary
The goal of this clinical research study is to compare chemotherapy given with rituximab to chemotherapy followed by rituximab. The safety of both treatment schedules will be studied. Laboratory tests of genetic changes in blood and bone marrow before and during the study will also be monitored.
- Detailed Description
Rituximab is a monoclonal antibody that is designed to attach to leukemia cells and activate a series of events that may cause the cancer cells to die.
Fludarabine is designed to make cancer cells less able to repair damaged DNA (the genetic material of cells). This may increase the likelihood of the cells dying.
Mitoxantrone is designed to stop cancer cells from making DNA, which may stop the cells from making more cells.
Dexamethasone is a corticosteroid that is similar to a natural hormone made by your body. Dexamethasone is often given to MM patients in combination with other chemotherapy to treat cancer.
Study Groups:
If you are found eligible to take part in this study, you will be randomly assigned (as in the flip of a coin) to 1 of 2 study groups. Each group will receive 8 "cycles" of treatment. One (1) cycle will last 28 days.
Group 1:
If you are in Group 1, you will receive the following drugs at the following times. Each study cycle is 28 days:
* Rituximab will be given through a needle in the vein over about 90 minutes on Days 1 and 8 of the first course Cycle 1, and on Day 1 only of Cycles 2-5 of Fludarabine/ Mitoxantrone/ Dexamethasone (FND) treatment.
* Fludarabine will be given through a needle in the vein over about 15 minutes on Days 2-4 of each cycle.
* Mitoxantrone will be given through a needle in the vein over about 15 minutes on Day 2 of each cycle.
* You will take dexamethasone by mouth with water on Days 1-5 of each 28-day cycle (FND).
If you miss any doses of the study drugs, please contact the research staff for instructions.
You will not receive rituximab in Cycles 6-8. When the 8 cycles are finished, you will begin receiving the drug interferon on Days 1-14 each month for 1 year. Dexamethasone will be given on Days 1-3 every month for 1 year.
Patients in group 2 will receive fludarabine on Days 1-3, mitoxantrone on Day 1, and dexamethasone on Days 1-5 of each 28-day cycle. When 8 cycles of treatment are finished, patients will begin receiving the drug interferon on Days 1-14 each month for 1 year. Dexamethasone will be given on Days 1-3 every month for 1 year. About 4 months after interferon treatment starts, patients in group 2 will begin receiving rituximab once a month for 6 months.
Other drugs may be given to help decrease the risk of or ease side effects. Treatment may be delayed or stopped if side effects are severe.
Most of the drugs are given by vein. A catheter (a tube) will be placed in a vein to decrease the number of needle sticks. Dexamethasone may be taken by mouth instead of given by vein.
Some patients in this study, with changes in certain genes will receive different chemotherapy drugs than other patients in the study will. The patients will, like all the other patients, receive rituximab and interferon. But instead of the FND chemotherapy regimen, they will receive a sequence of three regimens, CHOD-Bleo, ESHAP, and NOPP. The drugs in these regimens include: cyclophosphamide, doxorubicin, vincristine, bleomycin, VP-16, Ara-C, cisplatin, mitoxantrone, procarbazine, and corticosteroids (prednisone, methylprednisolone, dexamethasone).
During the study, patients will have blood tests every week. Complete exams will be given in Cycles 2 and 4; patients will return to the clinic for these. Every 2 or 3 cycles, patients will have a chest x-ray and CT scans of the abdomen and pelvis. Bone marrow samples will be taken. Heart function tests (EKG) will be done as needed.
After the study ends, patients will return for checkups every 3 months in the first year, every 4 months in years 2 and 3, and every 6 months in years 4 and 5. After that, checkups will be needed once a year. Blood and bone marrow samples will be taken at these visits.
This is an investigational study. Rituximab is approved by FDA for commercial use. The other drugs used in the study are also approved for commercial use. About 210 patients will take part in the study. All will be enrolled at University of Texas MD Anderson Cancer Center (UTMDACC).
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 210
- Previously untreated stage IV indolent B-cell lymphoma [Amendment May 2001: eligibility restricted to follicular lymphoma]
- Age <76
N/A
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description 2: FND Followed by Interferon & Rituximab Fludarabine Fludarabine/Novantrone/Decadron Followed by Interferon \& Rituximab 3: CHOD-Bleo, ESHAP, NOPP + Rituximab Followed by Interferon Interferon Cyclophosphamide/Vincristine/Doxorubicin/Bleomycin (1st Sequence) + Rituximab; Etoposide/Cisplatin/Ara-C/Methyl-Prednisol (2nd Sequence); Novantrone/Vincristine/Procarbazine/Prednisone + Rituximab (3rd Sequence) Followed by Interferon 1: FND + Rituximab Followed by Interferon Interferon Fludarabine/Novantrone/Decadron + Rituximab Followed by Interferon 2: FND Followed by Interferon & Rituximab Decadron Fludarabine/Novantrone/Decadron Followed by Interferon \& Rituximab 2: FND Followed by Interferon & Rituximab Interferon Fludarabine/Novantrone/Decadron Followed by Interferon \& Rituximab 3: CHOD-Bleo, ESHAP, NOPP + Rituximab Followed by Interferon Methyl-Prednisolone Cyclophosphamide/Vincristine/Doxorubicin/Bleomycin (1st Sequence) + Rituximab; Etoposide/Cisplatin/Ara-C/Methyl-Prednisol (2nd Sequence); Novantrone/Vincristine/Procarbazine/Prednisone + Rituximab (3rd Sequence) Followed by Interferon 1: FND + Rituximab Followed by Interferon Fludarabine Fludarabine/Novantrone/Decadron + Rituximab Followed by Interferon 1: FND + Rituximab Followed by Interferon Novantrone Fludarabine/Novantrone/Decadron + Rituximab Followed by Interferon 1: FND + Rituximab Followed by Interferon Decadron Fludarabine/Novantrone/Decadron + Rituximab Followed by Interferon 1: FND + Rituximab Followed by Interferon Rituximab Fludarabine/Novantrone/Decadron + Rituximab Followed by Interferon 2: FND Followed by Interferon & Rituximab Novantrone Fludarabine/Novantrone/Decadron Followed by Interferon \& Rituximab 2: FND Followed by Interferon & Rituximab Rituximab Fludarabine/Novantrone/Decadron Followed by Interferon \& Rituximab 3: CHOD-Bleo, ESHAP, NOPP + Rituximab Followed by Interferon Novantrone Cyclophosphamide/Vincristine/Doxorubicin/Bleomycin (1st Sequence) + Rituximab; Etoposide/Cisplatin/Ara-C/Methyl-Prednisol (2nd Sequence); Novantrone/Vincristine/Procarbazine/Prednisone + Rituximab (3rd Sequence) Followed by Interferon 3: CHOD-Bleo, ESHAP, NOPP + Rituximab Followed by Interferon Decadron Cyclophosphamide/Vincristine/Doxorubicin/Bleomycin (1st Sequence) + Rituximab; Etoposide/Cisplatin/Ara-C/Methyl-Prednisol (2nd Sequence); Novantrone/Vincristine/Procarbazine/Prednisone + Rituximab (3rd Sequence) Followed by Interferon 3: CHOD-Bleo, ESHAP, NOPP + Rituximab Followed by Interferon Rituximab Cyclophosphamide/Vincristine/Doxorubicin/Bleomycin (1st Sequence) + Rituximab; Etoposide/Cisplatin/Ara-C/Methyl-Prednisol (2nd Sequence); Novantrone/Vincristine/Procarbazine/Prednisone + Rituximab (3rd Sequence) Followed by Interferon 3: CHOD-Bleo, ESHAP, NOPP + Rituximab Followed by Interferon Doxorubicin Cyclophosphamide/Vincristine/Doxorubicin/Bleomycin (1st Sequence) + Rituximab; Etoposide/Cisplatin/Ara-C/Methyl-Prednisol (2nd Sequence); Novantrone/Vincristine/Procarbazine/Prednisone + Rituximab (3rd Sequence) Followed by Interferon 3: CHOD-Bleo, ESHAP, NOPP + Rituximab Followed by Interferon Bleomycin Cyclophosphamide/Vincristine/Doxorubicin/Bleomycin (1st Sequence) + Rituximab; Etoposide/Cisplatin/Ara-C/Methyl-Prednisol (2nd Sequence); Novantrone/Vincristine/Procarbazine/Prednisone + Rituximab (3rd Sequence) Followed by Interferon 3: CHOD-Bleo, ESHAP, NOPP + Rituximab Followed by Interferon Vincristine Cyclophosphamide/Vincristine/Doxorubicin/Bleomycin (1st Sequence) + Rituximab; Etoposide/Cisplatin/Ara-C/Methyl-Prednisol (2nd Sequence); Novantrone/Vincristine/Procarbazine/Prednisone + Rituximab (3rd Sequence) Followed by Interferon 3: CHOD-Bleo, ESHAP, NOPP + Rituximab Followed by Interferon Etoposide Cyclophosphamide/Vincristine/Doxorubicin/Bleomycin (1st Sequence) + Rituximab; Etoposide/Cisplatin/Ara-C/Methyl-Prednisol (2nd Sequence); Novantrone/Vincristine/Procarbazine/Prednisone + Rituximab (3rd Sequence) Followed by Interferon 3: CHOD-Bleo, ESHAP, NOPP + Rituximab Followed by Interferon Cyclophosphamide Cyclophosphamide/Vincristine/Doxorubicin/Bleomycin (1st Sequence) + Rituximab; Etoposide/Cisplatin/Ara-C/Methyl-Prednisol (2nd Sequence); Novantrone/Vincristine/Procarbazine/Prednisone + Rituximab (3rd Sequence) Followed by Interferon 3: CHOD-Bleo, ESHAP, NOPP + Rituximab Followed by Interferon Cisplatin Cyclophosphamide/Vincristine/Doxorubicin/Bleomycin (1st Sequence) + Rituximab; Etoposide/Cisplatin/Ara-C/Methyl-Prednisol (2nd Sequence); Novantrone/Vincristine/Procarbazine/Prednisone + Rituximab (3rd Sequence) Followed by Interferon 3: CHOD-Bleo, ESHAP, NOPP + Rituximab Followed by Interferon Ara-C Cyclophosphamide/Vincristine/Doxorubicin/Bleomycin (1st Sequence) + Rituximab; Etoposide/Cisplatin/Ara-C/Methyl-Prednisol (2nd Sequence); Novantrone/Vincristine/Procarbazine/Prednisone + Rituximab (3rd Sequence) Followed by Interferon 3: CHOD-Bleo, ESHAP, NOPP + Rituximab Followed by Interferon Procarbazine Cyclophosphamide/Vincristine/Doxorubicin/Bleomycin (1st Sequence) + Rituximab; Etoposide/Cisplatin/Ara-C/Methyl-Prednisol (2nd Sequence); Novantrone/Vincristine/Procarbazine/Prednisone + Rituximab (3rd Sequence) Followed by Interferon 3: CHOD-Bleo, ESHAP, NOPP + Rituximab Followed by Interferon Prednisone Cyclophosphamide/Vincristine/Doxorubicin/Bleomycin (1st Sequence) + Rituximab; Etoposide/Cisplatin/Ara-C/Methyl-Prednisol (2nd Sequence); Novantrone/Vincristine/Procarbazine/Prednisone + Rituximab (3rd Sequence) Followed by Interferon
- Primary Outcome Measures
Name Time Method Number of Participants With Overall Survival (10 Years) by Treatment 10 Years Overall Survival is the time from date of treatment start until date of death due to any cause or last Follow-up within 10 years.
- Secondary Outcome Measures
Name Time Method Number of Participants With Progression Free Survival (10 Years) by Treatment 10 years Progression is defined using Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0), as a 20% increase in the sum of the longest diameter of target lesions, or a measurable increase in a non-target lesion, or the appearance of new lesions.
Trial Locations
- Locations (1)
University of Texas MD Anderson Cancer Center
🇺🇸Houston, Texas, United States