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Rituximab in Treating Patients With Newly Diagnosed Stage II, Stage III, or Stage IV Follicular Non-Hodgkin's Lymphoma

Phase 3
Completed
Conditions
Lymphoma
Registration Number
NCT00112931
Lead Sponsor
University College, London
Brief Summary

RATIONALE: Monoclonal antibodies, such as rituximab, can block cancer growth in different ways. Some block the ability of cancer cells to grow and spread. Others find cancer cells and help kill them or carry cancer-killing substances to them. It is not yet known whether rituximab is more effective than observation in treating non-Hodgkin's lymphoma.

PURPOSE: This randomized phase III trial is studying rituximab to see how well it works compared to observation in treating patients with newly diagnosed stage II, stage III, or stage IV follicular non-Hodgkin's lymphoma with no symptoms.

Detailed Description

OBJECTIVES:

Primary

* Compare time to initiation of systemic chemotherapy or radiotherapy in patients with newly diagnosed, previously untreated, asymptomatic stage II-IV non-bulky follicular non-Hodgkin's lymphoma treated with rituximab vs observation only.

Secondary

* Compare the frequency of clinical spontaneous remission in patients treated with these regimens.

* Compare overall and cause-specific survival of patients treated with these regimens.

* Determine the effect of rituximab on complete and partial response in patients treated with subsequent systemic chemotherapy.

* Compare quality of life, in terms of functional well-being and anxiety and depression, of patients treated with these regimens.

OUTLINE: This is a randomized, multicenter study. Patients are stratified according to participating center, disease grade (1 vs 2 vs 3a), disease stage (II vs III vs IV), and age. Patients are randomized to 1 of 3 treatment arms.

* Arm I: Patients undergo observation only until disease progression.

* Arm II: Patients receive induction rituximab IV on day 1. Treatment repeats weekly for up to 4 weeks.

* Arm III: Patients receive induction rituximab as in arm II. Patients then receive maintenance rituximab IV once on day 1 of weeks 12, 20, 28, 36, 44, 52, 60, 68, 76, 84, 92, and 100.

In all arms, treatment continues in the absence of unacceptable toxicity or disease progression requiring systemic chemotherapy\* or radiotherapy.

NOTE: \*Rituximab administration in arm I is considered initiation of systemic chemotherapy

Quality of life is assessed at baseline (before and after randomization), every 2 months for 2 years, and then every 6 months for 2 years.

Patients are followed every 2 months for 2 years and then every 3 months thereafter.

Peer Reviewed and Funded or Endorsed by Cancer Research UK

PROJECTED ACCRUAL: A total of 600 patients (200 per treatment arm) will be accrued for this study within 3 years.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
462
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Primary Outcome Measures
NameTimeMethod
Time until initiation of therapy (chemotherapy or radiotherapy)Time from randomisation until the first day systemic chemotherapy or radiotherapy is given. If rituximab is given to patients in the watch and wait arm this will be considered as initiation of chemotherapy.
Secondary Outcome Measures
NameTimeMethod
Overall survivalTime from randomisation to death from any cause.
Cause specific survivalTime from randomisation to death from lymphoma or immediate therapy related toxicity
Response rate at 25 monthsResponse at 25 months
Frequency of clinical spontaneous remissionFrom randomisation until the initiation of chemotherapy in the watch and wait arm

Trial Locations

Locations (69)

Queen Elizabeth Hospital

🇬🇧

King's Lynn, England, United Kingdom

Royal Adelaide Hospital

🇦🇺

Adelaide, Australia

Ashford Cancer Centre

🇦🇺

Black Forest, Australia

Boxhill Hospital

🇦🇺

Box Hill, Australia

Royal Brisbane and Women's Hospital

🇦🇺

Brisbane, Australia

Canberra Hospital

🇦🇺

Canberra, Australia

Concord Repatriation General Hospital

🇦🇺

Concord, Australia

Frankston Hospital

🇦🇺

Frankston, Australia

Fremantle Hospital

🇦🇺

Fremantle, Australia

Gosford Hospital

🇦🇺

Gosford, Australia

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Queen Elizabeth Hospital
🇬🇧King's Lynn, England, United Kingdom

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