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MEDA Chemotherapy and Autologous Hematopoietic Stem Cell Transplantation for Stage IV Natural Killer/T-cell Lymphoma

Not Applicable
Completed
Conditions
Extranodal NK-T-Cell Lymphoma, Nasal Type
Interventions
Drug: MEDA
Procedure: Auto-HSCT
Registration Number
NCT02764281
Lead Sponsor
Xinhua Hospital, Shanghai Jiao Tong University School of Medicine
Brief Summary

The purpose of this study is to evaluate the efficacy and safety of methotrexate, etoposide, pegaspargase and dexamethasone (MEDA) chemotherapy and autologous hematopoietic stem cell transplantation (Auto-HSCT) in patients with stage IV extranodal natural killer/T-cell lymphoma, nasal type.

Detailed Description

Extranodal natural killer/T-cell lymphoma (ENKTCL), nasal type, is a rare subtype of non-Hodgkin lymphoma (NHL) with relatively high incidence in China. L-asparaginase based chemotherapy improved overall response and prolonged the long-term survival for patients with stage IV. But the optimal treatment schedule has not been established. This study is designed with four cycles MEDA chemotherapy, followed by Auto-HSCT for stage IV patients with newly onset, relapsed or refractory diseases. The efficacy and safety of this protocol in the treatment of will be measured.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
53
Inclusion Criteria

Pathological diagnosis of extranodal natural killer/T-cell lymphoma, nasal type based on WHO 2008 classification of tumors of haematopoietic and lymphoid tissue.

Eastern Cooperative Oncology Group (ECOG ) performance status 0~3.

Stage IV disease with at least one measurable lesion.

Preserved organ functions for: Platelet>50×10*9/L, hemoglobin>80g/L, total bilirubin (TBIL)<3×ULN, alanine transaminase (ALT)<5×ULN, serum creatinine (Cr)<1.5×ULN, fibrinogen≥0.5g/L, LVEF≥50%.

Signed Informed consented.

Exclusion Criteria

Relapsed or progressive disease to prior L-asparaginase-based chemotherapy.

Concurrent cancers need surgery or chemotherapy within 6 months.

History of chemotherapy or radiotherapy for other solid cancers within 3 years.

Recent history of radiotherapy of upper-aero-digestive tract within last 3 months.

Significant complications: LVEF≤50%, coagulopathy, autoimmune disease, severe infection, or liver cirrhosis, severe hemophagocytic lymphohistiocytosis.

Mental disorders.

Pregnant or lactation.

HIV, hepatitis virus C (HCV), or active hepatitis virus B (HBV) infection with HBV DNA≥10*5 copies/ml.

History of pancreatitis.

Known history for grade 3/4 allergy to the drugs in chemotherapy regimen.

Enrolled in other trial treatment.

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
MEDA/Auto-HSCTMEDAPatients will be initially treated with four cycles MEDA chemotherapy, followed by autologous hematopoietic stem cell transplantation (Auto-HSCT).
MEDA/Auto-HSCTAuto-HSCTPatients will be initially treated with four cycles MEDA chemotherapy, followed by autologous hematopoietic stem cell transplantation (Auto-HSCT).
Primary Outcome Measures
NameTimeMethod
Complete response rateDay 28 of the 4th course of MEDA chemotherapy

The complete response rate will be assessed on day 28 of the 4th course of MEDA chemotherapy.

Secondary Outcome Measures
NameTimeMethod
Progression free survival2-year

Progression free survival is the time from entry onto the treatment until lymphoma progression or death of any reason.

Overall response rateDay 28 of the 4th course of MEDA chemotherapy

The overall response rate will be assessed on day 28 of the 4th course of MEDA chemotherapy.

Treatment-Related Adverse Events as Assessed by CTCAE v4.0Day 1 of each course of chemotherapy and then every 3 months for 2 years

Treatment-Related Adverse Events will be assessed and graded by NCI CTCAE v4.0.

Overall survival2-year

Overall survival is defiend as the time from entry onto the treatment until death of any reason

Trial Locations

Locations (7)

Shanghai Ninth People's Hospital

🇨🇳

Shanghai, Shanghai, China

Shanghai Eye Ear Nose and Throat Hospital, Fudan University

🇨🇳

Shanghai, Shanghai, China

Zhongshan Hospital, Fudan University

🇨🇳

Shanghai, Shanghai, China

Xinhua Hospital

🇨🇳

Shanghai, Shanghai, China

Shanghai Dong Fang hospital

🇨🇳

Shanghai, Shanghai, China

Shanghai Tong Ren Hospital

🇨🇳

Shanghai, Shanghai, China

Xin Jiang People's Hospital

🇨🇳

Urumqi, Xinjiang, China

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