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Methotrexate and Thiotepa in Treating Patients With Newly Diagnosed Primary CNS Lymphoma

Primary Purpose

Lymphoma

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
leucovorin calcium
methotrexate
thiotepa
Sponsored by
New Approaches to Brain Tumor Therapy Consortium
About
Eligibility
Locations
Outcomes
Full info

About this trial

This is an interventional treatment trial for Lymphoma focused on measuring primary central nervous system non-Hodgkin lymphoma

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

DISEASE CHARACTERISTICS: Histologically confirmed primary CNS lymphoma Confirmed by 1 of the following: Brain biopsy or resection CSF cytology Positive cytology or immunohistochemical diagnosis of monoclonality and measurable intracranial tumor Vitreal biopsy Measurable and contrast-enhancing disease on the postoperative, pretreatment MRI or CT scan No radiographic evidence of ascites or pleural effusions PATIENT CHARACTERISTICS: Age 18 and over Performance status Karnofsky 60-100% Life expectancy Not specified Hematopoietic Absolute neutrophil count at least 1,500/mm^3 Platelet count at least 100,000/mm^3 Hepatic Bilirubin no greater than 2.0 mg/dL SGOT no greater than 4 times upper limit of normal Renal Creatinine no greater than 2 mg/dL Creatinine clearance at least 50 mL/min Other Mini mental score of at least 15 HIV negative Able to achieve hydration No other malignancy within the past 5 years except curatively treated basal cell or squamous cell skin cancer or carcinoma in situ No allergy to methotrexate No serious infection No medical illness that would preclude study participation Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception PRIOR CONCURRENT THERAPY: Biologic therapy No prior immunotherapy or biologic therapy for this disease Chemotherapy No prior chemotherapy for this disease No other concurrent chemotherapeutic agents Endocrine therapy No prior hormonal therapy for this disease Prior glucocorticoid therapy allowed Radiotherapy No prior radiotherapy for this disease No prior cranial irradiation Surgery See Disease Characteristics Other At least 1 week since prior salicylates, non-steroidal anti-inflammatory drugs, probenecid, folic acid, or sulfonamide medications No other concurrent investigational agents

Sites / Locations

  • Comprehensive Cancer Center at University of Alabama at Birmingham
  • H. Lee Moffitt Cancer Center and Research Institute at University of South Florida
  • Winship Cancer Institute of Emory University
  • Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
  • Massachusetts General Hospital Cancer Center
  • Josephine Ford Cancer Center at Henry Ford Hospital
  • Comprehensive Cancer Center at Wake Forest University
  • Cleveland Clinic Taussig Cancer Center
  • Abramson Cancer Center of the University of Pennsylvania

Outcomes

Primary Outcome Measures

Complete radiographic response

Secondary Outcome Measures

Duration of progression-free survival and overall survival
Toxicity
Association of tumor BCL-6 expression with response
Relationship among initial response to steroids, response to chemotherapy, and survival

Full Information

First Posted
September 6, 2002
Last Updated
June 21, 2013
Sponsor
New Approaches to Brain Tumor Therapy Consortium
Collaborators
National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT00045539
Brief Title
Methotrexate and Thiotepa in Treating Patients With Newly Diagnosed Primary CNS Lymphoma
Official Title
A Phase II Study of Methotrexate and Thiotepa Chemotherapy for Patients With Newly Diagnosed Primary CNS Lymphoma
Study Type
Interventional

2. Study Status

Record Verification Date
December 2005
Overall Recruitment Status
Completed
Study Start Date
October 2002 (undefined)
Primary Completion Date
undefined (undefined)
Study Completion Date
January 2006 (Actual)

3. Sponsor/Collaborators

Name of the Sponsor
New Approaches to Brain Tumor Therapy Consortium
Collaborators
National Cancer Institute (NCI)

4. Oversight

5. Study Description

Brief Summary
RATIONALE: Drugs used in chemotherapy, such as methotrexate and thiotepa, work in different ways to stop cancer cells from dividing so they stop growing or die. Combining more than one drug may kill more tumor cells. PURPOSE: Phase II trial to study the effectiveness of combining methotrexate with thiotepa in treating patients who have newly-diagnosed primary CNS lymphoma.
Detailed Description
OBJECTIVES: Determine the complete radiographic response in patients with newly diagnosed primary CNS lymphoma treated with methotrexate and thiotepa. Determine the duration of progression-free survival and overall survival of patients treated with this regimen. Determine the toxicity of this regimen in these patients. Determine whether tumor expression of BCL-6 is associated with response to this chemotherapy regimen and survival of these patients. Describe the relationship between initial response to steroids (if administered), response to this chemotherapy regimen, and survival of these patients. OUTLINE: This is a multicenter study. Patients receive thiotepa IV over 15 minutes on day 1. Patients also receive methotrexate IV over 4 hours on days 1 (8 hours after thiotepa) and 14. Beginning 24 hours after the start of methotrexate infusion, patients receive leucovorin calcium IV or orally every 6 hours until rescue is achieved. Treatment repeats every 28 days for up to 4 courses in the absence of disease progression or unacceptable toxicity. Patients achieving disappearance of enhancement of disease on MRI receive an additional 28-day course followed by maintenance therapy comprising thiotepa and methotrexate once a month for 11 courses. Patients undergo neuro-ophthalmologic exams annually for 2 years. Patients are followed every 2 months. PROJECTED ACCRUAL: A total of 23-39 patients will be accrued for this study within 8-20 months.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Lymphoma
Keywords
primary central nervous system non-Hodgkin lymphoma

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Masking
None (Open Label)

8. Arms, Groups, and Interventions

Intervention Type
Drug
Intervention Name(s)
leucovorin calcium
Intervention Type
Drug
Intervention Name(s)
methotrexate
Intervention Type
Drug
Intervention Name(s)
thiotepa
Primary Outcome Measure Information:
Title
Complete radiographic response
Secondary Outcome Measure Information:
Title
Duration of progression-free survival and overall survival
Title
Toxicity
Title
Association of tumor BCL-6 expression with response
Title
Relationship among initial response to steroids, response to chemotherapy, and survival

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
DISEASE CHARACTERISTICS: Histologically confirmed primary CNS lymphoma Confirmed by 1 of the following: Brain biopsy or resection CSF cytology Positive cytology or immunohistochemical diagnosis of monoclonality and measurable intracranial tumor Vitreal biopsy Measurable and contrast-enhancing disease on the postoperative, pretreatment MRI or CT scan No radiographic evidence of ascites or pleural effusions PATIENT CHARACTERISTICS: Age 18 and over Performance status Karnofsky 60-100% Life expectancy Not specified Hematopoietic Absolute neutrophil count at least 1,500/mm^3 Platelet count at least 100,000/mm^3 Hepatic Bilirubin no greater than 2.0 mg/dL SGOT no greater than 4 times upper limit of normal Renal Creatinine no greater than 2 mg/dL Creatinine clearance at least 50 mL/min Other Mini mental score of at least 15 HIV negative Able to achieve hydration No other malignancy within the past 5 years except curatively treated basal cell or squamous cell skin cancer or carcinoma in situ No allergy to methotrexate No serious infection No medical illness that would preclude study participation Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception PRIOR CONCURRENT THERAPY: Biologic therapy No prior immunotherapy or biologic therapy for this disease Chemotherapy No prior chemotherapy for this disease No other concurrent chemotherapeutic agents Endocrine therapy No prior hormonal therapy for this disease Prior glucocorticoid therapy allowed Radiotherapy No prior radiotherapy for this disease No prior cranial irradiation Surgery See Disease Characteristics Other At least 1 week since prior salicylates, non-steroidal anti-inflammatory drugs, probenecid, folic acid, or sulfonamide medications No other concurrent investigational agents
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Tracy Batchelor, MD, MPH
Organizational Affiliation
Massachusetts General Hospital
Official's Role
Study Chair
Facility Information:
Facility Name
Comprehensive Cancer Center at University of Alabama at Birmingham
City
Birmingham
State/Province
Alabama
ZIP/Postal Code
35294-3410
Country
United States
Facility Name
H. Lee Moffitt Cancer Center and Research Institute at University of South Florida
City
Tampa
State/Province
Florida
ZIP/Postal Code
33612-9497
Country
United States
Facility Name
Winship Cancer Institute of Emory University
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30322
Country
United States
Facility Name
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21231-2410
Country
United States
Facility Name
Massachusetts General Hospital Cancer Center
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02114
Country
United States
Facility Name
Josephine Ford Cancer Center at Henry Ford Hospital
City
Detroit
State/Province
Michigan
ZIP/Postal Code
48202
Country
United States
Facility Name
Comprehensive Cancer Center at Wake Forest University
City
Winston-Salem
State/Province
North Carolina
ZIP/Postal Code
27157-1096
Country
United States
Facility Name
Cleveland Clinic Taussig Cancer Center
City
Cleveland
State/Province
Ohio
ZIP/Postal Code
44195
Country
United States
Facility Name
Abramson Cancer Center of the University of Pennsylvania
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19104-4283
Country
United States

12. IPD Sharing Statement

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Methotrexate and Thiotepa in Treating Patients With Newly Diagnosed Primary CNS Lymphoma

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