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Oblimersen, Rituximab, Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone in Treating Patients With Stage II, Stage III, or Stage IV Diffuse Large B-Cell Lymphoma

Primary Purpose

Lymphoma

Status
Completed
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
oblimersen sodium
rituximab
cyclophosphamide
doxorubicin hydrochloride
prednisone
vincristine sulfate
Sponsored by
British Columbia Cancer Agency
About
Eligibility
Locations
Outcomes
Full info

About this trial

This is an interventional treatment trial for Lymphoma focused on measuring contiguous stage II adult diffuse large cell lymphoma, noncontiguous stage II adult diffuse large cell lymphoma, stage III adult diffuse large cell lymphoma, stage IV adult diffuse large cell lymphoma

Eligibility Criteria

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

DISEASE CHARACTERISTICS: Histologically confirmed* CD20+ diffuse large B-cell lymphoma, including any of the following stages: Extensive stage II (not radio-encompassable within a single involved field or not a candidate for brief chemotherapy and radiotherapy) Bulky stage II (any single mass greater than 10 cm) Stage III Stage IV NOTE: *Confirmed by tissue biopsy Previously untreated disease Measurable disease At least 2 cm by imaging studies Circulating lymphoma cells no greater than 5,000/mm^3 No history of other lymphoproliferative disorder No history of indolent lymphoma No T-cell lymphoma No CNS involvement No post-transplantation lymphoproliferative disorder PATIENT CHARACTERISTICS: Age 19 and over Performance status ECOG 0-2 Life expectancy Not specified Hematopoietic Absolute neutrophil count at least 1,500/mm^3 (unless due to bone marrow involvement with lymphoma) Platelet count at least 100,000/mm^3 (unless due to splenomegaly or bone marrow involvement with lymphoma) Hepatic Bilirubin no greater than 3 mg/dL (unless due to lymphoma) No known hepatitis B virus Renal Creatinine no greater than 2 mg/dL (unless due to lymphoma) Cardiovascular No cardiac contraindication to doxorubicin therapy (e.g., abnormal contractility on echocardiography) History of cardiac disease allowed provided ejection fraction is normal Other Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception Adequate venous access HIV negative No other malignancy within the past 5 years except adequately treated nonmelanoma skin cancer, localized basal cell or squamous cell skin cancer, or curatively treated carcinoma in situ of the cervix No neurological contraindication to vincristine (e.g., peripheral neuropathy) No active systemic infection No medical condition that would compromise study treatment, add toxicity, or impair assessment PRIOR CONCURRENT THERAPY: Biologic therapy Not specified Chemotherapy No prior systemic chemotherapy Endocrine therapy Not specified Radiotherapy No prior radiotherapy Prior radiotherapy for localized basal cell or squamous cell skin cancer used with curative intent allowed Surgery Not specified

Sites / Locations

  • Stanford Cancer Center at Stanford University Medical Center
  • British Columbia Cancer Agency - Centre for the Southern Interior
  • Fraser Valley Cancer Centre at British Columbia Cancer Agency
  • British Columbia Cancer Agency - Vancouver Cancer Centre

Outcomes

Primary Outcome Measures

Secondary Outcome Measures

Full Information

First Posted
October 3, 2003
Last Updated
April 4, 2009
Sponsor
British Columbia Cancer Agency
Collaborators
National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT00070083
Brief Title
Oblimersen, Rituximab, Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone in Treating Patients With Stage II, Stage III, or Stage IV Diffuse Large B-Cell Lymphoma
Official Title
A Phase I Study Of G3139 Antisense Oligonucleotide (Oblimersen) In Combination With CHOP And Rituximab In Untreated Advanced Stage Diffuse Large B Cell Lymphoma
Study Type
Interventional

2. Study Status

Record Verification Date
June 2005
Overall Recruitment Status
Completed
Study Start Date
July 2003 (undefined)
Primary Completion Date
undefined (undefined)
Study Completion Date
undefined (undefined)

3. Sponsor/Collaborators

Name of the Sponsor
British Columbia Cancer Agency
Collaborators
National Cancer Institute (NCI)

4. Oversight

5. Study Description

Brief Summary
RATIONALE: Monoclonal antibodies, such as rituximab, can locate cancer cells and either kill them or deliver cancer-killing substances to them without harming normal cells. Drugs used in chemotherapy, such as cyclophosphamide, doxorubicin, vincristine, and prednisone, use different ways to stop cancer cells from dividing so they stop growing or die. Oblimersen may increase the effectiveness of a chemotherapy drug by making cancer cells more sensitive to the drug. Combining oblimersen with rituximab and combination chemotherapy may kill more cancer cells. PURPOSE: This phase I trial is studying the side effects and best dose of oblimersen when given together with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone in treating patients with stage II, stage III, or stage IV large B-cell lymphoma
Detailed Description
OBJECTIVES: Primary Determine the feasibility and safety of oblimersen administered in combination with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone, in terms of short-term and long-term toxicity, in patients with previously untreated stage III or IV or extensive or bulky stage II diffuse large B-cell lymphoma. Determine the maximum tolerated dose of oblimersen administered with this regimen in these patients. Secondary Determine the remission rate and failure-free, progression-free, and overall survival of patients treated with this regimen. OUTLINE: This is a nonrandomized, non-blinded, multicenter, dose-escalation study of oblimersen. Patients receive CHOP-R* therapy comprising cyclophosphamide IV over 15-45 minutes, doxorubicin IV over 5-10 minutes, vincristine IV, and rituximab IV over 30-90 minutes on day 1 and oral prednisone on days 1-5. Patients also receive oblimersen IV continuously on days -4 to 3. Treatment repeats every 21 days for 6-8 courses in the absence of disease progression or unacceptable toxicity. Patients who discontinue treatment due to unacceptable toxicity to oblimersen may continue to receive standard therapy comprising CHOP-R. NOTE: *Patients treated at the British Columbia Cancer Agency receive cyclophosphamide, doxorubicin, vincristine, and rituximab on days 1 and 2 and prednisone as above. Cohorts of 3-6 patients receive escalating doses of oblimersen until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity. Once the MTD is determined, at least 10 patients are treated at that dose level. Patients are followed every 3 months for 2 years, every 4 months for 1 year, every 6 months for 2 years, and then annually thereafter. PROJECTED ACCRUAL: A total of 19-28 patients will be accrued for this study within 5-10 months.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Lymphoma
Keywords
contiguous stage II adult diffuse large cell lymphoma, noncontiguous stage II adult diffuse large cell lymphoma, stage III adult diffuse large cell lymphoma, stage IV adult diffuse large cell lymphoma

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1

8. Arms, Groups, and Interventions

Intervention Type
Biological
Intervention Name(s)
oblimersen sodium
Intervention Type
Biological
Intervention Name(s)
rituximab
Intervention Type
Drug
Intervention Name(s)
cyclophosphamide
Intervention Type
Drug
Intervention Name(s)
doxorubicin hydrochloride
Intervention Type
Drug
Intervention Name(s)
prednisone
Intervention Type
Drug
Intervention Name(s)
vincristine sulfate

10. Eligibility

Sex
All
Minimum Age & Unit of Time
19 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
DISEASE CHARACTERISTICS: Histologically confirmed* CD20+ diffuse large B-cell lymphoma, including any of the following stages: Extensive stage II (not radio-encompassable within a single involved field or not a candidate for brief chemotherapy and radiotherapy) Bulky stage II (any single mass greater than 10 cm) Stage III Stage IV NOTE: *Confirmed by tissue biopsy Previously untreated disease Measurable disease At least 2 cm by imaging studies Circulating lymphoma cells no greater than 5,000/mm^3 No history of other lymphoproliferative disorder No history of indolent lymphoma No T-cell lymphoma No CNS involvement No post-transplantation lymphoproliferative disorder PATIENT CHARACTERISTICS: Age 19 and over Performance status ECOG 0-2 Life expectancy Not specified Hematopoietic Absolute neutrophil count at least 1,500/mm^3 (unless due to bone marrow involvement with lymphoma) Platelet count at least 100,000/mm^3 (unless due to splenomegaly or bone marrow involvement with lymphoma) Hepatic Bilirubin no greater than 3 mg/dL (unless due to lymphoma) No known hepatitis B virus Renal Creatinine no greater than 2 mg/dL (unless due to lymphoma) Cardiovascular No cardiac contraindication to doxorubicin therapy (e.g., abnormal contractility on echocardiography) History of cardiac disease allowed provided ejection fraction is normal Other Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception Adequate venous access HIV negative No other malignancy within the past 5 years except adequately treated nonmelanoma skin cancer, localized basal cell or squamous cell skin cancer, or curatively treated carcinoma in situ of the cervix No neurological contraindication to vincristine (e.g., peripheral neuropathy) No active systemic infection No medical condition that would compromise study treatment, add toxicity, or impair assessment PRIOR CONCURRENT THERAPY: Biologic therapy Not specified Chemotherapy No prior systemic chemotherapy Endocrine therapy Not specified Radiotherapy No prior radiotherapy Prior radiotherapy for localized basal cell or squamous cell skin cancer used with curative intent allowed Surgery Not specified
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Richard J. Klasa, MD
Organizational Affiliation
British Columbia Cancer Agency
Official's Role
Study Chair
Facility Information:
Facility Name
Stanford Cancer Center at Stanford University Medical Center
City
Stanford
State/Province
California
ZIP/Postal Code
94305
Country
United States
Facility Name
British Columbia Cancer Agency - Centre for the Southern Interior
City
Kelowna
State/Province
British Columbia
ZIP/Postal Code
V1Y 5L3
Country
Canada
Facility Name
Fraser Valley Cancer Centre at British Columbia Cancer Agency
City
Surrey
State/Province
British Columbia
ZIP/Postal Code
V3V 1Z2
Country
Canada
Facility Name
British Columbia Cancer Agency - Vancouver Cancer Centre
City
Vancouver
State/Province
British Columbia
ZIP/Postal Code
V5Z 4E6
Country
Canada

12. IPD Sharing Statement

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Oblimersen, Rituximab, Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone in Treating Patients With Stage II, Stage III, or Stage IV Diffuse Large B-Cell Lymphoma

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