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Phase I/II Trial of R-CHOP + Azacytidine in Diffuse Large B Cell Lymphoma

Primary Purpose

Diffuse Large B Cell Lymphoma

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
rituximab
cyclophosphamide
vincristine
doxorubicin
prednisone
azacytidine
Sponsored by
Weill Medical College of Cornell University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Diffuse Large B Cell Lymphoma

Eligibility Criteria

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

Inclusion Criteria:

  • Patients must have histologically confirmed DLBCL with characteristic immunophenotypic profiles. Tumor tissue must be confirmed to express the CD20 antigen by flow cytometry or immunohistochemistry.
  • Patients must have at least one site of measurable disease, 1.5 cm in diameter or greater.
  • Patient has not had any previous treatment.
  • Stage II (not appropriate for abbreviated chemoimmunotherapy and radiotherapy), III or IV disease
  • Able to adhere to the study visit schedule and other protocol requirements.
  • Patients must have laboratory test results within these ranges:

    • Absolute neutrophil count > = 1500/mm³
    • Platelet count > = 75,000/mm³
    • Serum creatinine < = 1.5X upper limit of normal (ULN)
    • Total bilirubin < = 1.5X ULN. Higher levels are acceptable if these can be attributed to active hemolysis or ineffective erythropoiesis.
    • AST (SGOT) and ALT (SGPT) < = 2 x ULN
  • Disease free of prior malignancies for > = 5 years with exception of currently treated basal cell, squamous cell carcinoma of the skin, or carcinoma "in situ" of the cervix or breast.
  • Women of childbearing potential must have a negative serum pregnancy test prior to azacitidine treatment.
  • Women of childbearing potential should be advised to avoid becoming pregnant and men should be advised to not father a child while receiving treatment with azacitidine. The effects of azacytidine on the developing human fetus at the recommended therapeutic dose are unknown. For this reason, women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry and for the duration of study participation. Should a woman become pregnant or suspect she is pregnant while participating in this study, she should inform her treating physician immediately.
  • Age >18 years.
  • Ability to understand and the willingness to sign a written informed consent document.
  • ECOG performance status of 0-2

Exclusion Criteria:

  • Patients must not have any serious medical condition, laboratory abnormality,or psychiatric illness that would prevent the subject from signing the informed consent form.
  • Patients must not have any condition, including the presence of laboratory abnormalities, which places the subject at unacceptable risk if he/she were to participate in the study or confounds the ability to interpret data from the study.
  • Use of any other experimental drug or therapy within 28 days of baseline.
  • Concurrent use of other anti-cancer agents or treatments.
  • Known positive for HIV or infectious hepatitis B.
  • Known central nervous system involvement by lymphoma.
  • Known or suspected hypersensitivity to azacitidine or mannitol.
  • Patients must not have advanced malignant hepatic tumors.
  • Pregnant and lactating women are excluded from the study because the risks to an unborn fetus or potential risks in nursing infants are unknown.

Sites / Locations

  • Weill Cornell Medical College

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

All patients

Arm Description

subjects will receive azacytidine dose dependent on dose-escalation schedule at time of enrollment - all will receive standard dose RCHOP

Outcomes

Primary Outcome Measures

Complete Response
Complete Response

Secondary Outcome Measures

Full Information

First Posted
October 29, 2009
Last Updated
February 23, 2017
Sponsor
Weill Medical College of Cornell University
Collaborators
Celgene
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1. Study Identification

Unique Protocol Identification Number
NCT01004991
Brief Title
Phase I/II Trial of R-CHOP + Azacytidine in Diffuse Large B Cell Lymphoma
Official Title
Phase I/II Trial of Azacytidine + R-CHOP in Diffuse Large B-Cell Lymphoma
Study Type
Interventional

2. Study Status

Record Verification Date
February 2017
Overall Recruitment Status
Completed
Study Start Date
January 2010 (Actual)
Primary Completion Date
September 2013 (Actual)
Study Completion Date
February 2016 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Weill Medical College of Cornell University
Collaborators
Celgene

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
This is a phase I/II open label, multi-center study of azacytidine in combination with standard RCHOP therapy in patients with DLBCL. Patients will be treated with azacytidine at escalating doses on days 1-5, followed by standard dose rituximab plus CHOP chemotherapy on day 8, every 21 days. Patients will be treated for a total 6 cycles. The phase II portion will then evaluate efficacy of the combination at the established MTD.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Diffuse Large B Cell Lymphoma

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
14 (Actual)

8. Arms, Groups, and Interventions

Arm Title
All patients
Arm Type
Experimental
Arm Description
subjects will receive azacytidine dose dependent on dose-escalation schedule at time of enrollment - all will receive standard dose RCHOP
Intervention Type
Biological
Intervention Name(s)
rituximab
Intervention Description
375 mg/m2 on Day 8 of each of 6 cycles
Intervention Type
Drug
Intervention Name(s)
cyclophosphamide
Intervention Description
750 mg/m2 on Day 8 of each of 6 cycles
Intervention Type
Drug
Intervention Name(s)
vincristine
Intervention Description
1.4 mg/m2 on Day 8 of each of 6 cycles
Intervention Type
Drug
Intervention Name(s)
doxorubicin
Intervention Description
50 mg/m2 on Day 8 of each of 6 cycles
Intervention Type
Drug
Intervention Name(s)
prednisone
Intervention Description
100 mg PO days 8-12 of each of 6 cycles
Intervention Type
Drug
Intervention Name(s)
azacytidine
Intervention Description
Dose level 1: azacytidine 25 mg/m2 days 1-5 Dose level 2: azacytidine 50 mg/m2 days 1-5 Dose level 3: azacytidine 75 mg/m2 days 1-5
Primary Outcome Measure Information:
Title
Complete Response
Description
Complete Response
Time Frame
13 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patients must have histologically confirmed DLBCL with characteristic immunophenotypic profiles. Tumor tissue must be confirmed to express the CD20 antigen by flow cytometry or immunohistochemistry. Patients must have at least one site of measurable disease, 1.5 cm in diameter or greater. Patient has not had any previous treatment. Stage II (not appropriate for abbreviated chemoimmunotherapy and radiotherapy), III or IV disease Able to adhere to the study visit schedule and other protocol requirements. Patients must have laboratory test results within these ranges: Absolute neutrophil count > = 1500/mm³ Platelet count > = 75,000/mm³ Serum creatinine < = 1.5X upper limit of normal (ULN) Total bilirubin < = 1.5X ULN. Higher levels are acceptable if these can be attributed to active hemolysis or ineffective erythropoiesis. AST (SGOT) and ALT (SGPT) < = 2 x ULN Disease free of prior malignancies for > = 5 years with exception of currently treated basal cell, squamous cell carcinoma of the skin, or carcinoma "in situ" of the cervix or breast. Women of childbearing potential must have a negative serum pregnancy test prior to azacitidine treatment. Women of childbearing potential should be advised to avoid becoming pregnant and men should be advised to not father a child while receiving treatment with azacitidine. The effects of azacytidine on the developing human fetus at the recommended therapeutic dose are unknown. For this reason, women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry and for the duration of study participation. Should a woman become pregnant or suspect she is pregnant while participating in this study, she should inform her treating physician immediately. Age >18 years. Ability to understand and the willingness to sign a written informed consent document. ECOG performance status of 0-2 Exclusion Criteria: Patients must not have any serious medical condition, laboratory abnormality,or psychiatric illness that would prevent the subject from signing the informed consent form. Patients must not have any condition, including the presence of laboratory abnormalities, which places the subject at unacceptable risk if he/she were to participate in the study or confounds the ability to interpret data from the study. Use of any other experimental drug or therapy within 28 days of baseline. Concurrent use of other anti-cancer agents or treatments. Known positive for HIV or infectious hepatitis B. Known central nervous system involvement by lymphoma. Known or suspected hypersensitivity to azacitidine or mannitol. Patients must not have advanced malignant hepatic tumors. Pregnant and lactating women are excluded from the study because the risks to an unborn fetus or potential risks in nursing infants are unknown.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Peter Martin, MD
Organizational Affiliation
Weill Medical College of Cornell University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Weill Cornell Medical College
City
New York
State/Province
New York
ZIP/Postal Code
10065
Country
United States

12. IPD Sharing Statement

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Phase I/II Trial of R-CHOP + Azacytidine in Diffuse Large B Cell Lymphoma

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