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VP-16, Ifosfamide, Dexamethasone, L-asparaginase Chemotherapy in Patients With Extranodal Natural Killer T Cell Lymphoma (VIDL+ASCT) (VIDL+ASCT)

Primary Purpose

Extranodal NK-T-Cell Lymphoma

Status
Unknown status
Phase
Phase 2
Locations
Korea, Republic of
Study Type
Interventional
Intervention
Etoposide
Ifosfamide
Dexamethasone
L-asparaginase
Busulfan
Melphalan
Sponsored by
Samsung Medical Center
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Extranodal NK-T-Cell Lymphoma

Eligibility Criteria

19 Years - 65 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Histologically confirmed extranodal NK/T cell lymphoma
  • Aged between 19 and 65 years
  • Previously untreated history
  • Performance status: Eastern Cooperative Oncology Group 0-2
  • Ann Arbor stage III and IV
  • At least one in positron emission tomograph(PET)/CT positive lesion or in 2-dimensional computerized tomography

    • mass lesions more than 2 cm by conventional CT or more than 1 cm by spiral CT
    • Skin lesions or physically detected mass more than 2 cm
  • Cardiac ejection fraction ≥ 45 % as measured by multiple gated acquisition scan(MUGA) or 2D echogram(ECHO) without clinically significant abnormalities
  • Adequate liver functions: Transaminase (AST/ALT) < 3 X upper normal value(or < 5 x upper limit of normal in the presence of NK/T lymphoma involvement of the liver)
  • Bilirubin < 2 X upper normal value(or < 5 x upper limit of normal in the presence of DLBCL involvement of the liver)
  • Serum Creatinine < 2.0 mg/dL
  • Adequate bone marrow functions: hemoglobin ≥ 9 g/dL absolute neutrophil count (ANC) ≥ 1,500/μL and platelet count ≥ 75,000/μL, unless abnormalities are due to bone marrow involvement by lymphoma
  • Expected life is more than 180 days (more than 6 months)
  • A negative serum or urine pregnancy test prior to treatment must be available both for pre-menopausal women and for women who are < 1years after the onset of menopause. Premenopausal women should be treated with appropriate contraception such as hormone contraception, intra-uterine device, spermicidal condom and etc. during and one month after the treatment.
  • Voluntarily signed the informed consent including fully understand of clinical procedures and processing steps for the clinical trial

Exclusion Criteria:

  • Patients who have serious medical condition, abnormal laboratory results or psychiatric problems
  • Other subtypes non-Hodgkin's lymphoma than NK/T cell lymphoma
  • Patients who have aggressive NK/T cell leukemia
  • NK/T cell lymphoma with Primary Central Nervous System (CNS) involvement. However, patients who have only had prophylactic intrathecal chemotherapy against CNS disease are eligible.
  • Patients with a known history of HIV seropositivity or hepatitis C virus (HCV) (+). Patients who have carrier hepatitis B virus (HBV) (+) are eligible. However, primary prophylaxis using antiviral agents is recommended for HBV carrier to prevent HBV reactivation during whole treatment period.
  • Any other malignancies within the past 5 years except curatively treated non-melanoma skin cancer or in situ carcinoma of cervix uteri
  • Pregnant or lactating women, women of childbearing potential not employing adequate contraception
  • Other serious illness or medical conditions i. Unstable cardiac disease despite treatment, myocardial infarction within 6 months prior to study entry ii. History of significant neurologic or psychiatric disorders including dementia or seizures iii. Active uncontrolled infection (viral, bacterial or fungal infection) iv. Other serious medical illnesses
  • Concomitant administration of any other experimental drug under investigation, or concomitant chemotherapy, hormonal therapy, or immunotherapy.
  • Serious allergy history for experimental drugs
  • Patients who contraindication to the study drug use

Sites / Locations

  • Samsung Medical CenterRecruiting
  • Samsung Medical CenterRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

VIDL+ASCT

Arm Description

VIDL Induction (repeated 28 days) : VP-16, Ifosfamide, Dexamethasone, L-asparaginase Peripheral blood stem cell mobilization:Etoposide Conditioning regimen for autologous stem cell transplantation:Busulfan,Melphalan,Etoposide

Outcomes

Primary Outcome Measures

progression-free survival (PFS)

Secondary Outcome Measures

objective overall response rate
Number of subjects with Adverse Events as a Measure of safety and tolerability
overall survival

Full Information

First Posted
September 6, 2015
Last Updated
October 21, 2020
Sponsor
Samsung Medical Center
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1. Study Identification

Unique Protocol Identification Number
NCT02544425
Brief Title
VP-16, Ifosfamide, Dexamethasone, L-asparaginase Chemotherapy in Patients With Extranodal Natural Killer T Cell Lymphoma (VIDL+ASCT)
Acronym
VIDL+ASCT
Official Title
Phase II Study of VIDL (VP-16, Ifosfamide, Dexamethasone, L-asparaginase) Chemotherapy Followed by High-dose Chemotherapy and Autologous Stem Cell Transplantation in Patients With Stage III/IV Extranodal NK-T-Cell Lymphoma
Study Type
Interventional

2. Study Status

Record Verification Date
October 2020
Overall Recruitment Status
Unknown status
Study Start Date
February 21, 2016 (Actual)
Primary Completion Date
August 31, 2021 (Anticipated)
Study Completion Date
November 30, 2021 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Samsung Medical Center

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
Open-labeled, multicenter phase II study of VIDL (VP-16, Ifosfamide, Dexamethasone, L-asparaginase) chemotherapy followed by high-dose chemotherapy and autologous stem cell transplantation in patients with stage III/IV extranodal NK/T-cell Lymphoma.
Detailed Description
Extranodal NK/T cell lymphoma (ENKTL) is a rare and aggressive lymphoma subtype, but standard front-line therapy has not been established. The clinical outcome of patients (pts) with ENKTL after the treatment of conventional chemotherapy, especially pts with advanced stage, was generally poor. Therefore, high-dose chemotherapy followed by autologous stem cell transplantation (ASCT) as a consolidation could be one of promising strategies to improve the outcome of ENKTL. However, there have been few studies reporting the survival outcome or prognostic significances of front-line ASCT in pts with ENKTL. Thus, the aim of this study was to investigate the outcome of patients with advanced-stage ENKTL who had undergone front-line ASCT.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Extranodal NK-T-Cell Lymphoma

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
27 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
VIDL+ASCT
Arm Type
Experimental
Arm Description
VIDL Induction (repeated 28 days) : VP-16, Ifosfamide, Dexamethasone, L-asparaginase Peripheral blood stem cell mobilization:Etoposide Conditioning regimen for autologous stem cell transplantation:Busulfan,Melphalan,Etoposide
Intervention Type
Drug
Intervention Name(s)
Etoposide
Other Intervention Name(s)
VP-16
Intervention Description
Subjects will receive Etoposide 100 mg/m2 + 5% dextrose in water 500 mL intravenous over 90 mins D1-3 of VIDL chemotherapy. After that, Etoposide will be administered 375mg/m2 D1-2 with G-colony stimulating factor (10 ug/kg) injection in step of Peripheral Blood Stem Cell Collection. Also It will be administered 400mg/m2 on conditioning regimen.
Intervention Type
Drug
Intervention Name(s)
Ifosfamide
Intervention Description
It will be administered1.2g/m2 + 5% dextrose in water 100 mL intravenous over 1 hr D1-3
Intervention Type
Drug
Intervention Name(s)
Dexamethasone
Intervention Description
It will be administered 40mg/day PO or IV D1-3
Intervention Type
Drug
Intervention Name(s)
L-asparaginase
Intervention Description
It will be administered 4000 IU/m2 intramuscular D8, 10, 12, 14, 16, 18, 20
Intervention Type
Drug
Intervention Name(s)
Busulfan
Intervention Description
Conditioning regimen for autologous stem cell transplantation: Busulfan 3.2 mg/kg D -8, -7, -6
Intervention Type
Drug
Intervention Name(s)
Melphalan
Intervention Description
Conditioning regimen for autologous stem cell transplantation: Melphalan 70 mg/m2 D -3, -2
Primary Outcome Measure Information:
Title
progression-free survival (PFS)
Time Frame
2 years
Secondary Outcome Measure Information:
Title
objective overall response rate
Time Frame
2 years
Title
Number of subjects with Adverse Events as a Measure of safety and tolerability
Time Frame
2 years
Title
overall survival
Time Frame
4 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
19 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Histologically confirmed extranodal NK/T cell lymphoma Aged between 19 and 65 years Previously untreated history Performance status: Eastern Cooperative Oncology Group 0-2 Ann Arbor stage III and IV At least one in positron emission tomograph(PET)/CT positive lesion or in 2-dimensional computerized tomography mass lesions more than 2 cm by conventional CT or more than 1 cm by spiral CT Skin lesions or physically detected mass more than 2 cm Cardiac ejection fraction ≥ 45 % as measured by multiple gated acquisition scan(MUGA) or 2D echogram(ECHO) without clinically significant abnormalities Adequate liver functions: Transaminase (AST/ALT) < 3 X upper normal value(or < 5 x upper limit of normal in the presence of NK/T lymphoma involvement of the liver) Bilirubin < 2 X upper normal value(or < 5 x upper limit of normal in the presence of DLBCL involvement of the liver) Serum Creatinine < 2.0 mg/dL Adequate bone marrow functions: hemoglobin ≥ 9 g/dL absolute neutrophil count (ANC) ≥ 1,500/μL and platelet count ≥ 75,000/μL, unless abnormalities are due to bone marrow involvement by lymphoma Expected life is more than 180 days (more than 6 months) A negative serum or urine pregnancy test prior to treatment must be available both for pre-menopausal women and for women who are < 1years after the onset of menopause. Premenopausal women should be treated with appropriate contraception such as hormone contraception, intra-uterine device, spermicidal condom and etc. during and one month after the treatment. Voluntarily signed the informed consent including fully understand of clinical procedures and processing steps for the clinical trial Exclusion Criteria: Patients who have serious medical condition, abnormal laboratory results or psychiatric problems Other subtypes non-Hodgkin's lymphoma than NK/T cell lymphoma Patients who have aggressive NK/T cell leukemia NK/T cell lymphoma with Primary Central Nervous System (CNS) involvement. However, patients who have only had prophylactic intrathecal chemotherapy against CNS disease are eligible. Patients with a known history of HIV seropositivity or hepatitis C virus (HCV) (+). Patients who have carrier hepatitis B virus (HBV) (+) are eligible. However, primary prophylaxis using antiviral agents is recommended for HBV carrier to prevent HBV reactivation during whole treatment period. Any other malignancies within the past 5 years except curatively treated non-melanoma skin cancer or in situ carcinoma of cervix uteri Pregnant or lactating women, women of childbearing potential not employing adequate contraception Other serious illness or medical conditions i. Unstable cardiac disease despite treatment, myocardial infarction within 6 months prior to study entry ii. History of significant neurologic or psychiatric disorders including dementia or seizures iii. Active uncontrolled infection (viral, bacterial or fungal infection) iv. Other serious medical illnesses Concomitant administration of any other experimental drug under investigation, or concomitant chemotherapy, hormonal therapy, or immunotherapy. Serious allergy history for experimental drugs Patients who contraindication to the study drug use
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
won-Seog Kim, MD,Ph.D.
Phone
2-3410-6548
Ext
82
Email
wonseog.kim@samsung.com
First Name & Middle Initial & Last Name or Official Title & Degree
Seok-Jin Kim, MD,Ph.D.
Phone
2-3410-1766
Ext
82
Email
seokjin88.kim@samsung.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
won-Seog Kim, MD,Ph.D
Organizational Affiliation
Samsung Medical Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
Samsung Medical Center
City
Seoul
State/Province
Seoul, Korea, Republic Of
ZIP/Postal Code
135-710
Country
Korea, Republic of
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
WonSeog Kim, M.D, Ph. D
Phone
234106548
Ext
82
Email
wskimsmc@skku.edu
First Name & Middle Initial & Last Name & Degree
SeokJin Kim, M.D,Ph. D
Phone
234101766
Ext
82
Email
seokjin88.kim@samsung.com
Facility Name
Samsung Medical Center
City
Seoul
ZIP/Postal Code
135-710
Country
Korea, Republic of
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Wonseog Kim, M.D., Ph.D.
Phone
82-2-3410-6548
Email
wonseog.kim@samsung.com
First Name & Middle Initial & Last Name & Degree
Seokjin Kim, M.D., Ph.D.
Email
seokjin88.kim@samsung.com
First Name & Middle Initial & Last Name & Degree
Seokjin Kim, M.D., Ph.D.
First Name & Middle Initial & Last Name & Degree
Wonseog Kim, M.D. Ph.D

12. IPD Sharing Statement

Plan to Share IPD
Yes

Learn more about this trial

VP-16, Ifosfamide, Dexamethasone, L-asparaginase Chemotherapy in Patients With Extranodal Natural Killer T Cell Lymphoma (VIDL+ASCT)

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