NCT00389818

Combination Chemotherapy and Rituximab in Treating Patients With Newly Diagnosed AIDS-Related B-Cell Non-Hodgkin's Lymphoma

A Phase II Trial of Doxil, Rituximab, Cyclophosphamide, Vincristine, and Prednisone (DR-COP) in Patients With Newly Diagnosed AIDS-Associated B-Cell Non-Hodgkin's Lymphoma

• Status: Completed
• Phase: Phase 2
• Study type: Interventional
• Enrollment: 43 (actual)
• Sponsor: AIDS Malignancy Consortium · Network
• Sex: All
• Age: 18 Years – 120 Years
• Healthy volunteers: Not accepted

Summary

RATIONALE: Drugs used in chemotherapy work in different ways to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Monoclonal antibodies, such as rituximab, can block cancer growth in different ways. Some find cancer cells and help kill them or carry cancer-killing substances to them. Others interfere with the ability of cancer cells to grow and spread. Giving combination chemotherapy together with rituximab may kill more cancer cells. PURPOSE: This phase II trial is studying how well giving combination chemotherapy together with rituximab works in treating patients with newly diagnosed AIDS-related B-cell non-Hodgkin's lymphoma.

Detailed description

OBJECTIVES: Primary * Determine the complete response rate (complete response and complete response unconfirmed) in patients with newly diagnosed, AIDS-related B-cell non-Hodgkin's lymphoma treated with doxorubicin hydrochloride liposome, rituximab, cyclophosphamide, vincristine, and prednisone (DR-COP). * Determine the duration of response (relapse-free survival) in patients treated with this regimen. * Determine the median survival time of patients treated with this regimen. * Determine rate of bacterial, fungal, and opportunistic infections in patients treated with this regimen. Secondary * Determine, preliminarily, the relationship between MDR-1 expression in tumor tissue and response to therapy in patients treated with this regimen. * Determine, preliminarily, any relationship between response and survival and BCL-2 expression in tumor tissue in patients treated with this regimen. * Determine any relationship between development of bacterial, fungal, and/or opportunistic infections and baseline CD4 lymphocyte count, HIV-1 RNA level, and quantitative immunoglobulin levels, or changes in quantitative immunoglobulin levels over time in patients treated with this regimen. * Compare the results of positron emission tomography (PET) scanning with traditional CT scans in predicting response to therapy in these patients. * Examine the relationship between chemotherapeutic drug levels and receipt of specific antiretroviral and/or anti-infective medications in these patients. * Examine the mortality and the causes of death in patients treated with this regimen. * Determine event-free survival at 1 year. OUTLINE: This is a nonrandomized, multicenter study. Patients receive doxorubicin hydrochloride liposome IV over 90 minutes, rituximab IV over 5-7 hours, cyclophosphamide IV over 1 hour, and vincristine IV over 1-2 minutes on day 1 and oral prednisone on days 1-5. Patients also receive filgrastim (G-CSF), sargramostim (GM-CSF), or pegfilgrastim beginning on day 3 and continuing until blood counts recover. Treatment repeats every 21-28 days for up to 8 courses in the absence of disease progression or unacceptable toxicity. Patients undergo laboratory/biomarker studies at baseline and after every 2 courses of chemotherapy. Tissue is examined by immunohistochemistry for BCL-2, Ki67, and MDR-1, along with other markers. After completion of study treatment, patients are followed periodically for 3 years. PROJECTED ACCRUAL: A total of 44 patients will be accrued for this study.

Conditions

• Lymphoma

Interventions

Type	Name	Description
BIOLOGICAL	filgrastim	Supportive therapy: GF therapy with G-CSF, GM-CSF, or pegfilgrastim will be used in all patients, beginning on Day 3 of each cycle, until post nadir of blood counts from each chemotherapy cycle.
BIOLOGICAL	pegfilgrastim	GF therapy with G-CSF, GM-CSF, or pegfilgrastim will be used in all patients, beginning on Day 3 of each cycle, until post nadir of blood counts from each chemotherapy cycle.
BIOLOGICAL	rituximab	375 mg/m2 IV Day 1 of each cycle
BIOLOGICAL	sargramostim	GF therapy with G-CSF, GM-CSF, or pegfilgrastim will be used in all patients, beginning on Day 3 of each cycle, until post nadir of blood counts from each chemotherapy cycle.
DRUG	cyclophosphamide	750 mg/m2 IV Day 1 of each cycle
DRUG	pegylated liposomal doxorubicin hydrochloride	40 mg/m2 IV Day 1 of each cycle
DRUG	prednisone	100 mg PO Days 1-5 of each cycle
DRUG	vincristine sulfate	1.4 mg/m2 IV Day 1 (2.0 mg maximum) of each cycle
OTHER	immunohistochemistry staining method	tissue specimen collected at baseline
OTHER	laboratory biomarker analysis	tissue specimen collected at baseline

Timeline

• Start date: 2007-01-01
• Primary completion: 2011-09-01
• Completion: 2011-09-01
• First posted: 2006-10-19
• Last updated: 2018-06-06
• Results posted: 2012-06-29

Locations

14 sites across 1 country: United States