ACVBP Plus Rituximab Versus CHOP Plus Rituximab in Patients With Diffuse Large B-cell Lymphoma and Age-adjusted IPI of 1

Overview[ - collapse ][ - ]

Purpose This study is a multicentric randomized trial evaluating the efficacy of the combination ACVBP+rituximab compared to the combination of CHOP+rituximab in patients aged from 18 to 59 years with diffuse large B-cell lymphoma and one factor of the age-adjusted international prognostic index (IPI).
ConditionDiffuse Large-Cell Lymphoma
InterventionDrug: rituximab
Drug: doxorubicin
Drug: cyclophosphamide
PhasePhase 3
SponsorLymphoma Study Association
Responsible PartyLymphoma Study Association
ClinicalTrials.gov IdentifierNCT00140595
First ReceivedAugust 31, 2005
Last UpdatedMarch 3, 2011
Last verifiedMarch 2011

Tracking Information[ + expand ][ + ]

First Received DateAugust 31, 2005
Last Updated DateMarch 3, 2011
Start DateDecember 2003
Estimated Primary Completion DateJanuary 2009
Current Primary Outcome MeasuresEvent-free survival (EFS), events defined as death from any cause, relapse for complete responders (CR) and unconfirmed complete responders (CRu), progression during or after treatment, changes of therapy during allocated treatment.
Current Secondary Outcome MeasuresResponse rate at the end of the treatment, progression rate, relapse rate, disease-free survival for complete responders, overall survival, neuromeningeal relapse rate and additional toxicities with ACVBP+rituximab combination

Descriptive Information[ + expand ][ + ]

Brief TitleACVBP Plus Rituximab Versus CHOP Plus Rituximab in Patients With Diffuse Large B-cell Lymphoma and Age-adjusted IPI of 1
Official TitleRandomized Study of ACVBP Plus Rituximab Versus CHOP Plus Rituximab in Patients Aged From 18 to 59 Years With Diffuse Large B-cell Lymphoma and a Age-adjusted IPI of 1.
Brief Summary
This study is a multicentric randomized trial evaluating the efficacy of the combination
ACVBP+rituximab compared to the combination of CHOP+rituximab in patients aged from 18 to 59
years with diffuse large B-cell lymphoma and one factor of the age-adjusted international
prognostic index (IPI).
Detailed Description
This phase III multicentric open label randomized study is based on the results of previous
LNH 93-5 and LNH98-5 studies.

The LNH93-5 study has shown that the ACVBP regimen gave a longer EFS (39% vs 29% at 5 years,
p=0.005) and a longer overall survival (46% vs 38% at 5 years, p=0.036) than CHOP in
patients aged between 61 and 69 with an IPI score ≥1. However ACVBP had a more important
toxicity and a higher treatment related mortality (13% vs 7%, p<0.01), specially after 65
years. In younger patients ACVBP is better tolerated.

The addition of Rituximab to standard CHOP (R-CHOP) has been shown in LNH98-5 study to
improve complete remission rate (CR), event-free survival (EFS) and overall survival (OS) in
elderly patients with B-DLCL. Considering only patients with an aa-IPI score of 1, the 2
year EFS was 75% in the R-CHOP group as compared with 42% in the CHOP group.

This study is designed to test whether addition of rituximab to ACVBP is better than R-CHOP
in patients younger than 60. Primary endpoint is event-free survival, we expect a gain in 2
years-EFS of 10% in R-ACVBP group as compared with R-CHOP group.

This study is a multicentric, phase III open-label, randomized trial evaluating the efficacy
of ACVBP+rituximab compared to CHOP+rituximab in patients aged from 18 to 59 years with non
previously treated diffuse large B-cell lymphoma and one factor of the age-adjusted
international prognostic index
Study TypeInterventional
Study PhasePhase 3
Study DesignAllocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
ConditionDiffuse Large-Cell Lymphoma
InterventionDrug: rituximab
Drug: doxorubicin
Drug: cyclophosphamide
Study Arm (s)Not Provided

Recruitment Information[ + expand ][ + ]

Recruitment StatusCompleted
Estimated Enrollment380
Estimated Completion DateJanuary 2009
Estimated Primary Completion DateJanuary 2009
Eligibility Criteria
Inclusion Criteria:

Patient with histologically proven CD20+ diffuse large B-cell lymphoma (WHO
classification) Aged from 18 to 59 years. Age-adjusted International Prognostic Index
equal to 1 (elevated LDH level OR stage III-IV OR ECOG status 2-3-4).

Patient not previously treated. With a minimum life expectancy of 3 months. Negative HIV,
HBV and HCV serologies test 4 weeks (except after vaccination). Having previously signed a
written informed consent.

Exclusion Criteria:

Any other histological type of lymphoma. Any history of treated or non-treated indolent
lymphoma. However, patients not previously diagnosed and having a diffuse large B-cell
lymphoma with some small cell infiltration in bone marrow or lymph node may be included.

Central nervous system or meningeal involvement by lymphoma. Contra-indication to any drug
contained in the chemotherapy regimens. Any serious active disease (according to the
investigator's decision). Poor renal function (creatinin level>150µmol/l), poor hepatic
function (total bilirubin level>30mmol/l, transaminases>2.5 maximum normal level) unless
these abnormalities are related to the lymphoma.

Poor bone marrow reserve as defined by neutrophils <1.5 G/l or platelets <100 G/l, unless
related to bone marrow infiltration.

Any history of cancer during the last 5 years with the exception of non-melanoma skin
tumors or stage 0 (in situ) cervical carcinoma.

Treatment with any investigational drug within 30 days before planned first cycle of
chemotherapy and during the study.

Pregnant or lactating women. Adult patient under tutelage.
GenderBoth
Ages18 Years
Accepts Healthy VolunteersNo
ContactsNot Provided
Location CountriesBelgium, France

Administrative Information[ + expand ][ + ]

NCT Number NCT00140595
Other Study ID NumbersLNH03-2B
Has Data Monitoring CommitteeNot Provided
Information Provided ByLymphoma Study Association
Study SponsorLymphoma Study Association
CollaboratorsAmgen
Investigators Principal Investigator: Christian Recher, MD Lymphoma Study AssociationStudy Chair: Hervé Tilly, MD Lymphoma Study AssociationStudy Chair: Corinne Haioun, MD Lymphoma Study Association
Verification DateMarch 2011

Locations[ + expand ][ + ]

Groupe d'étude des lymphomes de l'adulte
Yvoir, Belgium
Hôpital Henri Mondor
Créteil, France, 94010
Centre Léon Bérard
Lyon, France, 69008
Hôpital Saint Louis
Paris, France, 75010
Hématologie Adultes - Hôpital Necker
Paris, France, 75743
Service d'Hématologie - Centre Hospitalier Lyon-Sud
Pierre-Bénite cedex, France, 69495
Centre Hospitalier Robert Debré
Reims, France, 51092
Centre Henri Becquerel
Rouen, France, 76038
Hématologie CHU Purpan
Toulouse, France, 31059
Institut Gustave Roussy
Villejuif, France