Is your age greater than or equal to 18 yrs? |
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Gender: Male or Female |
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Do you have any of these conditions: Non-Hodgkin's Lymphoma or Lymphoma? |
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Do you have any of these conditions: non-hodgkin's lymphoma (nhl) or Lymphoma or Non-Hodgkin's Lymphoma? |
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Do you have any of these conditions: Lymphoma or non-hodgkin's lymphoma (nhl) or Non-Hodgkin's Lymphoma? |
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Do you have any of these conditions: non-hodgkin's lymphoma (nhl) or Lymphoma or Non-Hodgkin's Lymphoma? |
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Do you have any of these conditions: Lymphoma or non-hodgkin's lymphoma (nhl) or Non-Hodgkin's Lymphoma? |
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patients with first relapse or progression of an aggressive Non-Hodgkin's lymphoma |
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all patient >65 years of age or older than 18 years if HCT-CI score > 2 or patients who underwent prior autologous stem cell transplantation and are not eligible for allogeneic stem cell Transplantation |
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All risk groups (IPI 0 to 5) |
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Diagnosis of aggressive Non-Hodgkin's lymphoma, based on an excisional biopsy of a lymph node or on an appropriate sample of a lymph node or of an extranodal involvement at initial diagnosis or relapse or Progression. The entities treated in the study will be based on the WHO 2017 classification |
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ECOG 0 - 2 |
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only one prior chemotherapy regimen including an anthracycline. The last cytotoxic drug must be given at least four weeks before entering the study. Rituximab must be part of the first-line regimen in case of B-cell lymphoma. Patients may have received prior radiation therapy as part of their first-line therapy |
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Men who are sexually active with women of childbearing potential (WOCBP) must not father a child during and up to 6 months after GemOx and up to 12 months after Rituximab and/or Nivolumab. They are advised to do cryoconservation of sperm prior to treatment |
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Written informed consent of the patient |
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Patient must be covered by social security system |
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Already initiated lymphoma therapy after first relapse or progression |
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Serious accompanying disorder or impaired organ function |
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WBC < 2.5 G/l, Neutrophils < 2 G/l, Platelets < 100 G/l |
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Prolongation of QTc interval > 450 ms, demonstrated in one electrocardiogram (done as triplicate). This does not apply for patients with a block of the right and/or left bundle branch |
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Family history for Long QT-Syndrome |
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active, known or suspected autoimmune disease |
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no requirement for immunosuppressive doses of systemic corticosteroids |
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Chronic active hepatitis B or C |
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HIV-infection |
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Patients with a severe immunodeficiency |
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Previous therapy with Nivolumab,Gemcitabine or Oxaliplatin |
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Patients with a "currently active" second malignancy other than non-melanoma skin cancer |
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CNS involvement of lymphoma |
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Persistent neuropathy grade >2 |
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Pregnancy or breast-feeding women |
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Women of childbearing potential |
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Active serious infections not controlled by oral and/or intravenous antibiotics or anti-fungal medication |
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Any medical condition which in the opinion of the investigator places the subject at an unacceptably high risk for toxicities |
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Lymphomas other than those listed in the inclusion criteria notably indolent lymphoma, Mantle cell lymphoma, Burkitt lymphoma, adult T-cell leukemia/lymphoma |
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Persons not able to understand the impact, nature, risks and consequences of the trial (including language barrier) |
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Persons not agreeing to the transmission of their pseudonymous data |
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Persons depending on sponsor or investigator |
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Persons from highly protected Groups |
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Allergies and Adverse Drug Reaction History to study drug components |
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Participation in another clinical trial with drug intervention within 4 weeks prior to start of the first cycle and during the study. However, participation in a clinical trial of firstline therapy of lymphoma is allowed |
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