Study of Zevalin Versus Observation in Participants at Least 60 Years Old With Newly Diagnosed Diffuse Large B-cell Lymphoma in Positron Emission Tomography (PET)-Negative Complete Remission After Rituximab-Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone (R-CHOP) or R-CHOP-like Therapy

Last updated: November 18, 2021
Sponsor: Spectrum Pharmaceuticals, Inc
Overall Status: Terminated

Phase

3

Condition

Lymphoma, B-cell

Follicular Lymphoma

Hematologic Cancer

Treatment

N/A

Clinical Study ID

NCT01510184
SPI-ZEV-11-301
  • Ages > 60
  • All Genders

Study Summary

The purpose of this study is to evaluate the efficacy and safety of Zevalin compared with observation alone in participants who are in PET-negative complete remission after first-line R-CHOP or R-CHOP like therapy.

Eligibility Criteria

Inclusion

Inclusion Criteria:

  1. Participant was 60-years of age or older at time of randomization
  2. Histologically confirmed Ann Arbor stage II, III, or IV diffuse large B-cell lymphoma (DLBCL); or follicular lymphoma (FCL) Grade 3B according to the Revised EuropeanAmerican lymphoma (REAL)/ World health organization (WHO) classification (from initialdiagnosis made prior to starting R-CHOP therapy. Results from a pre R-CHOP marrowshall be available for review.
  3. Local pathology review confirming the DLBCL diagnosis and cluster of differentiation 20 (CD20) positivity, and no evidence of DLBCL in bone marrow upon confirmation ofcomplete remission (CR).
  4. A paraffin block or original slides available for confirmatory pathology review.Participants may be randomized based on the local pathology result.
  5. Age-adjusted international prognostic index (IPI) of 1, 2, or 3. The age-adjusted IPIwas defined by one point for Lactate dehydrogenase (LDH) > upper limit of normal (ULN); Stage III or IV; and Karnofsky performance status <80% or WHO/ easterncooperative operations group (ECOG) performance status >1.
  6. First-line treatment of DLBCL must have been 6 cycles of standard R-CHOP21, R-CHOP14or dose-adjusted etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin,and rituximab (DA-EPOCH-R) chemotherapy. Participants who received pre-phase therapyfor the purpose of improving performance status prior to initiating R-CHOP areeligible.
  7. Complete remission (CR) according to the International Workshop Response Criteria fornon-Hodgkin's lymphoma (NHL) described by Cheson et al after first-line treatment.Computerized tomography (CT) scans of chest, abdomen, pelvis, and neck (if applicable)must have been performed within 6 weeks after the last dose of the last course ofchemotherapy. Applicability of the neck CT means that the participant had involvementof the neck region by palpation / physical examination at first diagnosis.
  8. A negative Fluorine-18-deoxyglucose positron emission tomography (FDG-PET) scanconfirming complete response, with negative defined as a score of 1-3 on the Deauville 5-point scale used to quantify radionucleotide density in PET scans as determinedlocally (Morschhauser 200735).
  9. Bone marrow cellularity greater than 15%, no evidence of myelodysplasiamorphologically and no evidence of involvement with lymphoma either at the pre R-CHOPmarrow or on repeat assessment pre-Zevalin. After completing R-chemotherapy, a repeatmarrow is required for participant randomized to the Zevalin arm only.
  10. A world health organization/eastern cooperative oncology group (WHO/ECOG) performancestatus of 0, 1 or 2.
  11. Adequate hematopoietic functions: Absolute neutrophil count (ANC) ≥ 1.0 x 10^9/ liter (L), Hemoglobin (Hgb) ≥ 9 g/dL, Platelets ≥ 100 x 10^9/L.
  12. Life expectancy of 6 months or longer.
  13. Written informed consent obtained according to local guidelines.

Exclusion

Exclusion Criteria:

  1. Presence of any other malignancy or history of prior malignancy within 5 years ofstudy entry. Within 5 years, participants treated for Stage I or II cancers areeligible provided they have a life expectancy of > 5 years. The 5-year exclusion ruledoes not apply to-non melanoma skin tumors and in situ cervical cancer.
  2. Prior radioimmunotherapy, including radiation therapy for Non-Hodgkin's lymphoma) NHL,or any other NHL therapy.
  3. Presence of primary gastric, central nervous system (CNS), or testicular lymphoma atfirst diagnosis.
  4. Histological transformation of low-grade NHL.
  5. Active hepatitis B or C.
  6. Known history of human immunodeficiency virus (HIV) infection.
  7. Abnormal liver function: total bilirubin > 2 × ULN unless secondary to Gilbertdisease.
  8. Abnormal renal function: serum creatinine > 2.0 × ULN.
  9. Non-recovery from the toxic effects of chemotherapy to < grade 2, or interfering withZevalin treatment.
  10. Known hypersensitivity to murine or chimeric antibodies or proteins.
  11. Granulocyte-colony stimulating factor (G-CSF) or Granulocyte macrophage-colonystimulating factor (GM-CSF) therapy within 4 weeks prior to Zevalin or observation.
  12. Concurrent severe and/or medically uncontrolled disease (e.g. uncontrolled diabetes,congestive heart failure, myocardial infarction within 6 months of study, unstable anduncontrolled hypertension, chronic renal disease, or active uncontrolled infection)which could compromise participation in the study.
  13. Treatment with investigational drugs less than 4 weeks prior to Zevalin orobservation.
  14. Major surgery less than 4 weeks prior to Zevalin or start of observation.
  15. Concurrent systemic corticosteroid use for any reason except as premedication in caseof known or suspected allergies to contrast media or as premedication for potentialside effects of rituximab treatment. Participants on a chronic dose of prednisone fora medical condition (e.g. Asthma or autoimmune disease) less than or equal to 20milligram (mg) daily, stable for 4 weeks, are permissible.
  16. Unwillingness or inability to comply with the protocol.

Study Design

Total Participants: 79
Study Start date:
April 19, 2012
Estimated Completion Date:
October 23, 2014

Connect with a study center

  • Royal Hobart Hospital

    Hobart, Tasmania 7001
    Australia

    Site Not Available

  • Royal Melbourne

    Parkville, Victoria 3052
    Australia

    Site Not Available

  • Royal Adelaide Hospital

    Adelaide,
    Australia

    Site Not Available

  • Barwon Health

    Geelong, 3220
    Australia

    Site Not Available

  • Western Hospital

    Melbourne,
    Australia

    Site Not Available

  • Medizinische Universität Wien -AKH Wien

    Vienna, A-1090
    Austria

    Site Not Available

  • Nuclear Medicine Physician, Jules Bordet Institute

    Bruxelles, 1000
    Belgium

    Site Not Available

  • University Hospital Gasthuisberg

    Leuven, 3000
    Belgium

    Site Not Available

  • Thunder Bay Regional Health Sciences Centre-Regional Cancer Care

    Thunder Bay, Ontario P7B 6V4
    Canada

    Site Not Available

  • Sunnybrook Research Institute

    Toronto, Ontario
    Canada

    Site Not Available

  • CSSS Champlain Charles LeMoyne

    Greenfield Park, Quebec J4V2H1
    Canada

    Site Not Available

  • CHU Dupuytren

    Limoges, Cedex 87042
    France

    Site Not Available

  • CHU A Michallon

    Grenoble, Cedex 9 38043
    France

    Site Not Available

  • CHU Amiens, Hôpital Sud

    Amiens, 80054
    France

    Site Not Available

  • CH Avignon

    Avignon, 84902
    France

    Site Not Available

  • CH de la Côte Basque, Service d'Hématologie

    Bayonne, 64109
    France

    Site Not Available

  • Hématologie - CHU Jean Minjoz

    Besancon, 25030
    France

    Site Not Available

  • Institut Bergonié

    Bordeaux, 33076
    France

    Site Not Available

  • Hopital MORVAN - CHU Brest

    Brest, 29609
    France

    Site Not Available

  • Centre François Baclesse, Comite Hématologie

    Caen, 14076
    France

    Site Not Available

  • Hôpital Henri MONDOR

    Creteil, 94010
    France

    Site Not Available

  • CHD Vendée

    La Roche-sur-Yon, 85925
    France

    Site Not Available

  • CHRU Lille- Hospital Claude Huriez

    Lille, 59037
    France

    Site Not Available

  • Institut Paoli-Calmettes

    Marseille, 13273
    France

    Site Not Available

  • CHR Metz-Thionville

    Metz, 57085
    France

    Site Not Available

  • CH de Mulhouse - Hôpital Emile Muller

    Mulhouse, 68100
    France

    Site Not Available

  • Centre Antoine Lacassagne

    Nice, 06189
    France

    Site Not Available

  • CHR Orléans

    Orleans, 45100
    France

    Site Not Available

  • Institut Curie

    Paris, 75005
    France

    Site Not Available

  • Centre Hospitalier Saint Jean

    Perpignan, 66000
    France

    Site Not Available

  • Hôpital Haut-Levêque Centre F.Magendie

    Pessac, 33600
    France

    Site Not Available

  • Centre Hospitalier René Dubos,

    Pontoise, 95303
    France

    Site Not Available

  • Service d'Hématologie Centre Henri Becquerel

    Rouen, 76038
    France

    Site Not Available

  • CHU de Brabios

    Vandoeuvre-les-nancy, 54511
    France

    Site Not Available

  • St James 's Hospital

    Dublin, 8
    Ireland

    Site Not Available

  • University Hospital Galway

    Galway,
    Ireland

    Site Not Available

  • Soroka Medical Centre

    Beersheba, 84101
    Israel

    Site Not Available

  • Rambam Health Care Campus

    Haifa,
    Israel

    Site Not Available

  • Hadassah Medical Organization

    Jerusalem, 91120
    Israel

    Site Not Available

  • Shaare Zedek Medical Center

    Jerusalem, 93722
    Israel

    Site Not Available

  • Tel Aviv Sourasky Medical Centre

    Tel Aviv, 64239
    Israel

    Site Not Available

  • Chaim Sheba Medical Center

    Tel-Hashomer, 52621
    Israel

    Site Not Available

  • Policlinico S Orsola Malpighi, Istituto di Ematologia ''L.e A. Seragnoli''

    Bologna, 40138
    Italy

    Site Not Available

  • New Ematologia dell'Ospedale "Spedali Civili" di Brescia

    Brescia, 25123
    Italy

    Site Not Available

  • Divisione di Ematoncologia

    Milano, 20141
    Italy

    Site Not Available

  • Azienda Ospedaliera Sant'Andrea

    Roma, 00189
    Italy

    Site Not Available

  • Azienda Ospedaliera San. Giovanni Battista di Torino, Dipartimento di Oncologia U.O.A Ematologia, Le Molinette,

    Torino, 10126
    Italy

    Site Not Available

  • Meander Medisch Centrum

    Amersfoort, 3813 TZ
    Netherlands

    Site Not Available

  • VU Medisch Centrum

    Amsterdam, 1081
    Netherlands

    Site Not Available

  • Haga Ziekenhuis

    Den Haag, 2545 CH
    Netherlands

    Site Not Available

  • University Medical Centre Groningen (UMCG)

    Groningen, 9713GZ
    Netherlands

    Site Not Available

  • Spaarne Ziekenhuis, Internal Medicine/Ocology

    Hoofddorp, 2134TM
    Netherlands

    Site Not Available

  • Medisch Centrum Leeuwarden

    Leeuwarden, 8934 AD
    Netherlands

    Site Not Available

  • St. Antonius Hospital

    Nieuwegein, 3435 CM
    Netherlands

    Site Not Available

  • University Medical Center Radboud Nijmegen

    Nijmegen, 6525
    Netherlands

    Site Not Available

  • Erasmus Medisch Centrum

    Rotterdam, NL-3015
    Netherlands

    Site Not Available

  • Auxilio Mutuo Cancer Center

    San Juan, 00918
    Puerto Rico

    Site Not Available

  • Clínica Universidad de Navarra (CUN)

    Pamplona,
    Spain

    Site Not Available

  • Hospital Universitario Miguel Servet

    Zaragoza, 50009
    Spain

    Site Not Available

  • Miguel Servet University Hospital

    Zaragoza,
    Spain

    Site Not Available

  • Department of Haematology Bristol Royal Infirmary

    Bristol, BS2 8HW
    United Kingdom

    Site Not Available

  • Poole General Hospital

    Dorset, BH15
    United Kingdom

    Site Not Available

  • Beatson Cancer Centre

    Glasgow, G12 0YN
    United Kingdom

    Site Not Available

  • King's College Hospital

    London, SE5 9RS
    United Kingdom

    Site Not Available

  • The Christie NHS Foundation Trust, The Christie Hospital,

    Manchester, M20 4BX
    United Kingdom

    Site Not Available

  • Cancer Treatment Services Arizona

    Casa Grande, Arizona 85122
    United States

    Site Not Available

  • Sutter East Bay Hospitals

    Berkeley, California 94704
    United States

    Site Not Available

  • Sutter East Bay Hospitals

    Berkley, California 94704
    United States

    Site Not Available

  • City of Hope

    Duarte, California 91010
    United States

    Site Not Available

  • Halifax Health Medical Center

    Daytona Beach, Florida 32114
    United States

    Site Not Available

  • H. Lee Moffitt Cancer Center

    Tampa, Florida 33612
    United States

    Site Not Available

  • Piedmont Hospital Cancer Center

    Atlanta, Georgia 30318
    United States

    Site Not Available

  • St. Luke's Mountain States Tumor Institute (MSTI)

    Boise, Idaho 83712
    United States

    Site Not Available

  • Northwestern University Feinberg School of Medicine

    Chicago, Illinois 60611
    United States

    Site Not Available

  • Rush University Medical Center

    Chicago, Illinois 60612
    United States

    Site Not Available

  • Decatur Memorial Hospital Cancer Care Specialists of Central Illinois

    Decatur, Illinois 62526
    United States

    Site Not Available

  • Illinois Cancer Specialists

    Niles, Illinois 60714
    United States

    Site Not Available

  • Midwestern Regional Medical Center

    Zion, Illinois 60099
    United States

    Site Not Available

  • University of Iowa Hospitals and Clinics

    Iowa City, Iowa 52242
    United States

    Site Not Available

  • Norton Cancer Institute, Suburban

    Louisville, Kentucky 40207
    United States

    Site Not Available

  • Norton Cancer Institute, Suburban

    Lousiville, Kentucky 40207
    United States

    Site Not Available

  • Beth Israel Deaconess Medical Center

    Boston, Massachusetts 02215
    United States

    Site Not Available

  • St. John Hospital and Medical Center

    Grosse Pointe Woods, Michigan 48236
    United States

    Site Not Available

  • Oncology Research-Park Nicollet Institute

    Saint Louis Park, Minnesota 55426
    United States

    Site Not Available

  • Oncology Research-Park Nicollet Institute

    St. Louis Park, Minnesota 55426
    United States

    Site Not Available

  • Saint Louis University

    Saint Louis, Missouri 63110
    United States

    Site Not Available

  • Saint Louis University

    St. Louis, Missouri 63110
    United States

    Site Not Available

  • Comprehensive Cancer Centers of Nevada

    Henderson, Nevada 89044
    United States

    Site Not Available

  • Hackensack UMC / John Theurer Cancer Center

    Hackensack, New Jersey 07601
    United States

    Site Not Available

  • Memorial Sloan-Kettering Cancer Center

    New York, New York 10065
    United States

    Site Not Available

  • Adams Cancer center

    Gettysburg, Pennsylvania 17325
    United States

    Site Not Available

  • York Cancer Center / Cancer Care Associates of York

    York, Pennsylvania 17403
    United States

    Site Not Available

  • Saint Francis Hospital

    Greenville, South Carolina 29601
    United States

    Site Not Available

  • Avera Hematology and Transplant

    Sioux Falls, South Dakota 57105
    United States

    Site Not Available

  • Associates In Oncology and Hematology

    Chattanooga, Tennessee 37421
    United States

    Site Not Available

  • The University of Texas M.D. Anderson Cancer Center

    Houston, Texas 77030
    United States

    Site Not Available

  • Seattle Cancer Care Alliance

    Seattle, Washington 98109
    United States

    Site Not Available

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