Dose-Adjusted EPOCH Chemotherapy and Rituximab (CD20+) in Previously Untreated Aggressive Non-Hodgkin's Lymphoma

Part of paid clinical trials in Fort Lauderdale, Florida.

Sponsor
National Cancer Institute (NCI)
Study ID
NCT00001337
Phase
PHASE2
Status
Completed

Conditions

  • Anaplastic Large-Cell Lymphoma
  • Burkitt Lymphoma
  • Diffuse Large B-Cell Lymphoma (DLBCL)
  • Gray Zone Lymphoma
  • Primary Mediastinal Large B-cell Lymphoma

Eligibility Criteria

Sex
ALL
Age
12 Years - N/A
Healthy Volunteers
Not accepted

Interventions

  • Etoposide — DRUG
    Etoposide 50mg/m\^2/day were delivered as continuous intravenous (CIV) infusions over 96 hours starting on day 1 every 21 days. Combination chemotherapy given with Rituximab, Etoposide, VP-16; Prednisone, Cyclophosphamide, Vincristine, and Doxorubicin (EPOCH-R) intravenous (IV) every 3 weeks for 6 cycles.
  • Rituximab — BIOLOGICAL
    Rituximab given on Day 1 of combination chemotherapy (EPOCH-R) every 3 weeks for 6 cycles. Combination chemotherapy given with Rituximab, Etoposide, VP-16; Prednisone, Cyclophosphamide, Vincristine, and Doxorubicin (EPOCH-R) intravenous (IV) every 3 weeks for 6 cycles.
  • Prednisone — DRUG
    Prednisone 100mg by mouth (PO) twice a day (bid) on days 1 through 5 every 21 days. Combination chemotherapy given with Rituximab, Etoposide, VP-16; Prednisone, Cyclophosphamide, Vincristine, and Doxorubicin (EPOCH-R) intravenous (IV) every 3 weeks for 6 cycles.
  • Cyclophosphamide — DRUG
    Cyclophosphamide 750mg/m\^2 on day 5 every 21 days. Combination chemotherapy given with Rituximab, Etoposide, VP-16; Prednisone, Cyclophosphamide, Vincristine, and Doxorubicin (EPOCH-R) intravenous (IV) every 3 weeks for 6 cycles.
  • Vincristine — DRUG
    Vincristine 0.4mg/m\^2/day. Combination chemotherapy given with Rituximab, Etoposide, VP-16; Prednisone, Cyclophosphamide, Vincristine, and Doxorubicin (EPOCH-R) intravenous (IV) every 3 weeks for 6 cycles.
  • Doxorubicin — DRUG
    Doxorubicin 10mg/m\^2/day. Combination chemotherapy given with Rituximab, Etoposide, VP-16; Prednisone, Cyclophosphamide, Vincristine, and Doxorubicin (EPOCH-R) intravenous (IV) every 3 weeks for 6 cycles.
  • MRI — DIAGNOSTIC_TEST
    Baseline and/or on completion of therapy.
  • CT — DIAGNOSTIC_TEST
    Baseline and/or on completion of therapy.
  • Biopsy — PROCEDURE
    Baseline and/or on completion of therapy.
  • PET scan — DIAGNOSTIC_TEST
    As clinically indicated.
  • Laparotomy — PROCEDURE
    As clinically indicated.
  • Ondansetron — OTHER
    Nausea and/or vomiting.
  • Prochlorperazine — OTHER
    Nausea and/or vomiting.
  • Omeprazole — OTHER
    Gastroesophageal reflux disease (GERD).
  • Docusate Sodium + Sennosides — OTHER
    Constipation.
  • Lactulose — OTHER
    Constipation

Study Details

5-Drug Combination Chemotherapy with Hematologic Toxicity Attenuation. Etoposide phosphate, prednisone, vincristine sulfate (Oncovin), cyclophosphamide, and doxorubicin hydrochloride (hydroxydaunorubicin)(EPOCH): Etoposide, VP-16, NSC-141540; Prednisone, PRED, NSC-10023; Vincristine, VCR, NSC-67574; Cyclophosphamide, CTX, NSC-26271; Doxorubicin, DOX, NSC-123127; with Granulocyte Colony-Stimulating Factor (Amgen), Granulocyte colony-stimulating factor (G-CSF), NSC-614629.

Key Dates

Start date
May 8, 1993
Status verified
Jun 2025
Primary completion
May 24, 2024
Completion
May 24, 2024

Study Design

Enrollment
348 participants (actual)
Allocation
NON_RANDOMIZED
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT

Arms

  • Experimental: With EPOCH-R (Etoposide, Doxorubicin, Prednisone, Cyclophosphamide and Rituximab)
    Subgroup 1 (SG1) - All participants who received combination Rituximab (EPOCH-R). Rituximab 375 mg/m\^2 intravenous (IV) on day 1, every 21 days, prednisone 100mg by mouth (PO) twice a day (bid) on days 1 through 5 every 21 days, and cyclophosphamide 750mg/m\^2 on day 5 every 21 days. Doxorubicin 10mg/m\^2/day, vincristine 0.4mg/m\^2/day, and etoposide 50mg/m\^2/day were delivered as continuous intravenous (CIV) infusions over 96 hours starting on day 1 every 21 days. Dose levels were adjusted on doxorubicin, etoposide, and cyclophosphamide each cycle based on neutrophil nadir.
  • Experimental: EPOCH Alone (Etoposide, Doxorubicin, Prednisone, and Cyclophosphamide)
    Subgroup 2 (SG2) - EPOCH alone: All participants who received Prednisone 100mg by mouth (PO) twice a day (bid) on days 1 through 5 every 21 days, and cyclophosphamide 750mg/m\^2 on day 5 every 21 days. Doxorubicin 10mg/m\^2/day, vincristine 0.4mg/m\^2/day, and etoposide 50mg/m\^2/day were delivered as continuous intravenous (CIV) infusions over 96 hours starting on day 1 every 21 days. Dose levels were adjusted on doxorubicin, etoposide, and cyclophosphamide each cycle based on neutrophil nadir.

Primary Outcome Measure

Overall Response (Complete Response + Partial Response) [ Time Frame: Time frame was from beginning of therapy until the end of therapy, an average of 6 months ]

Locations (5)

FacilityCityStateZIPSite coordinators
Holy Cross Hospital, Fort LauderdaleFort LauderdaleFlorida33308-
University of Maryland, BaltimoreBaltimoreMaryland21201-1595-
National Institutes of Health Clinical CenterBethesdaMaryland20892-
Brigham and Women's HospitalBostonMassachusetts02115-
St. Luke's Roosevelt HospitalNew YorkNew York10025-

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