Clinical Trials /

Dose Adjusted EPOCH Regimen in Combination With Ofatumumab or Rituximab in Treating Patients With Newly Diagnosed or Relapsed or Refractory Burkitt Lymphoma or Relapsed or Refractory Acute Lymphoblastic Leukemia

NCT02199184

Description:

This phase II trial studies how well a dose adjusted regimen consisting of etoposide, prednisone, vincristine sulfate, cyclophosphamide, and doxorubicin hydrochloride (EPOCH) works in combination with ofatumumab or rituximab in treating patients with Burkitt lymphoma that is newly diagnosed, or has returned after a period of improvement (relapsed), or has not responded to previous treatment (refractory) or relapsed or refractory acute lymphoblastic leukemia. Drugs used in chemotherapy, such as etoposide, prednisone, vincristine sulfate, cyclophosphamide, and doxorubicin hydrochloride, work in different ways to stop the growth of cancer cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Monoclonal antibodies, such as ofatumumab and rituximab, may interfere with the ability of cancer cells to grow and spread. Giving more than one drug (combination chemotherapy) together with monoclonal antibody therapy may kill more cancer cells.

Related Conditions:
  • Acute Lymphoblastic Leukemia
  • Burkitt Leukemia
  • Burkitt Lymphoma
  • Diffuse Large B-Cell Lymphoma
  • Double-Hit Lymphoma
  • Triple-Hit Lymphoma
Recruiting Status:

Recruiting

Phase:

Phase 2

Trial Eligibility

Document

Title

  • Brief Title: Dose Adjusted EPOCH Regimen in Combination With Ofatumumab or Rituximab in Treating Patients With Newly Diagnosed or Relapsed or Refractory Burkitt Lymphoma or Relapsed or Refractory Acute Lymphoblastic Leukemia
  • Official Title: Phase II Study of the Dose Adjusted EPOCH Regimen in Combination With Ofatumumab/Rituximab as Therapy for Patients With Newly Diagnosed or Relapsed/Refractory Burkitt Leukemia or Relapsed/Refractory Acute Lymphoblastic Leukemia

Clinical Trial IDs

  • ORG STUDY ID: 2014-0123
  • SECONDARY ID: NCI-2014-01707
  • SECONDARY ID: 2014-0123
  • SECONDARY ID: P30CA016672
  • NCT ID: NCT02199184

Conditions

  • AIDS-Related Burkitt Lymphoma
  • Atypical Burkitt/Burkitt-Like Lymphoma
  • High Grade B-Cell Lymphoma With MYC and BCL2 or BCL6 Rearrangements
  • High Grade B-Cell Lymphoma With MYC, BCL2, and BCL6 Rearrangements
  • Recurrent Acute Lymphoblastic Leukemia
  • Recurrent Burkitt Lymphoma
  • Refractory Acute Lymphoblastic Leukemia
  • Refractory Burkitt Lymphoma

Interventions

DrugSynonymsArms
Cyclophosphamide(-)-Cyclophosphamide, 2H-1,3,2-Oxazaphosphorine, 2-[bis(2-chloroethyl)amino]tetrahydro-, 2-oxide, monohydrate, Carloxan, Ciclofosfamida, Ciclofosfamide, Cicloxal, Clafen, Claphene, CP monohydrate, CTX, CYCLO-cell, Cycloblastin, Cycloblastine, Cyclophospham, Cyclophosphamid monohydrate, Cyclophosphamide Monohydrate, Cyclophosphamidum, Cyclophosphan, Cyclophosphane, Cyclophosphanum, Cyclostin, Cyclostine, Cytophosphan, Cytophosphane, Cytoxan, Fosfaseron, Genoxal, Genuxal, Ledoxina, Mitoxan, Neosar, Revimmune, Syklofosfamid, WR- 138719Treatment (DA-EPOCH and ofatumumab or rituximab)
Doxorubicin Hydrochloride5,12-Naphthacenedione, 10-[(3-amino-2,3,6-trideoxy-alpha-L-lyxo-hexopyranosyl)oxy]-7,8, 9,10-tetrahydro-6,8,11-trihydroxy-8-(hydroxyacetyl)-1-methoxy-, hydrochloride, (8S-cis)- (9CI), ADM, Adriacin, Adriamycin, Adriamycin Hydrochloride, Adriamycin PFS, Adriamycin RDF, ADRIAMYCIN, HYDROCHLORIDE, Adriamycine, Adriblastina, Adriblastine, Adrimedac, Chloridrato de Doxorrubicina, DOX, DOXO-CELL, Doxolem, Doxorubicin HCl, Doxorubicin.HCl, Doxorubin, Farmiblastina, FI 106, FI-106, hydroxydaunorubicin, RubexTreatment (DA-EPOCH and ofatumumab or rituximab)
EtoposideDemethyl Epipodophyllotoxin Ethylidine Glucoside, EPEG, Lastet, Toposar, Vepesid, VP 16, VP 16-213, VP-16, VP-16-213, VP16Treatment (DA-EPOCH and ofatumumab or rituximab)
OfatumumabArzerra, GSK1841157, HuMax-CD20, HuMax-CD20, 2F2Treatment (DA-EPOCH and ofatumumab or rituximab)
Prednisone.delta.1-Cortisone, 1, 2-Dehydrocortisone, Adasone, Cortancyl, Dacortin, DeCortin, Decortisyl, Decorton, Delta 1-Cortisone, Delta-Dome, Deltacortene, Deltacortisone, Deltadehydrocortisone, Deltasone, Deltison, Deltra, Econosone, Lisacort, Meprosona-F, Metacortandracin, Meticorten, Ofisolona, Orasone, Panafcort, Panasol-S, Paracort, Perrigo Prednisone, PRED, Predicor, Predicorten, Prednicen-M, Prednicort, Prednidib, Prednilonga, Predniment, Prednisone Intensol, Prednisonum, Prednitone, Promifen, Rayos, Servisone, SK-PrednisoneTreatment (DA-EPOCH and ofatumumab or rituximab)
RituximabABP 798, BI 695500, C2B8 Monoclonal Antibody, Chimeric Anti-CD20 Antibody, CT-P10, IDEC-102, IDEC-C2B8, IDEC-C2B8 Monoclonal Antibody, MabThera, Monoclonal Antibody IDEC-C2B8, PF-05280586, Rituxan, Rituximab ABBS, Rituximab Biosimilar ABP 798, Rituximab Biosimilar BI 695500, Rituximab Biosimilar CT-P10, Rituximab Biosimilar GB241, Rituximab Biosimilar IBI301, Rituximab Biosimilar JHL1101, Rituximab Biosimilar PF-05280586, Rituximab Biosimilar RTXM83, Rituximab Biosimilar SAIT101, rituximab biosimilar TQB2303, rituximab-abbs, RTXM83, TruximaTreatment (DA-EPOCH and ofatumumab or rituximab)
Vincristine SulfateKyocristine, Leurocristine sulfate, Leurocristine, sulfate, Oncovin, Vincasar, Vincosid, Vincrex, Vincristine, sulfateTreatment (DA-EPOCH and ofatumumab or rituximab)

Purpose

This phase II trial studies how well a dose adjusted regimen consisting of etoposide, prednisone, vincristine sulfate, cyclophosphamide, and doxorubicin hydrochloride (EPOCH) works in combination with ofatumumab or rituximab in treating patients with Burkitt lymphoma that is newly diagnosed, or has returned after a period of improvement (relapsed), or has not responded to previous treatment (refractory) or relapsed or refractory acute lymphoblastic leukemia. Drugs used in chemotherapy, such as etoposide, prednisone, vincristine sulfate, cyclophosphamide, and doxorubicin hydrochloride, work in different ways to stop the growth of cancer cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Monoclonal antibodies, such as ofatumumab and rituximab, may interfere with the ability of cancer cells to grow and spread. Giving more than one drug (combination chemotherapy) together with monoclonal antibody therapy may kill more cancer cells.

Detailed Description

      PRIMARY OBJECTIVE:

      I. To evaluate the clinical efficacy of the combination of dose adjusted (DA)-EPOCH +
      ofatumumab in patients with newly diagnosed or relapsed/refractory Burkitt leukemia or
      relapsed/refractory acute lymphoblastic leukemia (ALL) defined by complete response rate.

      SECONDARY OBJECTIVE:

      I. To evaluate the safety of this combination, the overall survival and event-free survival
      rates.

      OUTLINE:

      Patients receive DA-EPOCH regimen comprising doxorubicin hydrochloride intravenously (IV),
      vincristine sulfate IV, and etoposide IV continuously over 96 hours on days 1-4;
      cyclophosphamide IV over 1-2 hours on day 5; and prednisone orally (PO) twice daily (BID) on
      days 1-5. Patients also receive ofatumumab IV over 2 hours on days 1, 2, and 11 of cycle 1;
      on days 1 and 8 of cycles 2 and 4; and on days 1 and 11 of cycle 3 for a total of 9
      injections. Patients may receive rituximab instead of ofatumumab if their insurance provider
      does not cover the cost of ofatumumab. Patients receive rituximab IV over 2 hours on days 1
      and 11 of cycles 1 and 3 and on days 2 and 8 of cycles 2 and 4. Treatment repeats every 21-28
      days for up to 8 cycles in the absence of disease progression or unacceptable toxicity.

      After completion of study treatment, patients are followed up every 2-4 months for 1 year and
      then every 4-8 months for 2 years.
    

Trial Arms

NameTypeDescriptionInterventions
Treatment (DA-EPOCH and ofatumumab or rituximab)ExperimentalPatients receive DA-EPOCH regimen comprising doxorubicin hydrochloride IV, vincristine sulfate IV, and etoposide IV continuously over 96 hours on days 1-4; cyclophosphamide IV over 1-2 hours on day 5; and prednisone PO BID on days 1-5. Patients also receive ofatumumab IV over 2 hours on days 1, 2, and 11 of cycle 1; on days 1 and 8 of cycles 2 and 4; and on days 1 and 11 of cycle 3 for a total of 9 injections. Patients may receive rituximab instead of ofatumumab if their insurance provider does not cover the cost of ofatumumab. Patients receive rituximab IV over 2 hours on days 1 and 11 of cycles 1 and 3 and on days 2 and 8 of cycles 2 and 4. Treatment repeats every 21-28 days for up to 8 cycles in the absence of disease progression or unacceptable toxicity.
  • Cyclophosphamide
  • Doxorubicin Hydrochloride
  • Etoposide
  • Ofatumumab
  • Prednisone
  • Rituximab
  • Vincristine Sulfate

Eligibility Criteria

        Inclusion Criteria:

          -  Burkitt's or Burkitt-like leukemia/lymphoma, either previously untreated, or
             relapsed/refractory, or human immunodeficiency virus (HIV)-related; patients with
             double or triple hit high-grade leukemia/lymphoma are eligible also; patients HIV
             positive will be described and reported separately or relapsed/refractory acute
             lymphoblastic leukemia (ALL).

          -  Zubrod performance status =< 3 (Eastern Cooperative Oncology Group [ECOG] scale)

          -  Creatinine less than or equal to 2.0 mg/dL (unless considered tumor related)

          -  Bilirubin less than or equal to 2.0 mg/dL (unless considered tumor related)

          -  Adequate cardiac function defined as no history of clinically significant arrhythmia,
             or history of myocardial infarction (MI) within 3 months prior to study enrollment;
             cardiac function will be assessed by history and physical examination

        Exclusion Criteria:

          -  Pregnant or nursing women

          -  Active and uncontrolled disease/infection as judged by the treating physician

          -  Unable or unwilling to sign the consent form

          -  Subjects who have current active hepatic or biliary disease (with exception of
             patients with Gilbert's syndrome, asymptomatic gallstones, liver metastases or stable
             chronic liver disease per investigator assessment)
      
Maximum Eligible Age:N/A
Minimum Eligible Age:N/A
Eligible Gender:All
Healthy Volunteers:No

Primary Outcome Measures

Measure:Complete response rates
Time Frame:Up to 3 years
Safety Issue:
Description:Will be estimated along with the 95% credible intervals.

Secondary Outcome Measures

Measure:Incidence of adverse events
Time Frame:Up to 3 years
Safety Issue:
Description:Safety data will be summarized using frequency and percentage.
Measure:Overall survival time
Time Frame:Up to 3 years
Safety Issue:
Description:Will be estimated using the Kaplan-Meier method.
Measure:Event-free survival
Time Frame:Up to 3 years
Safety Issue:
Description:Will be estimated using the Kaplan-Meier method.
Measure:Complete response duration
Time Frame:Up to 3 years
Safety Issue:
Description:Will be estimated using the Kaplan-Meier method.

Details

Phase:Phase 2
Primary Purpose:Interventional
Overall Status:Recruiting
Lead Sponsor:M.D. Anderson Cancer Center

Last Updated

September 30, 2019