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Combination Chemotherapy in Treating Younger Patients With Hodgkin Lymphoma

University College London (UCL) logo

University College London (UCL)

Status and phase

Completed
Phase 2

Conditions

Lymphoma
Neurotoxicity

Treatments

Drug: prednisolone
Drug: doxorubicin hydrochloride
Drug: cyclophosphamide
Drug: procarbazine hydrochloride
Radiation: radiation therapy
Drug: vincristine sulfate
Drug: etoposide

Study type

Interventional

Funder types

Other

Identifiers

NCT00666484
CDR0000593560
UCL/07/005 (Other Identifier)
2007-003080-45 (EudraCT Number)
EU-20844

Details and patient eligibility

About

RATIONALE: Drugs used in chemotherapy work in different ways to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. It is not yet known which regimen of combination chemotherapy is more effective for Hodgkin lymphoma.

PURPOSE: This phase II trial is studying the side effects of three different regimens of combination chemotherapy and to see how well they work in treating younger patients with Hodgkin lymphoma.

Full description

OBJECTIVES:

Primary

  • To establish neurotoxicity of OEPA+COPP chemotherapy in young adults.

Secondary

  • To determine response rates in patients treated with this regimen.
  • To determine disease-free survival of patients treated with this regimen.
  • To determine overall survival of patients treated with this regimen.
  • To determine gonadal toxicity in patients treated with this regimen.

OUTLINE: Patients are assigned to treatment group according to stage.

  • Group 1 (patients with stage 1A, 1B, or 2A disease): Patients receive OEPA chemotherapy comprising vincristine IV on days 1, 8, and 15; oral prednisolone on days 1-15; etoposide IV on days 1-5; and doxorubicin hydrochloride IV on days 1 and 15. Courses repeat every 28 days for 2 courses. Patients achieving a partial response also undergo radiotherapy after completion of chemotherapy; patients achieving a complete response do not undergo radiotherapy.
  • Group 2 (patients with stage 2AE, 2B, or 3A disease): Patients receive 2 courses of OEPA chemotherapy as in group 1. Patients then receive COPP chemotherapy comprising cyclophosphamide IV on days 1 and 8; vincristine IV on days 1 and 8; oral procarbazine hydrochloride on days 1-15; and oral prednisolone on days 1-15. Courses repeat every 28 days for 2 courses. Patients also undergo radiotherapy after completion of chemotherapy.
  • Group 3 (patients with stage 2BE, 3AE, 3BE, 3B, 4A, or 4B disease): Patients receive 2 courses of OEPA chemotherapy as in group 1. Patients then receive COPP chemotherapy as in group 2. Treatment with COPP chemotherapy repeats every 28 days for 4 courses. Patients also undergo radiotherapy after completion of chemotherapy.

In all groups, treatment continues in the absence of disease progression or unacceptable toxicity.

After completion of study therapy, patients are followed periodically.

Peer Reviewed and Funded or Endorsed by Cancer Research UK.

Enrollment

47 patients

Sex

All

Ages

18 to 30 years old

Volunteers

No Healthy Volunteers

Inclusion and exclusion criteria

DISEASE CHARACTERISTICS:

  • Biopsy proven de-novo classical Hodgkin lymphoma

    • Any stage disease
    • No nodular lymphocyte-predominant Hodgkin lymphoma

PATIENT CHARACTERISTICS:

  • No known or suspected HIV infection
  • No pre-existing neurological disorder
  • No serious comorbidity which may prevent administration of study treatment
  • No other previous malignancy
  • Not pregnant or nursing
  • Fertile patients must use effective contraception during and for up to 1 year after completion of study treatment
  • Creatinine ≤ 1.5 times upper limit of normal (ULN) unless due to the lymphoma
  • ALT/AST ≤ 1.5 times ULN unless due to the lymphoma
  • Bilirubin ≤ 2 times ULN unless due to the lymphoma

PRIOR CONCURRENT THERAPY:

  • No prior chemotherapy or radiotherapy
  • No prior organ transplant

Trial design

Primary purpose

Treatment

Allocation

Non-Randomized

Interventional model

Single Group Assignment

Masking

None (Open label)

47 participants in 3 patient groups

Treatment Group 1: stages 1A, 1B, 2A: OEPA x 2
Experimental group
Description:
OEPA (28day cycle): Vincristine 1.5mg/m\^2 iv d1,d8,d15 (capped at 2mg/dose) Etoposide 125mg/m\^2 iv d1-5 Prednisolone 60mg/m\^2 po d1-15 Adriamycin 40mg/m\^2 iv d1 and 15
Treatment:
Drug: vincristine sulfate
Drug: etoposide
Drug: doxorubicin hydrochloride
Radiation: radiation therapy
Drug: prednisolone
Treatment Group 2: stages 2AE, 2B, 3A: OEPA x 2 + COPP x 2
Experimental group
Description:
OEPA (28 day cycle) Vincristine 1.5mg/m\^2 iv d1,d8,d15 (capped at 2mg/dose) Etoposide 125mg/m\^2 iv d1-5 Prednisolone 60mg/m\^2 po d1-15 Adriamycin 40mg/m\^2 iv d1 and 15 COPP (28 day cycle) Cyclophosphamide 500mg/m\^2 iv d1 and 8 Vincristine 1.5mg/m\^2 iv d1,8 (capped 2mg/dose) Procarbazine 100mg/m\^2 po d1-15\* Prednisolone 40mg/m\^2 po d1-15
Treatment:
Drug: vincristine sulfate
Drug: cyclophosphamide
Drug: etoposide
Drug: doxorubicin hydrochloride
Drug: procarbazine hydrochloride
Radiation: radiation therapy
Drug: prednisolone
Treatment Group 3: stages 2BE, 3AE, 3B, 4: OEPAx2 + COPPx4
Experimental group
Description:
OEPA (28 day cycle) Vincristine 1.5mg/m\^2 iv d1,d8,d15 (capped at 2mg/dose) Etoposide 125mg/m\^2 iv d1-5 Prednisolone 60mg/m\^2 po d1-15 Adriamycin 40mg/m\^2 iv d1 and 15 COPP (28 day cycle) Cyclophosphamide 500mg/m\^2 iv d1 and 8 Vincristine 1.5mg/m\^2 iv d1,8 (capped 2mg/dose) Procarbazine 100mg/m\^2 po d1-15\* Prednisolone 40mg/m\^2 po d1-15
Treatment:
Drug: vincristine sulfate
Drug: cyclophosphamide
Drug: etoposide
Drug: doxorubicin hydrochloride
Drug: procarbazine hydrochloride
Radiation: radiation therapy
Drug: prednisolone

Trial contacts and locations

5

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Data sourced from clinicaltrials.gov

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