LymphomaPhase 3NCT00059839
Comparison of Two Combination Chemotherapy Regimens With Either Vincristine or Vinblastine in Treating Patients With Advanced Anaplastic Large Cell Lymphoma
A Phase 3 study testing doxorubicin hydrochloride, mercaptopurine and methotrexate in people with Lymphoma, run by Children's Oncology Group at 159 sites in 5 countries.
Trial summary
RATIONALE: Drugs used in chemotherapy use different ways to stop cancer cells from dividing so they stop growing or die. Combining more than one drug may kill more cancer cells. It is not yet known if combination chemotherapy with vinblastine is more effective than combination chemotherapy with vincristine in treating… Read more about this study
- Who is it for?
- Ages Up to 20 years
- Conditions the study is for
- Lymphoma
- What is being tested?
- doxorubicin hydrochloride, mercaptopurine and methotrexate
- Type of treatment
- Pill or oral medicine, Injection or infusion
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 129 participants
- Where
- 159 sitesin 5 countries
- Study dates
- Nov 2003to Jul 2014
- Phase
- Phase 3
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages Up to 20 years
- All sexes
- No healthy volunteers
- Child, Adult
DISEASE CHARACTERISTICS:
- Newly diagnosed advanced anaplastic large cell lymphoma
- Cluster of differentiation antigen 30 (CD30+)
- Murphy stage III or IV
- No B-cell large cell lymphoma
- No disease limited to the skin (regardless of how wide-spread)
PATIENT CHARACTERISTICS:
Age
- Under 21
Performance status
- Not specified
Life expectancy
- Not specified
Hematopoietic
- Not specified
Hepatic
- Bilirubin no greater than 1.5 times upper limit of normal (ULN)
- Aspartate aminotransferase (AST) or alanine transaminase (ALT) less than 2.5 times ULN (unless due to lymphoma)
Renal
- Not specified
Cardiovascular
- Shortening fraction (SF) at least 27% by echocardiogram OR
- Ejection fraction (EF) at least 50% by radionuclide angiogram
Other
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective contraception
PRIOR CONCURRENT THERAPY:
Biologic therapy
- Not specified
Chemotherapy
- Not specified
Endocrine therapy
- Prior steroids for management of a mediastinal mass allowed
Radiotherapy
- Prior limited-dose radiotherapy for a mediastinal mass allowed
Surgery
- Not specified
Trial locations and contacts
159 sites in 5 countries.
159 sites in 5 countries
United States136 sites
Akron Children's Hospital
Akron, Ohio, 44308-1062
University of New Mexico Cancer Center
Albuquerque, New Mexico, 87131-5636
Tulane Cancer Center Office of Clinical Research
Alexandria, Louisiana, 71315-3198
Texas Tech University Health Sciences Center School of Medicine - Amarillo
Amarillo, Texas, 79106
C.S. Mott Children's Hospital at University of Michigan Medical Center
Ann Arbor, Michigan, 48109-0286
Mission Hospitals - Memorial Campus
Asheville, North Carolina, 28801
Winship Cancer Institute of Emory University
Atlanta, Georgia, 30322
MBCCOP - Medical College of Georgia Cancer Center
Augusta, Georgia, 30912-3730
Children's Hospital Center for Cancer and Blood Disorders
Aurora, Colorado, 80045
Dell Children's Medical Center of Central Texas
Austin, Texas, 78723
Alvin and Lois Lapidus Cancer Institute at Sinai Hospital
Baltimore, Maryland, 21215
Lehigh Valley Hospital - Muhlenberg
Bethlehem, Pennsylvania, 18017
Lurleen Wallace Comprehensive Cancer at University of Alabama - Birmingham
Birmingham, Alabama, 35294
Mountain States Tumor Institute at St. Luke's Regional Medical Center
Boise, Idaho, 83712-6297
Floating Hospital for Children at Tufts - New England Medical Center
Boston, Massachusetts, 02111
Dana-Farber/Harvard Cancer Center at Dana Farber Cancer Institute
Boston, Massachusetts, 02115
Brooklyn Hospital Center
Brooklyn, New York, 11201-5493
Roswell Park Cancer Institute
Buffalo, New York, 14263-0001
Fletcher Allen Health Care - University Health Center Campus
Burlington, Vermont, 05401
West Virginia University Health Sciences Center - Charleston
Charleston, West Virginia, 25302
Blumenthal Cancer Center at Carolinas Medical Center
Charlotte, North Carolina, 28232-2861
Presbyterian Cancer Center at Presbyterian Hospital
Charlotte, North Carolina, 28233-3549
T.C. Thompson Children's Hospital
Chattanooga, Tennessee, 37403
Children's Memorial Hospital - Chicago
Chicago, Illinois, 60614
University of Chicago Cancer Research Center
Chicago, Illinois, 60637-1470
Cincinnati Children's Hospital Medical Center
Cincinnati, Ohio, 45229-3039
Rainbow Babies and Children's Hospital
Cleveland, Ohio, 44106-5000
Cleveland Clinic Taussig Cancer Center
Cleveland, Ohio, 44195
Ellis Fischel Cancer Center at University of Missouri - Columbia
Columbia, Missouri, 65203
Nationwide Children's Hospital
Columbus, Ohio, 43205-2696
Driscoll Children's Hospital
Corpus Christi, Texas, 78411
Medical City Dallas Hospital
Dallas, Texas, 75230
Simmons Comprehensive Cancer Center at University of Texas Southwestern Medical Center - Dallas
Dallas, Texas, 75390
Geisinger Cancer Institute at Geisinger Health
Danville, Pennsylvania, 17822-0001
Children's Medical Center - Dayton
Dayton, Ohio, 45404-1815
Presbyterian - St. Luke's Medical Center
Denver, Colorado, 80218
Blank Children's Hospital
Des Moines, Iowa, 50309
Barbara Ann Karmanos Cancer Institute
Detroit, Michigan, 48201-1379
Southern California Permanente Medical Group
Downey, California, 90027
Duke Comprehensive Cancer Center
Durham, North Carolina, 27710
CCOP - MeritCare Hospital
Fargo, North Dakota, 58122
Carole and Ray Neag Comprehensive Cancer Center at the University of Connecticut Health Center
Farmington, Connecticut, 06360-2875
Hurley Medical Center
Flint, Michigan, 48503
Broward General Medical Center Cancer Center
Fort Lauderdale, Florida, 33316
Lee Cancer Care of Lee Memorial Health System
Fort Myers, Florida, 33901
Cook Children's Medical Center - Fort Worth
Fort Worth, Texas, 76104
Butterworth Hospital at Spectrum Health
Grand Rapids, Michigan, 49503-2560
St. Vincent Hospital Regional Cancer Center
Green Bay, Wisconsin, 54307-3508
Leo W. Jenkins Cancer Center at ECU Medical School
Greenville, North Carolina, 27835-6028
Greenville Hospital Cancer Center
Greenville, South Carolina, 29605
Van Elslander Cancer Center at St. John Hospital and Medical Center
Grosse Pointe Woods, Michigan, 48236
Hackensack University Medical Center Cancer Center
Hackensack, New Jersey, 07601
Penn State Cancer Institute at Milton S. Hershey Medical Center
Hershey, Pennsylvania, 17033-0850
Memorial Cancer Institute at Memorial Regional Hospital
Hollywood, Florida, 33021
Cancer Research Center of Hawaii
Honolulu, Hawaii, 96813
Baylor University Medical Center - Houston
Houston, Texas, 77030-2399
M. D. Anderson Cancer Center at University of Texas
Houston, Texas, 77030-4009
Indiana University Melvin and Bren Simon Cancer Center
Indianapolis, Indiana, 46202-5289
St. Vincent Indianapolis Hospital
Indianapolis, Indiana, 46260
Holden Comprehensive Cancer Center at University of Iowa
Iowa City, Iowa, 52242-1002
University of Mississippi Cancer Clinic
Jackson, Mississippi, 39216-4505
Nemours Children's Clinic
Jacksonville, Florida, 32207
CCOP - Kalamazoo
Kalamazoo, Michigan, 49007-5381
Children's Mercy Hospital
Kansas City, Missouri, 64108
East Tennessee Children's Hospital
Knoxville, Tennessee, 37901
Breslin Cancer Center at Ingham Regional Medical Center
Lansing, Michigan, 48910
CCOP - Nevada Cancer Research Foundation
Las Vegas, Nevada, 89109-2306
Norris Cotton Cancer Center at Dartmouth-Hitchcock Medical Center
Lebanon, New Hampshire, 03756-0002
Lucille P. Markey Cancer Center at University of Kentucky
Lexington, Kentucky, 40536-0093
Arkansas Cancer Research Center at University of Arkansas for Medical Sciences
Little Rock, Arkansas, 72205
Loma Linda University Cancer Institute at Loma Linda University Medical Center
Loma Linda, California, 92354
Kosair Children's Hospital
Louisville, Kentucky, 40232
Covenant Children's Hospital
Lubbock, Texas, 79410
Children's Hospital Central California
Madera, California, 93638-8762
Marshfield Clinic - Marshfield Center
Marshfield, Wisconsin, 54449
St. Jude Children's Research Hospital
Memphis, Tennessee, 38105
University of Miami Sylvester Comprehensive Cancer Center - Miami
Miami, Florida, 33136
Miami Children's Hospital
Miami, Florida, 33155
Baptist-South Miami Regional Cancer Program
Miami, Florida, 33176
Midwest Children's Cancer Center at Children's Hospital of Wisconsin
Milwaukee, Wisconsin, 53226
Children's Hospitals and Clinics of Minnesota - Minneapolis
Minneapolis, Minnesota, 55404
Masonic Cancer Center at University of Minnesota
Minneapolis, Minnesota, 55455
Overlook Hospital
Morristown, New Jersey, 07962
Cancer Institute of New Jersey at UMDNJ - Robert Wood Johnson Medical School
New Brunswick, New Jersey, 08903
Schneider Children's Hospital
New Hyde Park, New York, 11040
Herbert Irving Comprehensive Cancer Center at Columbia University Medical Center
New York, New York, 10032
Newark Beth Israel Medical Center
Newark, New Jersey, 07112
Children's Hospital of The King's Daughters
Norfolk, Virginia, 23507-1971
Advocate Christ Medical Center
Oak Lawn, Illinois, 60453
Oklahoma University Cancer Institute
Oklahoma City, Oklahoma, 73104
Children's Hospital
Omaha, Nebraska, 68114-4113
UNMC Eppley Cancer Center at the University of Nebraska Medical Center
Omaha, Nebraska, 68198-6805
Children's Hospital of Orange County
Orange, California, 92868
Florida Hospital Cancer Institute at Florida Hospital Orlando
Orlando, Florida, 32803-1273
M.D. Anderson Cancer Center at Orlando
Orlando, Florida, 32806
Advocate Lutheran General Cancer Care Center
Park Ridge, Illinois, 60068-1174
St. Joseph's Hospital and Medical Center
Paterson, New Jersey, 07503
Sacred Heart Cancer Center at Sacred Heart Hospital
Pensacola, Florida, 32504
Saint Jude Midwest Affiliate
Peoria, Illinois, 61637
St. Christopher's Hospital for Children
Philadelphia, Pennsylvania, 19134-1095
Phoenix Children's Hospital
Phoenix, Arizona, 85016-7710
Children's Hospital of Pittsburgh
Pittsburgh, Pennsylvania, 15213
Legacy Emanuel Hospital and Health Center and Children's Hospital
Portland, Oregon, 97227
Oregon Health and Science University Cancer Institute
Portland, Oregon, 97239-3098
Rhode Island Hospital Comprehensive Cancer Center
Providence, Rhode Island, 02903
Virginia Commonwealth University Massey Cancer Center
Richmond, Virginia, 23298-0037
Carilion Medical Center for Children at Roanoke Community Hospital
Roanoke, Virginia, 24014
Mayo Clinic Cancer Center
Rochester, Minnesota, 55905
James P. Wilmot Cancer Center at University of Rochester Medical Center
Rochester, New York, 14642
Sutter Cancer Center
Sacramento, California, 95816
Kaiser Permanente Medical Center - Oakland
Sacramento, California, 95825
Primary Children's Medical Center
Salt Lake City, Utah, 84113-1100
University of Texas Health Science Center at San Antonio
San Antonio, Texas, 78207
Methodist Children's Hospital of South Texas
San Antonio, Texas, 78229-3993
Rady Children's Hospital - San Diego
San Diego, California, 92123-4282
UCSF Helen Diller Family Comprehensive Cancer Center
San Francisco, California, 94115
Curtis and Elizabeth Anderson Cancer Institute at Memorial Health University Medical Center
Savannah, Georgia, 31403-3089
Children's Hospital and Regional Medical Center - Seattle
Seattle, Washington, 98105
Sanford Cancer Center at Sanford USD Medical Center
Sioux Falls, South Dakota, 57117-5039
Providence Cancer Center at Sacred Heart Medical Center
Spokane, Washington, 99220-2555
Simmons Cooper Cancer Institute
Springfield, Illinois, 62794-9677
Baystate Regional Cancer Program at D'Amour Center for Cancer Care
Springfield, Massachusetts, 01199-0001
Siteman Cancer Center at Barnes-Jewish Hospital - Saint Louis
St Louis, Missouri, 63110
All Children's Hospital
St. Petersburg, Florida, 33701
Stanford Cancer Center
Stanford, California, 94305-5824
SUNY Upstate Medical University Hospital
Syracuse, New York, 13210
Mary Bridge Children's Hospital and Health Center - Tacoma
Tacoma, Washington, 98405
St. Joseph's Cancer Institute at St. Joseph's Hospital
Tampa, Florida, 33607
Albert Einstein Cancer Center at Albert Einstein College of Medicine
The Bronx, New York, 10461
Toledo Hospital
Toledo, Ohio, 43606
Medical University of Ohio Cancer Center
Toledo, Ohio, 43614
New York Medical College
Valhalla, New York, 10595
Children's National Medical Center
Washington D.C., District of Columbia, 20010-2970
Kaplan Cancer Center at St. Mary's Medical Center
West Palm Beach, Florida, 33407
Alfred I. duPont Hospital for Children
Wilmington, Delaware, 19803
Wake Forest University Comprehensive Cancer Center
Winston-Salem, North Carolina, 27157-1096
Canada16 sites
Alberta Children's Hospital
Calgary, Alberta, T3B 6A8
University of Alberta Hospital
Edmonton, Alberta, T6G 1Z2
IWK Health Centre
Halifax, Nova Scotia, B3K 6R8
McMaster Children's Hospital at Hamilton Health Sciences
Hamilton, Ontario, L8N 3Z5
Cancer Centre of Southeastern Ontario at Kingston General Hospital
Kingston, Ontario, K7L 2V7
Children's Hospital of Western Ontario
London, Ontario, N6A 5W9
Montreal Children's Hospital at McGill University Health Center
Montreal, Quebec, H3H 1P3
Hopital Sainte Justine
Montreal, Quebec, H3T 1C5
Children's Hospital of Eastern Ontario
Ottawa, Ontario, K1H 8L1
Centre Hospitalier Universitaire de Quebec
Québec, G1V 4G2
Allan Blair Cancer Centre at Pasqua Hospital
Regina, Saskatchewan, S4T 7T1
Saskatoon Cancer Centre at the University of Saskatchewan
Saskatoon, Saskatchewan, S7N 4H4
Janeway Children's Health and Rehabilitation Centre
St. John's, Newfoundland and Labrador, A1B 3V6
Hospital for Sick Children
Toronto, Ontario, M5G 1X8
Children's & Women's Hospital of British Columbia
Vancouver, British Columbia, V6H 3V4
CancerCare Manitoba
Winnipeg, Manitoba, R3E 0V9
Australia3 sites
Royal Children's Hospital
Brisbane, Queensland, 4029
Princess Margaret Hospital for Children
Perth, Western Australia, 6001
Westmead Institute for Cancer Research at Westmead Hospital
Westmead, New South Wales, 2145
Switzerland3 sites
Swiss Pediatric Oncology Group Bern
Bern, 3010
Swiss Pediatric Oncology Group Geneva
Geneva, 1205
Swiss Pediatric Oncology Group Lausanne
Lausanne, 1011
About this study
Official title: A Phase III Trial of Treatment of Advanced-Stage Anaplastic Large Cell Lymphoma (ALCL) With Standard APO (Doxorubicin, Prednisone, Vincristine) Versus Consolidation With a Regimen Including Vinblastine
RATIONALE: Drugs used in chemotherapy use different ways to stop cancer cells from dividing so they stop growing or die. Combining more than one drug may kill more cancer cells. It is not yet known if combination chemotherapy with vinblastine is more effective than combination chemotherapy with vincristine in treating advanced anaplastic large cell lymphoma.
PURPOSE: Randomized phase III trial to compare the effectiveness of two combination chemotherapy regimens with either vinblastine or vincristine in treating patients who have newly diagnosed advanced anaplastic large cell lymphoma.
Read the detailed description
OBJECTIVES:
- Compare the efficacy of a consolidation chemotherapy regimen comprising doxorubicin and prednisone in combination with vincristine vs vinblastine, in terms of event-free survival, in patients with advanced anaplastic large cell lymphoma.
- Compare overall survival of patients treated with these regimens.
- Compare the toxic effects of these regimens in these patients.
- Correlate biological tumor characteristics and outcome in patients treated with these regimens.
OUTLINE: This is a randomized, multicenter study.
Patients are randomized at enrollment to receive either Standard APO regimen or a consolidation regimen including vinblastine (VBL).
- Induction therapy: All Patients receive doxorubicin IV over 15 minutes on days 1 and 22; vincristine IV on days 1, 8, 15, 22, and 29; oral prednisone 3 times daily on days 1-28; and intrathecal (IT) methotrexate on days 1, 8, and 22 (patients with central nervous system (CNS) disease at diagnosis receive additional methotrexate IT on days 15, 29, and 36).
Patients undergo restaging after Induction such that consolidation therapy is started on day 43. All patients with complete response (CR), complete response unconfirmed (CRu) or partial response (PR) proceed to Consolidation based on CT or MRI scans at the end of induction (week 6). All other patients will be removed from protocol therapy and will be followed until they meet the criteria for off study. Follow-up data will be required unless consent is withdrawn.
- Standard APO (Arm I): Patients receive course-specific regimens without vinblastine.
- Courses 1-3: Patients receive doxorubicin IV over 15 minutes, vincristine IV, and methotrexate IT on day 1 and oral prednisone three times daily and oral mercaptopurine once daily on days 1-5.
- Courses 4-5: Patients receive doxorubicin, vincristine, prednisone, and mercaptopurine as in courses 1-3.
- Courses 6-15: Patients receive vincristine, prednisone, and mercaptopurine as in courses 1-3 and methotrexate IV on day 1.
- Consolidation with vinblastine (Arm II): Patients receive course-specific regimens including vinblastine.
- Courses 1-3: Patients receive doxorubicin, methotrexate IT, prednisone, and mercaptopurine as in arm I and vinblastine IV over 1 minute on days 1, 8, and 15.
- Courses 4-5: Patients receive doxorubicin, prednisone, and mercaptopurine as in arm I and vinblastine as in arm II (courses 1-3).
- Courses 6-15: Patients receive prednisone and mercaptopurine as in arm I, vinblastine as in arm II (courses 1-3), and methotrexate IV on day 1.
In both arms and all courses, treatment repeats every 21 days for up to 15 courses in the absence of disease progression or unacceptable toxicity.
Patients are followed monthly for 1 year, every 3 months for 1 year, every 6 months for 1 year, and then annually thereafter.
PROJECTED ACCRUAL: A total of 200-250 patients (100-125 per treatment arm) will be accrued for this study within 5 years.
- Conditions
- Lymphoma
- Being tested
- doxorubicin hydrochloride, mercaptopurine, methotrexate, prednisone, vinblastine sulfate
- Keywords
- anaplastic large cell lymphoma
- Medical subject headings
- Lymphoma, Lymphoma, Large-Cell, Anaplastic
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Given IV
mercaptopurineDrug
Given by mouth
methotrexateDrug
Given IV and intrathecally
prednisoneDrug
Given by mouth
vinblastine sulfateDrug
Given IV
Given IV
| Study group | Role | What they receive |
|---|---|---|
| Standard APO with Vincristine (Arm I ) | Experimental | In courses 1-3, patients receive doxorubicin hydrochloride (30 mg/m2) IV over 15 minutes, vincristine sulfate (1.5 mg/m2 (maximum dose 2 mg)) IV, and methotrexate intrathecally (age-adjusted dosing) (IT) on day 1 and oral prednisone (40 mg/m2/day) three times daily and oral mercaptopurine (225 mg/m2) once daily on days 1-5. In courses 4 and 5, patients receive doxorubicin (30 mg/m2), vincristine sulfate (1.5 mg/m2 (Maximum dose 2 mg)), prednisone (120 mg/m2/day), and mercaptopurine (225 mg/m2) as in courses 1-3. In courses 6-15, patients receive vincristine sulfate (1.5 mg/m2), prednisone (120 mg/m2/day), and mercaptopurine (225 mg/m2) as in courses 1-3 and methotrexate (60 mg/m2) IV on day 1. Treatment repeats every 21 days for up to 15 courses in the absence of disease progression or unacceptable toxicity. Receives: Drug: doxorubicin hydrochloride; Drug: mercaptopurine; Drug: methotrexate; Drug: prednisone; Drug: vincristine sulfate |
| Consolidation with Vinblastine | Experimental | In courses 1-3, patients receive doxorubicin hydrochloride (30 mg/m2) IV, methotrexate (age adjusted dosing) IT, prednisone (120 mg/m2/day), and mercaptopurine (225 mg/m2) as in arm I and vinblastine sulfate (4 mg/m2) IV over 1 minute on days 1, 8, and 15. In courses 4 and 5, patients receive doxorubicin hydrochloride (30 mg/m2) IV, prednisone (120 mg/m2/day), and mercaptopurine (225 mg/m2) as in arm I and vinblastine sulfate (4 mg/m2) as in arm II (courses 1-3). In courses 6-15, patients receive prednisone (120 mg/m2/day) and mercaptopurine (225 mg/m2) as in arm I, vinblastine sulfate (4 mg/m2) IV as in arm II (courses 1-3), and methotrexate (60 mg/m2) IV on day 1. Treatment repeats every 21 days for up to 15 courses in the absence of disease progression or unacceptable toxicity. Receives: Drug: doxorubicin hydrochloride; Drug: mercaptopurine; Drug: methotrexate; Drug: prednisone; Drug: vinblastine sulfate |
What is being measured
The primary outcome is the main question the study is designed to answer.
Event-free Survival (EFS)
Percentage of EFS patients. This is measured as the time from study entry until disease progression, disease recurrence, occurrence of a second malignant neoplasm, or death from any cause. To measure Event Free Survival, repeated one-sided logrank tests will be performed The upper critical values are based on the one-sided alpha-spending functions of t2 (alpha=0.05) and the lower critical values are based on testing the alternative hypothesis at 0.005 level.
Measured: From first enrollment up to 3 years.
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted7 May 2003 (estimated)
- Study startNov 2003
- Primary completionDec 2009
- Study completionJul 2014
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for LymphomaStudies of the same condition, open and under way.
- More trials run by Children's Oncology GroupThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 3
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 129 participants (actual)
Sponsor and investigators
- Lead sponsor
- Children's Oncology Group
- Sponsor type
- Research network
- Collaborators
- National Cancer Institute (NCI)
- Responsible party
- Sponsor
- Investigators
- Jacqueline Kraveka, DO, Study chair, Medical University of South Carolina
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT00059839
- Sponsor's protocol ID
- ANHL0131
- Other IDs
- CDR0000298777, COG-ANHL0131
- Status last verified
- Sep 2014
- First submitted
- 6 May 2003
- Last updated
- 22 Sep 2014
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- Yes
Publications
Alexander S, Kraveka JM, Weitzman S, Lowe E, Smith L, Lynch JC, Chang M, Kinney MC, Perkins SL, Laver J, Gross TG, Weinstein H. Advanced stage anaplastic large cell lymphoma in children and adolescents: results of ANHL0131, a randomized phase III trial of APO versus a modified regimen with vinblastine: a report from the children's oncology group. Pediatr Blood Cancer. 2014 Dec;61(12):2236-42. doi: 10.1002/pbc.25187. Epub 2014 Aug 23.
PubMed 25156886
Study at a glance
From the registry record, last updated by the sponsor on 22 Sep 2014. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Phase III Trial of Treatment of Advanced-Stage Anaplastic Large Cell Lymphoma (ALCL) With Standard APO (Doxorubicin, Prednisone, Vincristine) Versus Consolidation With a Regimen Including Vinblastine
- ClinicalTrials.gov ID
- NCT00059839
- Acronym / sponsor ID
- ANHL0131
- Conditions
- Lymphoma
- Keywords
- anaplastic large cell lymphoma
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 129 participants (actual)
- Lead sponsor
- Children's Oncology GroupResearch network
- Collaborators
- National Cancer Institute (NCI)
- Study start
- Nov 2003
- Primary completion
- Dec 2009 (actual)
- Study completion
- Jul 2014 (actual)
- First posted
- 7 May 2003 (estimated)
- Results
- Posted 8 Oct 2013
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
RATIONALE: Drugs used in chemotherapy use different ways to stop cancer cells from dividing so they stop growing or die. Combining more than one drug may kill more cancer cells. It is not yet known if combination chemotherapy with vinblastine is more effective than combination chemotherapy with vincristine in treating advanced anaplastic large cell lymphoma.
PURPOSE: Randomized phase III trial to compare the effectiveness of two combination chemotherapy regimens with either vinblastine or vincristine in treating patients who have newly diagnosed advanced anaplastic large cell lymphoma.
Detailed description
OBJECTIVES:
- Compare the efficacy of a consolidation chemotherapy regimen comprising doxorubicin and prednisone in combination with vincristine vs vinblastine, in terms of event-free survival, in patients with advanced anaplastic large cell lymphoma.
- Compare overall survival of patients treated with these regimens.
- Compare the toxic effects of these regimens in these patients.
- Correlate biological tumor characteristics and outcome in patients treated with these regimens.
OUTLINE: This is a randomized, multicenter study.
Patients are randomized at enrollment to receive either Standard APO regimen or a consolidation regimen including vinblastine (VBL).
- Induction therapy: All Patients receive doxorubicin IV over 15 minutes on days 1 and 22; vincristine IV on days 1, 8, 15, 22, and 29; oral prednisone 3 times daily on days 1-28; and intrathecal (IT) methotrexate on days 1, 8, and 22 (patients with central nervous system (CNS) disease at diagnosis receive additional methotrexate IT on days 15, 29, and 36).
Patients undergo restaging after Induction such that consolidation therapy is started on day 43. All patients with complete response (CR), complete response unconfirmed (CRu) or partial response (PR) proceed to Consolidation based on CT or MRI scans at the end of induction (week 6). All other patients will be removed from protocol therapy and will be followed until they meet the criteria for off study. Follow-up data will be required unless consent is withdrawn.
- Standard APO (Arm I): Patients receive course-specific regimens without vinblastine.
- Courses 1-3: Patients receive doxorubicin IV over 15 minutes, vincristine IV, and methotrexate IT on day 1 and oral prednisone three times daily and oral mercaptopurine once daily on days 1-5.
- Courses 4-5: Patients receive doxorubicin, vincristine, prednisone, and mercaptopurine as in courses 1-3.
- Courses 6-15: Patients receive vincristine, prednisone, and mercaptopurine as in courses 1-3 and methotrexate IV on day 1.
- Consolidation with vinblastine (Arm II): Patients receive course-specific regimens including vinblastine.
- Courses 1-3: Patients receive doxorubicin, methotrexate IT, prednisone, and mercaptopurine as in arm I and vinblastine IV over 1 minute on days 1, 8, and 15.
- Courses 4-5: Patients receive doxorubicin, prednisone, and mercaptopurine as in arm I and vinblastine as in arm II (courses 1-3).
- Courses 6-15: Patients receive prednisone and mercaptopurine as in arm I, vinblastine as in arm II (courses 1-3), and methotrexate IV on day 1.
In both arms and all courses, treatment repeats every 21 days for up to 15 courses in the absence of disease progression or unacceptable toxicity.
Patients are followed monthly for 1 year, every 3 months for 1 year, every 6 months for 1 year, and then annually thereafter.
PROJECTED ACCRUAL: A total of 200-250 patients (100-125 per treatment arm) will be accrued for this study within 5 years.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Standard APO with Vincristine (Arm I ) | Experimental | Drug: doxorubicin hydrochloride, Drug: mercaptopurine, Drug: methotrexate, Drug: prednisone, Drug: vincristine sulfateIn courses 1-3, patients receive doxorubicin hydrochloride (30 mg/m2) IV over 15 minutes, vincristine sulfate (1.5 mg/m2 (maximum dose 2 mg)) IV, and methotrexate intrathecally (age-adjusted dosing) (IT) on day 1 and oral prednisone (40 mg/m2/day) three times daily and oral mercaptopurine (225 mg/m2) once daily on days 1-5. In courses 4 and 5, patients receive doxorubicin (30 mg/m2), vincristine sulfate (1.5 mg/m2 (Maximum dose 2 mg)), prednisone (120 mg/m2/day), and mercaptopurine (225 mg/m2) as in courses 1-3. In courses 6-15, patients receive vincristine sulfate (1.5 mg/m2), prednisone (120 mg/m2/day), and mercaptopurine (225 mg/m2) as in courses 1-3 and methotrexate (60 mg/m2) IV on day 1. Treatment repeats every 21 days for up to 15 courses in the absence of disease progression or unacceptable toxicity. |
| Consolidation with Vinblastine | Experimental | Drug: doxorubicin hydrochloride, Drug: mercaptopurine, Drug: methotrexate, Drug: prednisone, Drug: vinblastine sulfateIn courses 1-3, patients receive doxorubicin hydrochloride (30 mg/m2) IV, methotrexate (age adjusted dosing) IT, prednisone (120 mg/m2/day), and mercaptopurine (225 mg/m2) as in arm I and vinblastine sulfate (4 mg/m2) IV over 1 minute on days 1, 8, and 15. In courses 4 and 5, patients receive doxorubicin hydrochloride (30 mg/m2) IV, prednisone (120 mg/m2/day), and mercaptopurine (225 mg/m2) as in arm I and vinblastine sulfate (4 mg/m2) as in arm II (courses 1-3). In courses 6-15, patients receive prednisone (120 mg/m2/day) and mercaptopurine (225 mg/m2) as in arm I, vinblastine sulfate (4 mg/m2) IV as in arm II (courses 1-3), and methotrexate (60 mg/m2) IV on day 1. Treatment repeats every 21 days for up to 15 courses in the absence of disease progression or unacceptable toxicity. |
Who may qualify
- Ages
- Up to 20 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Child, Adult
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| doxorubicin hydrochlorideGiven IV | Drug | Consolidation with Vinblastine, Standard APO with Vincristine (Arm I ) |
| mercaptopurineGiven by mouth | Drug | Consolidation with Vinblastine, Standard APO with Vincristine (Arm I ) |
| methotrexateGiven IV and intrathecally | Drug | Consolidation with Vinblastine, Standard APO with Vincristine (Arm I ) |
| prednisoneGiven by mouth | Drug | Consolidation with Vinblastine, Standard APO with Vincristine (Arm I ) |
| vinblastine sulfateGiven IV | Drug | Consolidation with Vinblastine |
| vincristine sulfateGiven IV | Drug | Standard APO with Vincristine (Arm I ) |
Primary outcome
Event-free Survival (EFS)
Time frame: From first enrollment up to 3 years.
Percentage of EFS patients. This is measured as the time from study entry until disease progression, disease recurrence, occurrence of a second malignant neoplasm, or death from any cause. To measure Event Free Survival, repeated one-sided logrank tests will be performed The upper critical values are based on the one-sided alpha-spending functions of t2 (alpha=0.05) and the lower critical values are based on testing the alternative hypothesis at 0.005 level.
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 22 Sep 2014.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Derived from this study: PubMed 25156886Alexander S, Kraveka JM, Weitzman S, Lowe E, Smith L, Lynch JC, Chang M, Kinney MC, Perkins SL, Laver J, Gross TG, Weinstein H. Advanced stage anaplastic large cell lymphoma in children and adolescents: results of ANHL0131, a randomized phase III trial of APO versus a modified regimen with vinblastine: a report from the children's oncology group. Pediatr Blood Cancer. 2014 Dec;61(12):2236-42. doi: 10.1002/pbc.25187. Epub 2014 Aug 23.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Jacqueline Kraveka, DO study chair
Medical University of South Carolina
159 sites in 5 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing doxorubicin hydrochloride, mercaptopurine and methotrexate in people with Lymphoma, run by Children's Oncology Group at 159 sites in 5 countries.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 22 Sep 2014. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 159 sites in United States, Canada, Australia, Switzerland, Puerto Rico. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
Yes. Results are posted in the registry (first posted 8 Oct 2013). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Event-free Survival (EFS) (time frame: From first enrollment up to 3 years.). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT00059839, which also lists 1 linked publication.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 22 Sep 2014.