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Burkitt LymphomaPhase 1NCT03864419

Rituximab Hyaluronidase in Combination With Chemotherapy in Treating Aggressive B-cell Lymphoma in Uganda

A Phase 1 study testing Rituximab and Hyaluronidase Human, Cyclophosphamide and Vincristine in people with Burkitt Lymphoma and KSHV-associated Multicentric Castleman Disease, run by Fred Hutchinson Cancer Center at 1 site in Uganda.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

This phase I trial studies how well rituximab hyaluronidase and combination chemotherapy work in treating patients in Uganda with Burkitt lymphoma, diffuse large B-cell lymphoma, or Kaposi sarcoma herpesvirus associated multicentric Castleman disease. Read more about this study

Who is it for?
Ages 2 years and older
What is being tested?
Rituximab and Hyaluronidase Human, Cyclophosphamide and Vincristine
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
18 participants
Where
1 siteUganda
Study dates
24 Oct 2019to 26 Jul 2023
Phase
Phase 1
Are there results?
None posted in the registry

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 2 years and older
  • All sexes
  • No healthy volunteers
  • Child, Adult, Older adult

Who may be able to join

  • Histology and immunohistochemistry (CD20+) confirmed Burkitt lymphoma (BL), diffuse large B-cell lymphoma (DLBCL), or histology confirmed KSHV-associated multicentric Castleman disease with elevated blood KSHV viral load
  • Cohort 1: Age should be equal to or greater than 15
  • Cohort 2: Age: 2-15
  • Measurable disease
  • Eastern Cooperative Oncology Group (ECOG) performance status =< 2
  • Able to provide informed consent (adults) or assent (children < 18 years) in English or Luganda
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  • Human immunodeficiency virus (HIV)-infected patients eligible if meet the following criteria:
  • CD4+ T-cell count > 200 cells/uL
  • HIV treatable with effective antiretroviral therapy that does not include agents with known significant drug-drug interactions with accompanying chemotherapy (ritonavir and cobicistat contraindicated)

Who cannot join

  • Previous therapy for lymphoma or KSHV-multicentric Castleman disease (MCD)
  • History of hypersensitivity to rituximab
  • Pregnant or nursing women. Men or women may not participate unless they have agreed to use effective contraception during treatment and for 12 months following completion of therapy
  • Inadequate organ function, unless attributed to lymphoma or KSHV-MCD
  • Aspartate aminotransferase (AST)/alanine aminotransferase (ALT) > 2.5 times upper limit of normal
  • Creatinine > 2 times upper limit than normal or calculated creatinine clearance < 60 mL/min
Show all 11Show fewer
  • New York Heart Association (NYHA) cardiac failure class III or IV
  • Patients with clinically significant anemia-hemoglobin less than 10 g/dL
  • Central nervous system (CNS) masses consistent with lymphoma or untreated infection; leptomeningeal disease will not be excluded
  • Patients with malignancy within 5 years, other than resected local skin cancer or limited Kaposi sarcoma (KS) (no known pulmonary KS)
  • Patients with evidence of active infections including malaria and hepatitis B (participants with hepatitis B virus [HBV] controlled on antivirals will not be excluded)

Trial locations and contacts

1 site in 1 country.

Uganda1 site
  • UCI-Fred Hutch Cancer Centre

    Kampala

Other trials in Uganda

About this study

Official title: A Phase I Study of Subcutaneous Rituximab Hyaluronidase Combined With Local Standard-of-Care Chemotherapy for the Treatment of Burkitt Lymphoma, Diffuse Large B-Cell Lymphoma or as Monotherapy for Kaposi Sarcoma Herpesvirus Associated Multicentric Castleman Disease in Pediatrics and Adults in Uganda

This phase I trial studies how well rituximab hyaluronidase and combination chemotherapy work in treating patients in Uganda with Burkitt lymphoma, diffuse large B-cell lymphoma, or Kaposi sarcoma herpesvirus associated multicentric Castleman disease. Rituximab hyaluronidase is a combination of rituximab and hyaluronidase. Rituximab binds to a molecule called CD20, which is found on B cells (a type of white blood cell) and some types of cancer cells. This may help the immune system kill cancer cells. Hyaluronidase allows rituximab to be given by injection under the skin. Giving rituximab and hyaluronidase by injection under the skin is faster than giving rituximab alone by infusion into the blood. Drugs used in chemotherapy, such as cyclophosphamide, vincristine, methotrexate, etoposide, doxorubicin, and prednisone work in different ways to stop the growth of tumor cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. While rituximab has a clear survival benefit in patients within developed countries, differences in supportive care and infectious co-morbidities require special attention. Giving rituximab hyaluronidase alone or in combination with chemotherapy may work better in treating patients with Burkitt lymphoma, diffuse large B-cell lymphoma, or Kaposi sarcoma herpesvirus associated multicentric Castleman disease compared to chemotherapy alone in Uganda.

Read the detailed description

OUTLINE:

Open-label Phase I study characterizing the safety, tolerability, and activity of subcutaneous rituximab hyaluronidase (sqR) alone (KSHV-MCD), or combined with local standard of care chemotherapy (BL or DLBCL), in 2 age-based cohorts of patients:

  1. Cohort 1: Age >= 15
  2. Cohort 2: Age: 2-14 sqR dose for Cohort 1 (adults) will be 1400 mg (flat dose); sqR dose for Cohort 2 (pediatrics) will depend on patient weight: >= 35 kg: 1400 mg, < 35 kg: 700 mg. For all participants, sqR will be administered with local standard of care chemotherapy (BL, DLBCL) or alone (KSHV-MCD), and supportive care.

Each cohort comprises two Therapy Groups. Therapy Group 1: up to 6 participants and will receive the first cycle of rituximab IV, and subsequent cycles as flat-dose sqR. Therapy Group 2: up to 12 participants and will receive flat-dose sqR for all cycles.

Disease-specific chemotherapy to be administered with rituximab hyaluronidase include:

PEDIATRIC BURKITT LYMPHOMA (BL): cyclophosphamide, vincristine and prednisone followed by 6 cycles of cyclophosphamide, vincristine, and methotrexate (COP-COM).

DLBCL: 6 cycles of cyclophosphamide, doxorubicin, vincristine and prednisone PO on days 1-5 of cycle 1 (CHOP).

ADULT BL: 6 cycles modified dose: etoposide, doxorubicin, vincristine, cyclophosphamide and prednisone PO on days 1-5 (adjusted EPOCH).

KSHV-MCD: Rituximab or rituximab hyaluronidase SC on days 1, 8, 15, and 22.

After completion of study treatment, patients are followed up at 30 days, 3, 6, 9 and 12 months.

Being tested
Rituximab and Hyaluronidase Human, Cyclophosphamide, Vincristine, Methotrexate, Doxorubicin
Medical subject headings
Burkitt Lymphoma, Multi-centric Castleman's Disease, Lymphoma, Large B-Cell, Diffuse

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Rituximab and Hyaluronidase HumanBiological

    Also called Rituxan Hycela, Rituximab Plus Hyaluronidase, Rituximab/Hyaluronidase, Rituximab/Hyaluronidase Human

    Given SC

  • CyclophosphamideDrug

    Also called Cycloblastin, Cycloblastine, Cyclophospham, Cyclophosphamid monohydrate

    Given IV

  • VincristineDrug

    Also called LEUROCRISTINE, VCR, Vincrystine

    Given IV

  • MethotrexateDrug

    Also called Abitrexate, Alpha-Methopterin, Amethopterin, Brimexate

    Given IV

  • DoxorubicinDrug

    Also called Hydroxyl Daunorubicin, Hydroxyldaunorubicin

    Given IV

  • Doxorubicin HydrochlorideDrug

    Also called Adriamycine, Adriblastina, Doxolem, Doxorubicin.HCl

    Given IV

  • PrednisoneDrug

    Also called Deltacortene, Decorton, Decortisyl, DeCortin

    Given PO

  • EtoposideDrug

    Also called Demethyl Epipodophyllotoxin Ethylidine Glucoside, EPEG, Vepesid

    Given IV

  • RituximabBiological

    Also called BI 695500, C2B8 Monoclonal Antibody, Chimeric Anti-CD20 Antibody, CT-P10

    Given IV

Study groups in NCT03864419
Study groupRoleWhat they receive
Cohort I (pediatric BL)ExperimentalPatients receive cyclophosphamide IV and vincristine IV on day 1, and prednisone IV or PO on days 1-7 in the absence of disease progression or unacceptable toxicity. Patients then receive rituximab IV or rituximab hyaluronidase SC, cyclophosphamide IV, vincristine IV, and methotrexate IV on day 1. Cycles repeat every 14 days for 6 cycles in the absence of disease progression or unacceptable toxicity.
Receives: Biological: Rituximab and Hyaluronidase Human; Drug: Cyclophosphamide; Drug: Vincristine; Drug: Methotrexate; Biological: Rituximab
Cohort II (DLBCL)ExperimentalPatients receive rituximab IV or rituximab and hyaluronidase human SC, cyclophosphamide IV, doxorubicin IV, and vincristine IV on day 1, and prednisone PO on days 1-5 of cycle 1. Cycles repeat every 21 days for 6 cycles in the absence of disease progression or unacceptable toxicity.
Receives: Biological: Rituximab and Hyaluronidase Human; Drug: Cyclophosphamide; Drug: Vincristine; Drug: Doxorubicin; Drug: Doxorubicin Hydrochloride; Drug: Prednisone; Drug: Etoposide; Biological: Rituximab
Cohort III (Adult BL)ExperimentalPatients receive rituximab IV or rituximab and hyaluronidase human SC in day 1, etoposide IV, doxorubicin IV, and vincristine IV on days 1-4. Patients also receive cyclophosphamide IV on day 5 and prednisone PO on days 1-5. Treatment repeats every 21 days for 6 cycles in the absence of disease progression or unacceptable toxicity.
Receives: Biological: Rituximab and Hyaluronidase Human; Drug: Cyclophosphamide; Drug: Vincristine; Drug: Doxorubicin; Drug: Doxorubicin Hydrochloride; Drug: Prednisone; Biological: Rituximab
Cohort IV (MCD)ExperimentalPatients receive rituximab IV or rituximab and hyaluronidase human SC on days 1, 8, 15, and 22 in the absence of disease progression or unacceptable toxicity.
Receives: Biological: Rituximab and Hyaluronidase Human; Biological: Rituximab

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Incidence of treatment-emergent adverse events

    Common Terminology Criteria for Adverse Events version 5.0 including unanticipated problems and grade 3-5 adverse events (AEs) at least probably related to subcutaneous rituximab hyaluronidase (sqR) administration.

    Measured: Up to 12 months

  2. Number of participants that result in sufficient pharmacodynamic criteria

    Pharmacodynamic criteria is a Ctrough level above 25 ug/ml in children and adolescents after the first subcutaneous dose.

    Measured: Up to 12 months

Secondary outcomes (4)
  1. Number of participants achieving a repose of complete response (CR)

    Response Evaluation Criteria in Solid Tumors (RECIST) criteria CR: complete disappearance of all target lesions.

    Measured: 1 year

  2. Overall survival

    Kaplan-Meier estimate

    Measured: 1 year

  3. Progression-free survival

    Kaplan-Meier estimate

    Measured: 1 year

  4. Disease-free survival

    Kaplan-Meier estimate

    Measured: 1 year

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted6 Mar 2019
  2. Study start24 Oct 2019
  3. Primary completion26 Jul 2023
  4. Study completion26 Jul 2023

Why it stopped: Closed per SRC Low Accrual Policy

Resources

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 1
Primary purpose
Treatment
Allocation
Non-randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
18 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03864419
Sponsor's protocol ID
RG1001799
Other IDs
U028, NCI-2019-01493, 10040
Status last verified
Dec 2023
First submitted
1 Mar 2019
Last updated
3 Jan 2024
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No

Publications

  • Menon MP, Ddungu H, Mubiru KR, Adams SV, Asea J, Namagembe R, Namuli P, Kambugu J, Towlerton AMH, Puronen C, Uldrick TS, Orem J, Warren EH. Phase I Study of Subcutaneous Rituximab Hyaluronidase Combined With CHOP Chemotherapy for the Treatment of Diffuse Large B-Cell Lymphoma in Uganda. JCO Glob Oncol. 2025 Apr;11:e2400489. doi: 10.1200/GO-24-00489. Epub 2025 Apr 4.

    PubMed 40184567

Questions about this trial

What is this clinical trial studying?

A Phase 1 study testing Rituximab and Hyaluronidase Human, Cyclophosphamide and Vincristine in people with Burkitt Lymphoma and KSHV-associated Multicentric Castleman Disease, run by Fred Hutchinson Cancer Center at 1 site in Uganda.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 9 inclusion and 11 exclusion criteria. 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: stopped early, as of the sponsor's last update on 3 Jan 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Uganda. 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 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

The study was stopped early (reason given: Closed per SRC Low Accrual Policy). Results are not available in the source record.

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?

Incidence of treatment-emergent adverse events (time frame: Up to 12 months). The study lists 2 primary outcomes in all. 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 NCT03864419, 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 3 Jan 2024.

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