RATIONALE: Monoclonal antibodies, such as bevacizumab, can block cancer growth in different ways. Some block the ability of cancer cells to grow and spread. Others find cancer cells and help kill them or carry cancer-killing substances to them. Bevacizumab may also stop the growth of cancer cells by blocking blood flow to the cancer. 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. Giving bevacizumab together with combination chemotherapy may kill more cancer cells. PURPOSE: This phase II trial is studying how well giving bevacizumab together with several chemotherapy drugs (combination chemotherapy) works in treating patients with peripheral T-cell lymphoma or natural killer cell neoplasms.
OBJECTIVES: Primary * Determine the 12-month progression-free survival of patients with peripheral T-cell or natural killer cell neoplasms treated with bevacizumab and combination chemotherapy comprising cyclophosphamide, doxorubicin, vincristine, and prednisone (A-CHOP). Secondary * Determine the overall response rate (complete remission \[CR, unconfirmed CR, or functional CR\] and partial remission) in these patients after courses 3, 6, and 8 of this treatment regimen. * Determine the overall survival of patients treated with this regimen. * Determine the toxicity of this regimen in these patients. OUTLINE: This is a multicenter study. Patients receive 6-8 cycles of A-CHOP followed by 8 cycles of maintenance bevacizumab (MA), as outlined below. Bevacizumab 15 mg/kg is administered on day 1 over 90 min (first cycle), 60 min (second cycle) and 30 min for the subsequent cycles. CHOP (cyclophosphamide 750 mg/m 2 ; doxorubicin 50 mg/m 2 ; vincristine 1.4 mg/m2 \[max. 2 mg\]; prednisone 100 mg daily on days 1-5) is administered on day 1 of a 21-day cycle. Radiographic response is assessed after cycles 3, 6 and 8 of ACHOP and after cycle 8 of MA. Patients receive six cycles of ACHOP if they achieve a complete response (CR) after three cycles, eight cycles if they achieve a partial response (PR) after three cycles. Non-responders are removed from the study. ACHOP responders receive maintenance bevacizumab 15 mg/kg every 21 days for eight cycles. After completion of study treatment, patients are followed every 3 months for 2 years, and then every 6 months for up to 5 years. PROJECTED ACCRUAL: A total of 43 patients will be accrued for this study within 22 months. ACTUAL ACCRUAL: 46
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
46
A - CHOP: 15 mg/kg IV infusion once every 21 days for 6-8 cycles. Bevacizumab is to be administered prior to CHOP therapy. Continuous bevacizumab: 15 mg/kg IV infusion once every 21 days. Initial dose should be infused over 90 minutes. If no adverse reactions occur, the second dose should be administered over 60 minutes. Again, if no adverse reactions occur, the third and subsequent doses should be administered over 30 minutes. If infusion-related adverse reactions occur, subsequent infusions should be administered over the shortest period that is well-tolerated. Infusions should be run in via a volumetric infusion device. Do NOT administer as an IV push or bolus.
IV infusion per institutional guidelines.
Intravenously, either as a bolus injection or as a continuous infusion through a central venous line.
Prednisone is taken orally.
IV push using extravasation precautions.
California Cancer Care, Incorporated - Greenbrae
Greenbrae, California, United States
Veterans Affairs Medical Center - Palo Alto
Palo Alto, California, United States
Front Range Cancer Specialists
Fort Collins, Colorado, United States
Rush-Copley Cancer Care Center
Aurora, Illinois, United States
St. Joseph Medical Center
Bloomington, Illinois, United States
12-Month Progression-Free Survival (PFS)
12-month progression-free survival is defined as the probability of patients remaining alive and progression-free at 12 months from study entry.
Time frame: Assessed every 3 months the first 2 years from study entry and every 6 months 3-5 years from study entry.
Overall Response Rate
Overall response rate is defined as proportion of patients who achieve complete remission \[CR, unconfirmed CR (CRu) or Functional CR\] or partial remission. Response is assessed using the criteria from the International Workshop to Standardize Criteria for Non-Hodgkin's Lymphoma (Chesen, 1999).
Time frame: Assessed after cycle 3, cycle 6, and cycle 8 (if given).
3-Year Overall Survival
3-year overall survival is defined as the probability of patients surviving at 3 years from study entry.
Time frame: Assessed every 3 months the first 2 years from study entry and every 6 months 3-5 years from study entry.
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