This phase II trial studies how well giving rituximab together with combination chemotherapy works in treating patients with previously untreated high- or high-intermediate-risk diffuse large B-cell lymphoma (DLBCL). Monoclonal antibodies, such as rituximab, can block cancer growth in different ways. Some block the ability of cancer to grow and spread. Others find cancer cells and help kill them or carry cancer-killing substances to them. Drugs used in chemotherapy, such as cyclophosphamide, doxorubicin hydrochloride, vincristine sulfate, and prednisone (CHOP), work in different ways to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Giving more than one drug, combination chemotherapy, may kill more cancer cells. Giving rituximab together with combination chemotherapy together may be an effective treatment for DLBCL
PRIMARY OBJECTIVES: I. To evaluate 1 year progression-free survival (PFS) following treatment with rituximab intense dosing and CHOP-21 (RID-CHOP) in previously untreated patients with high risk (International Prognostic Index \[IPI\] 3-5) DLBCL. SECONDARY OBJECTIVES: I. To evaluate, in previously untreated patients with high risk (IPI 3-5) DLBCL treated with rituximab intense dosing and CHOP-21: Complete response (CR) rate, (as defined by International Harmonization Project criteria using 18-fluorodeoxyglucose \[FDG\] -positron emission tomography \[PET\]/computed tomography \[CT\]). II. Overall survival. III. Toxicity profile. IV. Rituximab pharmacokinetics for this dose and schedule. V. Effect of immunophenotype of DLBCL on outcome. VI. Effect of Fc-Gamma Receptor III (FcyRIII) polymorphism genotype on outcome. OUTLINE: Patients receive rituximab intravenously (IV) on days 0, 1, 4, 8, and 15 of course 1; days 1, 8, and 15 of course 2; and day 1 of all subsequent courses. Patients also receive CHOP chemotherapy comprising cyclophosphamide IV, doxorubicin hydrochloride IV, and vincristine sulfate IV on day 1, and prednisone orally (PO) on days 1-5. Treatment repeats every 21 days for 6 courses in the absence of disease progression or unacceptable toxicity. After completion of study treatment, patients are followed up every 2-3 months for 2 years, every 6 months for 3 years, annually for up to 10 years.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Given IV
Given IV
Given IV
Given IV
Given PO
Correlative studies
Correlative studies
Fox Chase Cancer Center
Philadelphia, Pennsylvania, United States
PFS following treatment with rituximab intense dosing and CHOP-21 in previously untreated patients with high risk DLBCL
Defined as the time from entry onto study until lymphoma progression or death from any cause.
Time frame: 1 year
CR in previously untreated patients with high risk DLBCL treated with rituximab intense dosing and CHOP-21
Time frame: Baseline, between days 15 and 21 of course 3, and within 20-35 days after completion of treatment
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