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Phase III Randomized Study of Epirubicin, Bleomycin, Vinblastine, and Prednisone (EBVP) Versus Doxorubicin, Bleomycin, Vinblastine, and Dacarbazine (ABVD) Versus Cyclophosphamide, Doxorubicin, Vincristine, Bleomycin, Etoposide, Procarbazine, and Prednisone (BEACOPP), Followed By Involved-Field Radiotherapy (IF-RT) or No IF-RT in Patients With Hodgkin's Lymphoma
Alternate Title Basic Trial Information Objectives Entry Criteria Expected Enrollment Outline Published Results Related Publications Trial Contact Information Registry Information
Alternate Title
Combination Chemotherapy With or Without Radiation Therapy in Treating Patients With Hodgkin's Lymphoma
Basic Trial Information
Phase | Type | Status | Age | Protocol IDs |
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Phase III | Treatment | Closed | 15 to 70 | EORTC-20982 FRE-FNCLCC-98014, GELA-H9, NCT00005584 |
Objectives - Compare the late toxicity of 6 courses of epirubicin, bleomycin, vinblastine, and prednisone (EBVP) followed by involved-field radiotherapy (IF-RT) (36 Gy) vs IF-RT (20 Gy), vs no IF-RT (closed to accrual as of 6/2002) in patients with supradiaphragmatic Hodgkin's lymphoma, favorable prognosis, and complete remission (CR) or CR unconfirmed after completion of chemotherapy.
(Favorable prognosis group [group 1] closed to accrual as of 4/28/04.)
- Compare 6 courses of doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) vs 4 courses of ABVD vs 4 courses of cyclophosphamide, doxorubicin, vincristine, bleomycin, etoposide, procarbazine, and prednisone (BEACOPP) followed by IF-RT, with respect to overall survival and late treatment-related toxicity, in patients with supradiaphragmatic Hodgkin's lymphoma and unfavorable prognosis. (Unfavorable prognosis group [group 2] closed to accrual as of 9/2002.)
(Favorable prognosis group [group 1] closed to accrual as of 4/28/04.)
- Maintain the failure-free survival and relapse-free survival rates that were reached in the previous EORTC studies (H5 to H8), with a reduction in acute and delayed side effects of the treatment, in particular that of severe late radiotherapy and chemotherapy-related toxicity.
- Compare the quality of life, overall survival, treatment quality control, and duration of treatment in patients with favorable (closed to accrual as of 4/28/04) or unfavorable (closed to accrual as of 9/2002) prognoses treated with these regimens.
- Determine the efficacy of conservative therapy comprised of observation until disease progression (DP) and administration of IF-RT at the time of DP in patients with lymphocyte-predominant Hodgkin's lymphoma, nodular subtype (nodular paragranuloma).
Entry Criteria Disease Characteristics:
- Randomized groups: Histologically proven previously untreated stage I or II
supradiaphragmatic Hodgkin's lymphoma
- No prior staging laparotomy
- Favorable (closed to accrual as of 4/28/04) or unfavorable (closed to accrual as of 9/2002) prognosis
- Nonrandomized group: Histologically proven lymphocyte-predominant Hodgkin's lymphoma, nodular
subtype (nodular paragranuloma)
- Stage I with complete or incomplete resection
OR - Stage II
Prior/Concurrent Therapy:
Biologic therapy - No prior biologic therapy for this malignancy
Chemotherapy - No prior chemotherapy for this malignancy
Endocrine therapy - No prior endocrine therapy for this malignancy
Radiotherapy - No prior radiotherapy for this malignancy
Surgery - No prior surgery for this malignancy
Patient Characteristics:
Age: Performance status: Life expectancy: Hematopoietic: Hepatic: Renal: Cardiovascular: - No severe cardiac disease that would interfere with normal
life expectancy or study treatment
Pulmonary: - No severe pulmonary disease that would interfere with normal
life expectancy or study treatment
Other: - No other prior or concurrent malignancy except basal cell skin
cancer or carcinoma in situ of the cervix
- No severe neurologic or metabolic disease that would interfere
with normal life expectancy or study treatment
- No psychologic, familial, socioeconomic, or geographic
circumstances that would preclude proper staging or compliance
- HIV negative
- Not pregnant
- Fertile patients must use effective contraception
Expected Enrollment A total of 903 patients (group 1) will be accrued for this study within 7.7 years. A total of 723 patients (group 2) will be accrued for this study within 3.8 years. (Group 2 [unfavorable prognosis] closed to accrual as of 9/2002.) (Group 1 [favorable prognosis] closed to accrual as of 4/28/04.) Outline This is a randomized, multicenter study. Patients with classical Hodgkin's lymphoma are assigned to 1 of 2
randomized groups. (Group 2 [unfavorable prognosis] closed to accrual as of 9/2002.) (Group 1 [favorable prognosis] closed to accrual as of 4/28/04.) Patients with lymphocyte-predominant Hodgkin's lymphoma are
assigned to the nonrandomized group. Randomized groups - Patients are stratified by prognosis (favorable vs
unfavorable). Patients are assigned to 1 of 2 treatment groups based on
prognosis. (Group 2 [unfavorable prognosis] closed to accrual as of 9/2002.) (Group 1 [favorable prognosis] closed to accrual as of 4/28/04.)
- Group 1 (favorable prognosis) (closed to accrual as of 4/28/04): Patients receive epirubicin IV over
5 minutes, bleomycin intramuscularly (IM) (or IV if necessary),
and vinblastine IV on day 1 and oral prednisone on days 1-5. Treatment
repeats every 3 weeks for 6 courses. Patients are then assigned to 1 of 3
involved-field radiotherapy (IF-RT) groups based on response to chemotherapy:
- Group A (complete remission (CR) or CR unconfirmed [CRu]) Patients are randomized to 1 of 3 radiotherapy arms. (Arm III closed to accrual as of 6/2002.)
- Arm I (36 Gy): Patients undergo IF-RT 5 days a week for 3.5
weeks.
- Arm II (20 Gy): Patients undergo IF-RT 5 days a week for 2
weeks.
- Arm III (closed to accrual as of 6/2002): Patients undergo no IF-RT.
- Group B (partial remission [PR]): Patients undergo IF-RT 5 days a
week for 3.5 weeks and boost radiotherapy.
- Group C (stable disease or disease progression [DP]): Patients
receive no IF-RT and are taken off study.
- Group 2 (unfavorable prognosis) (closed to accrual as of 9/2002): Patients are randomized to 1 of 3
treatment arms.
- Groups 1 and 2 (group 2 closed to accrual as of 9/2002) (group 1 closed to accrual as of 4/28/04): IF-RT begins within 3-4 weeks after completion of the
last course of chemotherapy.
Nonrandomized group - Patients with completely resected stage I disease
undergo observation until DP and undergo IF-RT
after documentation of DP. Patients with stage II or incompletely resected
stage I disease undergo IF-RT immediately.
Quality of life is assessed before starting study therapy, immediately
after completion of study, and then annually for 10 years. Patients are followed at 2, 4, 6, 9, and 12 months; every 4 months for 1
year; every 6 months for 3 years; and then annually thereafter. Published ResultsEghbali H, Brice P, Creemers GY, et al.: Comparison of three radiation dose levels after EBVP regimen in favorable supradiaphragmatic clinical stages (CS) I-II Hodgkin’s lymphoma (HL): preliminary results of the EORTC-GELA H9-F trial. [Abstract] Blood 106 (11): A-814, 2005. Ferme C, Diviné M, Vranovsky A, et al.: Four ABVD and involved-field radiotherapy in unfavorable supradiaphragmatic clinical stages (CS) I-II Hodgkin’s lymphoma (HL): preliminary results of the EORTC-GELA H9-U trial. [Abstract] Blood 106 (11): A-813, 2005. Girinsky T, Gargi T, Carrie C, et al.: Quality assurance program in the EORTC-GELA H9 randomized study results on 282 patients. [Abstract] Int J Radiat Oncol Biol Phys 63 (2 Suppl 1): A77, S47, 2005. Noordijk EM, Thomas J, Fermé C, et al.: First results of the EORTC-GELA H9 randomized trials: the H9-F trial (comparing 3 radiation dose levels) and H9-U trial (comparing 3 chemotherapy schemes) in patients with favorable or unfavorable early stage Hodgkin's lymphoma (HL) . [Abstract] J Clin Oncol 23 (Suppl 16): A-6505, 561s, 2005. Thomas J, Ferme C, Noordijk EM, et al.: Six cycles of EBVP followed by 36 Gy involved-field irradiation vs. no irradiation in favourable supradiaphragmatic clinical stages I-II Hodgkin's lymphoma: the EORTC-GELA strategy in 771 patients (H9-F trial-20982). [Abstract] Eur J Haematol 75 (Suppl 65): A-E11a, 40, 2004. Thomas J, Ferme C, Noordijk EM, et al.: Six cycles of ABVD + IF-RT vs. four cycles of ABVD + IF-RT vs. four cycles of BEACOPP + IF-RT in unfavourable supradiaphragmatic clinical stages I-II Hodgkin's lymphoma: the EORTC-GELA H9-U randomized clinical trial (20982) in 808 patients. [Abstract] Eur J Haematol 73 (Supp 65): A-E12, 40, 2004. Related Publicationsvan der Kaaij MA, Heutte N, Le Stang N, et al.: Gonadal function in males after chemotherapy for early-stage Hodgkin's lymphoma treated in four subsequent trials by the European Organisation for Research and Treatment of Cancer: EORTC Lymphoma Group and the Groupe d'Etude des Lymphomes de l'Adulte. J Clin Oncol 25 (19): 2825-32, 2007.[PUBMED Abstract]
Trial Contact Information
Trial Lead Organizations European Organization for Research and Treatment of Cancer | | | Jose Thomas, MD, Study coordinator | | | | H. Eghbali, MD, Study coordinator | | | | E.M. Noordijk, MD, Study coordinator | | | | Christophe Ferme, Study coordinator | | | |
Groupe d'Etudes de Lymphomes de L'Adulte | | | Christian Gisselbrecht, MD, Study coordinator | | | |
Federation Nationale des Centres de Lutte Contre le Cancer | | | Thierry Philip, MD, Study coordinator | | | |
Registry Information | | Official Title | | Prospective Controlled Trial in Clinical Stages I-II Supradiaphragmatic Hodgkin's Disease: Evaluation of Treatment Efficacy, (Long Term) Toxicity and Quality of Life in Two Different Prognostic Subgroups | | Trial Start Date | | 1998-10-15 | | Registered in ClinicalTrials.gov | | NCT00005584 | | Date Submitted to PDQ | | 2000-02-11 | | Information Last Verified | | 2001-07-25 |
Note: The purpose of most clinical trials listed in this database is to test new cancer treatments, or new methods of diagnosing, screening, or preventing cancer. Because all potentially harmful side effects are not known before a trial is conducted, dose and schedule modifications may be required for participants if they develop side effects from the treatment or test. The therapy or test described in this clinical trial is intended for use by clinical oncologists in carefully structured settings, and may not prove to be more effective than standard treatment. A responsible investigator associated with this clinical trial should be consulted before using this protocol. Back to Top |
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