A Randomized Phase 3 Trial of Nivolumab (NSC# 748726) in Combination With Chemo-Immunotherapy for the Treatment of Newly Diagnosed Primary Mediastinal B-Cell Lymphoma

Who is this study for? Patients with Large B-Cell Lymphoma
What treatments are being studied? Doxorubicin Hydrochloride+Etoposide Phosphate+Filgrastim+Prednisone
Status: Active_not_recruiting
Location: See all (233) locations...
Intervention Type: Biological, Drug, Procedure, Radiation
Study Type: Interventional
Study Phase: Phase 3
SUMMARY

This phase III trial compares the effects of nivolumab with chemo-immunotherapy versus chemo-immunotherapy alone in treating patients with newly diagnosed primary mediastinal B-cell lymphoma (PMBCL). Immunotherapy with monoclonal antibodies, such as nivolumab, may help the body's immune system attack the cancer, and may interfere with the ability of cancer cells to grow and spread. Treatment for PMBCL involves chemotherapy combined with an immunotherapy called rituximab. Chemotherapy drugs work in different ways to stop the growth of cancer cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Rituximab is a monoclonal antibody. It binds to a protein 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. Giving nivolumab with chemo-immunotherapy may help treat patients with PMBCL.

Eligibility
Participation Requirements
Sex: All
Minimum Age: 2
Healthy Volunteers: f
View:

• Age \>= 2 years

• Patient must have histologically confirmed primary mediastinal B-cell lymphoma (PMBCL) as defined by World Health Organization (WHO) criteria

• Eastern Cooperative Oncology Group (ECOG) performance status of 0, 1, or 2 or ECOG performance status of 3 if poor performance is related to lymphoma

‣ Children's Oncology Group (COG) Institutions: Use Karnofsky for patients \>= 17 and \< 18 years of age and Lansky for patients \< 17 years of age

• Adults (age 18 or older): Creatinine clearance \>= 30 mL/min, as estimated by the Cockcroft and Gault formula. The creatinine value used in the calculation must have been obtained within 28 days prior to registration. Estimated creatinine clearance is based on actual body weight

• Pediatric Patients (age \< 18 years): The following must have been obtained within 14 days prior to registration:

‣ Measured or calculated (based on institutional standard) creatinine clearance or radioisotope glomerular filtration rate (GFR) \>= 70 ml/min/1.73 m\^2, or

⁃ Serum creatinine =\< 1.5 x institutional upper limit of normal (IULN), or a serum creatinine based on age/sex as follows:

• Age : 2 to \< 6 year; Maximum serum creatinine (mg/dL): 0.8 (male; 0.8 (female)

∙ Age : 6 to \< 10 years; Maximum serum creatinine (mg/dL): 1 (male); 1 (female)

∙ Age : \>= 16 years to \< 18 years; Maximum serum creatinine (mg/dL): 1.7 (male); 1.4 (female)

• Patients with abnormal liver function will be eligible to enroll if the lab abnormality is thought to be due to the lymphoma or Gilbert's syndrome

• Age \>= 18 years: Ejection fraction of \>= 50% by echocardiogram

• Age \< 18 years: Shortening fraction of \>= 27% by echocardiogram, or ejection fraction of \>= 50% by radionuclide angiogram

• Human immunodeficiency virus (HIV)-infected patients on effective anti-retroviral therapy with undetectable viral load within 6 months are eligible for this trial

• For patients with evidence of chronic hepatitis B virus (HBV) infection, the HBV viral load must be undetectable on suppressive therapy, if indicated

• Patients with a history of hepatitis C virus (HCV) infection must have been treated and cured. For patients with HCV infection who are currently on treatment, they are eligible if they have an undetectable HCV viral load

• All patients and/or their parents or legal guardians must sign a written informed consent

• All institutional, Food and Drug Administration (FDA), and National Cancer Institute (NCI) requirements for human studies must be met

Locations
United States
Alaska
Providence Alaska Medical Center
Anchorage
Alabama
Children's Hospital of Alabama
Birmingham
USA Health Strada Patient Care Center
Mobile
Arkansas
Arkansas Children's Hospital
Little Rock
Arizona
Banner Children's at Desert
Mesa
Banner University Medical Center - Tucson
Tucson
California
UC Irvine Health Cancer Center-Newport
Costa Mesa
Kaiser Permanente Downey Medical Center
Downey
City of Hope Comprehensive Cancer Center
Duarte
City of Hope at Irvine Lennar
Irvine
UCI Health - Chao Family Comprehensive Cancer Center and Ambulatory Care
Irvine
Loma Linda University Medical Center
Loma Linda
Miller Children's and Women's Hospital Long Beach
Long Beach
Cedars Sinai Medical Center
Los Angeles
Children's Hospital Los Angeles
Los Angeles
Mattel Children's Hospital UCLA
Los Angeles
Valley Children's Hospital
Madera
Kaiser Permanente-Oakland
Oakland
Children's Hospital of Orange County
Orange
UC Irvine Health/Chao Family Comprehensive Cancer Center
Orange
Lucile Packard Children's Hospital Stanford University
Palo Alto
University of California Davis Comprehensive Cancer Center
Sacramento
Rady Children's Hospital - San Diego
San Diego
Colorado
Children's Hospital Colorado
Aurora
Rocky Mountain Hospital for Children-Presbyterian Saint Luke's Medical Center
Denver
Connecticut
Connecticut Children's Medical Center
Hartford
Washington, D.c.
Children's National Medical Center
Washington D.c.
MedStar Georgetown University Hospital
Washington D.c.
Delaware
Alfred I duPont Hospital for Children
Wilmington
Florida
Broward Health Medical Center
Fort Lauderdale
Golisano Children's Hospital of Southwest Florida
Fort Myers
UF Health Cancer Institute - Gainesville
Gainesville
Memorial Regional Hospital/Joe DiMaggio Children's Hospital
Hollywood
Nemours Children's Clinic-Jacksonville
Jacksonville
University of Miami Miller School of Medicine-Sylvester Cancer Center
Miami
Arnold Palmer Hospital for Children
Orlando
Nemours Children's Hospital
Orlando
Johns Hopkins All Children's Hospital
St. Petersburg
Saint Joseph's Hospital/Children's Hospital-Tampa
Tampa
Tampa General Hospital
Tampa
Georgia
Children's Healthcare of Atlanta - Arthur M Blank Hospital
Atlanta
Emory Proton Therapy Center
Atlanta
Emory Saint Joseph's Hospital
Atlanta
Emory University Hospital Midtown
Atlanta
Emory University Hospital/Winship Cancer Institute
Atlanta
Memorial Health University Medical Center
Savannah
Hawaii
Kapiolani Medical Center for Women and Children
Honolulu
Iowa
UI Health Care Mission Cancer and Blood - Ankeny Clinic
Ankeny
UI Health Care Mission Cancer and Blood - West Des Moines Clinic
Clive
Blank Children's Hospital
Des Moines
Mercy Medical Center - Des Moines
Des Moines
UI Health Care Mission Cancer and Blood - Laurel Clinic
Des Moines
University of Iowa/Holden Comprehensive Cancer Center
Iowa City
Siouxland Regional Cancer Center
Sioux City
UI Health Care Mission Cancer and Blood - Waukee Clinic
Waukee
Idaho
Saint Luke's Cancer Institute - Boise
Boise
Illinois
Rush-Copley Medical Center
Aurora
Lurie Children's Hospital-Chicago
Chicago
Northwestern University
Chicago
University of Chicago Comprehensive Cancer Center
Chicago
University of Illinois
Chicago
Carle at The Riverfront
Danville
Decatur Memorial Hospital
Decatur
Northwestern Medicine Cancer Center Kishwaukee
Dekalb
Carle Physician Group-Effingham
Effingham
Northwestern Medicine Cancer Center Delnor
Geneva
Northwestern Medicine Lake Forest Hospital
Lake Forest
Carle Physician Group-Mattoon/Charleston
Mattoon
Loyola University Medical Center
Maywood
HSHS Saint Elizabeth's Hospital
O'fallon
Advocate Children's Hospital-Oak Lawn
Oak Lawn
Advocate Children's Hospital-Park Ridge
Park Ridge
Saint Jude Midwest Affiliate
Peoria
Southern Illinois University School of Medicine
Springfield
Springfield Clinic
Springfield
Springfield Memorial Hospital
Springfield
Carle Cancer Center
Urbana
Northwestern Medicine Cancer Center Warrenville
Warrenville
Indiana
Riley Hospital for Children
Indianapolis
Reid Health
Richmond
Kansas
Wesley Medical Center
Wichita
Kentucky
University of Kentucky/Markey Cancer Center
Lexington
Norton Children's Hospital
Louisville
Louisiana
Children's Hospital New Orleans
New Orleans
Ochsner Medical Center Jefferson
New Orleans
Massachusetts
Dana-Farber Cancer Institute
Boston
Tufts Medical Center
Boston
Maryland
Greater Baltimore Medical Center
Baltimore
Johns Hopkins University/Sidney Kimmel Cancer Center
Baltimore
Sinai Hospital of Baltimore
Baltimore
University of Maryland/Greenebaum Cancer Center
Baltimore
Walter Reed National Military Medical Center
Bethesda
Maine
Eastern Maine Medical Center
Bangor
Maine Children's Cancer Program
Scarborough
Michigan
C S Mott Children's Hospital
Ann Arbor
Children's Hospital of Michigan
Detroit
Henry Ford Hospital
Detroit
Michigan State University
East Lansing
Corewell Health Grand Rapids Hospitals - Helen DeVos Children's Hospital
Grand Rapids
Bronson Methodist Hospital
Kalamazoo
Corewell Health Lakeland Hospitals - Niles Hospital
Niles
Corewell Health Children's
Royal Oak
Minnesota
Minnesota Oncology - Burnsville
Burnsville
Mercy Hospital
Coon Rapids
Fairview Southdale Hospital
Edina
Unity Hospital
Fridley
Minnesota Oncology Hematology PA-Maplewood
Maplewood
Abbott-Northwestern Hospital
Minneapolis
Children's Hospitals and Clinics of Minnesota - Minneapolis
Minneapolis
Park Nicollet Clinic - Saint Louis Park
Saint Louis Park
United Hospital
Saint Paul
Missouri
Saint Luke's Hospital
Chesterfield
Siteman Cancer Center at Saint Peters Hospital
City Of Saint Peters
Siteman Cancer Center at West County Hospital
Creve Coeur
Children's Mercy Hospitals and Clinics
Kansas City
Mercy Hospital Saint Louis
St Louis
Siteman Cancer Center at Christian Hospital
St Louis
Siteman Cancer Center-South County
St Louis
Washington University School of Medicine
St Louis
Mississippi
University of Mississippi Medical Center
Jackson
North Carolina
AdventHealth Infusion Center Asheville
Asheville
Mission Hospital
Asheville
Carolinas Medical Center/Levine Cancer Institute
Charlotte
Novant Health Presbyterian Medical Center
Charlotte
East Carolina University
Greenville
AdventHealth Hendersonville
Hendersonville
Wake Forest University Health Sciences
Winston-salem
North Dakota
Sanford Broadway Medical Center
Fargo
Nebraska
Children's Hospital and Medical Center of Omaha
Omaha
University of Nebraska Medical Center
Omaha
New Hampshire
Dartmouth Hitchcock Medical Center/Dartmouth Cancer Center
Lebanon
New Jersey
Memorial Sloan Kettering Basking Ridge
Basking Ridge
Hackensack University Medical Center
Hackensack
Memorial Sloan Kettering Monmouth
Middletown
Memorial Sloan Kettering Bergen
Montvale
Morristown Medical Center
Morristown
Rutgers Cancer Institute of New Jersey
New Brunswick
Rutgers Cancer Institute of New Jersey-Robert Wood Johnson University Hospital
New Brunswick
Saint Joseph's Regional Medical Center
Paterson
New Mexico
Presbyterian Hospital
Albuquerque
Nevada
Alliance for Childhood Diseases/Cure 4 the Kids Foundation
Las Vegas
Renown Regional Medical Center
Reno
New York
Albany Medical Center
Albany
Roswell Park Cancer Institute
Buffalo
Memorial Sloan Kettering Commack
Commack
Memorial Sloan Kettering Westchester
Harrison
The Steven and Alexandra Cohen Children's Medical Center of New York
New Hyde Park
Memorial Sloan Kettering Cancer Center
New York
NYP/Columbia University Medical Center/Herbert Irving Comprehensive Cancer Center
New York
NYP/Weill Cornell Medical Center
New York
University of Rochester
Rochester
Stony Brook University Medical Center
Stony Brook
State University of New York Upstate Medical University
Syracuse
Montefiore Medical Center - Moses Campus
The Bronx
Memorial Sloan Kettering Nassau
Uniondale
New York Medical College
Valhalla
Wilmot Cancer Institute at Webster
Webster
Ohio
Children's Hospital Medical Center of Akron
Akron
Cincinnati Children's Hospital Medical Center
Cincinnati
Cleveland Clinic Foundation
Cleveland
Rainbow Babies and Childrens Hospital
Cleveland
Nationwide Children's Hospital
Columbus
Dayton Children's Hospital
Dayton
Dayton Physician LLC - Englewood
Dayton
Greater Dayton Cancer Center
Kettering
Kettering Medical Center
Kettering
ProMedica Toledo Hospital/Russell J Ebeid Children's Hospital
Toledo
Oklahoma
University of Oklahoma Health Sciences Center
Oklahoma City
Oregon
Legacy Emanuel Children's Hospital
Portland
Oregon Health and Science University
Portland
Pennsylvania
Lehigh Valley Hospital-Cedar Crest
Allentown
Geisinger Medical Center
Danville
Penn State Children's Hospital
Hershey
Children's Hospital of Philadelphia
Philadelphia
Saint Christopher's Hospital for Children
Philadelphia
Children's Hospital of Pittsburgh of UPMC
Pittsburgh
Rhode Island
Rhode Island Hospital
Providence
South Carolina
Prisma Health Richland Hospital
Columbia
BI-LO Charities Children's Cancer Center
Greenville
Prisma Health Cancer Institute - Eastside
Greenville
Saint Francis Cancer Center
Greenville
Saint Francis Hospital
Greenville
South Dakota
Sanford USD Medical Center - Sioux Falls
Sioux Falls
Tennessee
East Tennessee Childrens Hospital
Knoxville
Saint Jude Children's Research Hospital
Memphis
The Children's Hospital at TriStar Centennial
Nashville
Vanderbilt University/Ingram Cancer Center
Nashville
Texas
Texas Tech University Health Sciences Center-Amarillo
Amarillo
Dell Children's Medical Center of Central Texas
Austin
Driscoll Children's Hospital
Corpus Christi
Medical City Dallas Hospital
Dallas
UT Southwestern/Simmons Cancer Center-Dallas
Dallas
El Paso Children's Hospital
El Paso
Baylor College of Medicine/Dan L Duncan Comprehensive Cancer Center
Houston
Houston Methodist Hospital
Houston
M D Anderson Cancer Center
Houston
Covenant Children's Hospital
Lubbock
UMC Cancer Center / UMC Health System
Lubbock
Children's Hospital of San Antonio
San Antonio
Methodist Children's Hospital of South Texas
San Antonio
University of Texas Health Science Center at San Antonio
San Antonio
Utah
Primary Children's Hospital
Salt Lake City
Virginia
University of Virginia Cancer Center
Charlottesville
Inova Fairfax Hospital
Falls Church
Children's Hospital of The King's Daughters
Norfolk
VCU Massey Comprehensive Cancer Center
Richmond
Carilion Children's
Roanoke
Washington
Valley Medical Center
Renton
Seattle Children's Hospital
Seattle
Providence Sacred Heart Medical Center and Children's Hospital
Spokane
Madigan Army Medical Center
Tacoma
Mary Bridge Children's Hospital and Health Center
Tacoma
Wisconsin
University of Wisconsin Carbone Cancer Center - University Hospital
Madison
Marshfield Medical Center-Marshfield
Marshfield
West Virginia
West Virginia University Charleston Division
Charleston
Other Locations
Australia
John Hunter Children's Hospital
Hunter Regional Mail Centre
Royal Children's Hospital
Parkville
Perth Children's Hospital
Perth
Queensland Children's Hospital
South Brisbane
The Children's Hospital at Westmead
Westmead
Canada
University of Alberta Hospital
Edmonton
IWK Health Centre
Halifax
McMaster Children's Hospital at Hamilton Health Sciences
Hamilton
Children's Hospital
London
Centre Hospitalier Universitaire Sainte-Justine
Montreal
The Montreal Children's Hospital of the MUHC
Montreal
Children's Hospital of Eastern Ontario
Ottawa
CHU de Quebec-Centre Hospitalier de l'Universite Laval (CHUL)
Québec
Centre Hospitalier Universitaire de Sherbrooke-Fleurimont
Sherbrooke
Janeway Child Health Centre
St. John's
Hospital for Sick Children
Toronto
CancerCare Manitoba
Winnipeg
Puerto Rico
HIMA San Pablo Oncologic Hospital
Caguas
Time Frame
Start Date: 2021-10-05
Completion Date: 2026-12-31
Participants
Target number of participants: 244
Treatments
Active_comparator: Arm A (DA-EPOCH-R)
See Detailed Description
Experimental: Arm B (DA-EPOCH-R, nivolumab)
Patients receive treatment as in Arm A. Patients also receive nivolumab IV over 30 minutes on day 1. Treatment repeats every 21 days for up to 6 cycles (5 if the patient had 1 prior cycle of treatment) in the absence of disease progression or unacceptable toxicity. Patients undergo ECHO and LP for CSF collection during screening. Patients undergo ECHO during screening and as clinically indicated and LP for CSF collection optionally during screening. Patients also undergo CT or PET/CT throughout the trial. Additionally, patients undergo bone marrow biopsy and aspiration optionally during screening and as clinically indicated on study. Patients undergo blood sample collection on study.
Active_comparator: Arm C (R-CHOP)
Patients receive prednisone or prednisolone PO QD on days 1-5 and rituximab IV or rituximab and hyaluronidase human SC over 5 minutes on day 1 or 5. Patients also receive cyclophosphamide IV over 30-60 minutes, doxorubicin hydrochloride IV over 1-15 minutes or up to 60 minutes, and vincristine sulfate IV over 1 or up to 60 minutes on day 1. Treatment repeats every 21 days for up to 6 cycles (5 if the patient had 1 prior cycle of treatment) in the absence of disease progression or unacceptable toxicity. Patients undergo ECHO during screening and as clinically indicated and LP for CSF collection optionally during screening. Patients also undergo CT or PET/CT throughout the trial. Additionally, patients undergo bone marrow biopsy and aspiration optionally during screening and as clinically indicated on study. Patients undergo blood sample collection on study.
Experimental: Arm D (R-CHOP, nivolumab)
Patients receive treatment as in Arm C. Patients also receive nivolumab IV over 30 minutes on day 1. Treatment repeats every 21 days for up to 6 cycles (5 if the patient had 1 prior cycle of treatment) in the absence of disease progression or unacceptable toxicity. Patients undergo ECHO during screening and as clinically indicated and LP for CSF collection optionally during screening. Patients also undergo CT or PET/CT throughout the trial. Additionally, patients undergo bone marrow biopsy and aspiration optionally during screening and as clinically indicated on study. Patients undergo blood sample collection on study.
Active_comparator: Arm E (R-CHOP, radiation therapy)
Patients receive treatment as in Arm C. Within 6-8 weeks after completion of chemotherapy, patients undergo radiation therapy over 25 fractions. Patients undergo ECHO during screening and as clinically indicated and LP for CSF collection optionally during screening. Patients also undergo CT or PET/CT throughout the trial. Additionally, patients undergo bone marrow biopsy and aspiration optionally during screening and as clinically indicated on study. Patients undergo blood sample collection on study.
Experimental: Arm F (R-CHOP, nivolumab, radiation therapy)
Patients receive treatment as in Arm D. Within 6-8 weeks after completion of chemotherapy, patients undergo radiation therapy over 25 fractions. Patients undergo ECHO during screening and as clinically indicated and LP for CSF collection optionally during screening. Patients also undergo CT or PET/CT throughout the trial. Additionally, patients undergo bone marrow biopsy and aspiration optionally during screening and as clinically indicated on study. Patients undergo blood sample collection on study.
Authors
Thomas W. McLean, Craig Erker, Kathleen J. Yost, Nader K. El-Mallawany, Hamayun Imran, Elyssa M. Rubin, Robin Y. Dulman, Haydar A. Frangoul, Laurel C. Truscott, Nina S. Kadan-Lottick, Alissa Kahn, Kathryn L. Laurie, Marcio H. Malogolowkin, Jessica C. Hochberg, Rene Y. McNall-Knapp, Eric J. Lowe, Mary L. Schmidt, William A. May, Jennifer L. McNeer, Nadine P. SantaCruz, Robin E. Norris, Emily B. Walling, Jennifer A. Belsky, Keith J. August, Elizabeth A. Brem, Kishor M. Bhende, Anne F. Reilly, Howland E. Crosswell, Stanton C. Goldman, Michael S. Isakoff, Justine M. Kahn, Kayelyn J. Wagner, Mukund G. Dole, Laura E. Agresta, Joel A. Kaplan, Rabi Hanna, Erika Friehling, Timothy C. Griffin, Robin D. Hanson, Jordyn R. Griffin, Erwood G. Edwards, Jennifer A. Domm, Don E. Eslin, William B. Slayton, Holly E. Pariury, Mark A. Ranalli, Erin K. Barr, Leo Mascarenhas, Laura E. Hogan, Jamie L. Dargart, Theodore B. Moore, Duncan S. Stearns, Andrew L. Pendleton, Krishna C. Alluri, Lisa G. Roth, Craig A. Mullen, Jhon A. Guerra, Aarati V. Rao, Joseph C. Torkildson, Michelle A. Manalang, Clare J. Twist, Craig Lotterman, Aniket Saha, Burton E. Appel, Hector M. Rodriguez-Cortes, Kimberly J. Davies, Arlene S. Redner, Christopher J. Forlenza, Robert G. Irwin, Susan E. Spiller, Mallorie B. Heneghan, James T. Badgett, Judy L. Felgenhauer, Ryan J. Summers, Sarah E. Leary, Minnie Abromowitch, Wade T. Kyono, Emi H. Caywood, Gregory P. Brandt, Shannon M. Cohn, Stacy L. Cooper, Jagadeesh Ramdas, Philip M. Monteleone, Stuart L. Cramer, Andrea R. Whitfield, Jay Michael S. Balagtas, Brenda J. Wittman, Robert J. Hayashi, Alan K. Ikeda, Maria T. Grosse-Perdekamp, Laura K. Gowans, Martha M. Pacheco, Rebecca E. McFall, Michael K. Richards, Steven J. Kuerbitz, Joanna L. Weinstein, Lauren R. Weintraub, Kristie A. Blum, Jeffrey S. Dome, Melissa A. Forouhar, Mohamad H. Badawi, David M. King, Kelly W. Maloney, Eugene Suh, David L. Becton, Eugenia Chang, Albert Kheradpour, Samuel J. Milanovich, Ranjan Bista, Lisa A. Goodyear, David S. Dickens, Yvan Samson, Sharon B. Abish, Shayna M. Zelcer, Sarah J. McKillop, Bhavna Padhye, Donna L. Johnston, Uma H. Athale
Sponsors
Leads: National Cancer Institute (NCI)

This content was sourced from clinicaltrials.gov

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