HOVON HO170 NHL
Main info
- Identificatie:
- HOVON 170 DLBCL-ANTICIPATE
- Sponsor:
- HOVON
- Working group party:
- Lymphoma
- Age:
- >= 18
- Stadium:
- 1st lijn
- Echelon:
- Level D
- Included patients:
-
7(of 324)
- Active sites:
-
9(of 25)16 sites are pending
- Title:
ANTICIPATE: Prevention of ANThracycline-Induced Cardiac dysfunction by dexrazoxane In PATients with diffusE large B-cell lymphoma: a prospective randomized phase III trial
Timeline
News
03DEC2024: A new version (v3) of the authorization log is available.
09OCT2024: Due to delay the complete database is not yet available
24JUL2024: Instructions TTE training; template-standardized-TTE report and updated ECG manual are now available on the website - downloads
Details
- Phase:
- Prospective randomized Phase III study
- Monitoring Type:
- HOVON Monitoring Visit
- Objectives:
Primary objectives
- To establish the efficacy of dexrazoxane for the primary prevention of AICD in DLBCL patients treated with R-CHOP21
- To compare complete metabolic response (CMR) rates between treatment arms
Secondary objectives
- To assess whether there is a difference in LVEF (2D or 3D) and global longitudinal strain (GLS) between treatment arms
- To assess whether there is a difference in release of cardiac biomarkers (troponin) between treatment arms
- To determine the incidence of Major Adverse Cardiovascular Events (MACE)
- To evaluate adverse events
- To identify patient- and treatment related factors modulating individual AICD risk and develop a risk stratification model
- To analyse the impact of the addition of dexrazoxane on QoL
Eligibility
- Inclusion Criteria:
To be eligible to participate in this study a patient must meet all the following criteria:
- Untreated patients with a confirmed histologic diagnosis of CD20+ DLBCL according to the WHO classification 2022:
- DLBCL, not otherwise specified (NOS)
- High-grade B-cell lymphoma NOS
- High-grade B-cell lymphoma with MYC and BCL2 and/or BCL6 translocation when DA-EPOCH-R is not an option. R2-CHOP is allowed.
- Follicular lymphoma
- T-cell/histiocyte-rich B cell lymphoma (THRBCL)
- Note: Transformed, previously untreated lymphoma is allowed.
- Note: 5-day treatment of dexamethasone 15 mg/day or prednisone 100 mg/day or local radiotherapy in order to control life-threatening/invalidating tumor related symptoms is allowed.
- Note: It is allowed to start with the first cycle of R-CHOP21 pending the FISH results.
- Planned treatment with 6 R-CHOP21. The following regimens are also allowed:
- Treatment with reversed R-CHOP21
- Treatment with R2-CHOP21 (6 R-CHOP21 + lenalidomide 15 mg day 1-14) in case of double hit lymphoma
- Two additional administrations of rituximab after 6 cycles of R-CHOP21
- High dose MTX and/or MTX-it for CNS prophylaxis
- Ann Abor stages II-IV and stage I if the treatment plan is 6 R-CHOP21 in case of bulky disease (defined as a ≥10 cm mass)
- Age ≥ 18 years;
- WHO performance status ≤ 2, WHO 3 performance status is allowed when considered directly related to the DLBCL;
- Negative pregnancy test at study entry for women of childbearing potential;
- Female patient is either post-menopausal for at least 1 year before the screening visit or surgically sterile or if of childbearing potential, agrees to practice two effective methods of contraception, at the same time, from the time of signing the informed consent through at least 12 months after the last dose of protocol treatment, or agrees to completely abstain from heterosexual intercourse;
- Male patient, even if surgically sterilized, (i.e., status post vasectomy) agrees to practice effective barrier contraception during the entire study period and through 12 months after the last dose of protocol treatment, or agrees to completely abstain from heterosexual intercourse;
- Patient is able to adhere to the study visit schedule and other protocol requirements;
- Written informed consent.
- Untreated patients with a confirmed histologic diagnosis of CD20+ DLBCL according to the WHO classification 2022:
- Exclusion Criteria:
A patient who meets any of the following criteria cannot be included in this study:
- Any of the following B-cell lymphomas according to WHO classification 2022:
- Central Nervous System involvement by DLBCL (Note: high CNS-IPI is allowed)
- Testicular DLBCL;
- Primary mediastinal B-cell lymphoma;
- Epstein-Barr virus (EBV) post-transplant lymphoproliferative disorder;
- Any prior malignancy or present malignancy other than DLBCL that required or requires systemic therapy. Prior surgery or local radiotherapy is allowed in case the heart has not been exposed.
- Patients requiring treatment with mini-R-CHOP
- Pre-existing cardiac disease including:
- LVEF <50% measured with echocardiography (2D or 3D)
- Symptomatic heart failure (NYHA ≥II) or hospitalization for heart failure in the last year;
- Refractory anginal symptoms
- Cardiac arrhythmias not controlled with optimal medical treatment, in case of atrial fibrillation the ventricular response needs to be <110/min;
- Significant valvular dysfunction on echocardiography;
- Non-ischemic cardiomyopathy
- Non-diagnostic/poor transthoracic echocardiography imaging quality at baseline;
- Severe pulmonary dysfunction defined as breathlessness at rest (COPD GOLD III or IV), unless clearly related to DLBCL;
- Severe neurological or psychiatric disease;
- Inadequate hematological function (absolute Neutrophil Count (ANC) <1.0x109/L or platelets <75x109/L), unless clearly related to DLBCL;
- Significant hepatic dysfunction (serum bilirubin or transaminases ≥ 3 times the upper limit of normal) unless related to lymphoma infiltration of the liver;
- Active hepatitis B or C infection (serology testing is required at screening). Patients positive for hepatitis B surface antigen (HBsAg) regardless of antibody status or HBsAg negative but anti-HBc positive are only eligible if HBV-PCR is negative and patients are protected with lamuvidine or entecavir. Patients with positive hepatitis C serology are only eligible if HCV-(RNA) is confirmed negative;
- Significant renal dysfunction (creatinine clearance < 30 ml/min after rehydration) or requiring dialysis;
- Active uncontrolled fungal, bacterial and/or viral infection;
- Patient known to be HIV-positive;
- Breast-feeding female patients;
- Any psychological, familial, sociological and geographical condition potentially hampering compliance with the study protocol and follow-up schedule;
- Participation in another clinical trial with anti-cancer therapy or a cardiovascular drug.
- Any of the following B-cell lymphomas according to WHO classification 2022:
Registration Details
Eligible patients should be registered before start of treatment. Patients need to be registered at HOVON by one of the following options:
- By ALEA> Use goto eCRF button > select the [Patient tab] and click the [Add new patient] button. Complete all items and click the [Submit] button. (A registration manual can be requested at HOVON.)
- By sending the completed registration CRF by e-mail to hovon@erasmusmc.nl, Monday through Friday, from 09:00 to 17:00 CET
- By phone +31.10.7041560 Monday through Friday, from 09:00 to 17:00 CET
Participating Sites
Ziekenhuizen die deelnemen aan het onderzoek staan benoemd op de HOVON website bij het onderzoek. Het kan zijn dat uw ziekenhuis niet genoemd wordt, maar wel aan het onderzoek deelneemt. Informeer hiernaar bij uw arts.