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CompletedNCT00227695Updated May 15, 2019

Rituximab in Treating Patients With Follicular Non-Hodgkin's Lymphoma

A Phase 3 interventional study of rituximab in Lymphoma, sponsored by Swiss Group for Clinical Cancer Research. Completed at 26 sites in 7 countries. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2019-05-15.

Sponsored by Swiss Group for Clinical Cancer Research · Phase 3, Interventional, and Treatment

From the registry’s dates

  • Registered 1 year 3 months after the study started (first participant enrolled Jun 2004, registered Sep 2005).
Phase
Phase 3
Study type
Interventional
Enrollment
270
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

RATIONALE: Monoclonal antibodies, such as rituximab, 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. It is not yet known whether giving rituximab over a short period of time is more effective than giving it over a long period of time in treating follicular non-Hodgkin's lymphoma.

PURPOSE: This randomized phase III trial is studying rituximab to see how well it works when given over a short period of time compared to when given over a long period of time in treating patients with follicular non-Hodgkin's lymphoma.

Read the detailed description

OBJECTIVES:

Primary

  • Compare the efficacy of induction therapy with rituximab followed by short- vs long-term maintenance therapy with rituximab, in terms of event-free survival, in patients with follicular non-Hodgkin's lymphoma.

Secondary

  • Compare the safety of these regimens in these patients.
  • Compare the pharmaeconomical aspects of these regimens in these patients.
  • Compare the evolution of immunologic competence in patients treated with these regimens.

OUTLINE: This is a randomized, multicenter study.

  • Induction therapy: Patients receive rituximab IV weekly in weeks 1-4 and undergo restaging between weeks 11-13. Patients with stable disease or progressive disease are taken off study. Patients achieving partial or complete response are stratified according to prior treatment status (untreated* vs treated with or without anti-CD20 therapy), presence of bulky disease** at study entry (yes vs no), and participating center. Patients are then randomized to 1 of 2 maintenance treatment arms.

NOTE: *Patients treated with radiotherapy only are considered as therapy-naïve.

NOTE: **Defined as a mass or lymph node conglomerate ≥ 5 cm diameter.

  • Maintenance therapy: Patients start maintenance therapy within 7 days of randomization.

    • Arm I: Patients receive rituximab IV every 2 months for 4 treatments.
    • Arm II: Patients receive rituximab IV every 2 months for up to 5 years in the absence of disease progression or unacceptable toxicity.

After completion of study treatment, patients are followed every 3 months until disease progression or relapse and then annually for up to 10 years after randomization.

PROJECTED ACCRUAL: A total of 270 patients will be accrued for this study within 3 years.

02

Conditions studied

  • Lymphoma

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Keywords

  • stage I grade 1 follicular lymphoma
  • stage I grade 2 follicular lymphoma
  • stage I grade 3 follicular lymphoma
  • stage III grade 1 follicular lymphoma
  • stage III grade 2 follicular lymphoma
  • stage III grade 3 follicular lymphoma
  • stage IV grade 1 follicular lymphoma
  • stage IV grade 2 follicular lymphoma
  • stage IV grade 3 follicular lymphoma
  • contiguous stage II grade 1 follicular lymphoma
  • contiguous stage II grade 2 follicular lymphoma
  • contiguous stage II grade 3 follicular lymphoma
  • noncontiguous stage II grade 1 follicular lymphoma
  • noncontiguous stage II grade 2 follicular lymphoma
  • noncontiguous stage II grade 3 follicular lymphoma
  • recurrent grade 1 follicular lymphoma
  • recurrent grade 2 follicular lymphoma
  • recurrent grade 3 follicular lymphoma
03

In context

Lymphoma

5,578 studies on the registry are indexed under Lymphoma; 825 are open to participants now.

This study's enrollment of 270 is above the median of 40 across 4,508 interventional studies indexed under Lymphoma.

Browse Lymphoma studies →

Lead sponsor

Swiss Group for Clinical Cancer Research is the lead sponsor of 107 studies on the registry; none are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Eligibility criteria

DISEASE CHARACTERISTICS:

  • Histologically confirmed follicular lymphoma

    • Grade 1, 2, 3a, or 3b disease by WHO staging system
  • CD20-positive by immunohistochemistry
  • Previously untreated disease OR meets 1 of the following criteria for response to prior treatment:

    • Chemotherapy-resistant disease
    • Relapsed or progressive disease
    • Stable disease

      • At least 12 weeks since prior systemic treatment
  • At least 1 bidimensionally measurable lesion ≥ 11 mm by CT scan or MRI
  • No transformation to high-grade lymphoma secondary to low-grade follicular lymphoma
  • No prior or current CNS disease (i.e., CNS lymphoma or lymphomatous meningosis) NOTE: A new classification scheme for adult non-Hodgkin's lymphoma has been adopted by PDQ. The terminology of "indolent" or "aggressive" lymphoma will replace the former terminology of "low", "intermediate", or "high" grade lymphoma. However, this protocol uses the former terminology.

PATIENT CHARACTERISTICS:

Age

  • 18 and over

Performance status

  • WHO 0-2

Life expectancy

  • Not specified

Hematopoietic

  • Not specified

Hepatic

  • Not specified

Renal

  • Not specified

Cardiovascular

  • Ejection fraction ≥ 50% by echocardiography or MUGA

Immunologic

  • No acute or ongoing infection
  • No HIV infection
  • No active autoimmune disease

Other

  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception during and for 12 months after completion of the study treatment
  • No uncontrolled diabetes mellitus
  • No other medical condition that would preclude study participation
  • No other malignancy except nonmelanoma skin cancer or adequately treated carcinoma in situ of the cervix
  • No other condition (e.g., geographic proximity) that would preclude study compliance and follow-up

PRIOR CONCURRENT THERAPY:

Biologic therapy

  • See Radiotherapy
  • Prior rituximab allowed

Chemotherapy

  • See Disease Characteristics

Endocrine therapy

  • More than 4 weeks since prior regular administration of corticosteroids

    • Dose equivalent to ≤ 20 mg/day prednisone allowed for conditions other than lymphoma or lymphoma-related symptoms
  • No concurrent corticosteroids for prevention or treatment of side effects except acute life-threatening side effects

Radiotherapy

  • Prior radiolabeled anti-CD20 therapy (administered alone or in combination with cytostatic drugs) allowed provided patient has achieved partial or complete response after the therapy

    • At least 12 months since prior anti-CD20 therapy

Surgery

  • Not specified

Other

  • More than 30 days since prior systemic tumor therapy
  • More than 30 days since prior participation in another clinical trial
  • No other concurrent anticancer therapy
05

Study design

Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
270 participants (actual)

Study arms

  • Active comparator
    Arm A: Rituximab every 2 months x4

    Rituximab 375 mg/m2 every 2 months x4

    Biological: rituximab

  • Active comparator
    Arm B: Rituximab (5 years)

    Rituximab 375 mg/m2 every 2 months for 5 years or until PD, relapse or unacceptable toxicity

    Biological: rituximab

Interventions

  • Biologicalrituximab

    comparing two maintenance schedules of Rituximab

    Also known as: MABTHERA

06

What researchers measure

Primary outcomes

  1. Event-free survival

    Time frame: at 10 years

Secondary outcomes

  1. Progression-free survival

    Time frame: at 10 years

  2. Overall survival

    Time frame: at 10 years

  3. Adverse reactions during and after maintenance treatment

    Time frame: 10 years

07

Study locations

26 sites
  • Clinical Center - Institute of Hematology
    Sao Paulo, Brazil
  • Istituto Europeo di Oncologia IEO
    Milano, 20141, Italy
  • Clinical Center Skopje
    Skopje, 1000, North Macedonia
  • Clinical Center of Serbia
    Belgrade, SCG-11000, Serbia
  • NOU - National Institute for Oncology
    Bratislava, 83310, Slovakia
  • Panorama Medical Centre
    Cape Town, 7500, South Africa
  • Sandton Oncology Centre
    Johannesburg, 2121, South Africa
  • Kantonspital Aarau
    Aarau, CH-5001, Switzerland
  • Kantonsspital Baden
    Baden, CH-5404, Switzerland
  • St. Claraspital AG
    Basel, CH-4016, Switzerland
  • Universitaetsspital Basel
    Basel, CH-4031, Switzerland
  • Istituto Oncologico della Svizzera Italiana - Ospedale Regionale Bellinzona e Valli
    Bellinzona, 6500, Switzerland
  • Inselspital Bern
    Bern, 3010, Switzerland
  • Breitenbach Praxis Dr. Haberthür
    Breitenbach, 4226, Switzerland
  • Kantonsspital Bruderholz
    Bruderholz, CH-4101, Switzerland
  • Kantonsspital Graubuenden
    Chur, CH-7000, Switzerland
  • Hopital Cantonal Universitaire de Geneve
    Geneva, CH-1211, Switzerland
  • Centre Hospitalier Universitaire Vaudois
    Lausanne, CH-1011, Switzerland
  • Kantonsspital
    Liestal, CH-4410, Switzerland
  • Istituto Oncologico della Svizzera Italiana
    Lugano, CH-6900, Switzerland
  • Hôpital Pourtalès
    Neuchâtel, 2002, Switzerland
  • Kantonsspital - St. Gallen
    St. Gallen, CH-9007, Switzerland
  • SpitalSTS AG Simmental-Thun-Saanenland
    Thun, 3600, Switzerland
  • City Hospital Triemli
    Zurich, 8063, Switzerland
  • Klinik Hirslanden
    Zurich, CH-8032, Switzerland
  • UniversitaetsSpital Zuerich
    Zurich, CH-8091, Switzerland
08

References and documents

Publications

  • Taverna CJ, Baasi S, Hitz F, et al.: First results of long-term rituximab maintenance treatment in follicular lymphoma: safety analysis of the randomized phase III trial SAKK 35/03. [Abstract] J Clin Oncol 27 (Suppl 15): A-8534, 2009.
  • First results of long term rituximab maintenance treatment in follicular lymphoma: safety analysis of the randomized phase III trial SAKK 35/03. F. Hitz, S. Bassi, C. Taverna, W. Mingrone, T. Pabst, L. Cevreska, A. Del Giglio, D.A. Vorobiof, M. Simcock, M. Ghielmini Haematologica (2009) 94: s2; abstract 0413
  • First results of long term rituximab maintenance treatment in follicular lymphoma: safety analysis of the randomized phase III trial SAKK 35/03. C.J. Taverna, S. Bassi, F. Hitz, W. Mingrone, T. Pabst, L. Cevreska, A. del Giglio, D.A. Vorobiof, M. Simcock, M. Ghielmini J Clin Oncol (2009) 27: 15s supplement; abstract 8534
  • Rituximab maintenance treatment for a maximum of 5 years in follicular lymphoma: safety analysis of the randomized phase III trial SAKK 35/03. C. J. Taverna, S. Bassi, F. Hitz, W. Mingrone, T. Pabst, L. Cevreska, A. del Giglio, D.A. Vorobiof, M. Simcock, M. Ghielmini Blood (2010) 116: ASH Annual Meeting abstracts; abstract 1802
  • Taverna C, Martinelli G, Hitz F, Mingrone W, Pabst T, Cevreska L, Del Giglio A, Vanazzi A, Laszlo D, Raats J, Rauch D, Vorobiof DA, Lohri A, Biaggi Rudolf C, Rondeau S, Rusterholz C, Heijnen IA, Zucca E, Ghielmini M. Rituximab Maintenance for a Maximum of 5 Years After Single-Agent Rituximab Induction in Follicular Lymphoma: Results of the Randomized Controlled Phase III Trial SAKK 35/03. J Clin Oncol. 2016 Feb 10;34(5):495-500. doi: 10.1200/JCO.2015.61.3968. Epub 2015 Dec 28. PubMed 26712227 ↗

Individual participant data

Plan to share: No

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on May 15, 2019, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT00227695
Lead sponsor
Swiss Group for Clinical Cancer Research
Responsible party
Sponsor
First posted
Sep 28, 2005
Start date
Jun 8, 2004
Primary completion
May 3, 2013
Completion
Dec 19, 2017
Last update
May 15, 2019

Study contacts

Christian Taverna, MD
study chair · Kantonsspital Münsterlingen
Michele Ghielmini, Prof.
study chair · IOSI - Ospedale San Giovanni, Bellinzona

Oversight

Data monitoring committee
No
View the source record on ClinicalTrials.gov ↗

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This study is completed, as verified in May 2019. You cannot join it, but the record below documents what was studied.

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