CClinicalTrials.gg
Status unknownNCT00499018DLCL04Updated Feb 15, 2011

Dose Dense Chemotherapy + Rituximab +/-Intensified High Dose Chemoimmunotherapy With Support of Peripheral Autologous Stem Cell in Diffuse Large B-Cell Lymphoma

A Phase 3 interventional study of Rituximab and Ciclofosfamide in Diffuse Large B-Cell Lymphoma and IPI≥2, sponsored by Fondazione Italiana Linfomi - ETS. Status unknown at 75 sites in Italy. Open to participants aged 18 Years to 60 Years. Per ClinicalTrials.gov, last updated 2011-02-15.

Sponsored by Fondazione Italiana Linfomi - ETS · Phase 3, Interventional, and Treatment

The sponsor has not verified this record recently (last verified Feb 2011), so the status shown — last known as Active, not recruiting — may be out of date.
Phase
Phase 3
Study type
Interventional
Enrollment
399
Allocation
Randomized
Ages
18 Years to 60 Years
Sex
All
01

Study summary

The purpose of this study is to define an improvement in patients randomized in four different arms:

Arm 1: R-MegaCHOP14x4 + R-MAD + MAD + BEAM + ASCT; Arm 1BIS: R-CHOP14x4 + R-MAD + MAD + BEAM + ASCT; Arm 2: R-MegaCHOP14x4 + R-MegaCHOP14x2; Arm 2BIS: R-CHOP14x4 + R-CHOP14x4; Which are different in dose dense chemotherapy + Rituximab with or without intensified high dose chemoimmunotherapy and support of peripheral autologous stem cells.

02

Conditions studied

  • Diffuse Large B-Cell Lymphoma
  • IPI≥2

Keywords

  • Large B-Cell Lymphoma
  • Rituximab
  • Autologous Stem Cell Transplantation
03

In context

Lymphoma

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

This study's planned enrollment of 399 is above the median of 40 across 4,508 interventional studies indexed under Lymphoma.

Browse Lymphoma studies →

Lead sponsor

Fondazione Italiana Linfomi - ETS is the lead sponsor of 89 studies on the registry; 23 are open to participants now.

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

04

Who can participate

Ages eligible
18 Years to 60 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  1. Age 18-60;
  2. Histological confirmed diagnosis of Diffuse Large B-Cell Lymphoma CD20+ (newly diagnosis or shifted from low grade NHL and not previously treated) or of Follicular Lymphoma grade III according to REAL/WHO Classification.
  3. Advanced stage II, stage III and stage IV with at least two aa-IPI risk factors.
  4. Age-adjusted IPI 2-3.
  5. ECOG performance status 0-2.
  6. LVEF>45%, measured with echocardiography.
  7. Normal hepatic, renal and pulmonary functions.
  8. HIV, HCV and HBV negativity.
  9. HCV+ admitted only in histologically confirmed absence of replication marks.
  10. Positive serology for HBV (occult carriers: AntiHBcAg+, HbsAg-, AntiHBsAg+/-) admitted only upon negativity of weakly positive HBV-DNA test.
  11. Life expectancy > 3 months.
  12. Negative pregnancy test.
  13. Written Informed Consent.

Exclusion criteria

Exclusion Criteria:

  1. Histological diagnosis of:

    • Lymphoblastic NHL
    • Burkitt's Lymphoma
    • CD 20 negative B-cell Lymphoma
    • grade I-IIIa Follicular Lymphoma
    • Mantle Cell Lymphoma
    • Primary mediastinal NHL with exclusively intrathoracic localization.
  2. Age > 60
  3. Stage I disease
  4. Age-adjusted IPI 0-1
  5. ECOG-PS>3, if not related to Lymphoma
  6. Renal impairment (creatinine>1,2 mg/dl or creatinine clearance \< 60ml/min)
  7. Hepatic impairment (AST/ALT or bilirubin > 2,5 times normal limit, unless due to Lymphoma)
  8. HIV positive patients and/or with HBV or HCV active infection(documented by HBV-DNA and HCV-RNA positive tests)
  9. Clinically significant secondary cardiovascular disease e.g. uncontrolled hypertension (resting diastolic blood pressure > 115 mmHG), uncontrolled multifocal cardiac arrhythmias, symptomatic angina pectoris or congestive cardiac failure NYHA class III-IV
  10. LFEV\<45%
  11. Severe diabetes mellitus difficult to control with adequate insulin therapy
  12. Severe chronic obstructive pulmonary disease with hypoxemia
  13. Active bacterial, viral of fungal infection requiring systemic therapy
  14. Concurrent thrombohemolytic disease
  15. HIV positivity
  16. HBV positivity
  17. Positive serology for HBV (occult carriers: AntiHBc+, HbsAg-, AntiHbs+/-) with positive HBV-DNA test
  18. HCV positivity in presence of replication marks (HCV+, CRP+, AST 1,5-2 times normal ranges)
  19. CNS localization of disease
  20. Prior (during last 3 years) or concurrent malignancy except adequately treated basal cell carcinoma of the skin or carcinoma in situ of the cervix or early stage prostate cancer not requiring systemic therapy, or early breast cancer treated with surgery alone. Any other co.existing medical condition that would preclude study therapy administration
  21. Pregnancy or breast-feeding women
  22. Inability of the patient to give her/his informed consent
  23. Known hypersensitivity or anaphylactic reaction to murine antibodies or proteins
05

Study design

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

Study arms

  • Experimental
    1

    R-MegaCHOP14 x 4 Restaging + R-MAD + MAD + BEAM + ASCT

    Drug: Rituximab · Drug: Ciclofosfamide · Drug: Doxorubicina · Drug: Vincristina · Drug: Prednisone · Drug: Pegfilgrastim · Drug: Mitoxantrone · Drug: ARA-C · Drug: Lenograstim · Drug: BCNU · Drug: VP-16 · Procedure: ASCT

  • Experimental
    1 BIS

    R-CHOP14 x 4 Restaging + R-MAD + MAD + BEAM + ASCT

    Drug: Rituximab · Drug: Vincristina · Drug: Prednisone · Drug: Pegfilgrastim · Drug: Lenograstim · Drug: BCNU · Drug: ARA-C · Drug: VP-16 · Procedure: ASCT · Drug: Ciclofosfamide · Drug: Doxorubicina

  • Experimental
    2

    R-MegaCHOP14 x 4 Restaging + R-MegaCHOP x 2

    Drug: Rituximab · Drug: Ciclofosfamide · Drug: Doxorubicina · Drug: Vincristina · Drug: Prednisone · Drug: Pegfilgrastim · Drug: Mitoxantrone · Drug: ARA-C

  • Experimental
    2 BIS

    R-CHOP14 x 4 Restaging + R-CHOP14 x 4

    Drug: Rituximab · Drug: Vincristina · Drug: Prednisone · Drug: Ciclofosfamide · Drug: Doxorubicina

Interventions

  • DrugRituximab

    375 mg/m2 day 1

  • DrugCiclofosfamide

    1200 mg/m2 day 1

  • DrugDoxorubicina

    70 mg/m2 day 1

  • DrugVincristina

    1,4 mg/m2 (max 2 mg) day 1

  • DrugPrednisone

    100 mg day g 1-5

  • DrugPegfilgrastim

    6 mg day +1

  • DrugMitoxantrone

    8 mg/m2/days 1-3

  • DrugARA-C

    2000 mg/m2/12h day 1 - 3

  • DrugLenograstim

    5 μg/Kg/days +2

  • DrugBCNU

    300 mg/m2 day -7

  • DrugARA-C

    200 mg/m2/12 days -6,-5,-4,-3

  • DrugVP-16

    100 mg/m2/12h days -6,-5,-4,-3

  • ProcedureASCT

    PBSC Reinfusion

  • DrugCiclofosfamide

    750 mg/m2 day 1

  • DrugDoxorubicina

    50 mg/m2 day 1

  • DrugVincristina

    1,4 mg/m2 (max 2 mg) day 1

06

What researchers measure

Primary outcomes

  1. To evaluate the activity of arms "R-MegaCHOP14/R-CHOP14 + R-MAD+BEAM and ASCT" and "R-MegaCHOP14/R-CHOP14" in terms of 2-years Failure Free Survival (FFS).

    Time frame: 2 years

Secondary outcomes

  1. To evaluate the activity of arms "R-MegaCHOP14/R-CHOP14 + R-MAD+BEAM and ASCT" and "R-MegaCHOP14/R-CHOP14" in terms of 3-years Overall Survival (OS).

    Time frame: 3 years

  2. To evaluate the efficacy of two different dose-dense + Rituximab chemotherapy regimens in term of 2-years Failure Free Survival (FFS).

    Time frame: 2 years

  3. To evaluate the activity of the first four courses of two different dose dense + Rituximab chemotherapy regimens (standard dose R-CHOP14 or intensified dose R-MegaCHOP14) in terms of Overall Response Rate (ORR) and Complete Remission (RC).

    Time frame: 2 years

  4. To evaluate the efficacy of the four different induction arms in terms of 2-years FFS (exploratory analysis).

    Time frame: 2 years

07

Study locations

75 sites
  • Ospedale Umberto I - DH Oncoematologico
    Nocera Inferiore, Salerno, Italy
  • Ospedale Civile Umberto I
    Mestre, Venezia, Italy
  • Osp. Calvi, Noale
    Mirano, Venezia, Italy
  • Az. Osp. SS. Antonio e Biagio e Cesare Arrigo
    Alessandria, Italy
  • Ospedale Cardinal Massaia
    Asti, Italy
  • Centro di Riferimento Oncologico
    Aviano - PN, Italy
  • Azienda Ospedale Policlinico Consorziale
    Bari, Italy
  • IRCC Istituto tumori Ematologia
    Bari, Italy
  • Osp. Degli Infermi
    Biella, Italy
  • Ospedale Policlinico S. Orsola Malpighi
    Bologna, Italy
  • Spedali Civili
    Brescia, Italy
  • UTMO Ematologia Università Spedali Civili
    Brescia, Italy
  • Stabilimento "Perrino"
    Brindisi, Italy
  • Ospedale di Circolo
    Busto Arsizio - VA, Italy
  • Ospedale Armando Businco
    Cagliari, Italy
  • Università Cattolica del Sacro Cuore
    Campobasso, Italy
  • IRCC
    Candiolo (TO), Italy
  • Ospedale Pugliese
    Catanzaro, Italy
  • Ospedale Bufalini
    Cesena - FC, Italy
  • Stabilimento Ospedaliero
    Ciriè - TO, Italy
  • Ospedale Generale di Zona
    Civitanova Marche (MC), Italy
  • Presidio Ospedaliero Annunziata
    Cosenza, Italy
  • Istituti Ospitalieri
    Cremona, Italy
  • Az. Ospedaliero Universitaria Careggi
    Firenze, Italy
  • Stabilimento Forlì
    Forlì, Italy
  • Azienda Universitaria San Martino
    Genova, Italy
  • A.S.L. 9
    Ivrea, Italy
  • Ospedale Felettino
    La Spezia, Italy
  • Istituto Vito Fazzi
    Lecce, Italy
  • Azienda Ospedaliera Papardo
    Messina, Italy
  • Azienda Ospedaliero Universitaria Policlinico Gaetano Martino
    Messina, Italy
  • Istituto Europeo di Oncologia
    Milano, Italy
  • Osp. San Carlo Borromeo
    Milano, Italy
  • Ospedale Cà Grande - Niguarda
    Milano, Italy
  • Ospedale Fatebenefratelli
    Milano, Italy
  • Presidio Osp. Maggiore Policlinico
    Milano, Italy
  • Azienda Ospedaliera Policlinico
    Modena, Italy
  • Ospedale S. Gerardo
    Monza, Italy
  • Università degli Studi Federico II
    Napoli, Italy
  • Osp. Maggiore Della Carità
    Novara, Italy
  • Ospedale S. Francesco
    Nuoro, Italy
  • Ospedale San Luigi
    Orbassano (TO), Italy
  • Azienda Ospedaliera
    Padova, Italy
  • Università degli Studi
    Parma, Italy
  • Fond. Maugeri - Centro medico
    Pavia, Italy
  • Ospedale Policlinico San Matteo
    Pavia, Italy
  • Ospedale di Piacenza
    Piacenza, Italy
  • Azienda Ospedaliero Universitaria Pisana
    Pisa, Italy
  • Azienda Ospedaliera Ospedale San Carlo
    Potenza, Italy
  • Ospedale Santa Maria delle Croci
    Ravenna, Italy
  • Ospedale Bianchi Melacrino Morelli
    Reggio Calabria, Italy
  • Ospedale Santa Maria Nuova
    Reggio Emilia, Italy
  • Ospedale Oncologico Regionale
    Rionero in Vulture (PZ), Italy
  • Istituto Regina Elena
    Roma, Italy
  • Ospedale S. Eugenio
    Roma, Italy
  • Policlinico Universitario A. Gemelli
    Roma, Italy
  • Policlinico Universitario Campus Biomedico
    Roma, Italy
  • Università degli Studi di Roma "La Sapienza"
    Roma, Italy
  • Università degli Studi di Roma 'Tor Vergata'
    Roma, Italy
  • Ospedale di Ronciglione
    Ronciglione (VT), Italy
  • Istituto Clinico Humanitas
    Rozzano - MI, Italy
  • Casa Sollievo della Sofferenza
    San Giovanni Rotondo (FG), Italy
  • Ospedale SS.Annunziata
    Sassari, Italy
  • Spedali Riuniti
    Siena, Italy
  • Ospedale Morelli
    Sondalo, Italy
  • Stabilimento SS. Annunziata
    Taranto, Italy
  • Azienda Ospedaliera di Perugia
    Terni, Italy
  • Osp. S. Giovanni Battista "Molinette"
    Torino, Italy
  • Ospedale Ca Focello
    Treviso, Italy
  • Presidio Ospedaliero di Vittorio Veneto
    Treviso, Italy
  • Ospedale Generale Prov. Cardinale G. Panico
    Tricase (LE), Italy
  • Policlinico Universitario
    Udine, Italy
  • Osp. di Circolo e Fondazione Macchi
    Varese, Italy
  • Stabilimento Ospedaliero
    Verbania, Italy
  • Osp. Sant'Andrea Divisioen di Onco-Ematologia
    Vercelli, Italy
08

References and documents

Publications

  • Derenzini E, Mazzara S, Melle F, Motta G, Fabbri M, Bruna R, Agostinelli C, Cesano A, Corsini CA, Chen N, Righi S, Sabattini E, Chiappella A, Calleri A, Fiori S, Tabanelli V, Cabras A, Pruneri G, Vitolo U, Gianni AM, Rambaldi A, Corradini P, Zinzani PL, Tarella C, Pileri S. A three-gene signature based on MYC, BCL-2 and NFKBIA improves risk stratification in diffuse large B-cell lymphoma. Haematologica. 2021 Sep 1;106(9):2405-2416. doi: 10.3324/haematol.2019.236455. PubMed 32817282 ↗
  • Chiappella A, Martelli M, Angelucci E, Brusamolino E, Evangelista A, Carella AM, Stelitano C, Rossi G, Balzarotti M, Merli F, Gaidano G, Pavone V, Rigacci L, Zaja F, D'Arco A, Cascavilla N, Russo E, Castellino A, Gotti M, Congiu AG, Cabras MG, Tucci A, Agostinelli C, Ciccone G, Pileri SA, Vitolo U. Rituximab-dose-dense chemotherapy with or without high-dose chemotherapy plus autologous stem-cell transplantation in high-risk diffuse large B-cell lymphoma (DLCL04): final results of a multicentre, open-label, randomised, controlled, phase 3 study. Lancet Oncol. 2017 Aug;18(8):1076-1088. doi: 10.1016/S1470-2045(17)30444-8. Epub 2017 Jun 28. PubMed 28668386 ↗
09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Feb 15, 2011, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT00499018
Lead sponsor
Fondazione Italiana Linfomi - ETS
Collaborators
Centro di Riferimento per l'Epidemiologia e la Prev. Oncologica Piemonte
First posted
Jul 11, 2007
Start date
Jan 2006
Primary completion
Jun 2011 (estimated)
Completion
Sep 2013 (estimated)
Last update
Feb 15, 2011

Study contacts

Umberto Vitolo, MD
principal investigator · S.C. Ematologia II - OSP.S. GIOV.BATTISTA MOLINETTE - TORINO (TO) -

Oversight

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

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