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TerminatedNCT01510184Updated Dec 16, 2021Results posted

Study of Zevalin Versus Observation in Participants at Least 60 Years Old With Newly Diagnosed Diffuse Large B-cell Lymphoma in Positron Emission Tomography (PET)-Negative Complete Remission After Rituximab-Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone (R-CHOP) or R-CHOP-like Therapy

A Phase 3 interventional study of Zevalin and Y-90-Zevalin in Diffuse Large B-cell Lymphoma and Follicle Center Lymphoma, sponsored by Spectrum Pharmaceuticals, Inc. Terminated at 93 sites in 13 countries. Open to participants aged 60 Years and older. Per ClinicalTrials.gov, last updated 2021-12-16.

Sponsored by Spectrum Pharmaceuticals, Inc · Phase 3, Interventional, and Treatment

Phase
Phase 3
Study type
Interventional
Enrollment
79
Allocation
Randomized
Ages
60 Years and older
Sex
All
01

Study summary

The purpose of this study is to evaluate the efficacy and safety of Zevalin compared with observation alone in participants who are in PET-negative complete remission after first-line R-CHOP or R-CHOP like therapy.

02

Conditions studied

  • Diffuse Large B-cell Lymphoma
  • Follicle Center Lymphoma
03

In context

Lymphoma

5,577 studies on the registry are indexed under Lymphoma; 824 are open to participants now.

This study's enrollment of 79 is above the median of 40 across 4,507 interventional studies indexed under Lymphoma.

Browse Lymphoma studies →

Lead sponsor

Spectrum Pharmaceuticals, Inc is the lead sponsor of 59 studies on the registry; 1 is open to participants now.

Of its 17 completed or terminated interventional studies of FDA-regulated products, 12 (71%) have results posted.

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

04

Who can participate

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

Inclusion criteria

  1. Participant was 60-years of age or older at time of randomization
  2. Histologically confirmed Ann Arbor stage II, III, or IV diffuse large B-cell lymphoma (DLBCL); or follicular lymphoma (FCL) Grade 3B according to the Revised European American lymphoma (REAL)/ World health organization (WHO) classification (from initial diagnosis made prior to starting R-CHOP therapy. Results from a pre R-CHOP marrow shall be available for review.
  3. Local pathology review confirming the DLBCL diagnosis and cluster of differentiation 20 (CD20) positivity, and no evidence of DLBCL in bone marrow upon confirmation of complete remission (CR).
  4. A paraffin block or original slides available for confirmatory pathology review. Participants may be randomized based on the local pathology result.
  5. Age-adjusted international prognostic index (IPI) of 1, 2, or 3. The age-adjusted IPI was defined by one point for Lactate dehydrogenase (LDH) > upper limit of normal (ULN); Stage III or IV; and Karnofsky performance status \<80% or WHO/ eastern cooperative operations group (ECOG) performance status >1.
  6. First-line treatment of DLBCL must have been 6 cycles of standard R-CHOP21, R-CHOP14 or dose-adjusted etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin, and rituximab (DA-EPOCH-R) chemotherapy. Participants who received pre-phase therapy for the purpose of improving performance status prior to initiating R-CHOP are eligible.
  7. Complete remission (CR) according to the International Workshop Response Criteria for non-Hodgkin's lymphoma (NHL) described by Cheson et al after first-line treatment. Computerized tomography (CT) scans of chest, abdomen, pelvis, and neck (if applicable) must have been performed within 6 weeks after the last dose of the last course of chemotherapy. Applicability of the neck CT means that the participant had involvement of the neck region by palpation / physical examination at first diagnosis.
  8. A negative Fluorine-18-deoxyglucose positron emission tomography (FDG-PET) scan confirming complete response, with negative defined as a score of 1-3 on the Deauville 5-point scale used to quantify radionucleotide density in PET scans as determined locally (Morschhauser 200735).
  9. Bone marrow cellularity greater than 15%, no evidence of myelodysplasia morphologically and no evidence of involvement with lymphoma either at the pre R-CHOP marrow or on repeat assessment pre-Zevalin. After completing R-chemotherapy, a repeat marrow is required for participant randomized to the Zevalin arm only.
  10. A world health organization/eastern cooperative oncology group (WHO/ECOG) performance status of 0, 1 or 2.
  11. Adequate hematopoietic functions: Absolute neutrophil count (ANC) ≥ 1.0 x 10\^9/ liter (L), Hemoglobin (Hgb) ≥ 9 g/dL, Platelets ≥ 100 x 10\^9/L.
  12. Life expectancy of 6 months or longer.
  13. Written informed consent obtained according to local guidelines.

Exclusion criteria

Exclusion Criteria:

  1. Presence of any other malignancy or history of prior malignancy within 5 years of study entry. Within 5 years, participants treated for Stage I or II cancers are eligible provided they have a life expectancy of > 5 years. The 5-year exclusion rule does not apply to-non melanoma skin tumors and in situ cervical cancer.
  2. Prior radioimmunotherapy, including radiation therapy for Non-Hodgkin's lymphoma) NHL, or any other NHL therapy.
  3. Presence of primary gastric, central nervous system (CNS), or testicular lymphoma at first diagnosis.
  4. Histological transformation of low-grade NHL.
  5. Active hepatitis B or C.
  6. Known history of human immunodeficiency virus (HIV) infection.
  7. Abnormal liver function: total bilirubin > 2 × ULN unless secondary to Gilbert disease.
  8. Abnormal renal function: serum creatinine > 2.0 × ULN.
  9. Non-recovery from the toxic effects of chemotherapy to \< grade 2, or interfering with Zevalin treatment.
  10. Known hypersensitivity to murine or chimeric antibodies or proteins.
  11. Granulocyte-colony stimulating factor (G-CSF) or Granulocyte macrophage-colony stimulating factor (GM-CSF) therapy within 4 weeks prior to Zevalin or observation.
  12. Concurrent severe and/or medically uncontrolled disease (e.g. uncontrolled diabetes, congestive heart failure, myocardial infarction within 6 months of study, unstable and uncontrolled hypertension, chronic renal disease, or active uncontrolled infection) which could compromise participation in the study.
  13. Treatment with investigational drugs less than 4 weeks prior to Zevalin or observation.
  14. Major surgery less than 4 weeks prior to Zevalin or start of observation.
  15. Concurrent systemic corticosteroid use for any reason except as premedication in case of known or suspected allergies to contrast media or as premedication for potential side effects of rituximab treatment. Participants on a chronic dose of prednisone for a medical condition (e.g. Asthma or autoimmune disease) less than or equal to 20 milligram (mg) daily, stable for 4 weeks, are permissible.
  16. Unwillingness or inability to comply with the protocol.
05

Study design

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

Study arms

  • Experimental
    Zevalin

    Participants received rituximab 250 milligram per meter square (mg/m\^2) by intravenous infusion on Day 1. If required by the governing regulatory agency, rituximab was to be followed 4 hours later by In-111-Zevalin 5.0 millicurie (mCi) on Day 1. And on Days 7-9: participants received rituximab 250 mg/m\^2 by intravenous infusion, followed 4 hours later by Y-90-Zevalin 0.4 millicurie/kilogram (mCi/kg) 10-minute intravenous push (0.3 mCi/kg in participants with a platelet count in 100,000/ microliter \[μL\] to 149,000/μL).

    Drug: Zevalin · Drug: Y-90-Zevalin · Drug: Rituximab · Drug: In-111 Zevalin

  • No intervention
    Observation

    Participants who were randomized in this arm group did not receive any anti-lymphoma therapy unless they had a relapse of their disease.

Interventions

  • DrugZevalin

    Zevalin administered intravenous infusion.

    Also known as: Ibritumomab Tiuxetan

  • DrugY-90-Zevalin

    Y-90-Zevalin administered by intravenous infusion.

  • DrugRituximab

    Rituximab administered by intravenous infusion.

  • DrugIn-111 Zevalin

    In-111-Zevalin administered by intravenously.

06

What researchers measure

Primary outcomes

  1. Overall Survival (OS) for Living Participants

    OS was the time from randomization to death. In living participants, survival time was censored on the last date that participants were known to be alive. OS for living participant was calculated as (end of study date/last visit date - randomization date)+ 1/30.4375. Overall Survival was summarized separately for living participants as only few participants died in this study.

    Time frame: From randomization till death or end of study, whichever occurs first (Up to approximately 2.5 years)

  2. Overall Survival for Death

    OS was the time from randomization to death. OS for death calculated as (date of death - randomization date)+ 1/30.4375. Overall Survival was summarized separately for participants who were died as only few participants died in this study.

    Time frame: From randomization till death or end of study, whichever occurs first (Up to approximately 2.5 years)

Secondary outcomes

  1. Progression-Free Survival (PFS)

    PFS was defined as the time interval between the date of randomization and the date of relapse or death from any cause.

    Time frame: From randomization till death or end of study, whichever occurs first (Up to approximately 2.5 years)

  2. Overall Survival Rate at 24 Months

    The OS rate at 24-month defined as the percentage of all randomized participants who died within 24 months of randomization.

    Time frame: 24 Months

07

Results

Posted Dec 16, 2021
Limitations and caveats
The study was terminated early due to a sponsor business decision.

Participant flow

A total of 79 participants were enrolled into the study from 19 Apr 2012 to 23 Oct 2014.

Participant flow — Overall Study
MilestoneZevalinObservation
Started3643
Completed68
Not completed3035
Withdrew: Sponsor discretion2828
Withdrew: Death12
Withdrew: Withdrawal by subject14
Withdrew: Other01

Outcome measures

PrimaryOverall Survival (OS) for Living Participants

OS was the time from randomization to death. In living participants, survival time was censored on the last date that participants were known to be alive. OS for living participant was calculated as (end of study date/last visit date - randomization date)+ 1/30.4375. Overall Survival was summarized separately for living participants as only few participants died in this study.

Time frame:
From randomization till death or end of study, whichever occurs first (Up to approximately 2.5 years)
Reported as:
Median · months
Overall Survival (OS) for Living Participants
monthsZevalinObservation
Overall Survival (OS) for Living Participants8.90 (2.73 to 22.60)6.14 (0.07 to 21.32)
PrimaryOverall Survival for Death

OS was the time from randomization to death. OS for death calculated as (date of death - randomization date)+ 1/30.4375. Overall Survival was summarized separately for participants who were died as only few participants died in this study.

Time frame:
From randomization till death or end of study, whichever occurs first (Up to approximately 2.5 years)
Reported as:
Median · months
Overall Survival for Death
monthsZevalinObservation
Overall Survival for Death16.76 (16.76 to 16.76)5.82 (1.94 to 9.69)
SecondaryProgression-Free Survival (PFS)

PFS was defined as the time interval between the date of randomization and the date of relapse or death from any cause.

Time frame:
From randomization till death or end of study, whichever occurs first (Up to approximately 2.5 years)

No measurements were reported for this outcome.

SecondaryOverall Survival Rate at 24 Months

The OS rate at 24-month defined as the percentage of all randomized participants who died within 24 months of randomization.

Time frame:
24 Months

No measurements were reported for this outcome.

Adverse events

Collected over From first dose up to approximately 2.5 years. Non-serious events are listed at a 5% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Zevalin1/36 (2.8%)8/36 (22.2%)21/36 (58.3%)
Observation2/43 (4.7%)3/43 (7%)7/43 (16.3%)
Most frequent serious events
Showing 10 of 11
Most frequent serious events
EventZevalinObservation
NeutropeniaBlood and lymphatic system disorders4/361/43
ThrombocytopeniaBlood and lymphatic system disorders2/360/43
Platelet count decreasedInvestigations2/360/43
DeathGeneral disorders0/362/43
LeukopeniaBlood and lymphatic system disorders1/360/43
Lung infectionInfections and infestations1/360/43
Lymphocyte count decreasedInvestigations1/360/43
SyncopeNervous system disorders1/360/43
HypotensionVascular disorders1/360/43
Depressed level of consciousnessNervous system disorders0/361/43
Most frequent other events
Showing 10 of 20
Most frequent other events
EventZevalinObservation
FatigueGeneral disorders10/362/43
ThrombocytopeniaBlood and lymphatic system disorders6/360/43
NeutropeniaBlood and lymphatic system disorders6/361/43
Platelet count decreasedInvestigations6/360/43
Neutrophil count decreasedInvestigations6/360/43
White blood cell count decreasedInvestigations6/360/43
AnaemiaBlood and lymphatic system disorders5/360/43
ConstipationGastrointestinal disorders5/360/43
NauseaGastrointestinal disorders4/361/43
Lymphocyte count decreasedInvestigations4/360/43

Baseline characteristics

Safety population included all randomized participants classified according to the actual study treatment received, regardless of random assignment.

Age, Continuous
Age, Continuous(years)ZevalinObservationTotal
Mean69 ± 1.0271 ± 1.0670 ± 0.75
Sex: Female, Male
Sex: Female, Male(Participants)ZevalinObservationTotal
Female202242
Male162137
08

Study locations

93 sites
  • Cancer Treatment Services Arizona
    Casa Grande, Arizona 85122, United States
  • Sutter East Bay Hospitals
    Berkeley, California 94704, United States
  • City of Hope
    Duarte, California 91010, United States
  • Halifax Health Medical Center
    Daytona Beach, Florida 32114, United States
  • H. Lee Moffitt Cancer Center
    Tampa, Florida 33612, United States
  • Piedmont Hospital Cancer Center
    Atlanta, Georgia 30318, United States
  • St. Luke's Mountain States Tumor Institute (MSTI)
    Boise, Idaho 83712, United States
  • Northwestern University Feinberg School of Medicine
    Chicago, Illinois 60611, United States
  • Rush University Medical Center
    Chicago, Illinois 60612, United States
  • Decatur Memorial Hospital Cancer Care Specialists of Central Illinois
    Decatur, Illinois 62526, United States
  • Illinois Cancer Specialists
    Niles, Illinois 60714, United States
  • Midwestern Regional Medical Center
    Zion, Illinois 60099, United States
  • University of Iowa Hospitals and Clinics
    Iowa City, Iowa 52242, United States
  • Norton Cancer Institute, Suburban
    Louisville, Kentucky 40207, United States
  • Beth Israel Deaconess Medical Center
    Boston, Massachusetts 02215, United States
  • St. John Hospital and Medical Center
    Grosse Pointe Woods, Michigan 48236, United States
  • Oncology Research-Park Nicollet Institute
    Saint Louis Park, Minnesota 55426, United States
  • Saint Louis University
    Saint Louis, Missouri 63110, United States
  • Comprehensive Cancer Centers of Nevada
    Henderson, Nevada 89044, United States
  • Hackensack UMC / John Theurer Cancer Center
    Hackensack, New Jersey 07601, United States
  • Memorial Sloan-Kettering Cancer Center
    New York, New York 10065, United States
  • Adams Cancer center
    Gettysburg, Pennsylvania 17325, United States
  • York Cancer Center / Cancer Care Associates of York
    York, Pennsylvania 17403, United States
  • Saint Francis Hospital
    Greenville, South Carolina 29601, United States
  • Avera Hematology and Transplant
    Sioux Falls, South Dakota 57105, United States
  • Associates In Oncology and Hematology
    Chattanooga, Tennessee 37421, United States
  • The University of Texas M.D. Anderson Cancer Center
    Houston, Texas 77030, United States
  • Seattle Cancer Care Alliance
    Seattle, Washington 98109, United States
  • Royal Hobart Hospital
    Hobart, Tasmania 7001, Australia
  • Royal Melbourne
    Parkville, Victoria 3052, Australia
  • Royal Adelaide Hospital
    Adelaide, Australia
  • Barwon Health
    Geelong, 3220, Australia
  • Western Hospital
    Melbourne, Australia
  • Medizinische Universität Wien -AKH Wien
    Vienna, A-1090, Austria
  • Nuclear Medicine Physician, Jules Bordet Institute
    Bruxelles, 1000, Belgium
  • University Hospital Gasthuisberg
    Leuven, 3000, Belgium
  • Thunder Bay Regional Health Sciences Centre-Regional Cancer Care
    Thunder Bay, Ontario P7B 6V4, Canada
  • Sunnybrook Research Institute
    Toronto, Ontario, Canada
  • CSSS Champlain Charles LeMoyne
    Greenfield Park, Quebec J4V2H1, Canada
  • CHU A Michallon
    Grenoble, Cedex 9 38043, France
  • CHU Dupuytren
    Limoges, Cedex 87042, France
  • CHU Amiens, Hôpital Sud
    Amiens, 80054, France
  • CH Avignon
    Avignon, 84902, France
  • CH de la Côte Basque, Service d'Hématologie
    Bayonne, 64109, France
  • Hématologie - CHU Jean Minjoz
    Besancon, 25030, France
  • Institut Bergonié
    Bordeaux, 33076, France
  • Hopital MORVAN - CHU Brest
    Brest, 29609, France
  • Centre François Baclesse, Comite Hématologie
    Caen, 14076, France
  • Hôpital Henri MONDOR
    Creteil, 94010, France
  • CHD Vendée
    La Roche-sur-Yon, 85925, France
  • CHRU Lille- Hospital Claude Huriez
    Lille, 59037, France
  • Institut Paoli-Calmettes
    Marseille, 13273, France
  • CHR Metz-Thionville
    Metz, 57085, France
  • CH de Mulhouse - Hôpital Emile Muller
    Mulhouse, 68100, France
  • Centre Antoine Lacassagne
    Nice, 06189, France
  • CHR Orléans
    Orleans, 45100, France
  • Institut Curie
    Paris, 75005, France
  • Centre Hospitalier Saint Jean
    Perpignan, 66000, France
  • Hôpital Haut-Levêque Centre F.Magendie
    Pessac, 33600, France
  • Centre Hospitalier René Dubos,
    Pontoise, 95303, France
  • Service d'Hématologie Centre Henri Becquerel
    Rouen, 76038, France
  • CHU de Brabios
    Vandoeuvre-les-nancy, 54511, France
  • St James 's Hospital
    Dublin, 8, Ireland
  • University Hospital Galway
    Galway, Ireland
  • Soroka Medical Centre
    Beersheba, 84101, Israel
  • Rambam Health Care Campus
    Haifa, Israel
  • Hadassah Medical Organization
    Jerusalem, 91120, Israel
  • Shaare Zedek Medical Center
    Jerusalem, 93722, Israel
  • Tel Aviv Sourasky Medical Centre
    Tel Aviv, 64239, Israel
  • Chaim Sheba Medical Center
    Tel-Hashomer, 52621, Israel
  • Policlinico S Orsola Malpighi, Istituto di Ematologia ''L.e A. Seragnoli''
    Bologna, 40138, Italy
  • New Ematologia dell'Ospedale "Spedali Civili" di Brescia
    Brescia, 25123, Italy
  • Divisione di Ematoncologia
    Milano, 20141, Italy
  • Azienda Ospedaliera Sant'Andrea
    Roma, 00189, Italy
  • Azienda Ospedaliera San. Giovanni Battista di Torino, Dipartimento di Oncologia U.O.A Ematologia, Le Molinette,
    Torino, 10126, Italy
  • Meander Medisch Centrum
    Amersfoort, 3813 TZ, Netherlands
  • VU Medisch Centrum
    Amsterdam, 1081, Netherlands
  • Haga Ziekenhuis
    Den Haag, 2545 CH, Netherlands
  • University Medical Centre Groningen (UMCG)
    Groningen, 9713GZ, Netherlands
  • Spaarne Ziekenhuis, Internal Medicine/Ocology
    Hoofddorp, 2134TM, Netherlands
  • Medisch Centrum Leeuwarden
    Leeuwarden, 8934 AD, Netherlands
  • St. Antonius Hospital
    Nieuwegein, 3435 CM, Netherlands
  • University Medical Center Radboud Nijmegen
    Nijmegen, 6525, Netherlands
  • Erasmus Medisch Centrum
    Rotterdam, NL-3015, Netherlands
  • Auxilio Mutuo Cancer Center
    San Juan, 00918, Puerto Rico
  • Clínica Universidad de Navarra (CUN)
    Pamplona, Spain
  • Hospital Universitario Miguel Servet
    Zaragoza, 50009, Spain
  • Miguel Servet University Hospital
    Zaragoza, Spain
  • Department of Haematology Bristol Royal Infirmary
    Bristol, BS2 8HW, United Kingdom
  • Poole General Hospital
    Dorset, BH15, United Kingdom
  • Beatson Cancer Centre
    Glasgow, G12 0YN, United Kingdom
  • King's College Hospital
    London, SE5 9RS, United Kingdom
  • The Christie NHS Foundation Trust, The Christie Hospital,
    Manchester, M20 4BX, United Kingdom
09

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

10

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Dec 16, 2021, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
11

Registry details

Key details

Study ID
NCT01510184
Lead sponsor
Spectrum Pharmaceuticals, Inc
Responsible party
Sponsor
First posted
Jan 13, 2012
Start date
Apr 19, 2012
Primary completion
Oct 23, 2014
Completion
Oct 23, 2014
Results posted
Dec 16, 2021
Last update
Dec 16, 2021

Oversight

Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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