A Phase II Trial Involving Patients With Recurrent PCNSL Treated With Carboplatin/BBBD, by Adding Rituxan (Rituximab), An Anti CD-20 Antibody, To The Treatment Regimen
Rituxan
+ Cyclophosphamide
+ Etoposide
Cytopenia+14
+ Blood Platelet Disorders
+ Hematologic Diseases
Treatment Study
Summary
Study start date: January 1, 2003
Actual date on which the first participant was enrolled.OBJECTIVES: Primary * Determine the efficacy of rituximab, carboplatin, cyclophosphamide, etoposide or etoposide phosphate and cytarabine administered in conjunction with osmotic blood-brain barrier disruption and high-dose sodium thiosulfate, in terms of complete response rate, in patients with refractory or recurrent primary CNS lymphoma. Secondary * Determine the overall survival and 2-year progression-free survival of patients treated with this regimen. * Determine the quality of life and cognitive function of patients treated with this regimen. * Determine the neurotoxicity of this regimen in these patients. * Determine the percentage of patients with ototoxicity over time after treatment with this regimen. * Determine the effect of delayed administration of sodium thiosulfate on granulocyte and erythrocyte counts in these patients. OUTLINE: This is a multicenter study. Patients receive rituximab IV on day 1. On days 2 and 3, patients receive carboplatin intra-arterially over 10 minutes, cyclophosphamide IV over 10 minutes, and etoposide or etoposide phosphate IV over 10 minutes in conjunction with blood-brain barrier disruption. Patients also receive high-dose sodium thiosulfate IV over 15 minutes administered 4 and 8 hours after carboplatin on days 2 and 3 and intraventricular or intrathecal cytarabine on day 14. Beginning 48 hours after the last dose of chemotherapy, patients receive filgrastim (G-CSF)\* subcutaneously (SC) daily for 7-10 days or until blood counts recover. Treatment repeats every 4 weeks for up to 12 courses. NOTE: \* Alternatively, patients may receive a single dose of pegfilgrastim SC, administered 48 hours after the completion of chemotherapy Patients with intraocular lymphoma also receive methotrexate intravitreally twice weekly until the vitreous is clear of cells by slit lamp exam; once weekly for 1 month; and then monthly for 1 year. Quality of life is assessed at baseline, every 3 months during treatment, within 30 days of final treatment, then every 6 months for 1 year, and then annually thereafter. Patients are followed monthly for 3 months, every 2 months for 8 months, every 3 months for 1 year, and then every 6 months thereafter. PROJECTED ACCRUAL: A total of 11-25 patients will be accrued for this study within 7-10 years.
Protocol
This section provides details of the study plan, including how the study is designed and what the study is measuring.17 patients to be enrolled
Total number of participants that the clinical trial aims to recruit.Treatment Study
Eligibility
Researchers look for people who fit a certain description, called eligibility criteria: person's general health condition or prior treatments.Any sex
Biological sex of participants that are eligible to enroll.From 18 Months to 75 Years
Range of ages for which participants are eligible to join.Healthy volunteers not allowed
If individuals who are healthy and do not have the condition being studied can participate.Conditions
Pathology
Criteria
INCLUSION CRITERIA: * Signed informed consent form in accordance with institutional guidelines * Histologically or cytologically confirmed primary CNS lymphoma documented by brain biopsy or cerebrospinal fluid or vitrectomy analysis * CD20 positive disease * Progressive or relapsed disease during or after completion of prior methotrexate-based chemotherapy * Aged 18 months to 75 years * Performance status ECOG 0-3 OR Karnofsky 30-100% * Hematocrit at least 25% (transfusion or epoetin alfa allowed) * Absolute granulocyte count at least 1,200/mm\^3 * Platelet count at least 100,000/mm\^3 OR at least lower limit of normal * Bilirubin no greater than 2.0 times upper limit of normal * Creatinine less than 1.8 mg/dL * Calculated Creatinine clearance (CrCl) at least 50 mL/min * Adequate cardiac function to tolerate general anesthesia * Adequate pulmonary function to tolerate general anesthesia * Available for follow-up for 1 year post therapy * Fertile patients must use effective contraception for a minimum of 2 months before and during study participation EXCLUSION CRITERIA: * Radiographic signs of intra-cranial herniation and/or spinal block * HIV positive * Systemic lymphoma * Positive serum HCG, pregnant or lactating * Allergy to study agents * Hepatitis B or hepatitis C positive
Study Plan
Find out more about all the medication administered in this study, their detailed description and what they involve.One single intervention group is designated in this study
This study does not include a placebo group
Treatment Groups
Group I
ExperimentalStudy Objectives
Primary Objectives
Secondary Objectives
Study Centers
These are the hospitals, clinics, or research facilities where the trial is being conducted. You can find the location closest to you and its status.This study has 2 locations
Good Samaritan Hospital Cancer Treatment Center, Hatton Institute
Cincinnati, United StatesSee the locationKnight Cancer Institute at Oregon Health and Science University
Portland, United States