Recruitment

Recruitment Status
Active, not recruiting
Estimated Enrollment
130

Summary

Conditions
  • Ann Arbor Stage I Diffuse Large B-Cell Lymphoma
  • AIDS-Related Plasmablastic Lymphoma
  • AIDS-Related Primary Effusion Lymphoma
  • HIV Infection
  • Plasmablastic Lymphoma
  • Recurrent Grade 3 Follicular Lymphoma
  • Primary Effusion Lymphoma
  • Recurrent Diffuse Large B-Cell Lymphoma
  • Ann Arbor Stage I Grade 3 Follicular Lymphoma
  • Ann Arbor Stage II Diffuse Large B-Cell Lymphoma
  • Ann Arbor Stage II Grade 3 Contiguous Follicular Lymphoma
  • Ann Arbor Stage II Grade 3 Non-Contiguous Follicular Lymphoma
  • Ann Arbor Stage III Diffuse Large B-Cell Lymphoma
  • Ann Arbor Stage III Grade 3 Follicular Lymphoma
  • Ann Arbor Stage IV Diffuse Large B-Cell Lymphoma
  • Ann Arbor Stage IV Grade 3 Follicular Lymphoma
Type
Interventional
Phase
Phase 1Phase 2
Design
Allocation: RandomizedIntervention Model: Parallel AssignmentMasking: None (Open Label)Primary Purpose: Treatment

Participation Requirements

Age
Between 18 years and 125 years
Gender
Both males and females

Description

PRIMARY OBJECTIVES: I. Determine the recommended phase II dose (RPTD) of vorinostat that may be used in combination with dose-adjusted etoposide, prednisone, vincristine sulfate, cyclophosphamide, doxorubicin hydrochloride and rituximab (R-DA-EPOCH) (in high-risk disease) in participants with human ...

PRIMARY OBJECTIVES: I. Determine the recommended phase II dose (RPTD) of vorinostat that may be used in combination with dose-adjusted etoposide, prednisone, vincristine sulfate, cyclophosphamide, doxorubicin hydrochloride and rituximab (R-DA-EPOCH) (in high-risk disease) in participants with human immunodeficiency virus (HIV)-associated aggressive cluster of differentiation (CD)20 positive non-Hodgkin lymphoma (NHL). (Phase I) II. Determine the overall toxicity rates of R-DA-EPOCH (in high-risk disease) with and without vorinostat. (Phase II) III. Determine the efficacy of the combinations of R-DA-EPOCH (in high-risk disease) with and without vorinostat in HIV-associated aggressive CD20 positive NHL using complete response (CR) rates as study endpoints. (Phase II) SECONDARY OBJECTIVES: I. Determine 1-year event-free survival (EFS) and 1 year overall survival (OS). II. Assess the effect of vorinostat and chemotherapy on latent HIV in memory T cells. III. Assess the effect of vorinostat and/or chemotherapy on HIV, Epstein-Barr virus (EBV), and human herpes virus 8 (HHV-8) viral loads on banked specimens. IV. Assess the effect of vorinostat and/or chemotherapy on T-cell subsets (CD4 and CD8) and plasma immunoglobulin levels. V. Assess the effect of concurrent vorinostat and rituximab on plasma steady-state concentrations of etoposide, doxorubicin (doxorubicin hydrochloride), and vincristine (vincristine sulfate) (on Phase I only). VI. Perform wide human gene expression profiling and methylation studies in tumors banked at baseline. VII. Evaluate EBV and HHV-8 gene expression patterns in positive tumors banked at baseline. OUTLINE: This is a phase I, dose-escalation study of vorinostat followed by a phase II study. PHASE I: Patients receive vorinostat orally (PO) once daily (QD) on days 1-5; rituximab intravenously (IV) on day 1; etoposide IV over 24 hours, doxorubicin hydrochloride IV over 24 hours, and vincristine sulfate IV over 24 hours on days 1-4; prednisone PO daily on days 1-5; and cyclophosphamide IV over 1 hour on day 5. Treatment repeats every 21 days for 6 courses in the absence of disease progression or unacceptable toxicity. PHASE II: Patients are randomized to 1 of 2 treatment arms. ARM A (VR-DA-EPOCH): Patients receive vorinostat, rituximab, etoposide, doxorubicin hydrochloride, vincristine sulfate, prednisone, and cyclophosphamide as in Phase I. ARM B (DA-R-EPOCH): Patients receive rituximab, etoposide, doxorubicin hydrochloride, vincristine sulfate, prednisone, and cyclophosphamide as in Arm A. In all arms, treatment repeats every 21 days for 6 courses in the absence of disease progression or unacceptable toxicity. After completion of study therapy, patients are followed up every 3 months for 2 years and then every 6 months for 3 years.

Tracking Information

NCT #
NCT01193842
Collaborators
Not Provided
Investigators
Principal Investigator: Juan C Ramos AIDS Malignancy Consortium