NCT00822120
S0816 Fludeoxyglucose F 18-PET/CT Imaging and Combination Chemotherapy With or Without Additional Chemotherapy and G-CSF in Treating Patients With Stage III or Stage IV Hodgkin Lymphoma
PHASE2
COMPLETED
NCT00822120
INTERVENTIONAL
A Phase II Trial of Response-Adapted Therapy of Stage III-IV Hodgkin Lymphoma Using Early Interim FDG-PET Imaging
RATIONALE: Drugs used in chemotherapy work in different ways to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Giving more than one drug (combination chemotherapy) may kill more cancer cells. G-CSF may help lessen the side effects in patients receiving chemotherapy. Imaging procedures, such as fludeoxyglucose F 18-PET/CT imaging, may help doctors predict how patients will respond to treatment.
PURPOSE: This phase II trial is studying fludeoxyglucose F 18-PET/CT imaging to see how well it works in assessing response to combination chemotherapy and allow doctors to plan better additional further treatment in treating patients with stage III or stage IV Hodgkin lymphoma.
DISEASE CHARACTERISTICS:
* Histologically confirmed classical Hodgkin lymphoma (HL) (i.e., nodular sclerosis, mixed cellularity, lymphocyte-rich, or lymphocyte-depleted)
* Previously untreated stage III or IV disease
* No nodular lymphocyte predominant disease
* Bidimensionally measurable disease
* Adequate biopsy samples from original diagnostic specimen must be available for pathologic review
* Tissue obtained from core biopsies allowed
* No tissue obtained from needle aspirations or cytologies
* Must have known HIV status
* No multi-drug resistant HIV infection, CD4 counts \< 150/μL, or other concurrent AIDS-defining conditions in HIV-positive patients
* HIV-positive patients with CD4 counts ≥ 150/μL at the time of enrollment OR documented CD4 count \> 250/μL at any time within 8 months prior to HL diagnosis allowed
* Must have undergone unilateral or bilateral bone marrow biopsy within the past 42 days
* Must have a diagnostic quality CT scan of the chest/abdomen and pelvis AND baseline FDG-PET scan within the past 28 days
* Combined PET/CT scans required
* No older "stand-alone" FDG-PET scans
* No low-resolution "localization" CT scans as part of a combined PET/CT scans
PATIENT CHARACTERISTICS:
* Zubrod performance status 0-2
* Serum erythrocyte sedimentation rate, lactate dehydrogenase (LDH), hemoglobin, albumin, white blood cell count (WBC), and lymphocytes measured within the past 28 days
* Serum estradiol (women only), testosterone (men only), follicle stimulating hormone (FSH) and luteinizing hormone (LH) (both men and women) levels must be drawn within 60 days prior to registration
* Not pregnant or nursing
* Fertile patients must use effective contraception during and for ≥ 6 months after completion of study therapy
* No significant cardiac abnormalities as assessed by multiple gated acquisition scan (MUGA) or ECHO AND cardiac ejection fraction ≥ 45% in patients with a history of hypertension or cardiac symptoms
* Hepatitis B-negative (i.e., hepatitis B surface antigen-negative or anti-hepatitis B core antigen-negative)
* Patients immune to or immunized against hepatitis B (i.e., anti-hepatitis B surface antibody-positive) are eligible
* Hepatitis C-negative (i.e., anti-hepatitis C antibody-negative)
* No significant lung disease with abnormal lung function tests (i.e., diffusing capacity of lung for carbon monoxide (DLCO) \> 25% below predicted after correction for hemoglobin) unless attributable to lymphoma
* No requirement for continuous supplemental oxygen therapy
* No other prior malignancy except adequately treated basal cell or squamous cell skin cancer, in situ cervical cancer, adequately treated stage I or II cancer from which the patient is currently in complete remission, or any other cancer from which the patient has been disease-free for 5 years
PRIOR CONCURRENT THERAPY:
* See Disease Characteristics
* No prior chemotherapy, radiotherapy, or antibody therapy for lymphoma
* No prior solid organ transplantation
Lymphoma
Nonneoplastic Condition
- TREATMENT
-
- Type: BIOLOGICAL
- Name: bleomycin sulfate
- Description:
- Arm Group Labels: HIV Negative, PET Negative: ABVD, HIV Negative, PET Positive: BEACOPP escalated, HIV Positive, PET Negative: ABVD, HIV Positive, PET Positive: BEACOPP standard
-
- Type: BIOLOGICAL
- Name: filgrastim
- Description:
- Arm Group Labels: HIV Negative, PET Positive: BEACOPP escalated
-
- Type: DRUG
- Name: ABVD regimen
- Description:
- Arm Group Labels: HIV Negative, PET Negative: ABVD, HIV Positive, PET Negative: ABVD
-
- Type: DRUG
- Name: BEACOPP regimen
- Description:
- Arm Group Labels: HIV Negative, PET Positive: BEACOPP escalated, HIV Positive, PET Positive: BEACOPP standard
-
- Type: DRUG
- Name: cyclophosphamide
- Description:
- Arm Group Labels: HIV Negative, PET Positive: BEACOPP escalated, HIV Positive, PET Positive: BEACOPP standard
-
- Type: DRUG
- Name: dacarbazine
- Description:
- Arm Group Labels: HIV Negative, PET Negative: ABVD, HIV Positive, PET Negative: ABVD
-
- Type: DRUG
- Name: doxorubicin hydrochloride
- Description:
- Arm Group Labels: HIV Negative, PET Negative: ABVD, HIV Negative, PET Positive: BEACOPP escalated, HIV Positive, PET Negative: ABVD, HIV Positive, PET Positive: BEACOPP standard
-
- Type: DRUG
- Name: etoposide
- Description:
- Arm Group Labels: HIV Negative, PET Positive: BEACOPP escalated, HIV Positive, PET Positive: BEACOPP standard
-
- Type: DRUG
- Name: prednisone
- Description:
- Arm Group Labels: HIV Negative, PET Positive: BEACOPP escalated, HIV Positive, PET Positive: BEACOPP standard
-
- Type: DRUG
- Name: procarbazine hydrochloride
- Description:
- Arm Group Labels: HIV Negative, PET Positive: BEACOPP escalated, HIV Positive, PET Positive: BEACOPP standard
-
- Type: DRUG
- Name: vinblastine sulfate
- Description:
- Arm Group Labels: HIV Negative, PET Negative: ABVD, HIV Positive, PET Negative: ABVD
-
- Type: DRUG
- Name: vincristine sulfate
- Description:
- Arm Group Labels: HIV Negative, PET Positive: BEACOPP escalated, HIV Positive, PET Positive: BEACOPP standard
- SWOG Cancer Research Network