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Brief Title: Rituximab in Treating Patients With Newly Diagnosed Stage II, Stage III, or Stage IV Follicular Non-Hodgkin's Lymphoma
Official Title: An Intergroup Randomised Trial of Rituximab Versus a Watch and Wait Strategy in Patients With Advanced Stage, Asymptomatic, Non-Bulky Follicular Lymphoma
Study ID: NCT00112931
Brief Summary: RATIONALE: Monoclonal antibodies, such as rituximab, can block cancer growth in different ways. Some block the ability of cancer cells to grow and spread. Others find cancer cells and help kill them or carry cancer-killing substances to them. It is not yet known whether rituximab is more effective than observation in treating non-Hodgkin's lymphoma. PURPOSE: This randomized phase III trial is studying rituximab to see how well it works compared to observation in treating patients with newly diagnosed stage II, stage III, or stage IV follicular non-Hodgkin's lymphoma with no symptoms.
Detailed Description: OBJECTIVES: Primary * Compare time to initiation of systemic chemotherapy or radiotherapy in patients with newly diagnosed, previously untreated, asymptomatic stage II-IV non-bulky follicular non-Hodgkin's lymphoma treated with rituximab vs observation only. Secondary * Compare the frequency of clinical spontaneous remission in patients treated with these regimens. * Compare overall and cause-specific survival of patients treated with these regimens. * Determine the effect of rituximab on complete and partial response in patients treated with subsequent systemic chemotherapy. * Compare quality of life, in terms of functional well-being and anxiety and depression, of patients treated with these regimens. OUTLINE: This is a randomized, multicenter study. Patients are stratified according to participating center, disease grade (1 vs 2 vs 3a), disease stage (II vs III vs IV), and age. Patients are randomized to 1 of 3 treatment arms. * Arm I: Patients undergo observation only until disease progression. * Arm II: Patients receive induction rituximab IV on day 1. Treatment repeats weekly for up to 4 weeks. * Arm III: Patients receive induction rituximab as in arm II. Patients then receive maintenance rituximab IV once on day 1 of weeks 12, 20, 28, 36, 44, 52, 60, 68, 76, 84, 92, and 100. In all arms, treatment continues in the absence of unacceptable toxicity or disease progression requiring systemic chemotherapy\* or radiotherapy. NOTE: \*Rituximab administration in arm I is considered initiation of systemic chemotherapy Quality of life is assessed at baseline (before and after randomization), every 2 months for 2 years, and then every 6 months for 2 years. Patients are followed every 2 months for 2 years and then every 3 months thereafter. Peer Reviewed and Funded or Endorsed by Cancer Research UK PROJECTED ACCRUAL: A total of 600 patients (200 per treatment arm) will be accrued for this study within 3 years.
Minimum Age: 18 Years
Eligible Ages: ADULT, OLDER_ADULT
Sex: ALL
Healthy Volunteers: No
Queen Elizabeth Hospital, Adelaide, , Australia
Royal Adelaide Hospital, Adelaide, , Australia
Ashford Cancer Centre, Black Forest, , Australia
Boxhill Hospital, Box Hill, , Australia
Royal Brisbane and Women's Hospital, Brisbane, , Australia
Canberra Hospital, Canberra, , Australia
Concord Repatriation General Hospital, Concord, , Australia
Frankston Hospital, Frankston, , Australia
Fremantle Hospital, Fremantle, , Australia
Gosford Hospital, Gosford, , Australia
Royal Hobart Hospital, Hobart, , Australia
Nepean Hospital, Kingswood, , Australia
Lismore Base Hospital, Lismore, , Australia
Liverpool Hospital, Liverpool, , Australia
Alfred Hospital, Melbourne, , Australia
Austin Health, Melbourne, , Australia
Peter MacCallum Cancer Centre, Melbourne, , Australia
St Vincent's Hospital, Melbourne, , Australia
Mater Misericordiae Hospital, Newcastle, , Australia
Royal Perth Hospital, Perth, , Australia
Royal North Shore Hospital, St Leonards, , Australia
St Vincent's Hospital, Sydney, , Australia
Westmead Hospital, Westmead, , Australia
Murray Valley Private Hospital, Wodonga, , Australia
Wollongong Hospital, Wollongong, , Australia
Princess Alexandra Hospital, Woolloongabba, , Australia
Auckland Hospital, Auckland, , New Zealand
Middlemore Hospital, Auckland, , New Zealand
Christchurch Hospital, Christchurch, , New Zealand
North Shore Hospital, Westlake, , New Zealand
Birmingham Heartlands Hospital, Birmingham, England, United Kingdom
Blackpool Victoria Hospital, Blackpool, England, United Kingdom
West Suffolk Hospital, Bury St. Edmunds, England, United Kingdom
Kent and Canterbury Hospital, Canterbury, England, United Kingdom
St. Helier Hospital, Carshalton, England, United Kingdom
Royal Devon and Exeter Hospital, Exeter, England, United Kingdom
Queen Elizabeth Hospital, Gateshead, England, United Kingdom
Medway Maritime Hospital, Gillingham, England, United Kingdom
Hemel Hempstead General, Hemel Hempstead, England, United Kingdom
Hull Royal Infirmary, Hull, England, United Kingdom
West Middlesex University Hospital, Isleworth, England, United Kingdom
Kettering General Hosptial, Kettering, England, United Kingdom
Kidderminster Hospital, Kidderminster, England, United Kingdom
Queen Elizabeth Hospital, King's Lynn, England, United Kingdom
Leicester Royal Infirmary, Leicester, England, United Kingdom
St. George's Hospital, London, England, United Kingdom
Maidstone Hospital, Maidstone, England, United Kingdom
Sir James Spence Institute of Child Health at Royal Victoria Infirmary, Newcastle-Upon-Tyne, England, United Kingdom
Mount Vernon Cancer Centre at Mount Vernon Hospital, Northwood, England, United Kingdom
Rosemere Cancer Centre at Royal Preston Hospital, Preston, England, United Kingdom
Alexandra Healthcare NHS, Redditch, England, United Kingdom
Oldchurch Hospital, Romford, England, United Kingdom
Pembury Hospital, Royal Tunbridge Wells, England, United Kingdom
Southampton General Hospital, Southampton, England, United Kingdom
Staffordshire General Hospital, Stafford, England, United Kingdom
Royal Marsden - Surrey, Sutton, England, United Kingdom
Torbay Hospital, Torquay, England, United Kingdom
Royal Cornwall Hospital, Truro, England, United Kingdom
Weston General Hospital, Weston-super-Mare, England, United Kingdom
Worcester Royal Hospital, Worcester, England, United Kingdom
Aberdeen Royal Infirmary, Aberdeen, Scotland, United Kingdom
Monklands General Hospital, Airdrie, Scotland, United Kingdom
Hairmyres Hospital, East Kilbride, Scotland, United Kingdom
Edinburgh Cancer Centre at Western General Hospital, Edinburgh, Scotland, United Kingdom
Southern General Hospital, Glasgow, Scotland, United Kingdom
Raigmore Hospital, Inverness, Scotland, United Kingdom
Royal Alexandra Hospital, Paisley, Scotland, United Kingdom
Wishaw General Hospital, Wishaw, Scotland, United Kingdom
Velindre Cancer Center at Velindre Hospital, Cardiff, Wales, United Kingdom
Prince Charles Hospital, Merthyr Tydfil, Wales, United Kingdom
Glan Clwyd Hospital, Rhyl, Wales, United Kingdom
South West Wales Cancer Institute, Swansea, Wales, United Kingdom
Name: Kirit Ardeshna
Affiliation: Mount Vernon Cancer Centre at Mount Vernon Hospital
Role: STUDY_CHAIR