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Brief Title: Randomized, Open-label, Two-arms, Phase III Comparative Study Assessing the Role of Involved Mediastinal Radiotherapy After Rituximab Containing Chemotherapy Regimens to Patients With Newly Diagnosed Primary Mediastinal Large B-Cell Lymphoma
Official Title: IELSG37: A Randomized, Open-label, Multicentre, Two-arm Phase III Comparative Study Assessing the Role of Involved Mediastinal Radiotherapy After Rituximab Containing Chemotherapy Regimens to Patients With Newly Diagnosed Primary Mediastinal Large B-Cell Lymphoma (PMLBCL)
Study ID: NCT01599559
Brief Summary: Primary mediastinal large B cell lymphoma is treated with a combination of chemotherapy and the monoclonal antibody rituximab (chemoimmunotherapy). Following chemoimmunotherapy patients receive radiation therapy if they have residues which may be active tumour. However at the end of chemoimmunotherapy the majority of patients show tissue scarring that is not necessarily active tumor. In recent years, PET/CT has proved to be a good tool to accurately identify active tumor from scar tissue in patients treated for mediastinal lymphoma.The purpose of this trial is to test whether radiation therapy is really necessary in patients where PET/CT has shown that the tumor is no longer active. Therefore we will compare radiation treatment with careful observation. Patients that at the end of conventional treatment of chemoimmunotherapy have a negative PET/CT (i.e., without residues suspected to contain active tumor), will randomly assigned to two different treatment groups: one treatment group will receive the radiation treatment, and the other treatment group will receive careful observation. The trial is planned according to a non-inferiority design aimed at demonstrating that progression free survival after the experimental treatment (observation) is not worse than after the standard comparator (mediastinal irradiation.Participation in this study could spare patients with complete remission at the end of chemo immunotherapy (PET/CT negative) radiation therapy that may be unnecessary.
Detailed Description:
Minimum Age: 18 Years
Eligible Ages: ADULT, OLDER_ADULT
Sex: ALL
Healthy Volunteers: No
Norton Cancer Institute, Louisville, Kentucky, United States
Mayo Clinil Rocheser, Rochester, Minnesota, United States
MD Anderson Cancer Center, Houston, Texas, United States
Centro de Hematologia y Oncologia Pavlovsky, Buenos Aires, , Argentina
Princess Margaret Hospital, Toronto, , Canada
Ruijin Hospital, Shanghai, , China
Faculty Hospital Brno, Brno, , Czechia
University Hospital, Hradec Kralove, , Czechia
Faculty Hospital Kralovske Vinohrady, Prague, , Czechia
General University Hospital, Prague, , Czechia
University of Duisburg-Essen, Campus Essen, Essen, , Germany
A.O. SS. Antonio e Biagio e Cesare Arrigo, Alessandria, , Italy
Clinica di Ematologia Ospedali Riuniti "Umberto I", Ancona, , Italy
Centro di Riferimento Oncologico - Aviano, Aviano, , Italy
A.O.U Policlinico Consorziale di Bari, Bari, , Italy
Bari IRCCS Istituto Tumori, Bari, , Italy
Ospedale Mons. Dimiccoli, Barletta, , Italy
Ospedale Papa Giovanni Xxiii, Bergamo, , Italy
Sant'Orsola Malpighi, Bologna, , Italy
Comprensorio Sanitario di Bolzano, Bolzano, , Italy
Spedali Civili, Brescia, , Italy
Asl Uoc Ematologia A Perrino, Brindisi, , Italy
Ospedale Businco, Cagliari, , Italy
AO Garibaldi Nesima Catalia, Catania, , Italy
Ospedale S. Croce e Carle, Cuneo, , Italy
Unità Funzionale di Ematologia AOU Careggi, Firenze, , Italy
U.O. Ematologia Vito Fazzi, Lecce, , Italy
Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola, , Italy
SC Ematologia Azienda Ospedali Riuniti Papardo Piemonte, Messina, , Italy
Istituto Scientifico San Raffaele, Milano, , Italy
Milano Ieo, Milano, , Italy
SC Ematologia AO Niguarda, Milano, , Italy
AOU Policlinico di Modena, Modena, , Italy
Ematologia Università degli Studi di Federico II, Napoli, , Italy
Ospedale Umberto I, Nocera, , Italy
Azienda Ospedaliera Universitaria, Padova, , Italy
Ospedali Riuniti Villa Sofia, Palermo, , Italy
AOU di Parma, Parma, , Italy
Fondazione IRCCS S. Matteo, Pavia, , Italy
S.C. Ematologia Ospedale S. Marid Della Misericordia, Perugia, , Italy
Ospedale Civile di Pescara, Pescara, , Italy
Ospedale Civico Guglielmo di Saliceto, Piacenza, , Italy
Ospedale San Carlo di Potenza, Potenza, , Italy
U.O. Oncologia Ematologia Ospedale S. Maria Delle Croci, Ravenna, , Italy
A.O. Bianchi-Melacrino-Morelli, Divisione di Ematologia, Reggio Calabria, , Italy
ICCRS Azienda Ospedaliera Arcipedale "Santa Maria Nuova", Reggio Emilia, , Italy
Ospedale Degli Infermi, Rimini, , Italy
Fondazione PTV Policlinico Tor Vergata, Roma, , Italy
AO San Camillo Forlanini, Roma, , Italy
AOU S. Andrea Roma, Roma, , Italy
Ospedale S. Eugenio, Roma, , Italy
Policlinico Universitario Campus Bio-Medico, Roma, , Italy
Roma Regina Elena IFO, Roma, , Italy
Roma San Giovanni, Roma, , Italy
Università degli Studi La Sapienza, Roma, , Italy
Rozzano Humanitas, Rozzano, , Italy
Siena, Siena, , Italy
AOS Maria di Terni, Terni, , Italy
AOS S. Giovanni Battista "Molinette", Torino, , Italy
Azienda Ospedaliera Citta Della Salute E Della Scienza Di Torino, Torino, , Italy
Ospedale Cardinale Panico, Tricase, , Italy
Azienda Ospedaliera Univesritaria, Udine, , Italy
Asst Settelaghi Ospedale Macchi, Varese, , Italy
Oslo University Hospital, Oslo, , Norway
St Olavs Hospital, Trondheim, , Norway
Warsaw Centrum Onkologi Instytucie, Warsaw, , Poland
Istituto Portugues de Oncologia de Lisboa, Lisboa, , Portugal
Lund Universitet, Lund, , Sweden
IOSI, Bellinzona, , Switzerland
Inselspital Bern, Bern, , Switzerland
Kantonsspital Olten, Olten, , Switzerland
Kantonsspital, St Gallen, , Switzerland
Kyiv National Cancer Institute, Kiev, , Ukraine
Basingstoke & North Hamptshire Hospital, Basingstoke, , United Kingdom
Birmingham Heartlands Hospital, Birmingham, , United Kingdom
Glasgow Beatson Cancer Center, Glasgow, , United Kingdom
Leeds St. James's Hospital, Leeds, , United Kingdom
Royal Liverpool University Hospital, Liverpool, , United Kingdom
Guy's & St. Thomas London, London, , United Kingdom
UCLH St. Thomas, London, , United Kingdom
Manchester The Christie NHS Foundation Trust, Manchester, , United Kingdom
Newcastle Freeman Hospital, Newcastle, , United Kingdom
Norfolk & Norwich University Hospital, Norfolk, , United Kingdom
Nottingham University Hospital, Nottingham, , United Kingdom
General Hospital, Southampton, , United Kingdom
Name: Maurizio Martelli, MD
Affiliation: Università La Sapienza (Rome - Italy)
Role: STUDY_CHAIR
Name: Andrew J Davies, MD
Affiliation: University of Southampton (UK)
Role: STUDY_CHAIR
Name: Mary Gospodarowicz, MD
Affiliation: Princess Margaret Hospital Toronto (Canada)
Role: STUDY_CHAIR
Name: Sally F Barrington, MD
Affiliation: St. Thomas' - London (UK)
Role: STUDY_CHAIR
Name: Alberto Biggi, MD
Affiliation: AO S. Croce e Carle, Cuneo (Italia)
Role: STUDY_CHAIR
Name: Annibale Versari, MD
Affiliation: S.Maria Nuova Hospital, Reggio Emilia (Italia)
Role: STUDY_CHAIR
Name: Gianni Ciccone, MD
Affiliation: CPO Torino (Italy)
Role: STUDY_CHAIR
Name: Stèphane Chauvie, MD
Affiliation: AO S. Crtoce e Carle - Cuneo (Italy)
Role: STUDY_CHAIR
Name: Luca Ceriani, MD
Affiliation: IOSI - Bellinzona (Switzerland)
Role: STUDY_CHAIR