Extranodal NK/T-cell Lymphoma, Nasal Type
Conditions
Keywords
GAD-M regimen, first line chemotherapy, NK/T-cell Lymphoma
Brief summary
The purpose of this study is to evaluate the efficacy and safety of High dose of Methotrexate combined with gemcitabine, pegaspargase and dexamethasone (GAD-M regimen) as first-line treatment in patients with de novo extranodal NK/T cell lymphoma.
Detailed description
Studies have shown that effects of P glycoprotein mediated chemotherapy resistance reduce the therapeutic efficacy of anthracycline-based chemotherapy of NK/T cell lymphoma, and agents like pegaspargase and large doses of Methotrexate is not affected by the P glycoprotein. A number of reports suggest that gemcitabine combined with other chemotherapy drugs has good application prospect in the treatment of lymphomas. Dexamethasone is used in combination with other agents for the treatment of lymphomas which may be implicated in the development or growth of some cancers. So we explored to evaluate the efficacy and safety of High dose of methotrexate combined with gemcitabine, pegaspargase and dexamethasone (GAD-M regimen) as first-line treatment in patients with untreated extranodal NK/T cell lymphoma.
Interventions
DRUGHigh dose of methotrexate
Methotrexate 3.0g/Kg, intravenous drip D1
DRUGGemcitabine
Gemcitabine 1g/m2 intravenous drip D1,D8
DRUGPegaspargase
Pegaspargase 2500U/m2 intramuscular injection (IM) D1
DRUGDexamethasone
Dexamethasone 20mg/d intravenous drip D1, po D2-3
Sponsors
Eli Lilly and Company
Sun Yat-sen University
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* Histologic diagnosis of NK/T Cell Lymphoma; * Age:18-80 years; * Weight：Male：67±20Kg（47-87Kg），Female：55±20Kg（35-75Kg） * Eastern Cooperative Oncology Group (ECOG) status 0-3, Estimated survival time \> 3 months; * No history of other malignancies; No other current tumors； * Normal haematological, liver and renal function (WBC count≥3.5×109/L, Hemoglobin≥100g/L, platelet count≥90×109/L, bilirubin\<1.5×ULN, Alanine transaminase (ALT) and Aspartate Aminotransferase (AST)\<2.5×ULN, serum creatinine\<1.5×ULN), normal coagulation function and cardiac function; * Clinical staging I-IV； * No previous treatments including chemotherapy, radiotherapy, targeted therapy or stem cell transplantation; * Appreciable and measurable lesions, clinical assessment \>2cm，CT or MRI \>1.5cm; * No other serious diseases which conflict with the treatment in the present trial; * No concurrent treatments that conflict with the treatments in the present trial(including steroid drugs); * Voluntary participation and signed the informed consent.
Exclusion criteria
* The patients had the conditions below: clinically significant ventricular tachycardia (VT), atrial fibrillation (AF), heart block, myocardial infarction (MI), congestive heart failure (CHF), symptomatic coronary artery heart disease requiring medication; * The patients suffered from organ transplant * The patients participated in other clinical trials within the 30 days before enrollment or who are participating in other clinical studies; * The patients with active bleeding or new thrombotic disease, who are taking anticoagulant drugs or with a history of bleeding tendencies，who with active infection; * The patients suffered before surgery less than four weeks, or after less than six weeks; * The patients with abnormal liver function (total bilirubin\> 1.5 times the normal value, ALT / AST\> 2.5 times normal), abnormal renal function (serum creatinine\> 1.5 times normal), blood abnormalities (absolute neutrophil count \<1.5 × 109 / L, platelets \<80 × 109 / L, hemoglobin \<90g /L) ; * The patients with mentally ill / unable to obtain informed consent; * The patients with drug addiction, alcohol abuse which affects the long-term evaluation of test results; * The patients in pregnancy, lactation and women of childbearing age who do not want to take contraceptive measures subjects; * Clinical and laboratory support brain metastases; * The patients with a history of allergy or adverse reaction(s) to test drug; * The patients not suitable to participate in the investigator judged by researchers.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Overall Response Rate (ORR) | every 6 weeks, up to completion of treatment (approximately 6 months) | 21 days (3 weeks) for one cycle, Efficacy was evaluated every two cycles |
Secondary
| Measure | Time frame |
|---|---|
| Progress Free Survival (PFS) | up to end of follow-up-phase (approximately 5 years) |
| Overall Survival (OS) | up to the date of death (approximately 5 years) |
Other
| Measure | Time frame | Description |
|---|---|---|
| Urinary microglobulin β2 | every 3 weeks,up to completion of treatment(approximately 6 months) | 21 days(3 weeks) for one cycle |
| lymphocyte count | every 3 weeks,up to completion of treatment(approximately 6 months) 21 | 21 days(3 weeks) for one cycle |
| The number of participants with adverse events of grade 3-4 | every 3 weeks, up to completion of treatment (approximately 6 months) | 21 days (3 weeks) for one cycle, Toxicity was evaluated every cycle |
| C reactive protein | every 3 weeks,up to completion of treatment(approximately 6 months) | 21 days(3 weeks) for one cycle |
| Monocyte Count | every 3 weeks,up to completion of treatment(approximately 6 months) | 21 days(3 weeks) for one cycle |
| Epstein-Barr virus(EBV) DNA copies and antibodies | every 3 weeks,up to completion of treatment(approximately 6 months) | 21 days(3 weeks) for one cycle |
| Plasma β2-microglobulin | every 3 weeks,up to completion of treatment(approximately 6 months) | 21 days(3 weeks) for one cycle |
Countries
China
Outcome results
None listed