Interferon for Lymphomatoid Granulomatosis

No longer recruiting at 1 trial location
NM
CJ
Overseen ByChristopher J Melani, M.D.
Age: Any Age
Sex: Any
Trial Phase: Phase 2
Sponsor: National Cancer Institute (NCI)
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)
Prior Safety DataThis treatment has passed at least one previous human trial

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores the effectiveness of a protein called alpha-interferon in treating lymphomatoid granulomatosis (LYG), a condition where certain cells damage the lungs, skin, kidneys, and central nervous system. Participants will receive either alpha-interferon or a combination of chemotherapy drugs, including EPOCH and Rituximab, based on the severity of their condition. The trial aims to assess the impact of these treatments on LYG and enhance understanding of the disease. Individuals diagnosed with LYG who are interested in new treatment options might be suitable candidates for the trial. As a Phase 2 trial, the research focuses on evaluating the treatment's effectiveness in an initial, smaller group of people.

Do I have to stop taking my current medications for the trial?

The trial information does not specify if you need to stop taking your current medications. It's best to discuss your specific medications with the trial team to get a clear answer.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research has shown that interferon alfa-2b effectively treats low-grade lymphomatoid granulomatosis (LYG). In past studies, many patients experienced lasting remission, with significant and prolonged symptom improvement. However, interferon can cause flu-like side effects, such as headaches, fever, chills, and body aches.

EPOCH-R chemotherapy includes several drugs: etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin, and rituximab. These drugs may cause side effects like nausea, hair loss, and weakness. Rituximab can sometimes lead to more serious issues, such as severe skin reactions and hepatitis B reactivation. Patients might also experience bone pain due to G-CSF, a medication that helps bone marrow recover between chemotherapy sessions.

Both treatment options have been studied for safety, but they do have potential side effects that participants should consider. Always consult a healthcare provider to determine the best course of action.12345

Why are researchers excited about this trial's treatments?

Researchers are excited about these treatments for lymphomatoid granulomatosis because they offer different approaches from the standard therapies like chemotherapy and monoclonal antibodies alone. Interferon is unique because it boosts the immune system by increasing the body's defense cells, potentially leading to a longer-lasting remission. EPOCH-R combines several chemotherapy drugs with rituximab, a monoclonal antibody, which targets and destroys specific cancer cells, offering a comprehensive attack on the disease. Unlike traditional treatments, these approaches can potentially enhance effectiveness and provide options for patients who don't respond to standard care.

What evidence suggests that this trial's treatments could be effective for lymphomatoid granulomatosis?

Research has shown that interferon alfa-2b effectively treats lymphomatoid granulomatosis (LYG), particularly in its milder form. Studies have found that patients who begin treatment with interferon alfa-2b have a median survival time of 20 years, a significant improvement over the previous survival time of less than two years. Additionally, about 48.5% of these patients do not experience disease progression for at least five years. In this trial, participants in one arm will receive interferon as their treatment.

For more severe cases of LYG, participants in another arm of this trial will receive EPOCH-R, a treatment that includes several drugs like rituximab. Although EPOCH-R is primarily for more serious cases, it has been part of successful treatment plans and can be effective for patients with advanced disease. Overall, both treatments in this trial have shown promising results in managing LYG, offering hope for better survival and disease control.15678

Who Is on the Research Team?

CJ

Christopher J Melani, M.D.

Principal Investigator

National Cancer Institute (NCI)

Are You a Good Fit for This Trial?

This trial is for individuals aged 12 or older with a confirmed diagnosis of Lymphomatoid Granulomatosis (LYG), regardless of whether they've been treated before. It's not suitable for pregnant or breastfeeding women, those with certain heart conditions, significant kidney or liver dysfunction not caused by the tumor, poor psychiatric or medical risk as assessed by the investigator, prior high-dose doxorubicin recipients with low cardiac function, and patients with active hepatitis B.

Inclusion Criteria

My cancer is at any stage.
I am 12 years old or older.
Patients must have a tissue-diagnosis of grade 1, 2 and/or 3 LYG (or a diagnosis consistent with LYG) confirmed by the Laboratory of Pathology, NCI. Final histopathologic classification and pathologic grade will be determined by Stephania Pittaluga, M.D. or her designee
See 1 more

Exclusion Criteria

Informed consent must be obtained
Patients who in the opinion of the principle investigator are poor psychiatric or medical risk are not eligible
I have received more than 450 mg/m2 of doxorubicin and my heart's pumping ability is 40% or less.
See 3 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive alpha interferon or EPOCH-R chemotherapy based on disease grade. Alpha interferon is administered subcutaneously three times weekly, and EPOCH-R is administered every 3 weeks for up to 6 cycles.

Up to 1 year for alpha interferon; 18 weeks for EPOCH-R
Clinic visits every 2 to 12 weeks for follow-up

Follow-up

Participants are monitored for safety and effectiveness after treatment. Follow-up includes regular assessments to determine overall response and long-term efficacy.

3 years
Post treatment: every 3 months for 1 year, then every 4 months for 1 year, then every 6 months for 1 year, then yearly

What Are the Treatments Tested in This Trial?

Interventions

  • EPOCH
  • Interferon
  • Rituximab
Trial Overview The study tests alpha-interferon and EPOCH-R chemotherapy in treating LYG. Alpha-interferon is a natural protein given through skin injections thrice weekly. EPOCH-R involves multiple drugs administered intravenously over five days every three weeks. The treatment plan varies based on disease grade and patient response to previous cycles.
How Is the Trial Designed?
2Treatment groups
Experimental Treatment
Group I: Arm 2-Etoposide, Prednisone, Vincristine, Cyclophosphamide, Doxorubicin & Rituximab (EPOCH-R)Experimental Treatment9 Interventions
Group II: Arm 1-InterferonExperimental Treatment9 Interventions

Find a Clinic Near You

Who Is Running the Clinical Trial?

National Cancer Institute (NCI)

Lead Sponsor

Trials
14,080
Recruited
41,180,000+

Citations

Treatment and Natural History Study of Lymphomatoid ...This study will evaluate the response and long-term effects of alpha-interferon in patients with lymphomatoid granulomatosis (LYG).
Pathobiology and treatment of lymphomatoid granulomatosis ...In the prospective NCI study, patients with high-grade LYG receive primary therapy with DA-EPOCH-R (dose-adjusted etoposide, prednisone, vincristine, ...
Prognostic analysis of CD5 expression in double-hit diffuse ...Objectives. To compare the efficacy of rituximab, dose-adjusted etoposide, prednisone, vincristine, cyclophosphamide and doxorubicin (DA-EPOCH-R) ...
4.pubmed.ncbi.nlm.nih.govpubmed.ncbi.nlm.nih.gov/30501868/
Dose-adjusted EPOCH-R (etoposide, prednisone, vincristine ...Multiple retrospective studies of R-CHOP (rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone or prednisolone) have shown a worse outcome ...
Immunotherapy of Lymphomatoid GranulomatosisHerein, we present the results of a prospective phase 2 study, whereby patients with low-grade LYG received experimental immunotherapy with ...
6.pubmed.ncbi.nlm.nih.govpubmed.ncbi.nlm.nih.gov/37011643/
Interferon alfa-2b in patients with low-grade lymphomatoid ...Interferon alfa-2b is efficacious for treating low-grade lymphomatoid granulomatosis and hence reducing progression to high-grade disease.
rituxan - accessdata.fda.govWARNING: FATAL INFUSION-RELATED REACTIONS, SEVERE. MUCOCUTANEOUS REACTIONS, HEPATITIS B VIRUS. REACTIVATION and PROGRESSIVE MULTIFOCAL. LEUKOENCEPHALOPATHY.
783-DA-R-EPOCH (dose adjusted rituximab etoposide ...This study was designed to assess the efficacy and safety of an infusional DA-EPOCH (dose-adjusted etoposide/vincristine/doxorubicin/bolus cyclophosphamide/ ...
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