Chemotherapy + follow upChemotherapy + ASCT + follow up
Chemotherapy + follow up: * Chemotherapy administrated every 3 weeks for 6 cycles according to local investigator's choice based on usual practices.
* An intermediate evaluation will be performed after four cycles by PET-CT (or CT-Scan for non-avid PTCL)
* A post-induction evaluation by PET-CT or CT-Scan will be done between 3 and 5 weeks after the last chemotherapy drug administration for all patients
* A last evaluation by PET-CT or CT-Scan will be done between 08 and 12 weeks after the post-induction for all patients
Chemotherapy + ASCT + follow up: * Chemotherapy administrated every 3 weeks for 6 cycles according to local investigator's choice based on usual practices.
* An intermediate evaluation will be performed after four cycles by PET-CT (or CT-Scan for non-avid PTCL)
* The fifth or sixth cycles should be used as stem-cell mobilizing chemotherapy for patients with ASCT strategy
* A post-induction evaluation by PET-CT or CT-Scan will be done between 3 and 5 weeks after the last chemotherapy drug administration for all patients
* Patients with in Complete Response after 6 cycles will receive a High Dose Therapy as conditioning regimen before transplantation
* A last evaluation by PET-CT or CT-Scan will be done between 08 and 12 weeks after the post-induction for all patients
Study summary
Peripheral T-cell lymphoma (PTCL) encompasses a broad range of post-thymic (i.e., mature) sub-entities as defined by the 2017 WHO classification. The most common entities are angioimmunoblastic T-cell lymphoma (AITL) and other Tfh-phenotype PTCL or PTCL not otherwise specified (NOS), each representing approximately 20 to 25% of mature T- and NK/T-cell lymphomas. Compared to their B-cell counterparts, most PTCL confer dismal prognosis. In fact, except for anaplastic lymphoma kinase (ALK)-positive systemic anaplastic large cell lymphoma (sALCL), 10-year overall survival for patients with PTCL barely exceeds 30%. Given the infrequency and the heterogeneity of these malignancies, no real consensus on first-line treatment has been established for most PTCL.
The place of autologous stem cell transplantation (ASCT) as a consolidation procedure for patients with PTCL achieving a complete metabolic response after induction is still highly debated. ESMO recommendations and recent guidelines from a committee of the American Society for Blood and Marrow Transplantation currently propose ASCT as first-line therapy for transplant-eligible patients for all patients reaching at least a partial response (PR) after induction. NCCN guidelines (version 2.2017) recommend ASCT or observation in case of metabolic CR but salvage regimen in case of residual disease after induction.
Eligibility
Sex
ALL
Min age
18 Years
Max age
70 Years
Healthy volunteers
No
Inclusion Criteria:
1. Patient ≥ 18 years and \< 70 years of age at the time of signing the informed consent form (ICF)
2. Patient fit enough to receive autologous stem cell transplant as a consolidation strategy as assessed by the local investigator
3. Hemoglobin level \> 8g/dL (transfusion allowed); Neutrophil count \>0.5 G/L; Platelets count \> 50 G/L (transfusion allowed) Patient with histologically proven "nodal-type peripheral T-cell lymphoma (PTCL)" (latest WHO classification), not previously treated; as defined by the WHO classification, the following subtypes may be included,
* PTCL, not otherwise specified
* Follicular helper T-cell lymphomas: Angioimmunoblastic T-cell lymphoma and nodal PTCL with TFH phenotype and follicular T-cell lymphoma
* Anaplastic large cell lymphoma, ALK-negative
4. Ann Arbor staging (I-IV) except stage I with normal LDH and PS\<2 (i.e. stage I aaIPI 0)
5. Participant with a measurable disease by the Lugano criteria (i.e., longest diameter of a nodal site \> 1.5 cm and/or longest diameter of an extranodal site \> 1.0 cm and/or a hypermetabolic lesion)
6. FFPE Diagnostic tissue block should be available for central pathology review and ancillary molecular analyses
7. Participant with Eastern Cooperative Oncology Group (ECOG) performance status 0 to 2
8. Estimated minimum life expectancy of 3 months
9. Patient who understood and voluntarily signed and dated an informed consent prior to any study-specific assessments/procedures being conducted
10. Able to adhere to the study visit schedule and other protocol requirements
11. Patient covered by any social security system (France)
12. Patient who understands and speaks one of the country official languages
13. Males with partners of childbearing potential must agree to use effective birth control methods during the study as informed by the investigator in accordance with SmPC of each drugs administrated
14. Females of childbearing potential must agree to use effective birth control methods for at least 28 days before starting treatment; while participating in the study; during treatment interruptions and necessary period after the study as informed by the investigator in accordance with SmPC of each drugs administrated
Exclusion Criteria:
1. Known central nervous system or meningeal involvement by lymphoma
2. Impaired renal function (calculated MDRD or Cockcroft-Gault Creatinine Clearance \< 30 ml/min) or impaired liver function tests (serum total bilirubin level \> 2.0 mg/dl \[34 µmol/L\] (except in case of Gilbert's Syndrome, or documented liver or pancreatic involvement by lymphoma), serum transaminases (AST or ALT) \> 3 upper normal limit unless they are related to the lymphoma.
3. The following types of T-cell lymphomas:
* Adult T-cell lymphoma/leukemia (HTLV-1 related T-cell lymphoma)
* Extranodal T-cell/NK-cell lymphoma, nasal type
* Anaplastic large cell lymphoma, ALK-positive type
* Cutaneous T cell lymphoma (mycosis fungoides, Sézary syndrome)
* Primary cutaneous CD30+ T-cell lymphoproliferative disorder
* Primary cutaneous anaplastic T-cell lymphoma
* Enteropathy-associated T-cell lymphoma
* Hepatosplenic T-cell lymphoma
* Subcutaneous panniculitis-like T-cell lymphoma
* Primary cutaneous gamma-delta T-cell lymphoma
* Primary cutaneous CD8+ aggressive epidermotropic lymphoma
* Primary cutaneous CD4+ small/medium T-cell lymphoma
4. Active malignancy other than the one treated in this research. Prior history of malignancies unless the patient has been free of the disease for ≥ 2 years. However, patients with the following history are allowed:
1. Basal or squamous cell carcinoma of the skin
2. Carcinoma in situ of the cervix
3. Carcinoma in situ of the breast
4. Incidental histologic finding of prostate cancer (T1a or T1b) using the tumor, nodes, metastasis clinical staging system
5. Vaccinated with live, attenuated vaccines within 6 months of enrollment
6. Use of any standard or experimental anti-cancer drug therapy before the start of treatment except COP (cyclophosphamide, vincristine, prednisone) in case of (or high risk of tumor lysis syndrome) or etoposide for a maximum of 3 doses (at a maximum dose of 150mg/m2) for HLH (Hemophagocytic Lymphohistiocytosis).
7. A corticosteroids therapy \> 1mg/kg lasting more than 14 days prior to Cycle 1 Day 1
8. Positive serology for Human Immunodeficiency Virus (HIV) and Human T-Lymphotrophic Virus (HTLV1)
15\. Active Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) infections defined as:
* HBV :
* HBs Ag positive
* HBs Ag negative, anti-HBs antibody positive and anti-HBc antibody positive with detectable viral DNA
* HCV :
Anti-VHC antibody positive with detectable viral RNA 9. Pregnant, planning to become pregnant or lactating WOCBP 10. Any significant medical conditions, laboratory abnormality or psychiatric illness likely to interfere with the participation in this clinical study (according to the investigator's decision) 11. Person deprived of his/her liberty by a judicial or administrative decision 12. Person hospitalized without consent 13. Adult person under legal protection
Primary outcome measure(s)
to assess if ASCT is associated with a significant prolongation of progression-free survival (PFS) for patient with peripheral T-cell lymphoma (PTCL) reaching a complete response (CR) according to the response critter — When the last randomized patient has reached two years of follow-up or when 154 events (progression/relapse/new anti-lymphoma treatment/death) occured whichever comes first progression-free survival defined time from the date of randomization to the date of first documentation of relapse or progressive disease, death due to any cause, or receipt of subsequent systemic chemotherapy to treat residual or progressive peripheral T-cell lymphoma as determined by the investigator, whichever came first.
Trial sites (48)
Facility
City
Region
Status
Chu D'Amiens - Hopital Sud
Amiens
France
Not Yet Recruiting
Chu D'Angers
Angers
France
Not Yet Recruiting
Ch Victor Dupouy
Argenteuil
France
Not Yet Recruiting
Ch D'Avignon - Hopital Henri Duffaut
Avignon
France
Not Yet Recruiting
Ch de La Cote Basque
Bayonne
France
Not Yet Recruiting
Service d'Onco-radiolothérapie, Polyclinique Bordeaux Nord Aquitaine
Bordeaux
France
Not Yet Recruiting
Ch Metropole Savoie - Site Chambery
Chambéry
France
Not Yet Recruiting
Chu Estaing
Clermont-Ferrand
France
Not Yet Recruiting
Ch Alpes Leman
Contamine-sur-Arve
France
Not Yet Recruiting
Hopital Henri Mondor
Créteil
France
Not Yet Recruiting
René Olivier Casasnovas
Dijon
France
Not Yet Recruiting
CHU Francois MITTERRAND
Dijon
France
Not Yet Recruiting
Ch de Dunkerque
Dunkirk
France
Not Yet Recruiting
Chd de Vendee
La Roche-sur-Yon
France
Not Yet Recruiting
Ch de Versailles - Hopital Andre Mignot
Le Chesnay
France
Not Yet Recruiting
CHU du Mans
Le Mans
France
Not Yet Recruiting
Service Oncologie médicale, HOPITAL SAINT VINCENT-DE-PAUL
Lille
France
Not Yet Recruiting
Service Hématologie Clinique et Thérapie Cellulaire, CHU DE LIMOGES - HOPITAL DUPUYTREN,
Limoges
France
Not Yet Recruiting
Centre Leon Berard
Lyon
France
Not Yet Recruiting
Chu de Montpellier
Montpellier
France
Not Yet Recruiting
Chu de Nantes
Nantes
France
Not Yet Recruiting
Centre Antoine Lacassagne
Nice
France
Not Yet Recruiting
Chu de Nimes - Hopital Caremeau
Nîmes
France
Not Yet Recruiting
Chr Orleans
Orléans
France
Not Yet Recruiting
Hopital Cochin
Paris
France
Not Yet Recruiting
Hopital de La Pitie Salpetriere
Paris
France
Not Yet Recruiting
Hopital Necker
Paris
France
Not Yet Recruiting
Hopital Saint Antoine
Paris
France
Not Yet Recruiting
Ch de Perpignan
Perpignan
France
Not Yet Recruiting
Chu de Bordeaux - Hopital Haut-Leveque
Pessac
France
Not Yet Recruiting
Ch Perigueux
Périgueux
France
Not Yet Recruiting
Chu Lyon-Sud
Pierre-Bénite
France
Recruiting
Ch Annecy Genevois
Pringy
France
Not Yet Recruiting
Chu Pontchaillou_Rennes
Rennes
France
Not Yet Recruiting
Ch de Roubaix - Hopital Victor Provo
Roubaix
France
Not Yet Recruiting
Centre Henri Becquerel
Rouen
France
Not Yet Recruiting
Service Hématologie, Institut Curie - Hôpital René HUGUENIN
Saint-Cloud
France
Not Yet Recruiting
Chu de La Reunion - Hopital Felix Guyon
Saint-Denis
France
Not Yet Recruiting
Chu de La Reunion - Ghsr
Saint-Pierre
France
Not Yet Recruiting
Institut Cancerologie & Hematologie St-Etienne
Saint-Priest-en-Jarez
France
Not Yet Recruiting
+ 8 more sites — see the full list on the official registry below.
This page summarises publicly available registry data for informational purposes — not medical advice. Eligibility is determined by each study team; patients should discuss participation with their clinician.
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