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This feasibility trial studies how well daratumumab in combination with dose-adjusted etoposide, prednisone, vincristine sulfate, cyclophosphamide, and doxorubicin hydrochloride (DA-EPOCH) works in treating patients with newly diagnosed stage I-IV plasmablastic lymphoma. Plasmablastic lymphoma cells have high levels of a protein called CD38. Daratumumab is a monoclonal antibody that specifically targets CD38 expressing cells, and may help the body?s immune system attack the cancer and interfere with the ability of cancer cells to grow and spread. Drugs used in chemotherapy, such as etoposide, prednisone, vincristine sulfate, cyclophosphamide, and doxorubicin hydrochloride, work in different ways to stop the growth of cancer cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Giving daratumumab may enhance the effectiveness of a standard chemotherapy (DA-EPOCH) in patients with plasmablastic lymphoma.
I. To evaluate the feasibility of adding daratumumab to dose-adjusted (DA)-EPOCH by assessing the percentage of plasmablastic lymphoma (PBL) patients to complete >= 3 cycles of study treatment per protocol.
I. To estimate the complete response (CR) rate as defined by the 2017 Response Evaluation Criteria in Lymphoma (RECIL) Criteria in human immunodeficiency virus (HIV) positive and HIV negative patients with plasmablastic lymphoma treated with daratumumab and DA-EPOCH.
II. To evaluate the safety of dose-adjusted EPOCH with daratumumab as assessed by the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) version 5.0.
III. To estimate the overall survival (OS), progression free survival (PFS), and event free survival (EFS) at 1 year.
I. To explore the relationship of tumor characteristics as determined by immunohistochemistry (IHC) panels and fluorescent in situ hybridization (FISH) and clinical outcomes.
II. To assess the relationship between Epstein-Barr virus (EBV)-tumor association and EBV plasma copy number and to assess any prognostic significance of clearance of viral deoxyribonucleic acid (DNA) from plasma during or at the end of therapy.
III. To determine the feasibility of identifying circulating tumor DNA (ctDNA) as reflected in plasma DNA mutation panels or clonal immunoglobulin DNA and to assess any prognostic significance of clearance of tumor DNA from plasma during therapy.
Patients receive daratumumab intravenously (IV) on days 1, 8, and 15 of cycles 1-3, and on day 1 of cycles 4-6. Patients also receive etoposide, doxorubicin hydrochloride, and vincristine sulfate IV continuous over 96 hours on days 1-4, prednisone orally (PO) on days 1-5, and cyclophosphamide IV over 1 hour on day 5. Treatment repeats every 21 days for up to 6 cycles in the absence of disease progression or unacceptable toxicity.
After completion of study treatment, patients are followed up every 3 months for up to 2 years.
Ann Arbor Stage I Diffuse Large B-Cell Lymphoma
Cyclophosphamide, Daratumumab, Doxorubicin, Doxorubicin Hydrochloride, Etoposide, Prednisone, Vincristine, Vincristine Sulfate
Not yet recruiting
AIDS Malignancy Consortium
Published on BioPortfolio: 2019-10-30T14:03:47-0400
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