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| ID | Type | Description | Link |
|---|---|---|---|
| 2010-020926-17 | EudraCT Number |
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The purpose of this study is to determine whether Bendamustine in combination with Etoposide, Cytarabine and Melphalan (BeEAM) are effective as conditioning followed by ASCT in patients with aggressive lymphoma.
BCNU (carmustine is a nitrosurea alkylating agent used for many years in the conditioning of patients with lymphoma however this drug is hardly available in some countries in Europe, moreover to improve conditioning regimens in autologous stem cell transplant is important because the anti-tumoral effect of high dose therapy are responsible for this procedure efficacy. Although for many years few advances have been achieved in this area now new drugs can be tested in these patients.
Bendamustine is a unique cytotoxic agent with structural similarities to alkylating agents and antimetabolites, but which is non-cross-resistant with alkylating agents and other drugs in vitro and in the clinic. Early clinical studies conducted in the German Democratic Republic more than 30 years ago suggested promising activity in indolent non-Hodgkin's lymphoma (NHL). Two North American trials reported responses in more than 70% of patients with chemotherapy- and rituximab-refractory disease, suggesting that bendamustine may be the most effective drug available for this patient population. Response rates of 90% to 92%, with complete remission in 55% to 60%, have been reported in patients with follicular and mantle-cell lymphoma with the combination of bendamustine and rituximab.(Cheson 2009) Leone et all have recently reported results on the characterization of the mechanisms of action of bendamustine and its comparison with structurally related compounds as chlorambucil and phosphoramide mustard have demonstrated that bendamustine displays a distinct mechanisms of action including activation of DNA-damage stress response and apoptosis, inhibition of mitotic checkpoints, and induction of mitotic catastrophe. Also bendamustine activates a base excision DNA repair pathway rather than an alkyltransferase DNA repair mechanism.
These data suggest that bendamustine possesses mechanistic features that differentiate it from other alkylating agents and makes this old new drug an attractive one to combine with other agents in the conditioning transplant setting (Leone 2008).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Bendamustine-EAM | Experimental |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Bendamustine-EAM | Drug | Bendamustine 200 mg/m2 starting dose on day -7 and -6 Etoposide 200 mg/m2 from day -5 to day -2 Ara-C 400 mg/m2 from day -5 to day -2 Melphalan 140 mg/m2 on day -1 |
| Measure | Description | Time Frame |
|---|---|---|
| Evaluate the progression free survival using techniques of image (PET and TC)of Bendamustine in combination with Etoposide, Cytarabine and Melphalan (BeEAM) as conditioning followed by ASCT in patients with aggressive lymphoma. | 18 months follow-up |
| Measure | Description | Time Frame |
|---|---|---|
| Evaluate safety BeEAM chemotherapy followed of reinfusion of autologous hematopoietic stem cells by considering the incidence of adverse event (with CTCAE).Evaluate % patients in CR.Evaluate response of ASCT using PET, TC.Evaluate overall survival | 18 months follow-up |
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Inclusion Criteria:
Patients being able to meet all requirements of the clinical trial, according to the investigator's criteria,
Patient giving voluntarily written informed consent before performing any essay test that is not part of routine care of patients.
Age >o=18 years and >0=70 years
Candidate for chemotherapy (QT) at high doses and ASCT
Performance status (ECOG) <0=2.
Adequate renal, hepatic, and bone marrow function (assessed < 14 days before initiation of the study treatment):
Adequate pulmonary function: forced expiratory volume at 1 second > 65% of predicted or a diffusing capacity of the lung for CO >o=50%.
Cardiac ejection fraction or greater than 50% by echocardiogram or FEVI.
A woman capable of gestation (see definition below) should:
A woman capable of gestation is defined as sexually mature woman who:
Exclusion Criteria:
Impossibility of collecting, via apheresis, a number of CD34+ cells >o=2 x 106/kg
To receive any of the following treatments in the 28 days before the start the study treatment:
i.chemotherapeutic or antitumor agents ii.radiation therapy, except in limited fields, to a maximum dose of \
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| Name | Affiliation | Role |
|---|---|---|
| Mª Dolores Caballero, MD | University of Salamanca | Principal Investigator |
| Alejandro Martín, MD | University of Salamanca | Principal Investigator |
| Javier Briones, MD | Fundació Institut de Recerca de l'Hospital de la Santa Creu i Sant Pau | Principal Investigator |
| Juan Manuel Sancho, MD | Germans Trias i Pujol Hospital | Principal Investigator |
| Cristina Barrenetxea, MD | Hospital Vall d'Hebrón | Principal Investigator |
| Javier López, MD | Hospital Universitario Ramon y Cajal | Principal Investigator |
| Mª José Rodríguez, MD | Hospital Universitario de Canarias | Principal Investigator |
| Jorge Gayoso, MD | Gregorio Marañón Hospital | Principal Investigator |
| Miguel Ángel Canales, MD | Hospital Universitario La Paz | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Complejo Hospitalario Universitario de Santiago | Santiago | A Coruña | 15706 | Spain | ||
| Hospital Vall d´Hebron |
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| Carlos Grande, MD | Hospital Universitario 12 de Octubre | Principal Investigator |
| Isidro Jarque, MD | Hospital La Fe | Principal Investigator |
| José Rifón, MD | Clínica Universitaria Navarra | Principal Investigator |
| Andres Sánchez, MD | Hospital Virgen de la Arrixaca | Principal Investigator |
| Cristina Castilla, MD | Hospital Morales Meseguer | Principal Investigator |
| José Luis Bello, MD | Complejo Hospitalario Universitario de Santiago de Compostela | Principal Investigator |
| Armando López, MD | Hospial Clínic de Barcelona | Principal Investigator |
| Eulogio Conde, MD | Hospital Marqués de Valdecilla | Principal Investigator |
| Reyes Arranz, MD | Fundación de Investigación Biomédica - Hospital Universitario de La Princesa | Principal Investigator |
| Encarnación Monzó, MD | Hospital Arnau de Vilanova de Valencia | Principal Investigator |
| Rosario Varela, MD | Complejo Hospitalario Universitario de A Coruña | Principal Investigator |
| Mª José Ramírez, MD | Hospital Jerez de la Frontera | Principal Investigator |
| Fátima de la Cruz, MD | Hospital Virgen del Rocío | Principal Investigator |
| Ana Pilar González, MD | Hospital Central de Asturias | Principal Investigator |
| Luis Palomera, MD | Hospital Clínico de Zaragoza "Lozano Blesa" | Principal Investigator |
| Raquel del Campo, MD | Hospital Son Llátzer | Principal Investigator |
| Mª José Terol, MD | Hospital Clínico de Valencia | Principal Investigator |
| Barcelona |
| Barcelona |
| 08035 |
| Spain |
| Hospital Clinic i Provincial | Barcelona | Barcelona | 08036 | Spain |
| H. de la Santa Creu i Sant Pau | Barcelona | Barcelona | Spain |
| H. U. Marqués de Valdecilla. | Santander | Cantabria | Spain |
| Hospital de Jerez | Jerez de la Frontera | Cádiz | 11407 | Spain |
| H.U. 12 de Octubre, | Madrid | Madrid | Spain |
| H.U. Gregorio Marañón, | Madrid | Madrid | Spain |
| H.U. La Paz | Madrid | Madrid | Spain |
| H.U. La Princesa | Madrid | Madrid | Spain |
| Hospital Ramon y Cajal | Madrid | Madrid | Spain |
| Hospital Son Llátzer | Palma de Mallorca | Mallorca | 07198 | Spain |
| Hospital Universitario Virgen de Arrixaca | El Palmar | Murcia | 30120 | Spain |
| Clinica Universitaria de Navarra | Pamplona | Navarre | Spain |
| Hospital Central de Asturias | Oviedo | Principality of Asturias | 33006 | Spain |
| H. Clínico Universitario de Salamanca | Salamanca | Salamanca | Spain |
| Hospital Universitario de Canarias | Santa Cruz de Tenerife | Tenerife | Spain |
| Hospital Clinico de Valencia | Valencia | Valencia | 46010 | Spain |
| Hospital Arnau de Vilanova | Valencia | Valencia | 46015 | Spain |
| H. La Fe | Valencia | Valencia | Spain |
| Hospital Clínico Lozano Blesa | Zaragoza | Zaragoza | 50009 | Spain |