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The goal of this clinical research study is to evaluate effectiveness and safety of ChiCGB regimen( chidamide, cladribine, gemcitabine and busulfan).
Busulfan are designed to kill cancer cells by binding to DNA (the genetic material of cells), which may cause cancer cells to die.
Gemcitabine and cladribine are designed to disrupt the growth of cancer cells, which may cause cancer cells to die. It may help to increase the effect of busulfan on cancer cells by not allowing these cells to repair the DNA damage caused by busulfan.
Chidamide is designed to open up the DNA and allow greater access to drugs that bind to DNA, such as cladribine, gemcitabine, busulfan.
Study Groups:
If you are found to be eligible to take part in this study, you will be enrolled in a group of at least 3 participants to begin receiving the study drugs.
The dose of the study drugs you receive will depend on when you enrolled in this study. If no intolerable side effects occur in your group, researchers will continue to enroll participants at the next dose level until either the vorinostat reaches the dose level currently used alone without stem cell transplant, or the highest tolerable dose of this drug is found. The dose that you receive will remain the same throughout this study.
You will be admitted to the hospital on Day -6.
Study Drug Administration (for all patients):
In stem cell transplant, the days before you receive your stem cells are called minus days. The day you receive the stem cells is called Day 0. The days after you receive your stem cells are called plus days.
On Day -7, -4, 0, +3 , you will take chidamide by mouth.
On Days -6, -5, -4, -3, and -2 you will receive cladribine by vein over 1/2 hours.
On Day -6, -2, you will receive gemcitabine by vein over 3 1/2 - 4 1/2 hours.
On Days -6, -5, -4, and -3, you will receive busulfan by vein over 3 hours.
On Day -1, you will rest.
On Day 0, you will receive your stem cells by vein over about 30-60 minutes.
As part of standard care, you will receive G-CSF (filgrastim) as an injection just under your skin twice a day starting on Day +5 until your blood cell levels return to normal.
Study Tests:
On Day -1, you will have an electrocardiogram (ECG) to check your heart function.
About 30-100 days after the transplant, you will have lung function tests.
About 100 days after the transplant:
Blood (about 4 teaspoons) will be drawn for routine tests. If the doctor thinks it is needed, you may have a bone marrow aspiration and biopsy to check the status of the disease.
You will have a PET/CT scan of your whole body to check the status of the disease.
Length of Study:
As part of standard care, you will remain in the hospital for about 3-4 weeks after the transplant. After you are released from the hospital, you will continue as an outpatient for infections and transplant-related complications.
You will be taken off study about 100 days after the transplant. You may be taken off study early if the disease gets worse, if intolerable side effects occur, or if you are unable to follow study directions.
This is an investigational study. Chidamide, gemcitabine, busulfan, melphalan, and rituximab are all FDA approved and commercially available. The use of these study drugs in combination is investigational.
Up to 93 patients will take part in this study.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| ChiCGB | Experimental | Experimental: ChiCGB Chidamide administered orally on D-7, -4, 0,+3 Cladribine administered at 10mg on D-6 to D-2 Gemcitabine administered at 2500 mg/m2 on days -6 and -2. Busulfan administered at 3.2 mg/kg (adjusted ideal body weight) on days -6 to -3. Dexamethasone 10 mg by vein daily from day -6 to day -1. Caphosol oral rinses 30 mL four times a day used from day -8. Interventions: Drug: Chidamide Drug: Cladribine Drug: Gemcitabine Drug: Busulfan Drug: Dexamethasone Procedure: Stem Cell Transplant |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Chidamide | Drug | 30 mg oral twice weekly for 2 weeks |
| |
| Cladribine |
| Measure | Description | Time Frame |
|---|---|---|
| Event free survival | 2 years |
| Measure | Description | Time Frame |
|---|---|---|
| Overall survival | 2 years | |
| Complete remission | 3 month after autologous hematopoietic stem cell transplantation | |
| Adverse events |
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Inclusion Criteria:
6. Adequate hepatic function, as defined by serum glutamate oxaloacetate transaminase (SGOT) and/or serum glutamate pyruvate transaminase (SGPT) </= 3 x upper limit of normal; serum bilirubin and alkaline phosphatase </= 2 x upper limit of normal.
7. Adequate pulmonary function with forced expiratory volume at one second (FEV1), forced vital capacity (FVC) and diffusing capacity of lung for carbon monoxide (DLCO) >/= 50% of expected corrected for hemoglobin.
8. Adequate cardiac function with left ventricular ejection fraction >/= 50%. No uncontrolled arrhythmias or symptomatic cardiac disease.
9. Performance status 0-1. 10. Negative Beta diffusing capacity of lung for carbon monoxide (HCG) text in a woman with child-bearing potential, defined as not post-menopausal for 12 months or no previous surgical sterilization
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Jie Ji, MD | Contact | 86-28-85422370 | JieJi@scu.edu.cn | |
| Ting Liu, MD | Contact | 86-28-85422373 | liuting@scu.edu.cn |
| Name | Affiliation | Role |
|---|---|---|
| Ting Liu, MD | West China Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Beijing cancer hospital | Not yet recruiting | Beijing | Beijing Municipality | 100142 | China |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 34398971 | Derived | Ji J, Liu Z, Kuang P, Dong T, Chen X, Li J, Zhang C, Liu J, Zhang L, Shen K, Liu T. A new conditioning regimen with chidamide, cladribine, gemcitabine and busulfan significantly improve the outcome of high-risk or relapsed/refractory non-Hodgkin's lymphomas. Int J Cancer. 2021 Dec 15;149(12):2075-2082. doi: 10.1002/ijc.33761. Epub 2021 Aug 25. |
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electronic case report form (eCRF)
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ChiCGB
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| Drug |
6 mg/m2 intravenously daily for 5 days |
|
| gemcitabine | Drug | 2500 mg/m2 intravenously twice weekly for 1 week |
|
| Busulfan | Drug | 3.2 mg/kg intravenously daily for 4 days |
|
| Autologous hematopoietic stem cell transplantation | Procedure | autologous hematopoietic stem cells infusion after ChiCGB chemotherapy |
|
| 2 years |
| Peking university third hospital | Not yet recruiting | Beijing | Beijing Municipality | 100191 | China |
|
| The first affiliated hospital of Chongqing medical university | Not yet recruiting | Chongqing | Chongqing Municipality | 400016 | China |
|
| Southwest Hospital | Recruiting | Chongqing | Chongqing Municipality | 400038 | China |
|
| General Hospital of Lanzhou military command | Not yet recruiting | Lanzhou | Gansu | 730070 | China |
|
| Henan cancer hospital | Not yet recruiting | Zhengzhou | Henan | 450008 | China |
|
| The first affiliated hospital of Zhengzhou university | Not yet recruiting | Zhengzhou | Henan | 450052 | China |
|
| Tongji Hospital | Not yet recruiting | Wuhan | Hubei | 430030 | China |
|
| Jiangsu province hospital | Not yet recruiting | Nanjing | Jiangsu | 210029 | China |
|
| Rui jin hospital Shanghai jiao tong University | Not yet recruiting | Shanghai | Shanghai Municipality | 200025 | China |
|
| Tong Ren Hospital | Not yet recruiting | Shanghai | Shanghai Municipality | China |
|
| Shan Xi Da Yi Hospital | Not yet recruiting | Taiyuan | Shanxi | 030032 | China |
|
| Tangdu Hospital | Not yet recruiting | Xi’an | Shanxi | 710038 | China |
|
| West China Hospital of Sichuan University | Recruiting | Chengdu | Sichuan | 610044 | China |
|
| Affiliated Hospital of Southwest Medical University | Recruiting | Nanchong | Sichuan | 646000 | China |
|
| Blood diseases hospital, Chinese academy of medica | Not yet recruiting | Tianjin | Tianjing | 300020 | China |
|
| The first affiliated hospital of Xinjiang medical Universtiy | Not yet recruiting | Ürümqi | Xinjiang | 830054 | China |
|
| Kunming General Hospital of Chengdu Military Area | Not yet recruiting | Kunming | Yunnan | 650032 | China |
|
| ID | Term |
|---|---|
| D008223 | Lymphoma |
| ID | Term |
|---|---|
| D009370 | Neoplasms by Histologic Type |
| D009369 | Neoplasms |
| D008232 | Lymphoproliferative Disorders |
| D008206 | Lymphatic Diseases |
| D006425 | Hemic and Lymphatic Diseases |
| D007160 | Immunoproliferative Disorders |
| D007154 | Immune System Diseases |
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| ID | Term |
|---|---|
| C547816 | N-(2-amino-5-fluorobenzyl)-4-(N-(pyridine-3-acrylyl)aminomethyl)benzamide |
| D017338 | Cladribine |
| D000093542 | Gemcitabine |
| D002066 | Busulfan |
| ID | Term |
|---|---|
| D015762 | 2-Chloroadenosine |
| D000241 | Adenosine |
| D011684 | Purine Nucleosides |
| D011687 | Purines |
| D006574 | Heterocyclic Compounds, 2-Ring |
| D000072471 | Heterocyclic Compounds, Fused-Ring |
| D006571 | Heterocyclic Compounds |
| D003839 | Deoxyadenosines |
| D003853 | Deoxyribonucleosides |
| D009705 | Nucleosides |
| D009706 | Nucleic Acids, Nucleotides, and Nucleosides |
| D012263 | Ribonucleosides |
| D003841 | Deoxycytidine |
| D003562 | Cytidine |
| D011741 | Pyrimidine Nucleosides |
| D011743 | Pyrimidines |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D002072 | Butylene Glycols |
| D006018 | Glycols |
| D000438 | Alcohols |
| D009930 | Organic Chemicals |
| D008698 | Mesylates |
| D000476 | Alkanesulfonates |
| D017738 | Alkanesulfonic Acids |
| D000473 | Alkanes |
| D006839 | Hydrocarbons, Acyclic |
| D006838 | Hydrocarbons |
| D013451 | Sulfonic Acids |
| D013456 | Sulfur Acids |
| D013457 | Sulfur Compounds |
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