Purpose

This phase III trial compares the effects of nivolumab with chemo-immunotherapy versus chemo-immunotherapy alone in treating patients with newly diagnosed primary mediastinal B-cell lymphoma (PMBCL). Immunotherapy with monoclonal antibodies, such as nivolumab, may help the body's immune system attack the cancer, and may interfere with the ability of cancer cells to grow and spread. Treatment for PMBCL involves chemotherapy combined with an immunotherapy called rituximab. Chemotherapy drugs 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. Rituximab is a monoclonal antibody. It binds to a protein called CD20, which is found on B cells (a type of white blood cell) and some types of cancer cells. This may help the immune system kill cancer cells. Giving nivolumab with chemo-immunotherapy may help treat patients with PMBCL.

Condition

Eligibility

Eligible Ages
Over 2 Years
Eligible Genders
All
Accepts Healthy Volunteers
No

Inclusion Criteria

  • Age >= 2 years - Patient must have histologically confirmed primary mediastinal B-cell lymphoma (PMBCL) as defined by World Health Organization (WHO) criteria - Eastern Cooperative Oncology Group (ECOG) performance status of 0, 1, or 2 or ECOG performance status of 3 if poor performance is related to lymphoma - Children's Oncology Group (COG) Institutions: Use Karnofsky for patients >= 17 and < 18 years of age and Lansky for patients < 17 years of age - Adults (age 18 or older): Creatinine clearance >= 30 mL/min, as estimated by the Cockcroft and Gault formula. The creatinine value used in the calculation must have been obtained within 28 days prior to registration. Estimated creatinine clearance is based on actual body weight - Pediatric Patients (age < 18 years): The following must have been obtained within 14 days prior to registration: - Measured or calculated (based on institutional standard) creatinine clearance or radioisotope glomerular filtration rate (GFR) >= 70 ml/min/1.73 m^2, or - Serum creatinine =< 1.5 x institutional upper limit of normal (IULN), or a serum creatinine based on age/gender as follows: - Age : 2 to < 6 year; Maximum serum creatinine (mg/dL): 0.8 (male; 0.8 (female) - Age : 6 to < 10 years; Maximum serum creatinine (mg/dL): 1 (male); 1 (female) - Age : 10 to < 13 years; Maximum serum creatinine (mg/dL): 1.2 (male); 1.2 (female) - Age : 13 to < 16 years; Maximum serum creatinine (mg/dL): 1.5 (male); 1.4 (female) - Age : >= 16 years to < 18 years; Maximum serum creatinine (mg/dL): 1.7 (male); 1.4 (female) - Patients with abnormal liver function will be eligible to enroll if the lab abnormality is thought to be due to the lymphoma or Gilbert's syndrome - Age >= 18 years: Ejection fraction of >= 50% by echocardiogram - Age < 18 years: Shortening fraction of >= 27% by echocardiogram, or ejection fraction of >= 50% by radionuclide angiogram - Human immunodeficiency virus (HIV)-infected patients on effective anti-retroviral therapy with undetectable viral load within 6 months are eligible for this trial - For patients with evidence of chronic hepatitis B virus (HBV) infection, the HBV viral load must be undetectable on suppressive therapy, if indicated - Patients with a history of hepatitis C virus (HCV) infection must have been treated and cured. For patients with HCV infection who are currently on treatment, they are eligible if they have an undetectable HCV viral load - All patients and/or their parents or legal guardians must sign a written informed consent - All institutional, Food and Drug Administration (FDA), and National Cancer Institute (NCI) requirements for human studies must be met

Exclusion Criteria

  • Administration of prior anti-cancer therapy except as outlined below: - A short course (=< 2 weeks) of corticosteroids for the relief of lymphoma-related symptoms - A single course of COP (cyclophosphamide, vincristine, and prednisone) - One cycle of chemo-immunotherapy including R-CHOP, DA-EPOCH-R, a pediatric mature B-cell non-Hodgkin lymphoma (B-NHL) induction therapy (such as ANHL1131), or intrathecal chemotherapy that has not started more than 21 days prior to enrollment - Active ischemic heart disease or heart failure - Active uncontrolled infection - Central nervous system (CNS) involvement of lymphoma - Previous cancer that required systemic chemotherapy and/or thoracic radiation. Other cancers will be permitted if in remission x 3 years - Active autoimmune disease that has required systemic treatment (such as disease modifying agents, corticosteroids, or immunosuppressive agents) in the past 2 years. Replacement therapy such as thyroxine, insulin or physiologic corticosteroid for adrenal or pituitary insufficiency is not considered a form of systemic treatment - In patients < 18 years of age hepatitis B serologies consistent with past or current infections - Patients with severe hepatic impairment (Child-Pugh class C or serum total bilirubin > 5.0 mg/dL) unless thought to be due to lymphoma or Gilbert's syndrome - Female patients who are pregnant since fetal toxicities and teratogenic effects have been noted for several of the study drugs. A pregnancy test is required for female patients of childbearing potential - Sexually active patients of reproductive potential who have not agreed to use a highly effective contraceptive method (failure rate of < 1% per year when used consistently and correctly) for the duration of their study participation - Lactating females are not eligible unless they have agreed not to breastfeed their infants starting with the first dose of study therapy and for at least 6 months after the last dose of rituximab

Study Design

Phase
Phase 3
Study Type
Interventional
Allocation
Randomized
Intervention Model
Parallel Assignment
Primary Purpose
Treatment
Masking
None (Open Label)

Arm Groups

ArmDescriptionAssigned Intervention
Active Comparator
Arm A (DA-EPOCH-R)
See Detailed Description
  • Procedure: Biospecimen Collection
    Undergo blood and CSF sample collection
    Other names:
    • Biological Sample Collection
    • Biospecimen Collected
    • Specimen Collection
  • Procedure: Bone Marrow Aspiration
    Undergo bone marrow biopsy and aspiration
  • Procedure: Bone Marrow Biopsy
    Undergo bone marrow biopsy and aspiration
    Other names:
    • Biopsy of Bone Marrow
    • Biopsy, Bone Marrow
  • Procedure: Computed Tomography
    Undergo CT or PET/CT
    Other names:
    • CAT
    • CAT Scan
    • Computed Axial Tomography
    • Computerized Axial Tomography
    • Computerized axial tomography (procedure)
    • Computerized Tomography
    • Computerized Tomography (CT) scan
    • CT
    • CT Scan
    • tomography
  • Drug: Cyclophosphamide
    Given IV
    Other names:
    • (-)-Cyclophosphamide
    • 2H-1,3,2-Oxazaphosphorine, 2-[bis(2-chloroethyl)amino]tetrahydro-, 2-oxide, monohydrate
    • Asta B 518
    • B-518
    • Carloxan
    • Ciclofosfamida
    • Ciclofosfamide
    • Cicloxal
    • Clafen
    • Claphene
    • CP monohydrate
    • CTX
    • CYCLO-cell
    • Cycloblastin
    • Cycloblastine
    • Cyclophospham
    • Cyclophosphamid monohydrate
    • Cyclophosphamide Monohydrate
    • Cyclophosphamidum
    • Cyclophosphan
    • Cyclophosphane
    • Cyclophosphanum
    • Cyclostin
    • Cyclostine
    • Cytophosphan
    • Cytophosphane
    • Cytoxan
    • Fosfaseron
    • Genoxal
    • Genuxal
    • Ledoxina
    • Mitoxan
    • Neosar
    • Revimmune
    • Syklofosfamid
    • WR- 138719
    • WR-138719
  • Drug: Doxorubicin Hydrochloride
    Given IV
    Other names:
    • 5,12-Naphthacenedione, 10-[(3-amino-2,3,6-trideoxy-alpha-L-lyxo-hexopyranosyl)oxy]-7,8, 9,10-tetrahydro-6,8,11-trihydroxy-8-(hydroxyacetyl)-1-methoxy-, hydrochloride, (8S-cis)- (9CI)
    • ADM
    • Adriacin
    • Adriamycin
    • Adriamycin Hydrochloride
    • Adriamycin PFS
    • Adriamycin RDF
    • ADRIAMYCIN, HYDROCHLORIDE
    • Adriamycine
    • Adriblastina
    • Adriblastine
    • Adrimedac
    • Chloridrato de Doxorrubicina
    • DOX
    • DOXO-CELL
    • Doxolem
    • Doxorubicin HCl
    • Doxorubicin.HCl
    • Doxorubin
    • Farmiblastina
    • FI 106
    • FI-106
    • hydroxydaunorubicin
    • Rubex
  • Procedure: Echocardiography
    Undergo ECHO
    Other names:
    • EC
  • Drug: Etoposide Phosphate
    Given IV
    Other names:
    • Etopophos
  • Biological: Filgrastim
    Given SC
    Other names:
    • Filgrastim Biosimilar Filgrastim-sndz
    • Filgrastim Biosimilar Tbo-filgrastim
    • Filgrastim XM02
    • Filgrastim-aafi
    • Filgrastim-ayow
    • Filgrastim-sndz
    • G-CSF
    • Granix
    • Neupogen
    • Neutroval
    • Nivestym
    • r-metHuG-CSF
    • Recombinant Methionyl Human Granulocyte Colony Stimulating Factor
    • Releuko
    • rG-CSF
    • Tbo-filgrastim
    • Tevagrastim
    • XM02
    • Zarxio
  • Procedure: Lumbar Puncture
    Undergo LP
    Other names:
    • LP
    • Spinal Tap
  • Biological: Pegfilgrastim
    Given SC
    Other names:
    • Dulastin
    • Filgrastim SD-01
    • filgrastim-SD/01
    • Fulphila
    • HSP-130
    • Jinyouli
    • Neulasta
    • Neulastim
    • Neupopeg
    • Nyvepria
    • PEG-filgrastim
    • Pegcyte
    • Pegfilgrastim Biosimilar HSP-130
    • Pegfilgrastim Biosimilar Nyvepria
    • Pegfilgrastim Biosimilar Pegcyte
    • Pegfilgrastim Biosimilar PF-06881894
    • Pegfilgrastim Biosimilar Udenyca
    • Pegfilgrastim Biosimilar Ziextenzo
    • Pegfilgrastim-apgf
    • Pegfilgrastim-bmez
    • Pegfilgrastim-cbqv
    • Pegfilgrastim-jmdb
    • Pegylated G-CSF
    • Pegylated GCSF
    • Pegylated Granulocyte Colony Stimulating Factor
    • PF-06881894
    • SD-01
    • SD-01 sustained duration G-CSF
    • Tripegfilgrastim
    • Udenyca
    • Ziextenzo
  • Procedure: Positron Emission Tomography
    Undergo PET/CT
    Other names:
    • Medical Imaging, Positron Emission Tomography
    • PET
    • PET Scan
    • Positron emission tomography (procedure)
    • Positron Emission Tomography Scan
    • Positron-Emission Tomography
    • proton magnetic resonance spectroscopic imaging
    • PT
  • Drug: Prednisolone
    Given PO
    Other names:
    • (11beta)-11,17,21-Trihydroxypregna-1,4-diene-3,20-dione
    • .delta.1-Hydrocortisone
    • Adnisolone
    • Aprednislon
    • Capsoid
    • Cortalone
    • Cortisolone
    • Dacortin H
    • Decaprednil
    • Decortin H
    • Delta(1)Hydrocortisone
    • Delta- Cortef
    • Delta-Cortef
    • Delta-Diona
    • Delta-F
    • Delta-Phoricol
    • Delta1-dehydro-hydrocortisone
    • Deltacortril
    • Deltahydrocortisone
    • Deltasolone
    • Deltidrosol
    • Dhasolone
    • Di-Adreson-F
    • Dontisolon D
    • Estilsona
    • Fisopred
    • Frisolona
    • Gupisone
    • Hostacortin H
    • Hydeltra
    • Hydeltrasol
    • Klismacort
    • Kuhlprednon
    • Lenisolone
    • Lepi-Cortinolo
    • Linola-H N
    • Linola-H-Fett N
    • Longiprednil
    • Metacortandralone
    • Meti Derm
    • Meticortelone
    • Opredsone
    • Panafcortelone
    • Precortisyl
    • Pred-Clysma
    • Predeltilone
    • Predni-Coelin
    • Predni-Helvacort
    • Prednicortelone
    • Prednisolonum
    • Prelone
    • Prenilone
    • Sterane
  • Drug: Prednisone
    Given PO
    Other names:
    • .delta.1-Cortisone
    • 1, 2-Dehydrocortisone
    • Adasone
    • Cortancyl
    • Dacortin
    • DeCortin
    • Decortisyl
    • Decorton
    • Delta 1-Cortisone
    • Delta-Dome
    • Deltacortene
    • Deltacortisone
    • Deltadehydrocortisone
    • Deltasone
    • Deltison
    • Deltra
    • Econosone
    • Lisacort
    • Meprosona-F
    • Metacortandracin
    • Meticorten
    • Ofisolona
    • Orasone
    • Panafcort
    • Panasol-S
    • Paracort
    • Perrigo Prednisone
    • PRED
    • Predicor
    • Predicorten
    • Prednicen-M
    • Prednicort
    • Prednidib
    • Prednilonga
    • Predniment
    • Prednisone Intensol
    • Prednisonum
    • Prednitone
    • Promifen
    • Rayos
    • Servisone
    • SK-Prednisone
  • Biological: Rituximab
    Given IV
    Other names:
    • ABP 798
    • BI 695500
    • C2B8 Monoclonal Antibody
    • Chimeric Anti-CD20 Antibody
    • CT-P10
    • IDEC-102
    • IDEC-C2B8
    • IDEC-C2B8 Monoclonal Antibody
    • Ikgdar
    • Mabtas
    • MabThera
    • Monoclonal Antibody IDEC-C2B8
    • PF-05280586
    • Riabni
    • Rituxan
    • Rituximab ABBS
    • Rituximab ARRX
    • Rituximab Biosimilar ABP 798
    • Rituximab Biosimilar BI 695500
    • Rituximab Biosimilar CT-P10
    • Rituximab Biosimilar GB241
    • Rituximab Biosimilar IBI301
    • Rituximab Biosimilar JHL1101
    • Rituximab Biosimilar PF-05280586
    • Rituximab Biosimilar RTXM83
    • Rituximab Biosimilar SAIT101
    • Rituximab Biosimilar SIBP-02
    • rituximab biosimilar TQB2303
    • Rituximab PVVR
    • Rituximab-abbs
    • Rituximab-arrx
    • Rituximab-pvvr
    • RTXM83
    • Ruxience
    • Truxima
  • Biological: Rituximab and Hyaluronidase Human
    Given SC
    Other names:
    • Rituxan Hycela
    • Rituximab Plus Hyaluronidase
    • Rituximab/Hyaluronidase
    • Rituximab/Hyaluronidase Human
  • Drug: Vincristine Sulfate
    Given IV
    Other names:
    • Kyocristine
    • Leurocristine Sulfate
    • Leurocristine, sulfate
    • Oncovin
    • Vincasar
    • Vincosid
    • Vincrex
    • Vincristine, sulfate
Experimental
Arm B (DA-EPOCH-R, nivolumab)
Patients receive treatment as in Arm A. Patients also receive nivolumab IV over 30 minutes on day 1. Treatment repeats every 21 days for up to 6 cycles (5 if the patient had 1 prior cycle of treatment) in the absence of disease progression or unacceptable toxicity. Patients undergo ECHO and LP for CSF collection during screening. Patients undergo ECHO during screening and as clinically indicated and LP for CSF collection optionally during screening. Patients also undergo CT or PET/CT throughout the trial. Additionally, patients undergo bone marrow biopsy and aspiration optionally during screening and as clinically indicated on study. Patients undergo blood sample collection on study.
  • Procedure: Biospecimen Collection
    Undergo blood and CSF sample collection
    Other names:
    • Biological Sample Collection
    • Biospecimen Collected
    • Specimen Collection
  • Procedure: Bone Marrow Aspiration
    Undergo bone marrow biopsy and aspiration
  • Procedure: Bone Marrow Biopsy
    Undergo bone marrow biopsy and aspiration
    Other names:
    • Biopsy of Bone Marrow
    • Biopsy, Bone Marrow
  • Procedure: Computed Tomography
    Undergo CT or PET/CT
    Other names:
    • CAT
    • CAT Scan
    • Computed Axial Tomography
    • Computerized Axial Tomography
    • Computerized axial tomography (procedure)
    • Computerized Tomography
    • Computerized Tomography (CT) scan
    • CT
    • CT Scan
    • tomography
  • Drug: Cyclophosphamide
    Given IV
    Other names:
    • (-)-Cyclophosphamide
    • 2H-1,3,2-Oxazaphosphorine, 2-[bis(2-chloroethyl)amino]tetrahydro-, 2-oxide, monohydrate
    • Asta B 518
    • B-518
    • Carloxan
    • Ciclofosfamida
    • Ciclofosfamide
    • Cicloxal
    • Clafen
    • Claphene
    • CP monohydrate
    • CTX
    • CYCLO-cell
    • Cycloblastin
    • Cycloblastine
    • Cyclophospham
    • Cyclophosphamid monohydrate
    • Cyclophosphamide Monohydrate
    • Cyclophosphamidum
    • Cyclophosphan
    • Cyclophosphane
    • Cyclophosphanum
    • Cyclostin
    • Cyclostine
    • Cytophosphan
    • Cytophosphane
    • Cytoxan
    • Fosfaseron
    • Genoxal
    • Genuxal
    • Ledoxina
    • Mitoxan
    • Neosar
    • Revimmune
    • Syklofosfamid
    • WR- 138719
    • WR-138719
  • Drug: Doxorubicin Hydrochloride
    Given IV
    Other names:
    • 5,12-Naphthacenedione, 10-[(3-amino-2,3,6-trideoxy-alpha-L-lyxo-hexopyranosyl)oxy]-7,8, 9,10-tetrahydro-6,8,11-trihydroxy-8-(hydroxyacetyl)-1-methoxy-, hydrochloride, (8S-cis)- (9CI)
    • ADM
    • Adriacin
    • Adriamycin
    • Adriamycin Hydrochloride
    • Adriamycin PFS
    • Adriamycin RDF
    • ADRIAMYCIN, HYDROCHLORIDE
    • Adriamycine
    • Adriblastina
    • Adriblastine
    • Adrimedac
    • Chloridrato de Doxorrubicina
    • DOX
    • DOXO-CELL
    • Doxolem
    • Doxorubicin HCl
    • Doxorubicin.HCl
    • Doxorubin
    • Farmiblastina
    • FI 106
    • FI-106
    • hydroxydaunorubicin
    • Rubex
  • Procedure: Echocardiography
    Undergo ECHO
    Other names:
    • EC
  • Drug: Etoposide Phosphate
    Given IV
    Other names:
    • Etopophos
  • Biological: Filgrastim
    Given SC
    Other names:
    • Filgrastim Biosimilar Filgrastim-sndz
    • Filgrastim Biosimilar Tbo-filgrastim
    • Filgrastim XM02
    • Filgrastim-aafi
    • Filgrastim-ayow
    • Filgrastim-sndz
    • G-CSF
    • Granix
    • Neupogen
    • Neutroval
    • Nivestym
    • r-metHuG-CSF
    • Recombinant Methionyl Human Granulocyte Colony Stimulating Factor
    • Releuko
    • rG-CSF
    • Tbo-filgrastim
    • Tevagrastim
    • XM02
    • Zarxio
  • Procedure: Lumbar Puncture
    Undergo LP
    Other names:
    • LP
    • Spinal Tap
  • Biological: Nivolumab
    Given IV
    Other names:
    • ABP 206
    • BCD-263
    • BMS-936558
    • CMAB819
    • MDX-1106
    • NIVO
    • Nivolumab Biosimilar ABP 206
    • Nivolumab Biosimilar BCD-263
    • Nivolumab Biosimilar CMAB819
    • ONO-4538
    • Opdivo
  • Biological: Pegfilgrastim
    Given SC
    Other names:
    • Dulastin
    • Filgrastim SD-01
    • filgrastim-SD/01
    • Fulphila
    • HSP-130
    • Jinyouli
    • Neulasta
    • Neulastim
    • Neupopeg
    • Nyvepria
    • PEG-filgrastim
    • Pegcyte
    • Pegfilgrastim Biosimilar HSP-130
    • Pegfilgrastim Biosimilar Nyvepria
    • Pegfilgrastim Biosimilar Pegcyte
    • Pegfilgrastim Biosimilar PF-06881894
    • Pegfilgrastim Biosimilar Udenyca
    • Pegfilgrastim Biosimilar Ziextenzo
    • Pegfilgrastim-apgf
    • Pegfilgrastim-bmez
    • Pegfilgrastim-cbqv
    • Pegfilgrastim-jmdb
    • Pegylated G-CSF
    • Pegylated GCSF
    • Pegylated Granulocyte Colony Stimulating Factor
    • PF-06881894
    • SD-01
    • SD-01 sustained duration G-CSF
    • Tripegfilgrastim
    • Udenyca
    • Ziextenzo
  • Procedure: Positron Emission Tomography
    Undergo PET/CT
    Other names:
    • Medical Imaging, Positron Emission Tomography
    • PET
    • PET Scan
    • Positron emission tomography (procedure)
    • Positron Emission Tomography Scan
    • Positron-Emission Tomography
    • proton magnetic resonance spectroscopic imaging
    • PT
  • Drug: Prednisolone
    Given PO
    Other names:
    • (11beta)-11,17,21-Trihydroxypregna-1,4-diene-3,20-dione
    • .delta.1-Hydrocortisone
    • Adnisolone
    • Aprednislon
    • Capsoid
    • Cortalone
    • Cortisolone
    • Dacortin H
    • Decaprednil
    • Decortin H
    • Delta(1)Hydrocortisone
    • Delta- Cortef
    • Delta-Cortef
    • Delta-Diona
    • Delta-F
    • Delta-Phoricol
    • Delta1-dehydro-hydrocortisone
    • Deltacortril
    • Deltahydrocortisone
    • Deltasolone
    • Deltidrosol
    • Dhasolone
    • Di-Adreson-F
    • Dontisolon D
    • Estilsona
    • Fisopred
    • Frisolona
    • Gupisone
    • Hostacortin H
    • Hydeltra
    • Hydeltrasol
    • Klismacort
    • Kuhlprednon
    • Lenisolone
    • Lepi-Cortinolo
    • Linola-H N
    • Linola-H-Fett N
    • Longiprednil
    • Metacortandralone
    • Meti Derm
    • Meticortelone
    • Opredsone
    • Panafcortelone
    • Precortisyl
    • Pred-Clysma
    • Predeltilone
    • Predni-Coelin
    • Predni-Helvacort
    • Prednicortelone
    • Prednisolonum
    • Prelone
    • Prenilone
    • Sterane
  • Drug: Prednisone
    Given PO
    Other names:
    • .delta.1-Cortisone
    • 1, 2-Dehydrocortisone
    • Adasone
    • Cortancyl
    • Dacortin
    • DeCortin
    • Decortisyl
    • Decorton
    • Delta 1-Cortisone
    • Delta-Dome
    • Deltacortene
    • Deltacortisone
    • Deltadehydrocortisone
    • Deltasone
    • Deltison
    • Deltra
    • Econosone
    • Lisacort
    • Meprosona-F
    • Metacortandracin
    • Meticorten
    • Ofisolona
    • Orasone
    • Panafcort
    • Panasol-S
    • Paracort
    • Perrigo Prednisone
    • PRED
    • Predicor
    • Predicorten
    • Prednicen-M
    • Prednicort
    • Prednidib
    • Prednilonga
    • Predniment
    • Prednisone Intensol
    • Prednisonum
    • Prednitone
    • Promifen
    • Rayos
    • Servisone
    • SK-Prednisone
  • Biological: Rituximab
    Given IV
    Other names:
    • ABP 798
    • BI 695500
    • C2B8 Monoclonal Antibody
    • Chimeric Anti-CD20 Antibody
    • CT-P10
    • IDEC-102
    • IDEC-C2B8
    • IDEC-C2B8 Monoclonal Antibody
    • Ikgdar
    • Mabtas
    • MabThera
    • Monoclonal Antibody IDEC-C2B8
    • PF-05280586
    • Riabni
    • Rituxan
    • Rituximab ABBS
    • Rituximab ARRX
    • Rituximab Biosimilar ABP 798
    • Rituximab Biosimilar BI 695500
    • Rituximab Biosimilar CT-P10
    • Rituximab Biosimilar GB241
    • Rituximab Biosimilar IBI301
    • Rituximab Biosimilar JHL1101
    • Rituximab Biosimilar PF-05280586
    • Rituximab Biosimilar RTXM83
    • Rituximab Biosimilar SAIT101
    • Rituximab Biosimilar SIBP-02
    • rituximab biosimilar TQB2303
    • Rituximab PVVR
    • Rituximab-abbs
    • Rituximab-arrx
    • Rituximab-pvvr
    • RTXM83
    • Ruxience
    • Truxima
  • Biological: Rituximab and Hyaluronidase Human
    Given SC
    Other names:
    • Rituxan Hycela
    • Rituximab Plus Hyaluronidase
    • Rituximab/Hyaluronidase
    • Rituximab/Hyaluronidase Human
  • Drug: Vincristine Sulfate
    Given IV
    Other names:
    • Kyocristine
    • Leurocristine Sulfate
    • Leurocristine, sulfate
    • Oncovin
    • Vincasar
    • Vincosid
    • Vincrex
    • Vincristine, sulfate
Active Comparator
Arm C (R-CHOP)
Patients receive prednisone or prednisolone PO QD on days 1-5 and rituximab IV or rituximab and hyaluronidase human SC over 5 minutes on day 1 or 5. Patients also receive cyclophosphamide IV over 30-60 minutes, doxorubicin hydrochloride IV over 1-15 minutes or up to 60 minutes, and vincristine sulfate IV over 1 or up to 60 minutes on day 1. Treatment repeats every 21 days for up to 6 cycles (5 if the patient had 1 prior cycle of treatment) in the absence of disease progression or unacceptable toxicity. Patients undergo ECHO during screening and as clinically indicated and LP for CSF collection optionally during screening. Patients also undergo CT or PET/CT throughout the trial. Additionally, patients undergo bone marrow biopsy and aspiration optionally during screening and as clinically indicated on study. Patients undergo blood sample collection on study.
  • Procedure: Biospecimen Collection
    Undergo blood and CSF sample collection
    Other names:
    • Biological Sample Collection
    • Biospecimen Collected
    • Specimen Collection
  • Procedure: Bone Marrow Aspiration
    Undergo bone marrow biopsy and aspiration
  • Procedure: Bone Marrow Biopsy
    Undergo bone marrow biopsy and aspiration
    Other names:
    • Biopsy of Bone Marrow
    • Biopsy, Bone Marrow
  • Procedure: Computed Tomography
    Undergo CT or PET/CT
    Other names:
    • CAT
    • CAT Scan
    • Computed Axial Tomography
    • Computerized Axial Tomography
    • Computerized axial tomography (procedure)
    • Computerized Tomography
    • Computerized Tomography (CT) scan
    • CT
    • CT Scan
    • tomography
  • Drug: Cyclophosphamide
    Given IV
    Other names:
    • (-)-Cyclophosphamide
    • 2H-1,3,2-Oxazaphosphorine, 2-[bis(2-chloroethyl)amino]tetrahydro-, 2-oxide, monohydrate
    • Asta B 518
    • B-518
    • Carloxan
    • Ciclofosfamida
    • Ciclofosfamide
    • Cicloxal
    • Clafen
    • Claphene
    • CP monohydrate
    • CTX
    • CYCLO-cell
    • Cycloblastin
    • Cycloblastine
    • Cyclophospham
    • Cyclophosphamid monohydrate
    • Cyclophosphamide Monohydrate
    • Cyclophosphamidum
    • Cyclophosphan
    • Cyclophosphane
    • Cyclophosphanum
    • Cyclostin
    • Cyclostine
    • Cytophosphan
    • Cytophosphane
    • Cytoxan
    • Fosfaseron
    • Genoxal
    • Genuxal
    • Ledoxina
    • Mitoxan
    • Neosar
    • Revimmune
    • Syklofosfamid
    • WR- 138719
    • WR-138719
  • Drug: Doxorubicin Hydrochloride
    Given IV
    Other names:
    • 5,12-Naphthacenedione, 10-[(3-amino-2,3,6-trideoxy-alpha-L-lyxo-hexopyranosyl)oxy]-7,8, 9,10-tetrahydro-6,8,11-trihydroxy-8-(hydroxyacetyl)-1-methoxy-, hydrochloride, (8S-cis)- (9CI)
    • ADM
    • Adriacin
    • Adriamycin
    • Adriamycin Hydrochloride
    • Adriamycin PFS
    • Adriamycin RDF
    • ADRIAMYCIN, HYDROCHLORIDE
    • Adriamycine
    • Adriblastina
    • Adriblastine
    • Adrimedac
    • Chloridrato de Doxorrubicina
    • DOX
    • DOXO-CELL
    • Doxolem
    • Doxorubicin HCl
    • Doxorubicin.HCl
    • Doxorubin
    • Farmiblastina
    • FI 106
    • FI-106
    • hydroxydaunorubicin
    • Rubex
  • Procedure: Echocardiography
    Undergo ECHO
    Other names:
    • EC
  • Procedure: Lumbar Puncture
    Undergo LP
    Other names:
    • LP
    • Spinal Tap
  • Procedure: Positron Emission Tomography
    Undergo PET/CT
    Other names:
    • Medical Imaging, Positron Emission Tomography
    • PET
    • PET Scan
    • Positron emission tomography (procedure)
    • Positron Emission Tomography Scan
    • Positron-Emission Tomography
    • proton magnetic resonance spectroscopic imaging
    • PT
  • Drug: Prednisolone
    Given PO
    Other names:
    • (11beta)-11,17,21-Trihydroxypregna-1,4-diene-3,20-dione
    • .delta.1-Hydrocortisone
    • Adnisolone
    • Aprednislon
    • Capsoid
    • Cortalone
    • Cortisolone
    • Dacortin H
    • Decaprednil
    • Decortin H
    • Delta(1)Hydrocortisone
    • Delta- Cortef
    • Delta-Cortef
    • Delta-Diona
    • Delta-F
    • Delta-Phoricol
    • Delta1-dehydro-hydrocortisone
    • Deltacortril
    • Deltahydrocortisone
    • Deltasolone
    • Deltidrosol
    • Dhasolone
    • Di-Adreson-F
    • Dontisolon D
    • Estilsona
    • Fisopred
    • Frisolona
    • Gupisone
    • Hostacortin H
    • Hydeltra
    • Hydeltrasol
    • Klismacort
    • Kuhlprednon
    • Lenisolone
    • Lepi-Cortinolo
    • Linola-H N
    • Linola-H-Fett N
    • Longiprednil
    • Metacortandralone
    • Meti Derm
    • Meticortelone
    • Opredsone
    • Panafcortelone
    • Precortisyl
    • Pred-Clysma
    • Predeltilone
    • Predni-Coelin
    • Predni-Helvacort
    • Prednicortelone
    • Prednisolonum
    • Prelone
    • Prenilone
    • Sterane
  • Drug: Prednisone
    Given PO
    Other names:
    • .delta.1-Cortisone
    • 1, 2-Dehydrocortisone
    • Adasone
    • Cortancyl
    • Dacortin
    • DeCortin
    • Decortisyl
    • Decorton
    • Delta 1-Cortisone
    • Delta-Dome
    • Deltacortene
    • Deltacortisone
    • Deltadehydrocortisone
    • Deltasone
    • Deltison
    • Deltra
    • Econosone
    • Lisacort
    • Meprosona-F
    • Metacortandracin
    • Meticorten
    • Ofisolona
    • Orasone
    • Panafcort
    • Panasol-S
    • Paracort
    • Perrigo Prednisone
    • PRED
    • Predicor
    • Predicorten
    • Prednicen-M
    • Prednicort
    • Prednidib
    • Prednilonga
    • Predniment
    • Prednisone Intensol
    • Prednisonum
    • Prednitone
    • Promifen
    • Rayos
    • Servisone
    • SK-Prednisone
  • Biological: Rituximab
    Given IV
    Other names:
    • ABP 798
    • BI 695500
    • C2B8 Monoclonal Antibody
    • Chimeric Anti-CD20 Antibody
    • CT-P10
    • IDEC-102
    • IDEC-C2B8
    • IDEC-C2B8 Monoclonal Antibody
    • Ikgdar
    • Mabtas
    • MabThera
    • Monoclonal Antibody IDEC-C2B8
    • PF-05280586
    • Riabni
    • Rituxan
    • Rituximab ABBS
    • Rituximab ARRX
    • Rituximab Biosimilar ABP 798
    • Rituximab Biosimilar BI 695500
    • Rituximab Biosimilar CT-P10
    • Rituximab Biosimilar GB241
    • Rituximab Biosimilar IBI301
    • Rituximab Biosimilar JHL1101
    • Rituximab Biosimilar PF-05280586
    • Rituximab Biosimilar RTXM83
    • Rituximab Biosimilar SAIT101
    • Rituximab Biosimilar SIBP-02
    • rituximab biosimilar TQB2303
    • Rituximab PVVR
    • Rituximab-abbs
    • Rituximab-arrx
    • Rituximab-pvvr
    • RTXM83
    • Ruxience
    • Truxima
  • Biological: Rituximab and Hyaluronidase Human
    Given SC
    Other names:
    • Rituxan Hycela
    • Rituximab Plus Hyaluronidase
    • Rituximab/Hyaluronidase
    • Rituximab/Hyaluronidase Human
  • Drug: Vincristine Sulfate
    Given IV
    Other names:
    • Kyocristine
    • Leurocristine Sulfate
    • Leurocristine, sulfate
    • Oncovin
    • Vincasar
    • Vincosid
    • Vincrex
    • Vincristine, sulfate
Experimental
Arm D (R-CHOP, nivolumab)
Patients receive treatment as in Arm C. Patients also receive nivolumab IV over 30 minutes on day 1. Treatment repeats every 21 days for up to 6 cycles (5 if the patient had 1 prior cycle of treatment) in the absence of disease progression or unacceptable toxicity. Patients undergo ECHO during screening and as clinically indicated and LP for CSF collection optionally during screening. Patients also undergo CT or PET/CT throughout the trial. Additionally, patients undergo bone marrow biopsy and aspiration optionally during screening and as clinically indicated on study. Patients undergo blood sample collection on study.
  • Procedure: Biospecimen Collection
    Undergo blood and CSF sample collection
    Other names:
    • Biological Sample Collection
    • Biospecimen Collected
    • Specimen Collection
  • Procedure: Bone Marrow Aspiration
    Undergo bone marrow biopsy and aspiration
  • Procedure: Bone Marrow Biopsy
    Undergo bone marrow biopsy and aspiration
    Other names:
    • Biopsy of Bone Marrow
    • Biopsy, Bone Marrow
  • Procedure: Computed Tomography
    Undergo CT or PET/CT
    Other names:
    • CAT
    • CAT Scan
    • Computed Axial Tomography
    • Computerized Axial Tomography
    • Computerized axial tomography (procedure)
    • Computerized Tomography
    • Computerized Tomography (CT) scan
    • CT
    • CT Scan
    • tomography
  • Drug: Cyclophosphamide
    Given IV
    Other names:
    • (-)-Cyclophosphamide
    • 2H-1,3,2-Oxazaphosphorine, 2-[bis(2-chloroethyl)amino]tetrahydro-, 2-oxide, monohydrate
    • Asta B 518
    • B-518
    • Carloxan
    • Ciclofosfamida
    • Ciclofosfamide
    • Cicloxal
    • Clafen
    • Claphene
    • CP monohydrate
    • CTX
    • CYCLO-cell
    • Cycloblastin
    • Cycloblastine
    • Cyclophospham
    • Cyclophosphamid monohydrate
    • Cyclophosphamide Monohydrate
    • Cyclophosphamidum
    • Cyclophosphan
    • Cyclophosphane
    • Cyclophosphanum
    • Cyclostin
    • Cyclostine
    • Cytophosphan
    • Cytophosphane
    • Cytoxan
    • Fosfaseron
    • Genoxal
    • Genuxal
    • Ledoxina
    • Mitoxan
    • Neosar
    • Revimmune
    • Syklofosfamid
    • WR- 138719
    • WR-138719
  • Drug: Doxorubicin Hydrochloride
    Given IV
    Other names:
    • 5,12-Naphthacenedione, 10-[(3-amino-2,3,6-trideoxy-alpha-L-lyxo-hexopyranosyl)oxy]-7,8, 9,10-tetrahydro-6,8,11-trihydroxy-8-(hydroxyacetyl)-1-methoxy-, hydrochloride, (8S-cis)- (9CI)
    • ADM
    • Adriacin
    • Adriamycin
    • Adriamycin Hydrochloride
    • Adriamycin PFS
    • Adriamycin RDF
    • ADRIAMYCIN, HYDROCHLORIDE
    • Adriamycine
    • Adriblastina
    • Adriblastine
    • Adrimedac
    • Chloridrato de Doxorrubicina
    • DOX
    • DOXO-CELL
    • Doxolem
    • Doxorubicin HCl
    • Doxorubicin.HCl
    • Doxorubin
    • Farmiblastina
    • FI 106
    • FI-106
    • hydroxydaunorubicin
    • Rubex
  • Procedure: Echocardiography
    Undergo ECHO
    Other names:
    • EC
  • Procedure: Lumbar Puncture
    Undergo LP
    Other names:
    • LP
    • Spinal Tap
  • Biological: Nivolumab
    Given IV
    Other names:
    • ABP 206
    • BCD-263
    • BMS-936558
    • CMAB819
    • MDX-1106
    • NIVO
    • Nivolumab Biosimilar ABP 206
    • Nivolumab Biosimilar BCD-263
    • Nivolumab Biosimilar CMAB819
    • ONO-4538
    • Opdivo
  • Procedure: Positron Emission Tomography
    Undergo PET/CT
    Other names:
    • Medical Imaging, Positron Emission Tomography
    • PET
    • PET Scan
    • Positron emission tomography (procedure)
    • Positron Emission Tomography Scan
    • Positron-Emission Tomography
    • proton magnetic resonance spectroscopic imaging
    • PT
  • Drug: Prednisolone
    Given PO
    Other names:
    • (11beta)-11,17,21-Trihydroxypregna-1,4-diene-3,20-dione
    • .delta.1-Hydrocortisone
    • Adnisolone
    • Aprednislon
    • Capsoid
    • Cortalone
    • Cortisolone
    • Dacortin H
    • Decaprednil
    • Decortin H
    • Delta(1)Hydrocortisone
    • Delta- Cortef
    • Delta-Cortef
    • Delta-Diona
    • Delta-F
    • Delta-Phoricol
    • Delta1-dehydro-hydrocortisone
    • Deltacortril
    • Deltahydrocortisone
    • Deltasolone
    • Deltidrosol
    • Dhasolone
    • Di-Adreson-F
    • Dontisolon D
    • Estilsona
    • Fisopred
    • Frisolona
    • Gupisone
    • Hostacortin H
    • Hydeltra
    • Hydeltrasol
    • Klismacort
    • Kuhlprednon
    • Lenisolone
    • Lepi-Cortinolo
    • Linola-H N
    • Linola-H-Fett N
    • Longiprednil
    • Metacortandralone
    • Meti Derm
    • Meticortelone
    • Opredsone
    • Panafcortelone
    • Precortisyl
    • Pred-Clysma
    • Predeltilone
    • Predni-Coelin
    • Predni-Helvacort
    • Prednicortelone
    • Prednisolonum
    • Prelone
    • Prenilone
    • Sterane
  • Drug: Prednisone
    Given PO
    Other names:
    • .delta.1-Cortisone
    • 1, 2-Dehydrocortisone
    • Adasone
    • Cortancyl
    • Dacortin
    • DeCortin
    • Decortisyl
    • Decorton
    • Delta 1-Cortisone
    • Delta-Dome
    • Deltacortene
    • Deltacortisone
    • Deltadehydrocortisone
    • Deltasone
    • Deltison
    • Deltra
    • Econosone
    • Lisacort
    • Meprosona-F
    • Metacortandracin
    • Meticorten
    • Ofisolona
    • Orasone
    • Panafcort
    • Panasol-S
    • Paracort
    • Perrigo Prednisone
    • PRED
    • Predicor
    • Predicorten
    • Prednicen-M
    • Prednicort
    • Prednidib
    • Prednilonga
    • Predniment
    • Prednisone Intensol
    • Prednisonum
    • Prednitone
    • Promifen
    • Rayos
    • Servisone
    • SK-Prednisone
  • Biological: Rituximab
    Given IV
    Other names:
    • ABP 798
    • BI 695500
    • C2B8 Monoclonal Antibody
    • Chimeric Anti-CD20 Antibody
    • CT-P10
    • IDEC-102
    • IDEC-C2B8
    • IDEC-C2B8 Monoclonal Antibody
    • Ikgdar
    • Mabtas
    • MabThera
    • Monoclonal Antibody IDEC-C2B8
    • PF-05280586
    • Riabni
    • Rituxan
    • Rituximab ABBS
    • Rituximab ARRX
    • Rituximab Biosimilar ABP 798
    • Rituximab Biosimilar BI 695500
    • Rituximab Biosimilar CT-P10
    • Rituximab Biosimilar GB241
    • Rituximab Biosimilar IBI301
    • Rituximab Biosimilar JHL1101
    • Rituximab Biosimilar PF-05280586
    • Rituximab Biosimilar RTXM83
    • Rituximab Biosimilar SAIT101
    • Rituximab Biosimilar SIBP-02
    • rituximab biosimilar TQB2303
    • Rituximab PVVR
    • Rituximab-abbs
    • Rituximab-arrx
    • Rituximab-pvvr
    • RTXM83
    • Ruxience
    • Truxima
  • Biological: Rituximab and Hyaluronidase Human
    Given SC
    Other names:
    • Rituxan Hycela
    • Rituximab Plus Hyaluronidase
    • Rituximab/Hyaluronidase
    • Rituximab/Hyaluronidase Human
  • Drug: Vincristine Sulfate
    Given IV
    Other names:
    • Kyocristine
    • Leurocristine Sulfate
    • Leurocristine, sulfate
    • Oncovin
    • Vincasar
    • Vincosid
    • Vincrex
    • Vincristine, sulfate
Active Comparator
Arm E (R-CHOP, radiation therapy)
Patients receive treatment as in Arm C. Within 6-8 weeks after completion of chemotherapy, patients undergo radiation therapy over 25 fractions. Patients undergo ECHO during screening and as clinically indicated and LP for CSF collection optionally during screening. Patients also undergo CT or PET/CT throughout the trial. Additionally, patients undergo bone marrow biopsy and aspiration optionally during screening and as clinically indicated on study. Patients undergo blood sample collection on study.
  • Procedure: Biospecimen Collection
    Undergo blood and CSF sample collection
    Other names:
    • Biological Sample Collection
    • Biospecimen Collected
    • Specimen Collection
  • Procedure: Bone Marrow Aspiration
    Undergo bone marrow biopsy and aspiration
  • Procedure: Bone Marrow Biopsy
    Undergo bone marrow biopsy and aspiration
    Other names:
    • Biopsy of Bone Marrow
    • Biopsy, Bone Marrow
  • Procedure: Computed Tomography
    Undergo CT or PET/CT
    Other names:
    • CAT
    • CAT Scan
    • Computed Axial Tomography
    • Computerized Axial Tomography
    • Computerized axial tomography (procedure)
    • Computerized Tomography
    • Computerized Tomography (CT) scan
    • CT
    • CT Scan
    • tomography
  • Drug: Cyclophosphamide
    Given IV
    Other names:
    • (-)-Cyclophosphamide
    • 2H-1,3,2-Oxazaphosphorine, 2-[bis(2-chloroethyl)amino]tetrahydro-, 2-oxide, monohydrate
    • Asta B 518
    • B-518
    • Carloxan
    • Ciclofosfamida
    • Ciclofosfamide
    • Cicloxal
    • Clafen
    • Claphene
    • CP monohydrate
    • CTX
    • CYCLO-cell
    • Cycloblastin
    • Cycloblastine
    • Cyclophospham
    • Cyclophosphamid monohydrate
    • Cyclophosphamide Monohydrate
    • Cyclophosphamidum
    • Cyclophosphan
    • Cyclophosphane
    • Cyclophosphanum
    • Cyclostin
    • Cyclostine
    • Cytophosphan
    • Cytophosphane
    • Cytoxan
    • Fosfaseron
    • Genoxal
    • Genuxal
    • Ledoxina
    • Mitoxan
    • Neosar
    • Revimmune
    • Syklofosfamid
    • WR- 138719
    • WR-138719
  • Drug: Doxorubicin Hydrochloride
    Given IV
    Other names:
    • 5,12-Naphthacenedione, 10-[(3-amino-2,3,6-trideoxy-alpha-L-lyxo-hexopyranosyl)oxy]-7,8, 9,10-tetrahydro-6,8,11-trihydroxy-8-(hydroxyacetyl)-1-methoxy-, hydrochloride, (8S-cis)- (9CI)
    • ADM
    • Adriacin
    • Adriamycin
    • Adriamycin Hydrochloride
    • Adriamycin PFS
    • Adriamycin RDF
    • ADRIAMYCIN, HYDROCHLORIDE
    • Adriamycine
    • Adriblastina
    • Adriblastine
    • Adrimedac
    • Chloridrato de Doxorrubicina
    • DOX
    • DOXO-CELL
    • Doxolem
    • Doxorubicin HCl
    • Doxorubicin.HCl
    • Doxorubin
    • Farmiblastina
    • FI 106
    • FI-106
    • hydroxydaunorubicin
    • Rubex
  • Procedure: Echocardiography
    Undergo ECHO
    Other names:
    • EC
  • Procedure: Lumbar Puncture
    Undergo LP
    Other names:
    • LP
    • Spinal Tap
  • Procedure: Positron Emission Tomography
    Undergo PET/CT
    Other names:
    • Medical Imaging, Positron Emission Tomography
    • PET
    • PET Scan
    • Positron emission tomography (procedure)
    • Positron Emission Tomography Scan
    • Positron-Emission Tomography
    • proton magnetic resonance spectroscopic imaging
    • PT
  • Drug: Prednisolone
    Given PO
    Other names:
    • (11beta)-11,17,21-Trihydroxypregna-1,4-diene-3,20-dione
    • .delta.1-Hydrocortisone
    • Adnisolone
    • Aprednislon
    • Capsoid
    • Cortalone
    • Cortisolone
    • Dacortin H
    • Decaprednil
    • Decortin H
    • Delta(1)Hydrocortisone
    • Delta- Cortef
    • Delta-Cortef
    • Delta-Diona
    • Delta-F
    • Delta-Phoricol
    • Delta1-dehydro-hydrocortisone
    • Deltacortril
    • Deltahydrocortisone
    • Deltasolone
    • Deltidrosol
    • Dhasolone
    • Di-Adreson-F
    • Dontisolon D
    • Estilsona
    • Fisopred
    • Frisolona
    • Gupisone
    • Hostacortin H
    • Hydeltra
    • Hydeltrasol
    • Klismacort
    • Kuhlprednon
    • Lenisolone
    • Lepi-Cortinolo
    • Linola-H N
    • Linola-H-Fett N
    • Longiprednil
    • Metacortandralone
    • Meti Derm
    • Meticortelone
    • Opredsone
    • Panafcortelone
    • Precortisyl
    • Pred-Clysma
    • Predeltilone
    • Predni-Coelin
    • Predni-Helvacort
    • Prednicortelone
    • Prednisolonum
    • Prelone
    • Prenilone
    • Sterane
  • Drug: Prednisone
    Given PO
    Other names:
    • .delta.1-Cortisone
    • 1, 2-Dehydrocortisone
    • Adasone
    • Cortancyl
    • Dacortin
    • DeCortin
    • Decortisyl
    • Decorton
    • Delta 1-Cortisone
    • Delta-Dome
    • Deltacortene
    • Deltacortisone
    • Deltadehydrocortisone
    • Deltasone
    • Deltison
    • Deltra
    • Econosone
    • Lisacort
    • Meprosona-F
    • Metacortandracin
    • Meticorten
    • Ofisolona
    • Orasone
    • Panafcort
    • Panasol-S
    • Paracort
    • Perrigo Prednisone
    • PRED
    • Predicor
    • Predicorten
    • Prednicen-M
    • Prednicort
    • Prednidib
    • Prednilonga
    • Predniment
    • Prednisone Intensol
    • Prednisonum
    • Prednitone
    • Promifen
    • Rayos
    • Servisone
    • SK-Prednisone
  • Radiation: Radiation Therapy
    Undergo radiation therapy
    Other names:
    • Cancer Radiotherapy
    • Energy Type
    • ENERGY_TYPE
    • Irradiate
    • Irradiated
    • Irradiation
    • Radiation
    • Radiation Therapy, NOS
    • Radiotherapeutics
    • Radiotherapy
    • RT
    • Therapy, Radiation
  • Biological: Rituximab
    Given IV
    Other names:
    • ABP 798
    • BI 695500
    • C2B8 Monoclonal Antibody
    • Chimeric Anti-CD20 Antibody
    • CT-P10
    • IDEC-102
    • IDEC-C2B8
    • IDEC-C2B8 Monoclonal Antibody
    • Ikgdar
    • Mabtas
    • MabThera
    • Monoclonal Antibody IDEC-C2B8
    • PF-05280586
    • Riabni
    • Rituxan
    • Rituximab ABBS
    • Rituximab ARRX
    • Rituximab Biosimilar ABP 798
    • Rituximab Biosimilar BI 695500
    • Rituximab Biosimilar CT-P10
    • Rituximab Biosimilar GB241
    • Rituximab Biosimilar IBI301
    • Rituximab Biosimilar JHL1101
    • Rituximab Biosimilar PF-05280586
    • Rituximab Biosimilar RTXM83
    • Rituximab Biosimilar SAIT101
    • Rituximab Biosimilar SIBP-02
    • rituximab biosimilar TQB2303
    • Rituximab PVVR
    • Rituximab-abbs
    • Rituximab-arrx
    • Rituximab-pvvr
    • RTXM83
    • Ruxience
    • Truxima
  • Biological: Rituximab and Hyaluronidase Human
    Given SC
    Other names:
    • Rituxan Hycela
    • Rituximab Plus Hyaluronidase
    • Rituximab/Hyaluronidase
    • Rituximab/Hyaluronidase Human
  • Drug: Vincristine Sulfate
    Given IV
    Other names:
    • Kyocristine
    • Leurocristine Sulfate
    • Leurocristine, sulfate
    • Oncovin
    • Vincasar
    • Vincosid
    • Vincrex
    • Vincristine, sulfate
Experimental
Arm F (R-CHOP, nivolumab, radiation therapy)
Patients receive treatment as in Arm D. Within 6-8 weeks after completion of chemotherapy, patients undergo radiation therapy over 25 fractions. Patients undergo ECHO during screening and as clinically indicated and LP for CSF collection optionally during screening. Patients also undergo CT or PET/CT throughout the trial. Additionally, patients undergo bone marrow biopsy and aspiration optionally during screening and as clinically indicated on study. Patients undergo blood sample collection on study.
  • Procedure: Biospecimen Collection
    Undergo blood and CSF sample collection
    Other names:
    • Biological Sample Collection
    • Biospecimen Collected
    • Specimen Collection
  • Procedure: Bone Marrow Aspiration
    Undergo bone marrow biopsy and aspiration
  • Procedure: Bone Marrow Biopsy
    Undergo bone marrow biopsy and aspiration
    Other names:
    • Biopsy of Bone Marrow
    • Biopsy, Bone Marrow
  • Procedure: Computed Tomography
    Undergo CT or PET/CT
    Other names:
    • CAT
    • CAT Scan
    • Computed Axial Tomography
    • Computerized Axial Tomography
    • Computerized axial tomography (procedure)
    • Computerized Tomography
    • Computerized Tomography (CT) scan
    • CT
    • CT Scan
    • tomography
  • Drug: Cyclophosphamide
    Given IV
    Other names:
    • (-)-Cyclophosphamide
    • 2H-1,3,2-Oxazaphosphorine, 2-[bis(2-chloroethyl)amino]tetrahydro-, 2-oxide, monohydrate
    • Asta B 518
    • B-518
    • Carloxan
    • Ciclofosfamida
    • Ciclofosfamide
    • Cicloxal
    • Clafen
    • Claphene
    • CP monohydrate
    • CTX
    • CYCLO-cell
    • Cycloblastin
    • Cycloblastine
    • Cyclophospham
    • Cyclophosphamid monohydrate
    • Cyclophosphamide Monohydrate
    • Cyclophosphamidum
    • Cyclophosphan
    • Cyclophosphane
    • Cyclophosphanum
    • Cyclostin
    • Cyclostine
    • Cytophosphan
    • Cytophosphane
    • Cytoxan
    • Fosfaseron
    • Genoxal
    • Genuxal
    • Ledoxina
    • Mitoxan
    • Neosar
    • Revimmune
    • Syklofosfamid
    • WR- 138719
    • WR-138719
  • Drug: Doxorubicin Hydrochloride
    Given IV
    Other names:
    • 5,12-Naphthacenedione, 10-[(3-amino-2,3,6-trideoxy-alpha-L-lyxo-hexopyranosyl)oxy]-7,8, 9,10-tetrahydro-6,8,11-trihydroxy-8-(hydroxyacetyl)-1-methoxy-, hydrochloride, (8S-cis)- (9CI)
    • ADM
    • Adriacin
    • Adriamycin
    • Adriamycin Hydrochloride
    • Adriamycin PFS
    • Adriamycin RDF
    • ADRIAMYCIN, HYDROCHLORIDE
    • Adriamycine
    • Adriblastina
    • Adriblastine
    • Adrimedac
    • Chloridrato de Doxorrubicina
    • DOX
    • DOXO-CELL
    • Doxolem
    • Doxorubicin HCl
    • Doxorubicin.HCl
    • Doxorubin
    • Farmiblastina
    • FI 106
    • FI-106
    • hydroxydaunorubicin
    • Rubex
  • Procedure: Echocardiography
    Undergo ECHO
    Other names:
    • EC
  • Procedure: Lumbar Puncture
    Undergo LP
    Other names:
    • LP
    • Spinal Tap
  • Biological: Nivolumab
    Given IV
    Other names:
    • ABP 206
    • BCD-263
    • BMS-936558
    • CMAB819
    • MDX-1106
    • NIVO
    • Nivolumab Biosimilar ABP 206
    • Nivolumab Biosimilar BCD-263
    • Nivolumab Biosimilar CMAB819
    • ONO-4538
    • Opdivo
  • Procedure: Positron Emission Tomography
    Undergo PET/CT
    Other names:
    • Medical Imaging, Positron Emission Tomography
    • PET
    • PET Scan
    • Positron emission tomography (procedure)
    • Positron Emission Tomography Scan
    • Positron-Emission Tomography
    • proton magnetic resonance spectroscopic imaging
    • PT
  • Drug: Prednisolone
    Given PO
    Other names:
    • (11beta)-11,17,21-Trihydroxypregna-1,4-diene-3,20-dione
    • .delta.1-Hydrocortisone
    • Adnisolone
    • Aprednislon
    • Capsoid
    • Cortalone
    • Cortisolone
    • Dacortin H
    • Decaprednil
    • Decortin H
    • Delta(1)Hydrocortisone
    • Delta- Cortef
    • Delta-Cortef
    • Delta-Diona
    • Delta-F
    • Delta-Phoricol
    • Delta1-dehydro-hydrocortisone
    • Deltacortril
    • Deltahydrocortisone
    • Deltasolone
    • Deltidrosol
    • Dhasolone
    • Di-Adreson-F
    • Dontisolon D
    • Estilsona
    • Fisopred
    • Frisolona
    • Gupisone
    • Hostacortin H
    • Hydeltra
    • Hydeltrasol
    • Klismacort
    • Kuhlprednon
    • Lenisolone
    • Lepi-Cortinolo
    • Linola-H N
    • Linola-H-Fett N
    • Longiprednil
    • Metacortandralone
    • Meti Derm
    • Meticortelone
    • Opredsone
    • Panafcortelone
    • Precortisyl
    • Pred-Clysma
    • Predeltilone
    • Predni-Coelin
    • Predni-Helvacort
    • Prednicortelone
    • Prednisolonum
    • Prelone
    • Prenilone
    • Sterane
  • Drug: Prednisone
    Given PO
    Other names:
    • .delta.1-Cortisone
    • 1, 2-Dehydrocortisone
    • Adasone
    • Cortancyl
    • Dacortin
    • DeCortin
    • Decortisyl
    • Decorton
    • Delta 1-Cortisone
    • Delta-Dome
    • Deltacortene
    • Deltacortisone
    • Deltadehydrocortisone
    • Deltasone
    • Deltison
    • Deltra
    • Econosone
    • Lisacort
    • Meprosona-F
    • Metacortandracin
    • Meticorten
    • Ofisolona
    • Orasone
    • Panafcort
    • Panasol-S
    • Paracort
    • Perrigo Prednisone
    • PRED
    • Predicor
    • Predicorten
    • Prednicen-M
    • Prednicort
    • Prednidib
    • Prednilonga
    • Predniment
    • Prednisone Intensol
    • Prednisonum
    • Prednitone
    • Promifen
    • Rayos
    • Servisone
    • SK-Prednisone
  • Radiation: Radiation Therapy
    Undergo radiation therapy
    Other names:
    • Cancer Radiotherapy
    • Energy Type
    • ENERGY_TYPE
    • Irradiate
    • Irradiated
    • Irradiation
    • Radiation
    • Radiation Therapy, NOS
    • Radiotherapeutics
    • Radiotherapy
    • RT
    • Therapy, Radiation
  • Biological: Rituximab
    Given IV
    Other names:
    • ABP 798
    • BI 695500
    • C2B8 Monoclonal Antibody
    • Chimeric Anti-CD20 Antibody
    • CT-P10
    • IDEC-102
    • IDEC-C2B8
    • IDEC-C2B8 Monoclonal Antibody
    • Ikgdar
    • Mabtas
    • MabThera
    • Monoclonal Antibody IDEC-C2B8
    • PF-05280586
    • Riabni
    • Rituxan
    • Rituximab ABBS
    • Rituximab ARRX
    • Rituximab Biosimilar ABP 798
    • Rituximab Biosimilar BI 695500
    • Rituximab Biosimilar CT-P10
    • Rituximab Biosimilar GB241
    • Rituximab Biosimilar IBI301
    • Rituximab Biosimilar JHL1101
    • Rituximab Biosimilar PF-05280586
    • Rituximab Biosimilar RTXM83
    • Rituximab Biosimilar SAIT101
    • Rituximab Biosimilar SIBP-02
    • rituximab biosimilar TQB2303
    • Rituximab PVVR
    • Rituximab-abbs
    • Rituximab-arrx
    • Rituximab-pvvr
    • RTXM83
    • Ruxience
    • Truxima
  • Biological: Rituximab and Hyaluronidase Human
    Given SC
    Other names:
    • Rituxan Hycela
    • Rituximab Plus Hyaluronidase
    • Rituximab/Hyaluronidase
    • Rituximab/Hyaluronidase Human

Recruiting Locations

Children's National and nearby locations

Children's National Medical Center
Washington, District of Columbia 20010
Contact:
Site Public Contact
202-476-2800
OncCRC_OnCall@childrensnational.org

More Details

NCT ID
NCT04759586
Status
Recruiting
Sponsor
National Cancer Institute (NCI)

Detailed Description

PRIMARY OBJECTIVE: I. To determine if nivolumab + chemo-immunotherapy results in a superior long term progression-free survival (PFS) (events defined as disease progression confirmed by central review or death) when compared with chemo-immunotherapy alone in patients with newly diagnosed primary mediastinal B-cell lymphoma. SECONDARY OBJECTIVES: I. To compare the rates of "efficacy-related event-free survival (EFS)" (eEFS) (events defined as progression, change in therapy due to finding that led to concern about efficacy, biopsy + disease after 6 cycles of therapy, or death) between chemo-immunotherapy alone and chemo-immunotherapy + nivolumab in patients with newly diagnosed PMBCL. II. To compare the rates of "therapy-related EFS" (tEFS) (events defined as relapse/progression, change in therapy for any reason, biopsy + disease after 6 cycles of therapy, secondary malignancy [SMN] or death) between chemo-immunotherapy alone and chemo-immunotherapy + nivolumab in patients with newly diagnosed PMBCL. III. To compare the rates of overall survival (OS) between chemo-immunotherapy alone and chemo-immunotherapy + nivolumab in patients with newly diagnosed PMBCL. IV. To establish the rate of a positive positron emission tomography (PET)-computed tomography (CT) (defined as Deauville score 4 or 5) at the completion of 6 cycles of nivolumab + rituximab (R)- cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP)/dose-adjusted (DA)-etoposide, prednisone, vincristine, cyclophosphamide, and doxorubicin (EPOCH)-R and R-CHOP/DA-EPOCH-R in patients with newly diagnosed PMBCL and evaluate the prognostic significance of such a finding. EXPLORATORY OBJECTIVES: I. To bank radiology images for further studies. II. To bank specimens for future correlative studies. III. Characterize the immune profile of patients treated with nivolumab + chemo-immunotherapy to identify markers predictive of response. IV. Define the rate of complete response at the completion of initial planned therapy. OUTLINE: Patients are randomly assigned to backbone therapy or backbone therapy + nivolumab within each of 6 strata. The strata are determined by physician's choice of backbone (DA-EPOCH-R versus [vs.] R-CHOP vs. R-CHOP + RT) and whether or not the patient had 1 prior cycle of therapy. ARM A (DA-EPOCH-R): Patients receive prednisone or prednisolone orally (PO) once daily (QD) on days 1-5 and rituximab intravenously (IV) or rituximab and hyaluronidase human subcutaneously (SC) over 5 minutes on day 1 or 5. Patients also receive etoposide phosphate, doxorubicin hydrochloride, and vincristine sulfate IV over 96 hours on days 1-4 and cyclophosphamide IV over 30-60 minutes on day 5. Beginning 24-72 hours after completing cyclophosphamide, patients receive filgrastim or pegylated filgrastim SC daily until absolute neutrophil count (ANC) is >= 500/uL after the expected nadir. Treatment repeats every 21 days for up to 6 cycles (5 if the patient had 1 prior cycle of treatment) in the absence of disease progression or unacceptable toxicity. Patients undergo echocardiography (ECHO) during screening and as clinically indicated and alumbar puncture (LP) for cerebral spinal fluid (CSF) collection optionally during screening. Patients also undergo computed tomography (CT) or positron emission tomography (PET)/CT throughout the trial. Additionally, patients undergo bone marrow biopsy and aspiration optionally during screening and as clinically indicated on study. Patients undergo blood sample collection on study. ARM B (DA-EPOCH-R + NIVOLUMAB): Patients receive treatment as in Arm A. Patients also receive nivolumab IV over 30 minutes on day 1. Patients undergo ECHO during screening and as clinically indicated and LP for CSF collection optionally during screening. Patients also undergo CT or PET/CT throughout the trial. Additionally, patients undergo bone marrow biopsy and aspiration optionally during screening and as clinically indicated on study. Patients undergo blood sample collection on study. ARM C (R-CHOP): Patients receive prednisone or prednisolone PO QD on days 1-5 and rituximab IV or rituximab and hyaluronidase human SC over 5 minutes on day 1 or 5. Patients also receive cyclophosphamide IV over 30-60 minutes, doxorubicin hydrochloride IV over 1-15 minutes or up to 60 minutes, and vincristine sulfate IV over 1 or up to 60 minutes on day 1. Treatment repeats every 21 days for up to 6 cycles (5 if the patient had 1 prior cycle of treatment) in the absence of disease progression or unacceptable toxicity. Patients undergo ECHO during screening and as clinically indicated and LP for CSF collection optionally during screening. Patients also undergo CT or PET/CT throughout the trial. Additionally, patients undergo bone marrow biopsy and aspiration optionally during screening and as clinically indicated on study. Patients undergo blood sample collection on study. ARM D (R-CHOP + NIVOLUMAB): Patients receive treatment as in Arm C. Patients also receive nivolumab IV over 30 minutes on day 1. Patients undergo ECHO during screening and as clinically indicated and LP for CSF collection optionally during screening. Patients also undergo CT or PET/CT throughout the trial. Additionally, patients undergo bone marrow biopsy and aspiration optionally during screening and as clinically indicated on study. Patients undergo blood sample collection on study. ARM E (R-CHOP + RADIOTHERAPY): Patients receive treatment as in Arm C. Within 6-8 weeks after completion of chemotherapy, patients undergo radiation therapy over 25 fractions. Patients undergo ECHO during screening and as clinically indicated and LP for CSF collection optionally during screening. Patients also undergo CT or PET/CT throughout the trial. Additionally, patients undergo bone marrow biopsy and aspiration optionally during screening and as clinically indicated on study. Patients undergo blood sample collection on study. ARM F (R-CHOP + RADIOTHERAPY + NIVOLUMAB): Patients receive treatment as in Arm D. Within 6-8 weeks after completion of chemotherapy, patients undergo radiation therapy over 25 fractions. Patients undergo ECHO during screening and as clinically indicated and LP for CSF collection optionally during screening. Patients also undergo CT or PET/CT throughout the trial. Additionally, patients undergo bone marrow biopsy and aspiration optionally during screening and as clinically indicated on study. Patients undergo blood sample collection on study. After completion of study treatment, patients are followed up every 3 months for year 1, every 6 months for years 2-3, and annually thereafter.

Notice

Study information shown on this site is derived from ClinicalTrials.gov (a public registry operated by the National Institutes of Health). The listing of studies provided is not certain to be all studies for which you might be eligible. Furthermore, study eligibility requirements can be difficult to understand and may change over time, so it is wise to speak with your medical care provider and individual research study teams when making decisions related to participation.