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Therapy of nodal Follicular Lymphoma (WHO grade 1/2) in clinical stage I/II using response adapted Involved Site Radiotherapy in combination with Obinutuzumab (Gazyvaro) - GAZAI Trial (GAZyvaro and response adapted Involved-site Radiotherapy): a study protocol for a single-arm, non-randomized, open, national, multi-center phase II trial

dc.contributor.authorKönig, Laila
dc.contributor.authorDreyling, Martin
dc.contributor.authorDürig, Jan
dc.contributor.authorEngelhard, Marianne
dc.contributor.authorHohloch, Karin
dc.contributor.authorViardot, Andreas
dc.contributor.authorWitzens-Harig, Mathias
dc.contributor.authorKieser, Meinhard
dc.contributor.authorKlapper, Wolfram
dc.contributor.authorPott, Christiane
dc.contributor.authorHerfarth, Klaus
dc.date.accessioned2019-09-01T03:52:49Z
dc.date.available2019-09-01T03:52:49Z
dc.date.issued2019
dc.identifier.urihttp://resolver.sub.uni-goettingen.de/purl?gs-1/16373
dc.description.abstractAbstract Background Large field irradiation had been standard for early-stage follicular lymphoma (FL) for a long time. Although involved field radiotherapy (IF-RT) was recently favored because of the toxicity of large field irradiation, smaller irradiation fields have been accompanied with an increased risk of out-of-field recurrence. The MIR (MabThera® and Involved field Radiation) trial has shown that the combination of IF-RT at a dose of 30–40 Gy with the anti-CD20 antibody rituximab has led to similar efficacy compared with large field irradiation but with markedly reduced side effects. Immune modulating radiation therapy alone using low-dose radiotherapy (LDRT) of 2 × 2 Gy has been shown to be effective in FL. The GAZAI (GAZyvaro and response Adapted Involved-site Radiotherapy) trial aims to prove the efficacy of LDRT in combination with a novel anti-CD20 therapy. Methods/design The GAZAI trial is a non-randomized, open, non-controlled, German, multi-center phase II trial that includes patients with early-stage (I and II) nodular FL (grades 1 and 2) confirmed by central histological review. A maximum of 93 patients will be included in the trial. Patients will receive a combined approach of immunotherapy with the fully humanized anti-CD20 antibody obinutuzumab (Gazyvaro®) and involved site radiotherapy (IS-RT) with 2 × 2 Gy. The primary endpoint of the trial is the rate of metabolic complete response (CR), based on fludeoxyglucose positron emission tomography/computed tomography, after obinutuzumab and 2 × 2 Gy IS-RT in week 18. Secondary endpoints are morphologic CR rate in weeks 7 and 18 and month 6, progression-free survival, toxicity, recurrence patterns, overall survival, and quality of life. Additionally, minimal residual disease response is assessed. The risk for a potentially higher recurrence rate after LDRT will be minimized by additional salvage radiation up to the “full dose” of 40 Gy for patients who have less than a metabolic CR and morphologic partial response/CR, which will be evaluated in week 18, offering a response-adapted approach. Discussion The goal of this trial is a further reduction of the radiation dose in patients with nodal early-stage FL showing a good response to a combination of LDRT and anti-CD20 immunotherapy and a comparison with the currently published MIR trial. Trial registration EudraCT number: 2016-002059-89. ClinicalTrials.gov identifier: NCT03341520 .
dc.language.isoen
dc.publisherBioMed Central
dc.identifier.bibliographicCitationTrials. 2019 Aug 30;20(1):544
dc.rightsopenAccess
dc.titleTherapy of nodal Follicular Lymphoma (WHO grade 1/2) in clinical stage I/II using response adapted Involved Site Radiotherapy in combination with Obinutuzumab (Gazyvaro) - GAZAI Trial (GAZyvaro and response adapted Involved-site Radiotherapy): a study protocol for a single-arm, non-randomized, open, national, multi-center phase II trial
dc.typejournalArticle
dc.identifier.doi10.1186/s13063-019-3614-y
dc.type.versionpublishedVersion
dc.date.updated2019-09-01T03:52:49Z
dc.rights.holderThe Author(s).
dc.bibliographicCitation.volume20
dc.bibliographicCitation.issue1
dc.type.subtypejournalArticle
dc.bibliographicCitation.articlenumber544
dc.bibliographicCitation.journalTrials


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