Prevention of Anthracycline-Induced Cardiac Dysfunction With Dexrazoxane in Patients With Diffuse Large-B Cell Lymphoma
Launched by STICHTING HEMATO-ONCOLOGIE VOOR VOLWASSENEN NEDERLAND · Jan 22, 2024
Trial Information
Current as of July 09, 2025
Recruiting
Keywords
ClinConnect Summary
This clinical trial, called ANTICIPATE, is looking at whether a medication called dexrazoxane can help prevent heart problems in patients being treated for Diffuse Large B-Cell Lymphoma (DLBCL). Patients with DLBCL often receive chemotherapy that includes a drug called anthracycline, which can lead to serious heart issues over time. The goal of this trial is to find out if dexrazoxane can protect the heart while still effectively treating the lymphoma.
To participate in this study, patients must be at least 18 years old and have a confirmed diagnosis of DLBCL. They should not have received any prior treatment for their lymphoma and must be planning to undergo a specific chemotherapy regimen called R-CHOP. Participants will receive regular check-ups and monitoring throughout the trial to assess their health and any side effects. It's important to note that certain individuals, like those with pre-existing heart conditions or other serious health issues, may not be eligible to join the study. Overall, this trial aims to improve the long-term health and quality of life for patients undergoing treatment for DLBCL.
Gender
ALL
Eligibility criteria
- Inclusion Criteria:
- 1. Untreated patients with a confirmed histologic diagnosis of CD20+ DLBCL according to WHO classification 2022:
- • DLBCL, not otherwise specified (NOS)
- • High-grade B-cell lymphoma NOS
- • High-grade B-cell lymphoma with MYC and BCL2 and/or BCL6 translocation when DA-EPOCH-R is not an option. R2- CHOP is allowed.
- • Follicular lymphoma
- • T-cell/histiocyte-rich B cell lymphoma (THRBCL)
- • Note: Transformed, previously untreated lymphoma is allowed.
- • Note: 5-day treatment of dexamethasone 15 mg/day or prednisone 100 mg/day or local radiotherapy in order to control life-threatening/invalidating tumor related symptoms is allowed.
- • Note: It is allowed to start with a first cycle of R-CHOP21 pending the FISH results.
- 2. Planned treatment with 6 R-CHOP21. The following regimens are also allowed:
- • Treatment with reversed R-CHOP21
- • Treatment with R2-CHOP21 (6 R-CHOP21 + lenalidomide 15 mg day 1-14) in case of double hit lymphoma
- • Two additional administrations of rituximab after 6 cycles of R-CHOP21
- • High dosis MTX and/or MTX-it for CNS prophylaxis
- • 3. Ann Abor stages II-IV and stage I if the treatment plan is 6 R-CHOP21 in case of bulky disease (defined as a ≥10 cm mass);
- • 4. Age ≥ 18 years;
- • 5. WHO performance status ≤ 2, WHO 3 performance status is allowed when considered directly related to the DLBCL;
- • 6. Negative pregnancy test at study entry for women of childbearing potential;
- • 7. Female patient is either post-menopausal for at least 1 year before the screening visit or surgically sterile or if of childbearing potential, agrees to practice two effective methods of contraception, at the same time, from the time of signing the informed consent through at least 12 months after the last dose of protocol treatment, or agrees to completely abstain from heterosexual intercourse;
- • 8. Male patient, even if surgically sterilized, (i.e., status post vasectomy) agrees to practice effective barrier contraception during the entire study period and through 12 months after the last dose of protocol treatment, or agrees to completely abstain from heterosexual intercourse;
- • 9. Patient is able to adhere to the study visit schedule and other protocol requirements;
- • 10. Written informed consent.
- Exclusion Criteria:
- 1. Any of the following B-cell lymphomas according to WHO classification 2022:
- • o Central Nervous System involvement by DLBCL;
- • Note: high CNS-IPI is allowed
- • Testicular DLBCL;
- • Primary mediastinal B-cell lymphoma;
- • Epstein-Barr virus (EBV) post-transplant lymphoproliferative disorder;
- • 2. Any prior malignancy or present malignancy other than DLBCL that required or requires systemic therapy. Prior surgery or local radiotherapy is allowed in case the heart has not been exposed.
- • 3. Patients requiring treatment with mini-R-CHOP
- 4. Pre-existing cardiac disease including:
- • LVEF \<50% measured with echocardiography (2D or 3D)
- • Symptomatic heart failure (NYHA ≥II) or hospitalization for heart failure in the last year;
- • Refractory anginal symptoms
- • Cardiac arrhythmias not controlled with optimal medical treatment, in case of atrial fibrillation the ventricular response needs to be \<110/min;
- • Significant valvular dysfunction on echocardiography;
- • Non-ischemic cardiomyopathy
- • 5. Non-diagnostic/poor transthoracic echocardiography imaging quality at baseline;
- • 6. Severe pulmonary dysfunction defined as breathlessness at rest (COPD GOLD III or IV), unless clearly related to DLBCL;
- • 7. Severe neurological or psychiatric disease;
- • 8. Inadequate hematological function (absolute Neutrophil Count (ANC) \<1.0x109/L or platelets \<75x109/L), unless clearly related to DLBCL;
- • 9. Significant hepatic dysfunction (serum bilirubin or transaminases ≥ 3 times the upper limit of normal) unless related to lymphoma infiltration of the liver;
- • 10. Active hepatitis B or C infection (serology testing is required at screening). Patients positive for hepatitis B surface antigen (HBsAg) regardless of antibody status or HBsAg negative but anti-HBc positive are only eligible if HBV-PCR is negative and patients are protected with lamuvidine or entecavir. Patients with positive hepatitis C serology are only eligible if HCV-(RNA) is confirmed negative;
- • 11. Significant renal dysfunction (creatinine clearance \< 30 ml/min after rehydration) or requiring dialysis;
- • 12. Active uncontrolled fungal, bacterial and/or viral infection;
- • 13. Patient known to be HIV-positive;
- • 14. Breast-feeding female patients;
- • 15. Any psychological, familial, sociological and geographical condition potentially hampering compliance with the study protocol and follow-up schedule;
- • 16. Participation in another clinical trial with anti-cancer therapy or a cardiovascular drug.
About Stichting Hemato Oncologie Voor Volwassenen Nederland
Stichting Hemato-Oncologie voor Volwassenen Nederland (HOVON) is a prominent clinical trial sponsor dedicated to advancing the field of hematologic oncology through collaborative research efforts. Based in the Netherlands, HOVON focuses on improving treatment outcomes for adults with blood cancers by facilitating innovative clinical trials that adhere to the highest scientific and ethical standards. The organization brings together a network of medical professionals, researchers, and institutions to promote the development of new therapies, enhance patient care, and contribute to the global understanding of hematologic malignancies. Through its commitment to excellence in research and patient-centered approaches, HOVON aims to make significant strides in the fight against blood-related cancers.
Contacts
Jennifer Cobb
Immunology at National Institute of Allergy and Infectious Diseases (NIAID)
Locations
Amstelveen, , Netherlands
Apeldoorn, , Netherlands
Arnhem, , Netherlands
Breda, , Netherlands
Delft, , Netherlands
Den Bosch, , Netherlands
Den Haag, , Netherlands
Dordrecht, , Netherlands
Eindhoven, , Netherlands
Eindhoven, , Netherlands
Goes, , Netherlands
Hilversum, , Netherlands
Hoofddorp, , Netherlands
Nieuwegein, , Netherlands
Nijmegen, , Netherlands
Rotterdam, , Netherlands
Tilburg, , Netherlands
Utrecht, , Netherlands
Venlo, , Netherlands
Zwolle, , Netherlands
Sneek, , Netherlands
Almelo, , Netherlands
Harderwijk, , Netherlands
Groningen, , Netherlands
Schiedam, , Netherlands
Sittard, , Netherlands
Patients applied
Trial Officials
A. van Rhenen, MD
Principal Investigator
UMC Utrecht
M.P.M. Linschoten, MD
Principal Investigator
Amsterdam UMC
Timeline
First submit
Trial launched
Trial updated
Estimated completion
Not reported