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A phase II study of vinblastine, endoxana (cyclophosphamide), procarbazine, prednisolone, etoposide, mitoxantrone and bleomycin in patients with Hodgkin's lymphoma aged over 60 years
ISRCTN ISRCTN87375595
ClinicalTrials.gov identifier
Public title A phase II study of vinblastine, endoxana (cyclophosphamide), procarbazine, prednisolone, etoposide, mitoxantrone and bleomycin in patients with Hodgkin's lymphoma aged over 60 years
Scientific title
Acronym SHIELD Study
Serial number at source Version 3: 20.1.2005
Study hypothesis Progress in the treatment of Hodgkin’s Lymphoma (HL) in patients under 60 years has been substantial but in the over 60 years age group only small studies have been conducted and limited progress in outcome has been seen. It is necessary to create a starting point of uniform treatment for HL in the over 60 years age group, giving potentially curative treatment in a form that would be acceptable to individuals in this age group.

Nationally and internationally there is no existing co-ordinated study of HL in this age group and recent data indicates that outcome has not improved in the last 15 years. A number of older patients with HL fail to enter clinical trials as they are "not fit" for multiple drug chemotherapy. This study will aim to register all pathologically eligible patients in participating centres in order to provide a clearer overall clinical picture of this disease, whether or not they undergo protocol chemotherapy.

This study is of a phase II nature that aims to assess the efficacy, toxicity and applicability of the Vinblastine, Endoxana (cyclophosphamide), Procarbazine, Prednisolone, Etoposide, Mitoxantrone and Bleomycin (VEPEMB) chemotherapy schedule in this particular patient population, as a prelude to a subsequent randomised trial. The linking of this phase II study with total data collection aims to assess:
1. The proportions of patients who can enter a study of curative intent within this age group.
2. To assess complete response rate, event free survival and overall survival following this treatment schedule.

Please note that, as of 12/12/2008, the anticipated end date of this trial has been updated from 31/08/2007 to 31/08/2009.
Lay summary http://cancerhelp.cancerresearchuk.org/trials/a-trial-looking-at-vepemb-chemotherapy-for-patients-over-60-years-old-with-hodgkins-lymphoma
Ethics approval Thames Valley Multi-Centre Research Ethics Committee, reference number: 03/12/062.
Study design Phase II two-arm non-randomised clinical study
Countries of recruitment United Kingdom
Disease/condition/study domain Hodgkin's lymphoma
Participants - inclusion criteria 1. Histologically confirmed classical Hodgkin's Lymphoma (HL)
2. No previous treatment for HL
3. Aged over 60
4. "Non fragile" patients, i.e. patient’s mental and physical status must be sufficient to withstand the treatment described
5. No concomitant neoplasia or known Human Immunodeficiency Virus (HIV) infection
6. Written informed consent
Participants - exclusion criteria 1. Nodular Lymphocyte Predominance Hodgkin's Lymphoma (NLPHL)
2. Aged under 60
3. Patient previously treated for HL
4. Known HIV infection or concomitant neoplasia
5. "Fragile patient" or significant abnormality of another system (pulmonary, cardiac, renal, and hepatic) which is a contraindication to full dose chemotherapy
6. Unable to give informed consent
Anticipated start date 01/09/2004
Anticipated end date 31/08/2009
Status of trial Completed
Patient information material Patient information can be found at: http://www.shieldstudy.co.uk/publicdocs/VEPEMBV5.doc
Target number of participants 150
Interventions The patient either receives the VEPEMB treatment or is simply registered on the database and the alternative treatment which they receive is recorded. The patient's treatment is determined by their physicians who assess their 'fragility'. If they are too 'fragile' they will not be given the VEPEMB regimen.
Primary outcome measure(s) The primary endpoints will be progression-free survival, with clinical progression and death as the events. On suspicion of progression (e.g. new or enlarging masses, development of ‘B’ symptoms) patients should be re-evaluated according to normal procedures to confirm relapse. Histological confirmation of relapse is recommended but not mandatory.

Survival time, including death from any cause, will also be investigated. For both endpoints, the event-free times will be dated from the date of histological diagnosis.
Secondary outcome measure(s) Analysis will be done to assess potential prognostic factors (Epstein-Barr Virus [EBV] status, "Fragility" assessment, Hasenclever index, soluble form of the CD30 molecule [sCD30]) which might be relevant in this age group.
Sources of funding Marrow & Stem Cell Transplant 2000 (The Millennium Fund) (UK)
Trial website http://www.shieldstudy.co.uk
Publications 2006 symposium article in http://www.ncbi.nlm.nih.gov/pubmed/16702179
Contact name Prof  Stephen John  Proctor
  Address Academic Haematology
Leech Building
Medical School
University of Newcastle upon Tyne
  City/town Newcastle upon Tyne
  Zip/Postcode NE2 4HH
  Country United Kingdom
  Tel +44 (0) 191 222 7791
  Fax +44 (0) 191 222 7632
  Email s.j.proctor@ncl.ac.uk
Sponsor Newcastle Hospitals NHS Trust (UK)
  Address Research & Development
Royal Victoria Infirmary
  City/town Newcastle upon Tyne
  Zip/Postcode NE2 4HH
  Country United Kingdom
  Sponsor website: http://www.shieldstudy.co.uk
Date applied 04/08/2006
Last edited 09/05/2012
Date ISRCTN assigned 18/08/2006
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