About this study
Immunotherapy helps the body’s immune system find and kill cancer cells. When immunotherapy is combined with chemotherapy, this is called chemoimmunotherapy. This type of treatment can improve the ability to kill cancer cells.
Primary mediastinal B-cell lymphoma (PMBCL) is a type of non-Hodgkin lymphoma that is often treated with chemoimmunotherapy using a medicine called rituximab and chemotherapy.
Nivolumab (Opdivo™) is another kind of immunotherapy that helps the body’s own immune cells fight cancer. This clinical trial will study the effects of using the drug nivolumab to treat patients with PMBCL. This study will randomly divide patients (children, teens, and adults) into treatment groups, based on the combination of chemoimmunotherapy medicines they receive:
- DA-EPOCH-R: these patients will get etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin, and rituximab with or without nivolumab. They will also get a medicine known as filgrastim, which helps the body grow more white blood cells to help fight infection. Patients may or may not receive radiation therapy.
- R-CHOP: these patients will be treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone with or without nivolumab.
- R-CHOP with radiation therapy
After 6 cycles of treatment (21 days each cycle), patients will have imaging tests and may or may not have a biopsy and radiation therapy.
Patients in this study will provide samples of blood, bone marrow, and spinal fluid from a lumbar puncture. This will help us find substances in the blood (biomarkers) that may show how well the treatment is working, Patients will also have imaging studies. The study will last about 4–6 months.
Eligibility overview
- Primary mediastinal B-cell lymphoma (PMBCL)
- 2 years and older