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A Phase II Trial of Lenalidomide (Revlimid (TM), CC-5013) (NSC #703813, IND#70116) Plus Rituximab in Previously Untreated Follicular Non-Hodgkin's Lymphoma (NHL)


Phase 2
18 Years
N/A
Open (Enrolling)
Both
Contiguous Stage II Grade 1 Follicular Lymphoma, Contiguous Stage II Grade 2 Follicular Lymphoma, Contiguous Stage II Grade 3 Follicular Lymphoma, Noncontiguous Stage II Grade 1 Follicular Lymphoma, Noncontiguous Stage II Grade 2 Follicular Lymphoma, Noncontiguous Stage II Grade 3 Follicular Lymphoma, Stage III Grade 1 Follicular Lymphoma, Stage III Grade 2 Follicular Lymphoma, Stage III Grade 3 Follicular Lymphoma, Stage IV Grade 1 Follicular Lymphoma, Stage IV Grade 2 Follicular Lymphoma, Stage IV Grade 3 Follicular Lymphoma

Thank you

Trial Information

A Phase II Trial of Lenalidomide (Revlimid (TM), CC-5013) (NSC #703813, IND#70116) Plus Rituximab in Previously Untreated Follicular Non-Hodgkin's Lymphoma (NHL)


PRIMARY OBJECTIVES:

I. To determine the response rate (overall and complete) to treatment with lenalidomide and
rituximab in patients with follicular non-Hodgkin lymphoma (NHL) who have received no prior
systemic therapy.

II. To determine the time to progression after treatment with lenalidomide and rituximab in
patients with previously untreated CD20+ follicular NHL.

SECONDARY OBJECTIVES:

I. To determine the toxicity profile of this regimen in patients with previously untreated
CD20+ follicular NHL.

II. To establish whether the therapeutic effects of this regimen are sufficiently promising
to warrant evaluation in a subsequent randomized trial (in comparison to rituximab alone).

III. To correlate Fcγ receptor polymorphism profiling with response to treatment with this
regimen in patients with previously untreated follicular NHL.

IV. To determine the impact of lenalidomide on immune parameters in patients with previously
untreated follicular NHL.

V. To determine the impact of lenalidomide on angiogenic parameters in patients with
previously untreated follicular NHL.

VI. To correlate lymphoma-associated macrophages (LAM) and FOXP3, GzB, CD10, MUM1, and BCL2
expression with response to treatment with this regimen in patients with previously
untreated follicular NHL.

VII. To determine whether immune gene signatures previously identified as prognostic factors
in follicular lymphoma can be applied to paraffin-embedded tissues in patients treated with
rituximab, to evaluate microRNA signatures associated with these gene signatures and
outcome, to validate immunohistochemical markers associated with outcome in follicular
lymphoma (CD68 LAMs, FOXP3, CD10, BCL6, FOXP1, MUM1), and to investigate whether markers of
angiogenesis may be of value in the prognosis of follicular NHL.

OUTLINE: This is a multicenter study.

Patients receive oral lenalidomide once daily on days 1-21. Treatment with lenalidomide
repeats every 28 days for 12 courses in the absence of disease progression or unacceptable
toxicity. Patients also receive rituximab IV in weeks 1, 2, 3, 4, 12, 20, 28, and 36 in the
absence of disease progression or unacceptable toxicity.

Blood, plasma, and tissue samples may be collected periodically for correlative studies.

After completion of study treatment, patients are followed up every 4 months for 2 years and
then every 6 months for up to 8 years.


Inclusion Criteria:



- Histologically* confirmed follicular non-Hodgkin lymphoma (NHL)

- WHO grade 1, 2, or 3a (> 15 centroblasts per high-power field with centrocytes
present) disease

- Stage III, IV, or bulky (i.e., single mass ≥ 7 cm in any unidimensional
measurement) stage II disease

- Previously untreated disease

- CD20-antigen expression as confirmed by institutional flow cytometry or IHC

- Low- or intermediate-risk disease by Follicular Lymphoma International Prognostic
Index (FLIPI) (i.e., 0-2 risk factors)

- Measurable disease on either physical examination or imaging studies

- Any tumor mass > 1 cm is allowed

- Non-measurable disease alone is not allowed

- Lesions that are considered non-measurable include, but are not limited to, the
following:

- Bone lesions (lesions if present should be noted)

- Ascites

- Pleural/pericardial effusion

- Lymphangitis cutis/pulmonis

- Bone marrow (involvement by NHL should be noted)

- No known CNS involvement by lymphoma

- ECOG performance status 0-2

- ANC ≥ 1,000/mm^3

- Platelet count ≥ 75,000/mm^3

- Creatinine clearance ≥ 30 mL/min (unless attributable to NHL)

- Total bilirubin ≤ 2 times upper limit of normal (unless attributable to NHL or
Gilbert disease)

- Not pregnant or nursing

- Negative pregnancy test

- Fertile patients must use two effective methods of contraception for ≥ 28 days
before, during, and for ≥ 3 months after completion of study treatment

- No history of erythema multiforme, toxic epidermal necrolysis, or Stevens-Johnson
syndrome

- No uncontrolled seizures

- No autoimmune disorder requiring active immunosuppression

- Patients with HIV infection are eligible, provided they meet the following criteria:

- No evidence of coinfection with hepatitis B or C

- CD4+ cell count ≥ 400/mm^3

- No evidence of resistant strains of HIV

- If not on anti-HIV therapy, HIV viral load < 10,000 copies HIV RNA/mL

- If on anti-HIV therapy, HIV viral load < 50 copies HIV RNA/mL

- No history of AIDS-defining conditions

- No evidence of active hepatitis B or C infection (i.e., no positive serology for
anti-HBc or anti-HCV antibodies)

- HBV-seropositive patients (HBsAg +) are eligible provided they are closely
monitored for evidence of active HBV infection by HBV DNA testing and receive
suppressive therapy with lamivudine or other HBV suppressive therapy until 6
months after the last dose of rituximab

- No known human anti-chimeric antibody (HACA) positivity

- Not on dialysis

- No other concurrent investigational or non-protocol therapy for lymphoma

- No prior systemic therapy for NHL, including chemotherapy or immunotherapy (e.g.,
monoclonal antibody-based therapy)

- Prior involved-field radiotherapy allowed

- More than 2 weeks since prior corticosteroids, except for maintenance therapy for a
nonmalignant disease

- No concurrent dexamethasone and other steroids as antiemetics

Type of Study:

Interventional

Study Design:

Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment

Outcome Measure:

Complete response rate

Outcome Description:

The true CR rate and its 95% confidence interval will be estimated for each risk group.

Outcome Time Frame:

At 12 months

Safety Issue:

No

Principal Investigator

Peter Martin

Investigator Role:

Principal Investigator

Investigator Affiliation:

Cancer and Leukemia Group B

Authority:

United States: Food and Drug Administration

Study ID:

NCI-2011-02047

NCT ID:

NCT01145495

Start Date:

June 2010

Completion Date:

Related Keywords:

  • Contiguous Stage II Grade 1 Follicular Lymphoma
  • Contiguous Stage II Grade 2 Follicular Lymphoma
  • Contiguous Stage II Grade 3 Follicular Lymphoma
  • Noncontiguous Stage II Grade 1 Follicular Lymphoma
  • Noncontiguous Stage II Grade 2 Follicular Lymphoma
  • Noncontiguous Stage II Grade 3 Follicular Lymphoma
  • Stage III Grade 1 Follicular Lymphoma
  • Stage III Grade 2 Follicular Lymphoma
  • Stage III Grade 3 Follicular Lymphoma
  • Stage IV Grade 1 Follicular Lymphoma
  • Stage IV Grade 2 Follicular Lymphoma
  • Stage IV Grade 3 Follicular Lymphoma
  • Lymphoma
  • Lymphoma, Follicular
  • Lymphoma, Non-Hodgkin

Name

Location

Washington University School of Medicine Saint Louis, Missouri  63110
Methodist Medical Center of Illinois Peoria, Illinois  61636
North Shore University Hospital Manhasset, New York  11030
Eastern Maine Medical Center Bangor, Maine  04401
Franklin Square Hospital Center Baltimore, Maryland  21237
University of Nebraska Medical Center Omaha, Nebraska  68198-3330
Weill Medical College of Cornell University New York, New York  10021
Long Island Jewish Medical Center New Hyde Park, New York  11040
Methodist Estabrook Cancer Center Omaha, Nebraska  68114-4199
Arthur G. James Cancer Hospital and Solove Research Institute at Ohio State University Medical Center Columbus, Ohio  43210-1240
Beebe Medical Center Lewes, Delaware  19958
Memorial Hospital Carthage, Illinois  62321
Galesburg Clinic Galesburg, Illinois  61401
Mason District Hospital Havana, Illinois  62644
McDonough District Hospital Macomb, Illinois  61455
BroMenn Regional Medical Center Normal, Illinois  61761
Proctor Hospital Peoria, Illinois  61614
Perry Memorial Hospital Princeton, Illinois  61356
Great Plains Regional Medical Center North Platte, Nebraska  69101-6598
Mountainview Medical Berlin, Vermont  05602
Eureka Hospital Eureka, Illinois  61530
Graham Hospital Association Canton, Illinois  61520
Holy Family Medical Center Des Plaines, Illinois  60016
Saint Joseph Medical Center Joliet, Illinois  60435
Center for Cancer Care and Research St. Louis, Missouri  63141
Randolph Hospital Asheboro, North Carolina  27203
Harold Alfond Center for Cancer Care Augusta, Maine  04330
Union Hospital of Cecil County Elkton MD, Maryland  21921
Saint Francis Medical Center Grand Island, Nebraska  68802
McLeod Regional Medical Center Florence, South Carolina  29501
University of North Carolina Chapel Hill, North Carolina  27599
Glens Falls Hospital Glens Falls, New York  12801
University Of Vermont Burlington,, Vermont  05403
Virginia Commonwealth University Richmond, Virginia  
Florida Hospital Orlando, Florida  32803
University of Chicago Comprehensive Cancer Center Chicago, Illinois  60637-1470
Southeast Cancer Center Cape Girardeau, Missouri  63703
Wake Forest University Health Sciences Winston-Salem, North Carolina  27157
OSF Saint Francis Medical Center Peoria, Illinois  61637
Lombardi Comprehensive Cancer Center at Georgetown University Washington, District of Columbia  20057
Community Cancer Center Foundation Normal, Illinois  61761
Illinois CancerCare-Ottawa Clinic Ottawa, Illinois  61350
Ottawa Regional Hospital and Healthcare Center Ottawa, Illinois  61350
Pekin Cancer Treatment Center Pekin, Illinois  61554
Illinois Oncology Research Association CCOP Peoria, Illinois  61615
Illinois CancerCare-Peoria Peoria, Illinois  61615
Illinois Valley Hospital Peru, Illinois  61354
Hematology Oncology Associates-Quad Cities Bettendorf, Iowa  52722
Missouri Baptist Medical Center Saint Louis, Missouri  63131
Exeter Hospital Exeter, New Hampshire  03833
Cooper Hospital University Medical Center Camden, New Jersey  08103
State University of New York Upstate Medical University Syracuse, New York  13210
Mission Hospitals Inc Asheville, North Carolina  28801
Wayne Memorial Hospital Goldsboro, North Carolina  27534
University of Illinois Chicago, Illinois  60612
Illinois CancerCare-Bloomington Bloomington%, Illinois  61701
Illinois CancerCare-Canton Canton, Illinois  61520
Illinois CancerCare-Carthage Carthage, Illinois  62321
Illinois CancerCare-Eureka Eureka, Illinois  61530
Illinois CancerCare-Havana Havana, Illinois  62644
Illinois CancerCare-Kewanee Clinic Kewanee, Illinois  61443
Illinois CancerCare-Macomb Macomb, Illinois  61455
Illinois CancerCare-Monmouth Monmouth, Illinois  61462
Illinois CancerCare-Community Cancer Center Normal, Illinois  61761
Illinois CancerCare-Pekin Pekin, Illinois  61603
Illinois CancerCare-Peru Peru, Illinois  61354
Illinois CancerCare-Princeton Princeton, Illinois  61356
Illinois CancerCare-Spring Valley Spring Valley, Illinois  61362
University of Missouri - Ellis Fischel Columbia, Missouri  65203
Moses Cone Health System-Regional Cancer Center Greensboro, North Carolina  27403
East Carolina University Greenville, North Carolina  27858
Annie Penn Memorial Hospital Reidsville, North Carolina  27320
Monter Cancer Center Lake Success, New York  11042
Capital Region Medical Center-Goldschmidt Cancer Center Jefferson City, Missouri  65109
Comprehensive Cancer Care PC Saint Louis, Missouri  63141
Walter Reed National Military Medical Center Bethesda, Maryland  20889
Cancer and Leukemia Group B Chicago, Illinois  60606
North Shore-LIJ Health System CCOP Manhasset, New York  11030
Christiana Care Health System-Christiana Hospital Newark, Delaware  19718