Clinical Trial: Rituximab and/or Lenalidomide in Treating Patients With Follicular Non-Hodgkin''s Lymphoma That Has Relapsed After Previous Rituximab Treatment

This study is not yet open for patient recruitment.
Verified by National Cancer Institute (NCI) October 2005

Sponsors and Collaborators: Cancer and Leukemia Group B
National Cancer Institute (NCI)
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00238238

Purpose

RATIONALE: Monoclonal antibodies, such as rituximab, can block cancer growth in different ways. Some block the ability of cancer cells to grow and spread. Others find cancer cells and help kill them or carry cancer-killing substances to them. Biological therapies, such as lenalidomide, may stimulate the immune system in different ways and stop cancer cells from growing. Lenalidomide may also stop the growth of non-Hodgkin''''s lymphoma by blocking blood flow to the cancer. Giving rituximab together with lenalidomide may kill more cancer cells.

PURPOSE: This randomized phase II trial is studying how well rituximab and/or lenalidomide work in treating patients with follicular non-Hodgkin''''s lymphoma that has relapsed after previous rituximab treatment.

Condition Intervention Phase
Recurrent Grade 1 Follicular Lymphoma
Recurrent Grade 2 Follicular Lymphoma
Recurrent Grade 3 Follicular Lymphoma
 Drug: lenalidomide
 Drug: rituximab
 Procedure: anti-cytokine therapy
 Procedure: antiangiogenesis therapy
 Procedure: antibody therapy
 Procedure: biological response modifier therapy
 Procedure: growth factor antagonist therapy
 Procedure: monoclonal antibody therapy
 Procedure: non-specific immune-modulator therapy
Phase II

MedlinePlus related topics:  Lymphoma

Study Type: Interventional
Study Design: Treatment

Official Title: Phase II Randomized Study of Rituximab and/or Lenalidomide in Patients With Follicular Non-Hodgkin''''s Lymphoma That Has Relapsed After Prior Rituximab-Based Combination Therapy

Further study details as provided by National Cancer Institute (NCI):

OBJECTIVES:

Primary

Secondary

  • Compare TTP after prior rituximab-based combination therapy vs TTP in patients treated with these regimens.
  • Determine the toxicity profile of these regimens in these patients.
  • Correlate Fc-receptor-polymorphism profiling with response in patients treated with these regimens.
  • Correlate changes in natural killer (NK) cells, activated NK cells, activated T-cells, and several plasma cytokines after exposure to lenalidomide therapy, followed by rituximab, with objective response rate in these patients.

OUTLINE: This is a randomized, multicenter study. Patients are stratified according to time to disease progression after prior rituximab-based combination therapy (≥ 6 months and < 12 months vs ≥ 12 months and < 24 months vs ≥ 24 months). Patients are randomized to 1 of 3 treatment arms.

  • Arm I: Patients receive rituximab IV on days 1, 8, 15, and 22.
  • Arm II: Patients receive oral lenalidomide once daily on days 1-21. Treatment repeats every 28 days for up to 4 courses in the absence of disease progression or unacceptable toxicity.
  • Arm III: Patients receive lenalidomide as in arm II. Patients also receive rituximab IV on days 8, 15, and 22 of course 1 and day 1 of course 2 of lenalidomide.

After completion of study treatment, patients are followed for up to 10 years from study entry.

PROJECTED ACCRUAL: A total of 180 patients (90 for arm I, 45 each for arms II and III) will be accrued for this study.

Eligibility

Ages Eligible for Study:  18 Years and above,  Genders Eligible for Study:  Both
Criteria

DISEASE CHARACTERISTICS:

  • Histologically* confirmed follicular non-Hodgkin''''s lymphoma
  • Grade 1, 2, or 3a disease (> 15 centroblasts per high-power field with centrocytes present) NOTE: *Bone marrow biopsy as the sole means of diagnosis is not acceptable; fine-needle aspirates are not acceptable
  • Confirmed CD20 antigen expression by flow cytometry or immunohistochemistry
  • Measurable disease > 1 cm
  • No non-measurable disease only, including any of the following:
  • Bone lesions
  • Ascites
  • Pleural/pericardial effusion
  • Lymphangitis cutis/pulmonis
  • Bone marrow involvement
  • Must have been treated with and achieved a complete or partial response or stable disease after prior rituximab-based combination therapy (e.g., rituximab and chemotherapy given either concurrently or within 30 days of each other)
  • Time to disease progression ≥ 6 months after first rituximab dose (administered during rituximab-based combination therapy)
  • No known CNS involvement

PATIENT CHARACTERISTICS:

Performance status

  • ECOG 0-2

Life expectancy

  • Not specified

Hematopoietic

  • Absolute neutrophil count ≥ 1,000/mm^3
  • Platelet count ≥ 75,000/mm^3

Hepatic

  • Bilirubin ≤ 2 times upper limit of normal (ULN) (unless due to Gilbert''''s disease or lymphoma)

Renal

  • Creatinine ≤ 2 times ULN (unless due to lymphoma)

Other

  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception
  • No known HIV positivity
  • No "currently active" secondary malignancy (e.g., Waldenstrom''''s macroglobulinemia) except nonmelanoma skin cancer
  • Patients are not considered to have a "currently active" second malignancy if they have completed anticancer therapy and are deemed to have < 30% risk of relapse by their physician

PRIOR CONCURRENT THERAPY:

Biologic therapy

  • See Disease Characteristics
  • See Radiotherapy

Chemotherapy

  • See Disease Characteristics
  • No concurrent chemotherapy

Endocrine therapy

Radiotherapy

  • No prior radioimmunotherapy

Other

  • No other concurrent investigational or commercial agents or therapies for lymphoma

Location and Contact Information

Please refer to this study by ClinicalTrials.gov identifier  NCT00238238


Study chairs or principal investigators

John P. Leonard, MD,  Study Chair,  New York Weill Cornell Cancer Center at Cornell University   

More Information

Clinical trial summary from the National Cancer Institute''''s PDQ® database

Study ID Numbers:  CDR0000442872; CALGB-50401
Last Updated:  December 8, 2005
Record first received:  October 12, 2005
ClinicalTrials.gov Identifier:  NCT00238238
Health Authority: United States: Federal Government
ClinicalTrials.gov processed this record on 2006-01-10



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