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Brief Title: Lenalidomide and Rituximab in Treating Patients With Previously Untreated Stage II, Stage III, or Stage IV Follicular Non-Hodgkin Lymphoma
Official Title: A Phase II Trial of Lenalidomide (Revlimid (TM), CC-5013) (NSC #703813) Plus Rituximab in Previously Untreated Follicular Non-Hodgkin Lymphoma (NHL)
Study ID: NCT01145495
Brief Summary: This phase II trial studies how well lenalidomide and rituximab work in treating patients with previously untreated stage II, stage III, or stage IV follicular non-Hodgkin lymphoma. Biological therapies, such as lenalidomide, may stimulate or suppress the immune system in different ways and stop cancer cells from growing. Monoclonal antibodies, such as rituximab, may interfere with the ability of cancer cells to grow and spread. Giving lenalidomide together with rituximab may kill more cancer cells.
Detailed Description: PRIMARY OBJECTIVES: I. To determine the response rate (overall and complete) to lenalidomide + rituximab in follicular non-Hodgkin lymphoma (NHL) patients who have received no prior systemic therapy. II. To determine the time to progression after lenalidomide + rituximab in previously untreated patients with cluster of differentiation (CD)20+ follicular NHL. SECONDARY OBJECTIVES: I. To determine the toxicity profile of lenalidomide + rituximab therapy in previously untreated patients with CD20+ follicular NHL. II. To establish whether the therapeutic effects of lenalidomide + rituximab combination are sufficiently promising to warrant evaluation in a subsequent randomized trial (in comparison to rituximab alone). III. To correlate fragment crystallizable gamma (Fcg) receptor polymorphism profiling with response to lenalidomide + rituximab in previously untreated patients with follicular NHL. IV. To determine the impact of lenalidomide on immune parameters in patients with previously untreated follicular lymphoma. V. To determine the impact of lenalidomide on angiogenic parameters in patients with previously untreated follicular lymphoma. VI. To correlate lymphoma-associated macrophages (LAM) and forkhead box P3 (FOXP3), granzyme B (GzB), CD10, multiple myeloma oncogene 1 (MUM1), and B-cell lymphoma 2 (BCL2) expression with response to rituximab + lenalidomide in previously untreated patients with follicular lymphoma. VII. Determine whether immune gene signatures previously identified as prognostic factors in follicular lymphoma (FL) can be applied to paraffin-embedded tissues in rituximab treated patients; evaluate micro ribonucleic acid (RNA) signatures associated with these gene signatures and outcome; to validate immunohistochemical markers associated with outcome in FL (CD68 LAMs, FOXP3, CD10, BCL6, FOXP1, MUM1); and investigate whether markers of angiogenesis may be of value in prognosis of FL. OUTLINE: Patients receive lenalidomide orally (PO) once daily (QD) 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 intravenously (IV) on days 1, 8, 15, and 22 and on weeks 13, 21, 29, and 37 in the absence of disease progression or unacceptable toxicity. 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.
Minimum Age: 18 Years
Eligible Ages: ADULT, OLDER_ADULT
Sex: ALL
Healthy Volunteers: No
Palo Alto Medical Foundation-Camino Division, Mountain View, California, United States
Palo Alto Medical Foundation Health Care, Palo Alto, California, United States
Beebe Medical Center, Lewes, Delaware, United States
Christiana Care Health System-Christiana Hospital, Newark, Delaware, United States
MedStar Georgetown University Hospital, Washington, District of Columbia, United States
AdventHealth Orlando, Orlando, Florida, United States
Saint Joseph Medical Center, Bloomington, Illinois, United States
Illinois CancerCare-Bloomington, Bloomington, Illinois, United States
Graham Hospital Association, Canton, Illinois, United States
Illinois CancerCare-Canton, Canton, Illinois, United States
Illinois CancerCare-Carthage, Carthage, Illinois, United States
Memorial Hospital, Carthage, Illinois, United States
University of Illinois, Chicago, Illinois, United States
University of Chicago Comprehensive Cancer Center, Chicago, Illinois, United States
Heartland Cancer Research NCORP, Decatur, Illinois, United States
Eureka Hospital, Eureka, Illinois, United States
Illinois CancerCare-Eureka, Eureka, Illinois, United States
Illinois CancerCare-Galesburg, Galesburg, Illinois, United States
Illinois CancerCare-Havana, Havana, Illinois, United States
Mason District Hospital, Havana, Illinois, United States
Illinois CancerCare-Kewanee Clinic, Kewanee, Illinois, United States
AMITA Health Adventist Medical Center, La Grange, Illinois, United States
Illinois CancerCare-Macomb, Macomb, Illinois, United States
Mcdonough District Hospital, Macomb, Illinois, United States
Holy Family Medical Center, Monmouth, Illinois, United States
Illinois CancerCare-Monmouth, Monmouth, Illinois, United States
Bromenn Regional Medical Center, Normal, Illinois, United States
Carle Cancer Institute Normal, Normal, Illinois, United States
Illinois CancerCare-Community Cancer Center, Normal, Illinois, United States
Illinois CancerCare-Ottawa Clinic, Ottawa, Illinois, United States
Ottawa Regional Hospital and Healthcare Center, Ottawa, Illinois, United States
Illinois CancerCare-Pekin, Pekin, Illinois, United States
OSF Saint Francis Radiation Oncology at Pekin Cancer Treatment Center, Pekin, Illinois, United States
Proctor Hospital, Peoria, Illinois, United States
Illinois CancerCare-Peoria, Peoria, Illinois, United States
Methodist Medical Center of Illinois, Peoria, Illinois, United States
OSF Saint Francis Medical Center, Peoria, Illinois, United States
Illinois CancerCare-Peru, Peru, Illinois, United States
Illinois Valley Hospital, Peru, Illinois, United States
Illinois CancerCare-Princeton, Princeton, Illinois, United States
Perry Memorial Hospital, Princeton, Illinois, United States
Illinois CancerCare-Spring Valley, Spring Valley, Illinois, United States
Fort Wayne Medical Oncology and Hematology Inc-Parkview, Fort Wayne, Indiana, United States
University of Iowa Healthcare Cancer Services Quad Cities, Bettendorf, Iowa, United States
Harold Alfond Center for Cancer Care, Augusta, Maine, United States
Eastern Maine Medical Center, Bangor, Maine, United States
MedStar Franklin Square Medical Center/Weinberg Cancer Institute, Baltimore, Maryland, United States
Walter Reed National Military Medical Center, Bethesda, Maryland, United States
Christiana Care - Union Hospital, Elkton, Maryland, United States
Minneapolis VA Medical Center, Minneapolis, Minnesota, United States
Southeast Cancer Center, Cape Girardeau, Missouri, United States
Saint Luke's Hospital, Chesterfield, Missouri, United States
University of Missouri - Ellis Fischel, Columbia, Missouri, United States
Capital Region Southwest Campus, Jefferson City, Missouri, United States
Washington University School of Medicine, Saint Louis, Missouri, United States
Missouri Baptist Medical Center, Saint Louis, Missouri, United States
Center for Cancer Care and Research, Saint Louis, Missouri, United States
Comprehensive Cancer Care PC, Saint Louis, Missouri, United States
CHI Health Saint Francis, Grand Island, Nebraska, United States
Great Plains Health Callahan Cancer Center, North Platte, Nebraska, United States
Nebraska Methodist Hospital, Omaha, Nebraska, United States
University of Nebraska Medical Center, Omaha, Nebraska, United States
New Hampshire Oncology Hematology PA-Concord, Concord, New Hampshire, United States
Exeter Hospital, Exeter, New Hampshire, United States
LRGHealthcare-Lakes Region General Hospital, Laconia, New Hampshire, United States
Solinsky Center for Cancer Care, Manchester, New Hampshire, United States
Cooper Hospital University Medical Center, Camden, New Jersey, United States
Hematology Oncology Associates of Central New York-East Syracuse, East Syracuse, New York, United States
Glens Falls Hospital, Glens Falls, New York, United States
Northwell Health NCORP, Lake Success, New York, United States
Northwell Health/Center for Advanced Medicine, Lake Success, New York, United States
North Shore University Hospital, Manhasset, New York, United States
Long Island Jewish Medical Center, New Hyde Park, New York, United States
NYP/Weill Cornell Medical Center, New York, New York, United States
State University of New York Upstate Medical University, Syracuse, New York, United States
Randolph Hospital, Asheboro, North Carolina, United States
Mission Hospital, Asheville, North Carolina, United States
UNC Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina, United States
Wayne Memorial Hospital, Goldsboro, North Carolina, United States
Cone Health Cancer Center, Greensboro, North Carolina, United States
East Carolina University, Greenville, North Carolina, United States
Vidant Oncology-Kinston, Kinston, North Carolina, United States
Annie Penn Memorial Hospital, Reidsville, North Carolina, United States
Iredell Memorial Hospital, Statesville, North Carolina, United States
Wake Forest University Health Sciences, Winston-Salem, North Carolina, United States
Ohio State University Comprehensive Cancer Center, Columbus, Ohio, United States
McLeod Regional Medical Center, Florence, South Carolina, United States
Central Vermont Medical Center/National Life Cancer Treatment, Berlin, Vermont, United States
University of Vermont and State Agricultural College, Burlington, Vermont, United States
Danville Regional Medical Center, Danville, Virginia, United States
Virginia Commonwealth University/Massey Cancer Center, Richmond, Virginia, United States
Name: Peter Martin
Affiliation: Alliance for Clinical Trials in Oncology
Role: PRINCIPAL_INVESTIGATOR