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Brief Title: Rituximab With or Without Lenalidomide in Treating Patients With Previously Untreated Follicular Lymphoma
Official Title: Rituximab Plus Lenalidomide or Rituximab Monotherapy for Untreated Patients With Follicular Lymphoma in Need of Therapy. A Randomized, Open-Label, Multicenter Phase II Trial.
Study ID: NCT01307605
Brief Summary: RATIONALE: Monoclonal antibodies, such as rituximab, can block cancer cell 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. Lenalidomide may stop the growth of non-Hodgkin lymphoma by blocking blood flow to the cancer. It is not yet known whether rituximab is more effective when given alone or together with lenalidomide in treating patients with follicular lymphoma. PURPOSE: This randomized phase II trial is studying rituximab to see how well it works compared with giving rituximab together with lenalidomide in treating patients with previously untreated follicular lymphoma.
Detailed Description: OBJECTIVES: Primary * To determine the activity of rituximab in combination with lenalidomide versus rituximab alone in patients with previously untreated follicular lymphoma in need of therapy. Secondary * To determine the safety of these regimens in these patients. OUTLINE: This is a multicenter study. Patients are stratified according to grade of disease (grades 1 or 2 vs 3a), presence of bulky disease (defined as masses ≥ 6 cm) (yes vs no), Follicular Lymphoma International Prognostic Index score (1 or 2 vs ≥ 3), and participating centers. Patients are randomized to 1 of 2 treatment arms. * Arm A: Patients receive rituximab IV on day 1 in weeks 1, 2, 3, 4 and weeks 12, 13, 14, 15 in the absence of disease progression or unacceptable toxicity. * Arm B: Patients receive rituximab IV as in arm A. Patients also receive oral lenalidomide once daily, starting 14 days before first rituximab administration and last until 14 days after the last rituximab administration, in the absence of disease progression or unacceptable toxicity. All patients undergo restaging at week 10. Patients who show less than a minimal response (i.e., reduction of more than 25% in sum of product of diameters \[SPD\]) are off study treatment and transferred to the follow-up phase. Patients undergo a second restaging in week 23. Some patients may undergo biopsies and blood and bone marrow sample collection periodically for biomarker studies. After completion of study treatment, patients are followed up periodically for 20 years.
Minimum Age: 18 Years
Eligible Ages: ADULT, OLDER_ADULT
Sex: ALL
Healthy Volunteers: No
Haukeland Hospital - University of Bergen, Bergen, , Norway
Sorlandet Sykehus HF Kristiansand, Kristiansand, , Norway
Ullevaal University Hospital, Oslo, , Norway
Helse Stavanger HF, Stavanger, , Norway
University Hospital of North Norway - Tromso, Tromso, , Norway
St. Olavs University Hospital, Trondheim, , Norway
Sahlgrenska University Hospital, Göteborg, , Sweden
University Hospital of Linkoping, Linkoping, , Sweden
Sunderbyn Hospital, Lulea, , Sweden
Lund University Hospital, Lund, , Sweden
Karolinska University Hospital - Huddinge, Stockholm, , Sweden
Karolinska University Hospital - Solna, Stockholm, , Sweden
Sundsvall Hospital, Sundsvall, , Sweden
Norrlands University Hospital, Umea, , Sweden
Uppsala University Hospital, Uppsala, , Sweden
Kantonsspital Aarau, Aarau, , Switzerland
Kantonsspital Baden, Baden, , Switzerland
Saint Claraspital AG, Basel, , Switzerland
Universitaetsspital-Basel, Basel, , Switzerland
Istituto Oncologico della Svizzera Italiana - Ospedale San Giovanni, Bellinzona, , Switzerland
Inselspital Bern, Bern, , Switzerland
Spitalzentrum Oberwallis - Brig, Brig, , Switzerland
Kantonsspital Bruderholz, Bruderholz, , Switzerland
Kantonsspital Graubuenden, Chur, , Switzerland
University Hospital, Geneva, , Switzerland
Kantonsspital Liestal, Liestal, , Switzerland
Kantonsspital Olten, Olten, , Switzerland
Kantonsspital - St. Gallen, St. Gallen, , Switzerland
Regionalspital, Thun, , Switzerland
Kantonsspital Winterthur, Winterthur, , Switzerland
Klinik Hirslanden, Zurich, , Switzerland
City Hospital Triemli, Zurich, , Switzerland
UniversitaetsSpital Zuerich, Zurich, , Switzerland
Name: Emanuele Zucca, MD
Affiliation: Istituto Oncologico della Svizzera Italiana - Ospedale San Giovanni
Role: STUDY_CHAIR
Name: Eva K. Kimby, MD, PhD
Affiliation: Karolinska Institutet
Role: STUDY_CHAIR
Name: Felicitas Hitz, MD
Affiliation: Cantonal Hospital of St. Gallen
Role: PRINCIPAL_INVESTIGATOR
Name: Bjorn Ostenstad, MD
Affiliation: Ullevaal University Hospital
Role: PRINCIPAL_INVESTIGATOR