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A Phase II Study of Revlimid in Combination With Rituximab as Initial Treatment for Patients With Indolent Non-Hodgkin's Lymphoma (NHL)


Phase 2
18 Years
N/A
Open (Enrolling)
Both
Lymphoma

Thank you

Trial Information

A Phase II Study of Revlimid in Combination With Rituximab as Initial Treatment for Patients With Indolent Non-Hodgkin's Lymphoma (NHL)


The Study Drugs:

Rituximab is a type of drug known as a monoclonal antibody. It is designed to act against
the CD20 antigen that is found on the surface of both normal B lymphocytes or on the
malignant lymphoma cells. When rituximab attacks the CD20 antigen, it may kill the lymphoma
cells.

Lenalidomide is designed to change the body's immune system. It may also interfere with the
development of tiny blood vessels that help support tumor growth. Therefore, in theory, it
may decrease or prevent the growth of cancer cells.

If you are found to be eligible to take part in this study, you will take lenalidomide by
mouth on Days 1-21 of each 28-day study cycle in schedule "A", or on Days 2-22 of schedule
"B". You should swallow lenalidomide capsules whole, with water, at the same time each day.
Do not break, chew or open the capsules.

If you miss a dose of lenalidomide, take it as soon as you remember on the same day. If you
miss taking your dose for the entire day, take your regular dose the next scheduled day (do
not take double your regular dose to make up for the missed dose).

Lenalidomide is being provided to you under a special distribution program called
RevAssist®. A company called Biologics will directly mail you your supply of lenalidomide
to your home. The RevAssist® toll-free contact number for patients is 1-888-423-5436. You
should contact that number in order to ask for information on how to properly dispose of any
unused supply of lenalidomide by shipping the drug back.

You will receive rituximab through a needle in your vein on Day 1 (Schedule A) or on Days 1,
8, 15, and 22 of Cycle 1 (Schedule B) over 4-8 hours. You will receive rituximab on Day 1
of all subsequent cycles.

You will be given a diary to record when you take all of the study drugs and any problems or
illnesses you may experience. You should also write down in the diary any other drugs you
take while you are on this study.

Study Visits:

After you begin your treatment, you will have study visits at the beginning of each cycle.
If your doctor thinks it is necessary, the check-up visits may take place more often.

At these visits, the following tests and procedure will be performed:

- You will have a complete physical exam, including measurement of vital signs.

- You will be asked questions about how you have felt since your last visit.

- You will be asked about any drugs you have taken since your last visit.

- You should bring the diary you were given earlier to each visit.

- Blood (about 8 tablespoons) will be drawn for routine blood tests and to check on the
status of the disease.

On Days 8 and 22 of Cycle 1, blood (about 2 tablespoons) will be drawn for routine tests.

On Day 14 of Cycles 2-12, blood (about 2 tablespoons) will be drawn for routine tests.

At the end of each 28-day treatment cycles, you will have a visit with the study doctor to
see if it is safe for you to continue on this study and make sure the cancer has not gotten
worse. At this visit, blood (about 8 tablespoons) will be drawn for routine blood tests to
check on the status of the disease.

If your doctor thinks it is necessary, at any of the study visits you may have a bone marrow
biopsy/aspirate, x-rays, CT scans, positron emission tomography (PET) scans, or
gastrointestinal endoscopy to check the status of the disease.

Pregnancy Tests:

Women who are able to become pregnant with regular or no menstrual cycles must agree to have
pregnancy tests weekly for the first 28 days of study and then every 28 days while on study,
at the end-of-study visit, and at Day 28 following discontinuation from the study.

Women with irregular menstrual cycles must have pregnancy tests weekly for the first 28
days, then every 14 days while on study, at the end-of-study visit, and at days 14 and 28
following discontinuation from the study.

Length of Study:

You may continue to take the study drugs for up to 12 cycles. You will be taken off study
earl if the disease gets worse or you experience intolerable side effects.

End-of-Study Visit:

Once you are off-study, you will have an end-of-study visit. At this visit, the following
tests and procedures will be performed:

- You will have a complete physical exam, including measurement of vital signs and
weight.

- You will be asked questions about how you have felt since your last visit.

- You will be asked about any drugs you have taken since your last visit.

- Blood (around 3 tablespoons) will be drawn for routine blood tests to check on the
status of the disease.

- You will have bone marrow biopsy/aspirate to check the status of disease.

- You will have x-rays or CT scans to check the status of the disease.

- You should return any unused lenalidomide capsules.

Long-Term Follow-Up:

After the end-of-study visit, you will be contacted by phone every 6 months from then on to
check on your health and for information about any other cancer treatments you may have
received.

You will have CT scans of your neck, thorax, abdomen and pelvis every 3 months for 1 year,
every 6 months for the following year, and then 1 time a year after that.

This is an investigational study. Lenalidomide is FDA approved and commercially available
for multiple myeloma and myelodysplastic syndrome. Its use in patients with indolent
non-Hodgkin's lymphoma is investigational.

Rituximab is FDA approved and commercially available for the treatment of non-Hodgkin's
lymphomas, including indolent non-Hodgkin's lymphoma.

Up to 155 participants with take part in this study. All will be enrolled at MD Anderson.


Inclusion Criteria:



1. Understand and voluntarily sign an informed consent form.

2. Age >/= 18 at the time of signing the informed consent form.

3. Able to adhere to the study visit schedule and other protocol requirements.

4. Untreated indolent non-Hodgkin's lymphoma stage III-IV including small lymphocytic
lymphoma, marginal zone lymphoma, grade 1 or 2 follicular lymphoma. (prior radiation
for localized disease allowed).

5. At least one measurable lesion according to the International workshop standardized
response criteria for non-Hodgkin's lymphomas (IWG) greater than 1.5cm.

6. ECOG performance status of
7. Laboratory test results within these ranges: Absolute neutrophil count >/= 1.5 x
10^9/L; Platelet count >/=100 x 10^9/L; Serum creatinine bilirubin metastases are present.

8. Disease free of prior malignancies for >/= 5 years with exception of currently
treated basal cell, squamous cell carcinoma of the skin, or carcinoma "insitu" of the
cervix or breast, or localized prostate cancer treated with curative intent.

9. All study participants must be registered into the mandatory RevAssist® program, and
be willing and able to comply with the requirements of RevAssist®.

10. Females of childbearing potential (FCBP) must have a negative serum or urine
pregnancy test with a sensitivity of at least 50 mIU/mL within 10 -14 days prior to
and again within 24 hours of prescribing lenalidomide and must either commit to
continued abstinence from heterosexual intercourse or begin TWO acceptable methods of
birth control, one highly effective method and one additional effective method AT THE
SAME TIME, at least 4 weeks before she starts taking lenalidomide. FCBP must also
agree to ongoing pregnancy testing.

11. Men must agree to use a latex condom during sexual contact with a female of child
bearing potential even if they have had a successful vasectomy.

12. For patients with bulky disease (tumors >5cm) must be able to take aspirin (81 mg or
325 mg) daily as prophylactic anticoagulation (patients intolerant to ASA may use
warfarin or low molecular weight heparin.

Exclusion Criteria:

1. Any serious medical condition, laboratory abnormality, or psychiatric illness that
would prevent the subject from signing the informed consent form.

2. Pregnant or breast feeding females.

3. Any condition, including the presence of laboratory abnormalities, which places the
subject at unacceptable risk if he/she were to participate in the study or confounds
the ability to interpret data from the study.

4. Use of any chemotherapy or experimental therapy within 28 days of enrollment.

5. Known hypersensitivity to thalidomide.

6. The development of erythema nodosum if characterized by a desquamating rash while
taking thalidomide or similar drugs.

7. Any prior use of lenalidomide.

8. Concurrent use of other anti-cancer agents or experimental treatments.

9. Known positive for HIV or infectious hepatitis type B or C. (Hepatitis B core
antibody can be positive if Hep B surface antigen is negative and no HBV DNA in
blood, indicating a cleared infection.)

Type of Study:

Interventional

Study Design:

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

Outcome Measure:

Overall Response (OR), Complete Response (CR) or Partial Response (PR)

Outcome Time Frame:

Assessed at end of 3 cycles (cycle is 28 days)

Safety Issue:

Yes

Principal Investigator

Felipe Samaniego, MD

Investigator Role:

Principal Investigator

Investigator Affiliation:

M.D. Anderson Cancer Center

Authority:

United States: Institutional Review Board

Study ID:

2008-0042

NCT ID:

NCT00695786

Start Date:

June 2008

Completion Date:

Related Keywords:

  • Lymphoma
  • Non-Hodgkin's Lymphoma
  • Lymphoma
  • Lenalidomide
  • Revlimid
  • Rituximab
  • Rituxan
  • Lymphoma
  • Lymphoma, Non-Hodgkin

Name

Location

UT MD Anderson Cancer CenterHouston, Texas  77030