Phase I/II Study of Lenalidomide and Ofatumumab for the Treatment of Relapsed or Refractory Non-Hodgkin's Lymphoma
- Histologically confirmed diagnosis of CD20+ non-Hodgkin's lymphoma that is recurrent
or refractory after at least one prior therapy and for which no other potentially
curative therapy is available.
- Subject, age > or = 19 years
- Patients must have relapsed or refractory disease after at least one prior systemic
therapy, with at least a 3 week interval from the completion of the most recent
chemotherapy or radiotherapy regimen (unless the patient has had progressive disease
prior to the 3 weeks). Patient has resolved all toxicities to ≤ grade 1, felt to
be related to prior therapy.
- Patients must be ineligible or relapsed after an autologous or allogeneic stem cell
transplant if clinically appropriate.
- Adequate Laboratory Parameters:
- ANC ≥ 1500/μL
- Platelet count ≥75,000/μL
- Total bilirubin ≤ 1.5 times the institutional Upper Limit of Normal (ULN)-
unless due to NHL
- Hepatic enzymes (AST, ALT ) ≤ 2.5 times the institutional ULN - unless due to
- Serum Creatinine < 3.0 times the institutional ULN - unless due to NHL
- Creatinine clearance ≥60ml/min during phase I (See Appendix A) Creatinine
clearance ≥ 30ml/min during phase II and patients with creatinine clearance ≥
30ml/min and < 60ml/min should start Lenalidomide at a reduced dose. See Section
- Females of child-bearing potential (FCBP) must agree to:
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 prior to prescribing lenalidomide (prescriptions must be filled within 7
days) 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 28 days before she starts taking
lenalidomide. FCBP must also agree to ongoing pregnancy testing. See Appendix B: Risks of
Fetal Exposure, Pregnancy Testing Guidelines and Acceptable Birth Control Methods.
Note: A FCBP is a sexually mature woman who: 1) has not undergone a hysterectomy or
bilateral oophorectomy or 2) has not been naturally postmenopausal (i.e., amenorrhea
following cancer therapy does not rule out childbearing potential) for at least 24
consecutive months (i.e., has had menses at any time in the preceding 24 consecutive
Male patients must:
- Agree to use a condom during sexual contact with a FCBP, even if they have had a
vasectomy, throughout study drug therapy, during any dose interruption and 28 days
after cessation of study therapy.
- Agree to not donate semen during study drug therapy and for a period after end of
study drug therapy
- ECOG Performance status of 0-2 (See Appendix C)
- Signed written informed consent including HIPAA according to institutional guidelines
- No malignancy [other than the one treated in this study] which required systemic
treatment within the past 3 years.
- Patients not willing to take DVT prophylaxis
- Pregnant or lactating females
- Positive serology for hepatitis B (HB) defined as positive test of HBsAg. In
addition, if negative for HBsAg but HBcAb positive (regardless of HBsAb status), a HB
DNA test will be performed and if positive the subject will be excluded. Patients
with documented vaccination against Hepatitis B will not be considered positive.
- Known seropositive for active viral infection with human immunodeficiency virus
(HIV), or hepatitis C virus (HCV). Patients who are seropositive because of hepatitis
B virus vaccine are eligible.
- Patients with ≥ Grade 2 neuropathy
- Active hepatic or biliary disease (with exception of patients with Gilbert's
syndrome, asymptomatic gallstones, liver metastases or stable chronic liver disease
per investigator assessment)
- Known CNS involvement with lymphoma
- Significant concurrent, uncontrolled medical condition, that in the judgment of the
investigator, may affect the patient's ability to sign the informed consent and
comply with study procedures.