Multiple Myeloma and Plasma Cell Neoplasm Clinical Trial
Official title:
Phase II Study of Lenalidomide and Rituximab for Patients With Relapsed and/or Refractory CD20+ Multiple Myeloma
RATIONALE: Lenalidomide may stop the growth of multiple myeloma by blocking blood flow to
the cancer. 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. Giving lenalidomide together
with rituximab may be an effective treatment for multiple myeloma.
PURPOSE: This phase II trial is studying the side effects of giving lenalidomide together
with rituximab and to see how well it works in treating patients with recurrent or
refractory multiple myeloma.
OBJECTIVES:
Primary
- To determine the safety and efficacy, as determined by response rate (complete response
[CR] + near CR + partial response), of lenalidomide administered with rituximab in
patients with relapsed and/or refractory CD20+ multiple myeloma.
Secondary
- To assess the effects of this regimen on patient lymphocyte subsets (T, B, and NK
cells) in peripheral blood and bone marrow samples from these patients.
- To perform detailed phenotypic analyses of NK cells in patient blood and bone marrow
samples at baseline and post-treatment.
OUTLINE: Patients receive oral lenalidomide once daily on days 1-21. Treatment with
lenalidomide repeats every 28 days for at least 4 courses. Patients also receive rituximab
IV once weekly in weeks 2-5 and in week 13. Patients with stable disease then receive
rituximab once every 8 weeks. Treatment continues in the absence of disease progression or
unacceptable toxicity.
Peripheral blood samples are collected at baseline, and after courses 2 and 4. Samples are
examined by flow cytometry for lymphocyte subset analysis (T-, B-, and NK-cell percentages
and absolute numbers) and NK-cell phenotyping (CD16, CD56, NKG2D expression). Samples are
also examined by immunologic assays of isolated peripheral blood mononuclear cells. Bone
marrow aspirate samples are also collected at baseline and after course 2. Bone marrow
mononuclear cells are isolated and evaluated by CD138+ plasma cell selection, ex vivo
antibody-dependent cellular cytotoxicity assays, and bone marrow lymphocyte subset analysis.
After completion of study therapy, patients are followed at 30 days.
;
Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
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