Lymphoma Clinical Trial
Official title:
A Phase II Randomized Study of Lenalidomide or Lenalidomide and Rituximab as Maintenance Therapy Following Standard Chemotherapy for Patients With High/High-intermediate Risk Diffuse Large B-Cell Lymphoma
RATIONALE: Lenalidomide may stop the growth of cancer cells by blocking blood flow to the
cancer. It may also stimulate the immune system in different ways and stop cancer cells from
growing. 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. It is not yet known whether
lenalidomide is more effective with or without rituximab in treating diffuse large B-cell
non-Hodgkin lymphoma.
PURPOSE: This randomized phase II trial is studying lenalidomide to see how well it works
when given with or without rituximab after standard chemotherapy in treating patients with
diffuse large B-cell non-Hodgkin lymphoma.
OBJECTIVES:
Primary
- To assess the 1-year disease-free and relapse-free survival of patients with high- or
high/intermediate-risk diffuse large B-cell non-Hodgkin lymphoma treated with
maintenance therapy comprising lenalidomide with or without rituximab following
standard chemotherapy.
Secondary
- To assess the 2-year disease-free survival of patients treated with these regimens.
- To define the safety and toxicity profile of these regimens.
- To perform antibody-dependent cellular cytotoxicity assays using peripheral blood
mononuclear cell samples from these patients.
- To assess the change in the number of natural killer cells by flow cytometric analysis.
- To evaluate cytokines including, but not limited to, sIL-2R, IL-6, IL-15, IL-12, TNF-α,
and IFN-γ in these patients.
- To study the KIR genotype receptor and FCγR polymorphisms.
OUTLINE: This is a multicenter study. Patients are randomized to 1 of 2 treatment arms.
- Arm I: Patients receive oral lenalidomide once daily on days 1-21. Treatment repeats
every 28 days for 12 courses in the absence of disease progression or unacceptable
toxicity.
- Arm II: Patients receive lenalidomide as in arm I and rituximab IV on day 8 of courses
1, 3, 5, 7, 9, and 11 in the absence of disease progression or unacceptable toxicity.
Peripheral blood mononuclear cells are collected periodically for correlative studies.
Samples are analyzed for change in the number of natural killer cells by flow cytometry;
antibody-dependent cellular cytotoxicity by assay; cytokines; KIR genotype receptor; and
FCγR polymorphisms.
After completion of study therapy, patients are followed at 30 days and then every 3 months
for 1 year.
;
Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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