Overview

This trial is active, not recruiting.

Condition hodgkin disease
Treatment lenalidomide
Phase phase 2
Sponsor Washington University School of Medicine
Collaborator Celgene Corporation
Start date September 2007
End date December 2016
Trial size 80 participants
Trial identifier NCT00540007, 07-0233 / 201104227

Summary

The purpose of this study is to determine the efficacy of lenalidomide in the treatment of relapsed or refractory classic Hodgkin lymphoma(cHL).

United States No locations recruiting
Other Countries No locations recruiting

Study Design

Allocation non-randomized
Intervention model single group assignment
Masking open label
Primary purpose treatment
Arm
(Experimental)
Lenalidomide 25 mg per day PO daily on days 1-21 of a 28 day cycle.
lenalidomide Revlimid
(Experimental)
Lenalidomide 25 mg per day PO daily on days 1-28 of a 28 day cycle.
lenalidomide Revlimid

Primary Outcomes

Measure
To assess the overall response rate (RR) in relapsed or refractory cHL.
time frame: After cycles 2, 4, 6, 9, 12, and then every 3 cycles. Follow-up every 6 months for 2 years, then annually for a maximum of 3.5 years from study entry or until disease progression

Secondary Outcomes

Measure
To assess the safety and tolerability of lenalidomide therapy in relapsed or refractory cHL.
time frame: 30 days following the completion of treatment
To assess the complete response rate (CR), partial response (PR) and stable disease (SD) rate in relapsed or refractory cHL.
time frame: After cycles 2, 4, 6, 9, 12, and then every 3 cycles. Follow-up every 6 months for 2 years, then annually for a maximum of 3.5 years from study entry or until disease progression
To assess time to progression (TTP).
time frame: After cycles 2, 4, 6, 9, 12, and then every 3 cycles. Follow-up every 6 months for 2 years, then annually for a maximum of 3.5 years from study entry or until disease progression
To assess overall survival (OS)
time frame: Follow-up through 3.5 years from study entry
To assess relapse free survival (RFS)
time frame: Follow-up through 3.5 years from study entry
To evaluate changes in NK cell number and function, plasma cytokines, gene expression profiles of peripheral blood, and plasma proteins via proteomics, before, during, and after lenalidomide therapy (correlative studies).
time frame: pre-therapy, day 15 of cycle 1, day 1 of cycles 2, 4, 6, 12, and then Q 6 cycles, and at 30 and 60 days post-therapy
To assess event free survival (EFS).
time frame: Follow up through 3.5 years from study entry
To assess duration of response.
time frame: After cycles 2, 4, 6, 9, 12, and then every 3 cycles. Follow-up every 6 months for 2 years, then annually for a maximum of 3.5 years from study entry or until disease progression

Eligibility Criteria

Male or female participants at least 18 years old.

Inclusion Criteria: - Histologically documented classical Hodgkin lymphoma that is recurrent or refractory to standard chemotherapy. - Patients must have relapsed or progressed after at least one prior systemic cytotoxic chemotherapy; prior autologous or allogeneic stem cell transplantation is allowed. - Measurable disease must be present either on physical examination or imaging studies (CT, MRI, PET/CT). Any tumor mass greater or equal to 1 cm is acceptable. - Age > 18 years old. - ECOG performance status of less than or equal to 2 at study entry - Adequate hematologic, renal, hepatic function as defined by: - Absolute neutrophil count greater than or equal to 1000 / uL - Platelets greater than or equal to 50,000 / uL - Serum creatinine less than or equal to 1.5X institution upper limit of normal (ULN) - Total bilirubin less than or equal to 2.0 mg/dL - AST (SGOT) and ALT (SGPT) less than or equal to 3 x ULN (if not attributed to cHL) - Disease free of prior malignancies for greater than or equal to 5 years with exception of currently treated basal cell, squamous cell carcinoma of the skin, or carcinoma "in situ" of the cervix or breast. - Understand and voluntarily sign an informed consent form. - Able to adhere to the study visit schedule and other protocol requirements - Females of childbearing potential (FCBP)† must agree to use two reliable forms of contraception simultaneously or to practice complete abstinence from heterosexual intercourse during the following time periods related to this study: 1) for at least 28 days before starting study drug; 2) while participating in the study; and 3) for at least 28 days after discontinuation from the study. The two methods of reliable contraception must include one highly effective method (i.e. intrauterine device (IUD), hormonal [birth control pills, injections, or implants], tubal ligation, partner's vasectomy) and one additional effective (barrier) method (i.e. latex condom, diaphragm, cervical cap). FCBP must be referred to a qualified provider of contraceptive methods if needed. - FCBP must have two negative serum or urine pregnancy tests (sensitivity of at least 50 mIU/mL) prior to starting study drug. The first pregnancy test must be performed within 10-14 days prior to the start of study drug and the second pregnancy test must be performed within 24 hours prior to prescribing lenalidomide for Cycle 1 (prescriptions must be filled within 7 days as required by RevAssist) 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. The subject may not receive study drug until the Investigator has verified that the results of these pregnancy tests are negative. - Men must agree to use a latex condom during sexual contact with females of childbearing potential while participating in the study and for at least 28 days following discontinuation from the study even if he has undergone a successful vasectomy. - All patients must be counseled at a minimum of every 28 days about pregnancy precautions and risks of fetal exposure. - Able to take aspirin (81 or 325 mg) daily as prophylactic anticoagulation (patients intolerant to ASA may use warfarin or low molecular weight - All study participants must be registered into the mandatory RevAssist program, and be willing and able to comply with the requirements of RevAssist. Exclusion Criteria: - Patients who are candidates for high dose chemotherapy and stem cell transplantation and have not yet undergone stem cell transplantation should not be enrolled. - Any serious medical condition, laboratory abnormality, or psychiatric illness that would prevent the subject from signing the informed consent form. - Any condition, including the presence of laboratory abnormalities. - Use of any other anti-cancer drug or therapy, including experimental, within 30 days of enrollment. - Known hypersensitivity to thalidomide. - The development of erythema nodosum if characterized by a desquamating rash while taking thalidomide or similar drugs. - Any prior use of lenalidomide. - Known positive for HIV or infectious hepatitis, type A, B or C. - Pregnant or breastfeeding females. - Concurrent use of other anti-cancer agents or treatments.

Additional Information

Official title A Phase II Multicenter Study of Lenalidomide in Relapsed or Refractory Classical Hodgkin Lymphoma
Principal investigator Todd Fehniger, M.D., Ph.D.
Description Hodgkin lymphoma (HL), an uncommon but significant subtype of lymphoma, is divided into classical HL (cHL) and nodular lymphocyte predominant HL (NLPHL). Progress has been made in cHL therapy resulting in 5-year failure free survival rates between 61%-89% even in the setting of advanced stage or bulky disease. Patients who relapse however, have a variable prognosis ranging from a 8-year overall survival rate of less than 8% for patients who never achieve a remission to 54% for patients with a complete remission lasting greater than 12 months. High dose chemotherapy with autologous stem cell support is the standard of care for patients with relapsed cHL but for those that relapse despite aggressive salvage therapy 20 - 50%, with median remission durations of approximately 6 months. Furthermore, a subset of relapsed HL patients may not be candidates for aggressive salvage regimens. These novel salvage therapies are needed for relapsed/refractory cHL, especially agents without serious late toxicities are particularly attractive in this disease. Advances in the understanding of HL pathogenesis and lenalidomide's mechanisms of action provide substantial rationale for evaluating lenalidomide in HL patients.
Trial information was received from ClinicalTrials.gov and was last updated in January 2016.
Information provided to ClinicalTrials.gov by Washington University School of Medicine.