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Safety And Efficacy Of Lenalidomide In Patients With Relapsed Or Refractory Aggressive Non-Hodgkin's Lymphoma (NHL)

A Phase II, Multicenter, Single-Arm, Open-Label Study To Evaluate The Safety And Efficacy Of Single-Agent Lenalidomide (Revlimid®, CC-5013) In Subjects With Relapsed Or Refractory Aggressive Non-Hodgkin's Lymphoma

Status
Completed
Phases
Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT00179660
Enrollment
50
Registered
2005-09-16
Start date
2005-08-31
Completion date
2008-06-30
Last updated
2016-01-21

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Non-Hodgkins Lymphoma

Keywords

celgene, cc-5013, CC5013, NHL, Non-Hodgkins Lymphoma, Revlimid

Brief summary

To determine the activity of lenalidomide in relapsed or refractory aggressive NHL.

Interventions

DRUGLenalidomide

Capsules for oral administration.

Sponsors

Prologue Research International
CollaboratorINDUSTRY
Celgene Corporation
Lead SponsorINDUSTRY

Study design

Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No

Inclusion criteria

1. Understand and voluntarily sign an informed consent form. 2. Age greater than or equal to 18 years at the time of signing the informed consent form 3. Able to adhere to the study visit schedule and other protocol requirements 4. Biopsy-proven non-Hodgkin's lymphoma 5. Aggressive lymphoma, the following histologies are acceptable: Follicular center lymphoma, grade 3, Diffuse large cell, Mantle cell, Transformed 6. Relapsed or refractory to previous therapy for lymphoma. Patients must have received at least one prior treatment regimen such as radiation, immunotherapy, chemotherapy, or radioimmunotherapy, and be ineligible or unwilling to undergo an autologous stem cell transplant. There is no limit on the number of prior therapies. 7. Patients must have measurable disease on cross sectional imaging that is at least 2 cm in the longest diameter. 8. Eastern Cooperative Oncology Group (ECOG) performance status score of 0, 1 or 2. 9. Women of childbearing potential (WCBP) must have a negative serum or urine pregnancy test within 7 days of starting study drug. In addition, sexually active WCBP must agree to use adequate contraceptive methods (oral, injectable, or implantable hormonal contraceptive; tubal ligation; intra-uterine device; barrier contraceptive with spermicide; or vasectomized partner) while on study drug.

Exclusion criteria

1. Any of the following laboratory abnormalities: 1. Absolute neutrophil count (ANC) \<1,500 cells/mm\^3 (1.5 x 10\^9/L) 2. Platelet count \<100,000/mm\^3 (100 x 10\^9/L) 3. Serum creatinine \>2.5 mg/dL (221 mmol/L) 4. Serum aspartate transaminase (AST) or alanine transaminase (ALT) \>5.0 x upper limit of normal (ULN) 5. Serum total bilirubin \>2.0 mg/dL (34 mmol/L) 2. 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 3. All patients with central nervous system (CNS) disease with the exception of those patients whose CNS disease has been treated with chemotherapy, radiotherapy or surgery and remains asymptomatic, with no active CNS disease, as shown by lumbar puncture, computed tomography (CT) scan or magnetic resonance imaging (MRI), for at least 6 months. 4. Prior history of malignancies other than non-Hodgkin's lymphoma (except for basal cell or squamous cell carcinoma of the skin or carcinoma in situ of the cervix or breast) unless the subject has been free of the disease for \> or equal to 1 year 5. Any serious medical condition, laboratory abnormality, or psychiatric illness that would prevent the subject from signing the informed consent form 6. Known positive for human immunodeficiency virus (HIV) 7. Pregnant or lactating females 8. Prior \> or equal to grade 3 National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) allergic reaction/hypersensitivity to thalidomide 9. Prior \> or equal to grade 3 NCI CTCAE rash or any desquamating (blistering) rash while taking thalidomide 10. Prior use of lenalidomide 11. Use of any standard or experimental anti-cancer drug therapy within 28 days of day 1 of study drug therapy 12. Known active Hepatitis C

Design outcomes

Primary

MeasureTime frameDescription
Percentage of Participants With ResponseFrom enrollment through study completion. Median duration on study was 3.7 months, with a maximum of 32.5 months.Response was defined as participants with a complete response (CR), unconfirmed complete response (Cru) or partial response (PR), assessed using the International Workshop Lymphoma Response Criteria (IWLRC) and based on best responses as determined by the investigator. CR: Complete disappearance of all detectable clinical and radiographic evidence of disease, disappearance of any disease-related symptoms, and normalization of biochemical abnormalities. Cru: Criteria for CR above but with 1 or more of the following: * A residual lymph node mass \> 1.5 cm in greatest transverse diameter that has regressed by more than 75% in the sum of the products of diameters (SPD) * Indeterminate bone marrow (increased number or size of aggregates without cytologic or architectural atypia). PR: 50% decrease in SPD of the 6 largest dominant nodes or nodal masses. No increase in the size of other nodes, liver, or spleen. Splenic and hepatic nodules must regress by at least 50% in the SPD.

Secondary

MeasureTime frameDescription
Percentage of Participants With Tumor ControlFrom enrollment through study completion. Median duration on study was 3.7 months, with a maximum of 32.5 months.Tumor control was defined as participants with a complete response, unconfirmed complete response, partial response or stable disease (SD), assessed using the International Workshop Lymphoma Response Criteria (IWLRC) and based on best responses as determined by the investigator. SD was defined as a response less than a PR (see above) but not Progressive Disease (PD). PD was defined as * ≥ 50 % increase from nadir in the SPD of any previously identified abnormal node for partial responders or non-responders. * Appearance of any new lesion during or at the end of therapy.
Duration of ResponseFrom enrollment through study completion. Median duration on study was 3.7 months, with a maximum of 32.5 months.The duration of response was calculated as the first response assessment demonstrating evidence of at least a partial response to the first documentation of progressive disease (as determined by computed tomography scan) or death due to NHL, whichever occurred first. For participants without documentation of progression, the duration of response was censored at the last date of tumor assessment indicating no progression. Median was based on the Kaplan-Meier estimate.
Duration of Tumor ControlFrom enrollment through study completion. Median duration on study was 3.7 months, with a maximum of 32.5 months.The duration of tumor control was calculated as the time from the first response assessment demonstrating at least stable disease to the first documentation of progressive disease or death due to NHL. For participants without documentation of progression, the duration of response was censored at the last date of tumor assessment indicating no progression. Median was based on the Kaplan-Meier estimate.
Progression-free SurvivalFrom enrollment through study completion. Median duration on study was 3.7 months, with a maximum of 32.5 months.Progression-free survival was defined as the time from the start of study drug therapy to the first observation of disease progression or death due to any cause, whichever came first. Participants who withdrew for any reason or received another NHL therapy including stem cell transplantation without documented progressive disease were censored on the date of their last adequate response assessment indicating no progression (or last adequate assessment prior to receiving other NHL therapy). Participants who were still active without progressive disease at the time of the data cut-off date were censored on the date of their last adequate response assessment.
Number of Participants With Adverse Events (AEs)From the start of study drug through 30 days after the last dose of study drug. Maximum time on study drug was 15.2 months.The Investigator determined the relationship between the administration of study drug and the occurrence of an AE as suspected if the temporal relationship of the adverse event to study drug administration made a causal relationship possible, and other drugs, therapeutic interventions, or underlying conditions did not provide a sufficient explanation for the observed event. The Investigator graded the severity of AEs according to National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) criteria and the following scale: * Grade 1 = Mild * Grade 2 = Moderate * Grade 3 = Severe * Grade 4 = Life threatening * Grade 5 = Death A Serious AE is defined as any AE which results in death, is life-threatening, requires inpatient hospitalization or prolongation of existing hospitalization, results in persistent or significant disability/incapacity, is a congenital anomaly/birth defect or constitutes an important medical event.

Countries

United States

Participant flow

Participants by arm

ArmCount
Lenalidomide
Participants received single-agent lenalidomide 25 mg orally once daily on Days 1 to 21 of every 28-day cycle for up to 52 weeks or until disease progression developed, lenalidomide treatment was discontinued for any reason, or the study was terminated.
49
Total49

Withdrawals & dropouts

PeriodReasonFG000
Overall StudyAdverse Event7
Overall StudyDeath3
Overall StudyLack of therapeutic effect28
Overall StudyLost to Follow-up1
Overall StudyOther - Unspecified9
Overall StudyWithdrawal by Subject2

Baseline characteristics

CharacteristicLenalidomide
Age, Continuous64.8 years
STANDARD_DEVIATION 11.53
Eastern Cooperative Oncology Group (ECOG) performance status
0
20 participants
Eastern Cooperative Oncology Group (ECOG) performance status
1
23 participants
Eastern Cooperative Oncology Group (ECOG) performance status
2
5 participants
Eastern Cooperative Oncology Group (ECOG) performance status
Missing
1 participants
International Prognostic Index (IPI)
High (4 to 5)
6 participants
International Prognostic Index (IPI)
High/Intermediate (3)
13 participants
International Prognostic Index (IPI)
Low (0 to 1)
8 participants
International Prognostic Index (IPI)
Low/Intermediate (2)
22 participants
NHL Duration4.0 years
STANDARD_DEVIATION 4.91
NHL histology
Diffuse large B-cell lymphoma
26 participants
NHL histology
Follicular lymphoma grade 3
5 participants
NHL histology
Mantle cell lymphoma
15 participants
NHL histology
Transformed
3 participants
Non-Hodgkin's Lymphoma (NHL) Stage
Stage I
1 participants
Non-Hodgkin's Lymphoma (NHL) Stage
Stage II
7 participants
Non-Hodgkin's Lymphoma (NHL) Stage
Stage III
9 participants
Non-Hodgkin's Lymphoma (NHL) Stage
Stage IV
32 participants
Race/Ethnicity, Customized
Asian/Pacific Islander
1 participants
Race/Ethnicity, Customized
Black
2 participants
Race/Ethnicity, Customized
Hispanic
10 participants
Race/Ethnicity, Customized
White
36 participants
Region of Enrollment
United States
49 participants
Sex: Female, Male
Female
24 Participants
Sex: Female, Male
Male
25 Participants

Adverse events

Event typeEG000
affected / at risk
deaths
Total, all-cause mortality
— / —
other
Total, other adverse events
48 / 49
serious
Total, serious adverse events
21 / 49

Outcome results

Primary

Percentage of Participants With Response

Response was defined as participants with a complete response (CR), unconfirmed complete response (Cru) or partial response (PR), assessed using the International Workshop Lymphoma Response Criteria (IWLRC) and based on best responses as determined by the investigator. CR: Complete disappearance of all detectable clinical and radiographic evidence of disease, disappearance of any disease-related symptoms, and normalization of biochemical abnormalities. Cru: Criteria for CR above but with 1 or more of the following: * A residual lymph node mass \> 1.5 cm in greatest transverse diameter that has regressed by more than 75% in the sum of the products of diameters (SPD) * Indeterminate bone marrow (increased number or size of aggregates without cytologic or architectural atypia). PR: 50% decrease in SPD of the 6 largest dominant nodes or nodal masses. No increase in the size of other nodes, liver, or spleen. Splenic and hepatic nodules must regress by at least 50% in the SPD.

Time frame: From enrollment through study completion. Median duration on study was 3.7 months, with a maximum of 32.5 months.

Population: Intent-to-treat (ITT) population, which included all enrolled patients who received at least 1 dose of study drug. Patients who dropped out without having a response assessment or who had a response after they had received other anti-cancer treatments were considered non-responders.

ArmMeasureValue (NUMBER)
LenalidomidePercentage of Participants With Response34.7 percentage of participants
Secondary

Duration of Response

The duration of response was calculated as the first response assessment demonstrating evidence of at least a partial response to the first documentation of progressive disease (as determined by computed tomography scan) or death due to NHL, whichever occurred first. For participants without documentation of progression, the duration of response was censored at the last date of tumor assessment indicating no progression. Median was based on the Kaplan-Meier estimate.

Time frame: From enrollment through study completion. Median duration on study was 3.7 months, with a maximum of 32.5 months.

Population: Intent to treat population with a response = CR, CRu or PR.

ArmMeasureValue (MEDIAN)
LenalidomideDuration of Response10.2 months
Secondary

Duration of Tumor Control

The duration of tumor control was calculated as the time from the first response assessment demonstrating at least stable disease to the first documentation of progressive disease or death due to NHL. For participants without documentation of progression, the duration of response was censored at the last date of tumor assessment indicating no progression. Median was based on the Kaplan-Meier estimate.

Time frame: From enrollment through study completion. Median duration on study was 3.7 months, with a maximum of 32.5 months.

Population: Intent to treat population with tumor control (CR, CRu, PR or SD).

ArmMeasureValue (MEDIAN)
LenalidomideDuration of Tumor Control6.0 months
Secondary

Number of Participants With Adverse Events (AEs)

The Investigator determined the relationship between the administration of study drug and the occurrence of an AE as suspected if the temporal relationship of the adverse event to study drug administration made a causal relationship possible, and other drugs, therapeutic interventions, or underlying conditions did not provide a sufficient explanation for the observed event. The Investigator graded the severity of AEs according to National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) criteria and the following scale: * Grade 1 = Mild * Grade 2 = Moderate * Grade 3 = Severe * Grade 4 = Life threatening * Grade 5 = Death A Serious AE is defined as any AE which results in death, is life-threatening, requires inpatient hospitalization or prolongation of existing hospitalization, results in persistent or significant disability/incapacity, is a congenital anomaly/birth defect or constitutes an important medical event.

Time frame: From the start of study drug through 30 days after the last dose of study drug. Maximum time on study drug was 15.2 months.

Population: Safety Population, which includes all participants who received at least one dose of study drug.

ArmMeasureGroupValue (NUMBER)
LenalidomideNumber of Participants With Adverse Events (AEs)Any adverse event49 participants
LenalidomideNumber of Participants With Adverse Events (AEs)Adverse event related to study drug42 participants
LenalidomideNumber of Participants With Adverse Events (AEs)Grade 3-5 adverse event36 participants
LenalidomideNumber of Participants With Adverse Events (AEs)Grade 3-5 adverse event related to study drug27 participants
LenalidomideNumber of Participants With Adverse Events (AEs)Serious adverse event21 participants
LenalidomideNumber of Participants With Adverse Events (AEs)Serious adverse event related to study drug6 participants
LenalidomideNumber of Participants With Adverse Events (AEs)AE leading to discontinuation of study drug9 participants
LenalidomideNumber of Participants With Adverse Events (AEs)Related AE leading to study drug discontinuation4 participants
LenalidomideNumber of Participants With Adverse Events (AEs)AE leading to dose reduction or interruption28 participants
Secondary

Percentage of Participants With Tumor Control

Tumor control was defined as participants with a complete response, unconfirmed complete response, partial response or stable disease (SD), assessed using the International Workshop Lymphoma Response Criteria (IWLRC) and based on best responses as determined by the investigator. SD was defined as a response less than a PR (see above) but not Progressive Disease (PD). PD was defined as * ≥ 50 % increase from nadir in the SPD of any previously identified abnormal node for partial responders or non-responders. * Appearance of any new lesion during or at the end of therapy.

Time frame: From enrollment through study completion. Median duration on study was 3.7 months, with a maximum of 32.5 months.

Population: Intent-to-treat (ITT) population. Patients who dropped out without having a response assessment or who had a response after they had received other anti-cancer treatments were considered non-responders.

ArmMeasureValue (NUMBER)
LenalidomidePercentage of Participants With Tumor Control59.2 percentage of participants
Secondary

Progression-free Survival

Progression-free survival was defined as the time from the start of study drug therapy to the first observation of disease progression or death due to any cause, whichever came first. Participants who withdrew for any reason or received another NHL therapy including stem cell transplantation without documented progressive disease were censored on the date of their last adequate response assessment indicating no progression (or last adequate assessment prior to receiving other NHL therapy). Participants who were still active without progressive disease at the time of the data cut-off date were censored on the date of their last adequate response assessment.

Time frame: From enrollment through study completion. Median duration on study was 3.7 months, with a maximum of 32.5 months.

Population: Intent to treat population

ArmMeasureValue (MEDIAN)
LenalidomideProgression-free Survival3.6 months

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026