study of lenalidomide to evaluate safety and effectiveness in patients with diffuse large b-cell lymphoma (dlbcl)

Conditions: Diffuse Large B-cell Lymphoma

Summary: the purpose of this study is to compare lenalidomide to a control drug and see which one delays diffuse large b-cell lymphoma (dlbcl) disease progression longer.

this research study is for patients who have been diagnosed with diffuse large b-cell lymphoma (dlbcl) that did not respond to (refractory) or that has come back after chemotherapy treatment (relapsed). lymphoma is a cancer of a type of blood cell called lymphocytes. dlbcl is just one type of lymphoma. within dlbcl there are two different subtypes called germinal center b-cell (gcb) and non-gcb which can be determined by cell surface marker tests or by gene expression tests. scientists can look at cells and genes in the laboratory and see that the two kinds are different, but they don't know yet what the difference means. to patients and doctors these two kinds seem the same. right now doctors don't usually do tests to find out which kind a patient has because the treatment is the same for both. this study will have two stages, 1 and 2. the main purpose of stage 1 is to separate patients by subtype and then test whether patients taking lenalidomide or any one of four other drugs have a better response. it is possible that lenalidomide will work better than one of the other drugs in zero, one, or both subtypes. stage 2 will further test only the subtype(s) from stage 1 that showed a good response to lenalidomide. the main purpose of stage 2 is to test how long patients are disease free on lenalidomide compared to one of the four other drugs. on 29 january 2013 the enrolment goal for the stage 1 portion of the study was met and enrollment was stopped. the final analysis for stage 1 was performed as of the 04 jul 2013 data cutoff date. according to the stage 1 results as assessed by the independent response adjudication committee (irac), neither subtype met the pre specified requirement to be further studied in stage 2. additionally, a suitable assay for the selection of participants for the stage 2 study was not available. therefore, on 6 january 2014, celgene decided to not open stage 2.

Eligibility criteria:
inclusion criteria: * histologically proven diffuse large b-cell lymphoma (dlbcl). * relapsed or refractory to combination chemotherapy for dlbcl that contains rituximab and an anthracycline, and one additional combination chemotherapy or stem cell transplant. * measurable dlbcl disease by computed tomograph (ct) / magnetic resonance imagining (mri). * eastern cooperative oncology group (ecog) performance status 0 - 2. exclusion criteria: * diagnosis of lymphoma histologies other than dlbcl. * history of malignancies, other than dlbcl, unless the patient has been disease free for 3 years or more. * eligible for autologous stem cell transplant. * known seropositive for, or history of, active human immunodeficiency virus (hiv) hepatitis b virus (hbv), hepatitis c virus (hcv) * neuropathy grade 4.

Keywords: diffuse large b-cell lymphoma non hodgkin's lymphoma relapsed refractory relapsed/refractory dlbcl diffuse large b cell lymphoma