Lenalidomide, Bendamustine and Rituximab as First-line Therapy for Patients Over 65 Years With Mantle Cell Lymphoma. (LENA-BERIT)

Lund University Hospital

Status and phase

Completed

Phase 2

Phase 1

Conditions

Mantle Cell Lymphoma

Treatments

Drug: lenalidomide, bendamustine, rituximab

Study type

Interventional

Funder types

Other

Industry

Identifiers

NCT00963534

NLG-MCL4

Details and patient eligibility

About

In phase I: Establishing maximally tolerated dose of lenalidomide in combination with bendamustine and rituximab.

In phase II: Evaluation of progression free survival with treatment with lenalidomide, bendamustine and rituximab

Full description

This trial consists of both a phase I portion and a phase II portion. In phase I, the MTD of lenalidomide is determined, starting with 5 mg/day given up to maximally 25 mg/day. In combination with this treatment, bendamustine and rituximab are given at fixed doses.

The phase I portion follows a sequential dose escalation, 3+3 design. Initially, three subjects are started treatment with dose regimen 1 (5 mg/day). After the third subject completed two cycles of treatment, if no DLT has occured, the next group of three subjects are treated at the next dose level of lenalidomide (10 mg/day). If one of the three initial subjects experiences a DLT, the cohort is expanded to six subjects. If less than two out of the six subjects experiences a DLT, then the next higher dose group is initiated. If two or more subjects experiences a DLT, no higher dose levels will be tested and the MTD dose has been exceeded.

Additional subjects are enrolled at the MTD on the phase II portion of the trial.

The above described treatment with lenalidomide, bendamustine and rituximab are given in 6 cycles, cycle length 22 days. Lenalidomide is given day 1-21, bendamustine day 1-2 and rituximab day 1. During the following maintenance treatment, single treatment with lenalidomide will be given with the same dose of lenalidomide (25 mg/day) for 7 cycles, whether in phase I or phase II portion of the trial.

Enrollment

51 patients

Sex

All

Ages

65+ years old

Volunteers

No Healthy Volunteers

Inclusion criteria

Age over 65 years, or age under 65 years, unable to tolerate high dose chemotherapy with autologous stem cell support
Histologically confirmed mantle cell lymphoma, stage II-IV at time of diagnosis
No previous treatment for lymphoma except radiotherapy or one cycle of any chemotherapy regimen for lymphoma
WHO Performance Status 0-3
Written informed concent
Female subjects of childbearing potential must agree to use and be able to comply with, effective contraception without interruption, 4 weeks before starting study drug, through study drug therapy and for 4 weeks after the end of study drug therapy
Male subjects must agree to use condoms throughout study drug therapy if their partner is of childbearing potential, and has no contraception, and agree to not donate semen during study drug therapy and for one week after end of study drug therapy
All subjects must agree to abstain from donating blood while taking study drug therapy and for one week following discontinuation, and agree not to share study medication with another person

Exclusion criteria

Impaired liver function
ANC less than 1.0 x 10 9, unless caused by bone marrow infiltration by lymphoma
Platelet count less than 60 x 10 9, unless caused by bone marrow infiltration by lymphoma
Creatinine clearance below 50 ml/min (cockcroft formula))
Known HIV positivity
Known seropositivity for HCV, HBsAG, anti-HBc, or other active infection uncontrolled by treatment
Psychiatric illness or condition which could interfere with the subject´s ability to understand the requirements of the study
Requirement of corticosteroid therapy at a dose over 10 mg prednisolone/day
Pregnant or lactating females