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| ID | Type | Description | Link |
|---|---|---|---|
| 2012-003786-17 | EudraCT Number |
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| Name | Class |
|---|---|
| Centre Hospitalier Universitaire, Amiens | OTHER |
| Institut Bergonié | OTHER |
| University Hospital, Clermont-Ferrand | OTHER |
| University Hospital, Lille |
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Because Primary Central Nervous System Lymphoma (PCNSL) are mainly diffuse large B-cell lymphoma of the activated B cells (ABC) type, the investigators hypothesize that the synergy of lenalidomide with rituximab shown in systemic non-Hodgkin's lymphoma (NHL) could be observed in PCNSL.
This study will assess the efficiency of the the combination of lenalidomide and rituximab in relapsed/refractory PCNSL, and the efficiency of a maintenance treatment with lenalidomide alone in maintaining the response.
The investigators use a two-stage Fleming's design based on the following hypotheses under treatment: 10% (null hypothesis, minimal clinical benefit rate), 30% (alternative hypothesis, acceptable clinical benefit rate), 3% type I error rate, 5% type II error rate. Under these hypotheses, a total of 45 assessable patients will be necessary: 22 for the first stage + 23 for the second stage.
Stage 1: following the inclusion of the first 22 assessable patients, if 0 or 1 patient has an objective response (CR, Complete Response + uCR, unconfirmed Complete Response + PR, Partial Response) at the end of induction treatment, the study would be terminated early and the treatment will be considered ineffective. If 2 or more patients have an objective response at the end of induction treatment, then the treatment will be considered as effective in this indication. Otherwise, the second group of 23 patients will be recruited.
Stage 2: if at the end of recruitment, 8 or less patients have an objective response, the investigators will conclude to inefficacy, and if 9 or more patients have an objective response, then the treatment will be considered as effective and need further exploration.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Lenalidomide & Rituximab | Experimental | Induction treatment : Lenalidomide 20 mg capsule on days 1 to 21 days of a 28 days cycle for the first cycle followed by 25 mg on daily on days 1 to 21 of a 28 days cycle for cycles 2 to 8 (in the absence of hematologic toxicity. Rituximab at day 1 of each induction course 375 mg/m² intravenous. Maintenance : Lenalidomide 10 mg capsule on days 1 to 21 days of a 28 days cycle for 1 year or until progression or intolerance. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Lenalidomide | Drug |
|
| |
| Rituximab |
| Measure | Description | Time Frame |
|---|---|---|
| Assess the efficacy of lenalidomide in combination with rituximab in relapsed/refractory PCNSL as measured by the objective response rate (CR + uCR + PR) at the end of the 8 cycles of induction therapy. | The objective response rate (CR+uCR+PR) will be evaluated according to the IPCG (International Primary CNS lymphoma Collaborative Group) recommendations. Patients will have an cerebral MRI, an ophthalmological examination and a lumbar puncture at several times. | 33 months |
| Measure | Description | Time Frame |
|---|---|---|
| The safety of the association during induction and maintenance therapy in a population of PCNSL (NCI V4) | 56 months | |
| The duration of response | 56 months | |
| Progressive Free Survival at one year from the date of inclusion to the date of progression of the disease or death |
| Measure | Description | Time Frame |
|---|---|---|
| Exploration of T cells and NK (Natural Killer) cells populations in PCNSL before and after treatment to correlate possible changes of these populations with therapeutic response | Pilot exploration of T cells and NK cells populations in PCNSL before and after treatment with the combination of lenalidomide-rituximab and to correlate possible changes of these populations with therapeutic response | 33 months |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Carole SOUSSAIN, MD | Institut Curie - Hopital Rene Huguenin | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Centre Léon Bérard | Lyon | Auvergne-Rhône-Alpes | 39373 | France | ||
| CHU Estaing |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 30698644 | Result | Ghesquieres H, Chevrier M, Laadhari M, Chinot O, Choquet S, Molucon-Chabrot C, Beauchesne P, Gressin R, Morschhauser F, Schmitt A, Gyan E, Hoang-Xuan K, Nicolas-Virelizier E, Cassoux N, Touitou V, Le Garff-Tavernier M, Savignoni A, Turbiez I, Soumelis V, Houillier C, Soussain C. Lenalidomide in combination with intravenous rituximab (REVRI) in relapsed/refractory primary CNS lymphoma or primary intraocular lymphoma: a multicenter prospective 'proof of concept' phase II study of the French Oculo-Cerebral lymphoma (LOC) Network and the Lymphoma Study Association (LYSA)dagger. Ann Oncol. 2019 Apr 1;30(4):621-628. doi: 10.1093/annonc/mdz032. |
| Label | URL |
|---|---|
| Related Info | View source |
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| ID | Term |
|---|---|
| D008223 | Lymphoma |
| D012008 | Recurrence |
| ID | Term |
|---|---|
| D009370 | Neoplasms by Histologic Type |
| D009369 | Neoplasms |
| D008232 | Lymphoproliferative Disorders |
| D008206 | Lymphatic Diseases |
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| ID | Term |
|---|---|
| D000077269 | Lenalidomide |
| D000069283 | Rituximab |
| ID | Term |
|---|---|
| D010797 | Phthalimides |
| D010795 | Phthalic Acids |
| D000146 | Acids, Carbocyclic |
| D002264 | Carboxylic Acids |
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| OTHER |
| Central Hospital, Nancy, France | OTHER |
| Groupe Hospitalier Pitie-Salpetriere | OTHER |
| Centre Henri Becquerel | OTHER |
| University Hospital, Tours | OTHER |
| Centre Leon Berard | OTHER |
| University Hospital, Grenoble | OTHER |
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| Drug |
|
|
| 56 months |
| Overall Survival from the date of inclusion to the date of death | 56 months |
| Quality of life using QLQ-C30 EORTC (European Organization for Research and Treatment of Cancer) questionnaire | 20 months |
| Clermont-Ferrand |
| Auvergne |
| 63003 |
| France |
| CHU Bretonneau - Centre Henry Kaplan | Tours | Centre-Val de Loire | 37044 | France |
| Institut Bergonié | Bordeaux | Gironde | 33076 | France |
| Chu Michallon | Grenoble | Isère | 38043 | France |
| Hôpital Central | Nancy | Lorraine | 54036 | France |
| CHRU Lille - Hôpital Claude Huriez | Lille | Nord | 59037 | France |
| Centre Henri Becquerel | Rouen | Seine Maritime | 76038 | France |
| CHU Amiens -Hôpital Sud | Amiens | Somme | 80054 | France |
| Chu La Timone | Marseille | 13005 | France |
| Hôpital de la Pitié Salpétrière | Paris | Île-de-France Region | 75013 | France |
| Institut curie - Hôpital René Huguenin | Saint-Cloud | Île-de-France Region | 92210 | France |
| D006425 | Hemic and Lymphatic Diseases |
| D007160 | Immunoproliferative Disorders |
| D007154 | Immune System Diseases |
| D020969 | Disease Attributes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D009930 |
| Organic Chemicals |
| D010881 | Piperidones |
| D010880 | Piperidines |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D006571 | Heterocyclic Compounds |
| D054833 | Isoindoles |
| D006574 | Heterocyclic Compounds, 2-Ring |
| D000072471 | Heterocyclic Compounds, Fused-Ring |
| D058846 | Antibodies, Monoclonal, Murine-Derived |
| D000911 | Antibodies, Monoclonal |
| D000906 | Antibodies |
| D007136 | Immunoglobulins |
| D007162 | Immunoproteins |
| D001798 | Blood Proteins |
| D011506 | Proteins |
| D000602 | Amino Acids, Peptides, and Proteins |
| D012712 | Serum Globulins |
| D005916 | Globulins |