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This study evaluates the efficacy and safety of penpulimab plus lenalidomide, rituximab, gemcitabine and oxaliplatin (R2-GemOx) in patients with relapsed/refractory diffuse large B cell lymphoma (DLBCL). All patients will receive six cycles of penpulimab plus R2-GemOx. Afterwards, 1) patients who achieve complete response (CR)/unconfirmed (CRu)/partial response (PR) assessed by positron emission tomography/computedtomography (PET-CT) and are eligible for autologous stem cell transplantation (ASCT) will undergo ASCT. 2) Patients who achieve CR/CRu/PR assessed by PET-CT and are not eligible for ASCT will directly receive penpulimab and lenalidomide as maintenance treatment, penpulimab for a maximum of 6 months, lenalidomide monotherapy for 18 months. 3) Patients achieved stable disease (SD) or progression disease (PD) assessed by PET-CT will withdraw from this study and receive proper treatment based on investigator's decision.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| penpulimab, lenalidomide, rituximab, gemcitabine and oxaliplatin(Penpulimab-R2-GemOx)) | Experimental | penpulimab: 200 mg q2w, iv, drip R2-GemOx: lenalidomide 10 mg,po; Rituximab 375mg/m2, iv, drip; Gemcitabine 1000mg, po; Oxaliplatin 100mg/m2, iv, drip; |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| penpulimab, lenalidomide, Rituximab, Gemcitabine, Oxaliplatin | Drug | Patients receive penpulimab+R2-GemOx two weeks for a cycle, detailed as follows: Combination therapy Anti-PD-1 antibody (penpulimab): Fixed dose of 200 mg every 2 weeks, d0, intravenous drip (without pretreatment), for 6 cycles. R2-GemOx: lenalidomide 10 mg,d1-7; Rituximab 375mg/m2, d0; Gemcitabine 1000mg, d1; Oxaliplatin 100mg/m2, d1; every 2 weeks for a cycle, 6 cycles as protocol specified. Maintenance treatment: Combination of two drugs:
|
| Measure | Description | Time Frame |
|---|---|---|
| Complete response rate | Complete response rate after treated by penpulimab and R2-GemOx | 6 weeks after the last dose of the combination therapy (each cycle is 14 days) |
| Measure | Description | Time Frame |
|---|---|---|
| Overall Survival (OS) | from date of inclusion to date of death from any cause | 2 years |
| Progression-free survival(PFS) | from date of inclusion to date of progression, relapse, or death from any cause |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Li Wang, M.D., Ph.D | Contact | 86 25 68306034 | lilyw7878@163.com | |
| Wei Xu, M.D., Ph.D | Contact | 86 25 68306034 | xuwei10000@hotmail.com |
| Name | Affiliation | Role |
|---|---|---|
| Wei Xu | The first Affiliated Hospital Of Nanjing Medical University(JiangSu Province Hospital) | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| The First affiliated Hospital of AnHui Medical Universtiy | Hefei | Anhui | China |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 41656201 | Derived | Liang JH, Xing TY, Gu WY, Yin H, Zeng QS, Du KX, Sibusiso L, Wu JZ, Li Y, Wang F, Gao R, Li JY, Shen HR, Wang L, Xu W. Penpulimab in combination with lenalidomide and R-GemOx regimen (R2-GemOx-PD1i) in relapsed or refractory diffuse large B-cell lymphoma: a multicenter, single-arm, phase 2 trial. BMC Med. 2026 Feb 9;24(1):156. doi: 10.1186/s12916-026-04679-1. |
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| ID | Term |
|---|---|
| D016403 | Lymphoma, Large B-Cell, Diffuse |
| D009370 | Neoplasms by Histologic Type |
| ID | Term |
|---|---|
| D016393 | Lymphoma, B-Cell |
| D008228 | Lymphoma, Non-Hodgkin |
| D008223 | Lymphoma |
| D009369 | Neoplasms |
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| ID | Term |
|---|---|
| C000720860 | penpulimab |
| D000077269 | Lenalidomide |
| D000069283 | Rituximab |
| D000093542 | Gemcitabine |
| D000077150 | Oxaliplatin |
| ID | Term |
|---|---|
| D010797 | Phthalimides |
| D010795 | Phthalic Acids |
| D000146 | Acids, Carbocyclic |
| D002264 | Carboxylic Acids |
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|
|
| 2 years |
| Rate of grade 3 or 4 treatment related adverse effect | All the adverse events of the patients related will be assessed and graded by NCI CTCAE v 5.0 | Up to 30 days after the last cycle of per-protocol treatment and 90 days after last dose of anti-PD-1 antibody |
| ChangZhou First People's Hospital | Changzhou | Jiangsu | 213003 | China |
|
| Hematological Department, People's Hospital of Jiangsu Province | Nanjing | Jiangsu | 210029 | China |
| The First Affiliated Hospital Of Nantong University | Nantong | Jiangsu | 226000 | China |
| D008232 |
| Lymphoproliferative Disorders |
| D008206 | Lymphatic Diseases |
| D006425 | Hemic and Lymphatic Diseases |
| D007160 | Immunoproliferative Disorders |
| D007154 | Immune System Diseases |
| 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 |
| D003841 | Deoxycytidine |
| D003562 | Cytidine |
| D011741 | Pyrimidine Nucleosides |
| D011743 | Pyrimidines |
| D056831 | Coordination Complexes |