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To explore the maximum tolerated dose (MTD) of pomalidomide in combination with obinutuzumab in patients with relapsed/refractory indolent lymphomas (including follicular lymphoma, marginal zone lymphoma, and chronic lymphocytic leukemia/small lymphocytic lymphoma) treated with the pomalidomide plus obinutuzumab combination regimen, and to determine the recommended phase II dose (RP2D); concurrently evaluating the efficacy and safety of pomalidomide combined with obinutuzumab in patients with relapsed/refractory indolent lymphomas.
Most indolent B-cell lymphomas have a prolonged natural course with frequent disease relapses, requiring multiple lines of therapy. There is currently no unified standard regimen for relapsed indolent lymphomas, and treatment options are limited for patients who develop resistance to the R2 regimen. Obinutuzumab is a next-generation CD20 monoclonal antibody, while pomalidomide, as a third-generation immunomodulatory drug (IMiDs), exhibits stronger immunomodulatory activity compared to lenalidomide.The Phase I trial evaluated the maximum tolerated dose(MTD) and recommended Phase II dose(RP2D) of the GP regimen (obinutuzumab combined with pomalidomide) in treating relapsed/refractory indolent lymphoma. The Phase II trial assessed the GP regimen, including both induction and maintenance therapy phases, aiming to enhance treatment efficacy, survival rates, and tolerability, thereby providing a novel therapeutic approach for this disease category.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Induction therapy and maintenance therapy of GP | Experimental |
Maintenance Therapy :Pomalidomide: For complete response (CR) patients, half of the RP2D dose; for PR patients, full RP2D dose, on days 1-21 (Cycles 7-18). Obinutuzumab: 1000 mg administered on day 1 of every 2 cycles |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Induction therapy of GP(Pomalidomide+Obinutuzumab) | Drug | Phase 1: Dose Escalation Phase. Obinutuzumab administered at 1000 mg on days 1, 8, and 15 (Cycle 1), and day 1 (Cycles 2-6), with a 28-day cycle. Pomalidomide is administered in three dose groups (2 mg, 3 mg, 4 mg) on days 1-21. Dose-limiting toxicity (DLT) is observed during the first cycle to determine the recommended Phase II dose (RP2D). 2、Phase 2: Dose Expansion Phase. Induction Therapy: Obinutuzumab administered at 1000 mg on days 1, 8, and 15 (Cycle 1), and day 1 (Cycles 2-6), with pomalidomide at RP2D on days 1-21, in 28-day cycles for 6 cycles. |
| Measure | Description | Time Frame |
|---|---|---|
| Recommended Phase II Dose (RP2D) | The drug dose for Phase 2 clinical trials was determined through dose escalation in Phase 1 clinical trials to identify the dose-limiting toxicity (DLT) and maximum tolerated dose (MTD). | day 28 (each cycle is 28 days) |
| Phase 2 : Objective response rate,ORR | defined as the proportion of patients with complete or partial response as assessed by response to induction therapy. | Up to the end of 6 cycles of treatment(each cycle is 28 days) |
| Measure | Description | Time Frame |
|---|---|---|
| complete response rate,CRR | Up to 24 weeks (each cycle is 28 days) | |
| progression-free survival,PFS | defined as the time from the start of treatment to disease progression or death due to any cause |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Shuhua Yi, Dr | Contact | +86-022-23909106 | yishuhua@ihcams.ac.cn |
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| maintenance therapy of GP(Pomalidomide+Obinutuzumab) | Drug | Maintenance Therapy :Pomalidomide: For complete response (CR) patients, half of the RP2D dose; for PR patients, full RP2D dose, on days 1-21 (Cycles 7-18). Obinutuzumab: 1000 mg administered on day 1 of every 2 cycles |
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| through study completion, an average of 5 year |
| Overall survival,OS | Defined as the time from enrollment to death for any cause. | through study completion, an average of 5 year |
| Adverse event rate | through maintenance therapy completion, an average of 2 years (each cycle is 28 days) |