Ann Arbor Stage I Small Lymphocytic LymphomaPhase 2NCT01351896
Lenalidomide and Vaccine Therapy in Treating Patients With Early-Stage Asymptomatic Chronic Lymphocytic Leukemia or Small Lymphocytic Lymphoma
A Phase 2 study testing Biospecimen Collection, Bone Marrow Aspiration and Bone Marrow Biopsy in people with Ann Arbor Stage I Small Lymphocytic Lymphoma and Ann Arbor Stage II Small Lymphocytic Lymphoma, run by National Cancer Institute (NCI) at 1 site in United States.
Trial summary
This phase II trial studies the effect of lenalidomide and vaccine in treating patients with early-stage asymptomatic chronic lymphocytic leukemia or small lymphocytic lymphoma. Lenalidomide may stop the growth of cancer cells by blocking blood flow to the cancer. Read more about this study
- Who is it for?
- Ages 18 to 79 years
- Conditions the study is for
- Ann Arbor Stage I Small Lymphocytic Lymphoma, Ann Arbor Stage II Small Lymphocytic Lymphoma, Chronic Lymphocytic Leukemia
- What is being tested?
- Biospecimen Collection, Bone Marrow Aspiration and Bone Marrow Biopsy
- Type of treatment
- Vaccines, Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 49 participants
- Where
- 1 siteUnited States
- Study dates
- 2 Nov 2011to 6 May 2027
- Phase
- Phase 2
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 79 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Patients must have histologically identified chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL) as defined by the World Health Organization (WHO) classification of hematopoietic neoplasms
- CLL/SLL cells must demonstrate one or more of the following high-risk genomic features:
- Deletion (Del) (17p13.1) as detected by fluorescence in-situ hybridization (FISH) in > 20% of cells
- Del(11q22.3) as detected by FISH in > 20% of cells
- Complex karyotype (>= 3 cytogenetic abnormalities on stimulated karyotype)
- Unmutated immunoglobulin variable heavy chain (IgVH) (>= 98% sequence homology compared with germline sequence)
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- Patients cannot meet any of the following consensus criteria for initiating treatment:
- Progressive splenomegaly and/or lymphadenopathy identified by physical examination or radiographic studies
- Progressive lymphocytosis with total white blood cell (WBC) >= 300,000/uL
- Anemia (< 11 g/dL) or thrombocytopenia (< 100,000/uL) due to bone marrow involvement
- Presence of unintentional weight loss > 10% over the preceding 6 months
- National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) grade 2 or 3 fatigue
- Fevers > 100.5 degrees or night sweats for > 2 weeks without evidence of infection
- Progressive lymphocytosis with an increase of > 50% over a 2 month period or an anticipated doubling time of < 6 months
- No prior therapy for CLL/SLL, including chemotherapy, radiotherapy, and/or immunotherapy will be allowed
- Age ≥ 18 years and < 80 years (or with justification if older than 80 years due to the higher risk of toxicity in patients older than 80 years). CLL is rare in children and likely represents a different disease process. As a result, children are excluded from this study but may be eligible for future pediatric phase 2 combination trials
- Estimated life expectancy of greater than 24 months
- Eastern Cooperative Oncology Group (ECOG) performance status =< 2 (Karnofsky >= 60%)
- Total bilirubin =< 1.5 times upper limit of normal (ULN) (unless secondary to Gilbert disease)
- Aspartate aminotransferase (AST) (serum glutamic-oxaloacetic transaminase [SGOT])/alanine aminotransferase (ALT) (serum glutamate-pyruvate transaminase [SGPT]) =< 2.5 times ULN
- Creatinine clearance >= 60 mL/min/1.73 m^2 for patients with creatinine levels above institutional normal according to the Cockcroft-Gault formula
- Absolute neutrophil count (ANC) >= 1,500/uL
- Platelet count >= 100,000/uL
- Able to swallow capsules without difficulty and no history of malabsorption syndrome, disease significantly affecting gastrointestinal function, or resection of the stomach or small bowel or ulcerative colitis, symptomatic inflammatory bowel disease, or partial or complete bowel obstruction
- Females of childbearing potential (FCBP) must have a negative serum or urine pregnancy test with a sensitivity of at least 25 mIU/mL within 10 - 14 days prior to and again within 24 hours of starting lenalidomide. Further, they must either commit to continued abstinence from heterosexual intercourse or begin TWO acceptable methods of birth control: one highly effective method and one additional effective method AT THE SAME TIME, at least 28 days before starting lenalidomide. FCBP must also agree to ongoing pregnancy testing. Men must agree to use a latex condom during sexual contact with a FCBP, even if they have had a successful vasectomy; a FCBP is a sexually mature woman who: 1) has not undergone a hysterectomy or bilateral oophorectomy; or 2) has not been naturally postmenopausal for at least 24 consecutive months (i.e., has had menses at any time in the preceding 24 consecutive months). All patients must be counseled at a minimum of every 28 days about pregnancy precautions and risks of fetal exposure
Who cannot join
- Patients who have had any treatment for their CLL/SLL, including but not limited to chemotherapy, radiotherapy, or immunotherapy, prior to entering the study
- No corticosteroid use will be permitted within two weeks prior to study, except for maintenance therapy for a non-malignant disease; maintenance therapy dose may not exceed 20 mg/day prednisone or equivalent
- Patients who meet consensus criteria for the treatment of CLL/SLL
- Patients may not be receiving any other investigational agents
- Patients with a recent history (within 6 months of study entry) of deep vein thrombosis (DVT)/pulmonary embolism (PE) are not eligible; patients with a distant history (greater than 6 months before study entry) of venous thromboembolic disease are eligible, but should receive prophylactic aspirin or low molecular weight heparin
- History of allergic reactions attributable to compounds of similar chemical or biologic composition to thalidomide, lenalidomide or any component of PCV7 or PCV13, including the diphtheria toxoid
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- Prior malignancy, except for adequately treated basal cell or squamous cell skin cancer, in situ cervical cancer, or other cancer from which the subject is considered by his or her physician to have a 2 year survival expectation
- Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements
- Pregnant women are excluded from this study because lenalidomide is an immunomodulatory agent (IMID) with the potential for teratogenic or abortifacient effects; because there is an unknown but potential risk for adverse events in nursing infants secondary to treatment of the mother with lenalidomide, breastfeeding should be discontinued if the mother is treated with lenalidomide
- Human immunodeficiency virus (HIV)-positive patients on combination antiretroviral therapy will be eligible if they otherwise meet required hematologic parameters and are not receiving an antiviral agent with known or potential interaction with lenalidomide; because the primary aim of this study is to measure the immune response to pneumococcal vaccination, only patients with CD4 cell counts >= 200 and viral load < 50 will be eligible
- Patients who have been treated for autoimmune hemolytic anemia or autoimmune thrombocytopenia within the last 6 months or are direct antiglobulin test/Coombs test or indirect antiglobulin test positive at the time of screening
- Patients who have developed erythema nodosum characterized by a desquamating rash while taking thalidomide or similar drugs in the past are excluded
- Because of the potential for H2-blockers to modulate antibody response to pneumococcal vaccine, patients must discontinue treatment with H2-blockers (cimetidine, ranitidine, etc.) prior to beginning protocol therapy
Trial locations and contacts
1 site in 1 country.
United States1 site
Ohio State University Comprehensive Cancer Center
Columbus, Ohio, 43210
About this study
Official title: Phase II Study of Lenalidomide to Repair Immune Synapse Response and Humoral Immunity in Early-Stage, Asymptomatic Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma (CLL/SLL) With High-Risk Genomic Features
This phase II trial studies the effect of lenalidomide and vaccine in treating patients with early-stage asymptomatic chronic lymphocytic leukemia or small lymphocytic lymphoma. Lenalidomide may stop the growth of cancer cells by blocking blood flow to the cancer. It may also stimulate the immune system in different ways and stop cancer cells from growing. Vaccines may help the body build an effective immune response to kill cancer cells. Giving lenalidomide together with vaccine therapy may make a stronger immune response and kill more cancer cells.
Read the detailed description
PRIMARY OBJECTIVE:
- To determine the proportion of early-stage, high-risk chronic lymphocytic leukemia (CLL) patients achieving a response (>= 4-fold increase from baseline and/or antibody concentrations >= 0.35 ug/mL in 6 of 7 type-specific anti-pneumococcal antibody levels) after 2 doses of pneumococcal 13-valent conjugated vaccine (Prevnar 13, PCV13 [pneumococcal polyvalent vaccine]) administered concurrent with versus sequential to low-dose lenalidomide.
SECONDARY OBJECTIVES:
- To determine the complete response (CR) rate after 2 years of lenalidomide therapy.
II. To determine the time to first treatment (TFT), defined as the time from diagnosis to first non-lenalidomide therapy for progressive CLL as described by International Workshop on Chronic Lymphocytic Leukemia (IWCLL) 2008 criteria.
III. To determine the incidence of infection and invasive pneumococcal infections following treatment with the PCV13 vaccine and either concurrent or sequential lenalidomide.
IV. To determine the frequency of humoral and cellular immune response to CLL tumor antigens following treatment with the PCV13 vaccine and either concurrent or sequential lenalidomide.
- To determine the safety and toxicity associated with long-term lenalidomide exposure.
VI. To perform correlative pharmacodynamic and pharmacokinetic studies and correlate these with vaccine/tumor immunologic and disease response.
OUTLINE: Patients are randomized to 1 of 2 treatment arms.
ARM A (concurrent PCV13 and lenalidomide): Patients receive low-dose lenalidomide orally (PO) once daily on days 1-28. Treatment repeats every 28 days for at least 24 cycles in the absence of disease progression or unacceptable toxicity. Patients also receive 13-valent protein-conjugated pneumococcal vaccine (PCV13) intramuscularly (IM) on day 1 of courses 3 and 5.
ARM B (sequential PCV13 and lenalidomide): Patients receive PCV13 IM on days 1 and 78 (cycles 1 and 3). Patients also receive low-dose lenalidomide as in arm 1 beginning on day 1 of cycle 4. Treatment repeats every 28 days for at least 24 cycles in the absence of disease progression or unacceptable toxicity.
Patients may undergo bone marrow biopsy and aspirate and computed tomography (CT) during screening and blood sample collection throughout the study. (Blood sample collection discontinued with approval of protocol version 24 dated 3/15/2024)
After completion of study treatment, patients are followed up for 30 days, every 3 months for 1 year, and then every 6 months thereafter.
- Conditions
- Ann Arbor Stage I Small Lymphocytic Lymphoma, Ann Arbor Stage II Small Lymphocytic Lymphoma, Chronic Lymphocytic Leukemia, Chronic Lymphocytic Leukemia With Unmutated Immunoglobulin Heavy Chain Variable-Region Gene, Small Lymphocytic Lymphoma, Small Lymphocytic Lymphoma With Unmutated Immunoglobulin Heavy Chain Variable-Region Gene
- Being tested
- Biospecimen Collection, Bone Marrow Aspiration, Bone Marrow Biopsy, Computed Tomography, Lenalidomide
- Medical subject headings
- Leukemia, Lymphocytic, Chronic, B-Cell
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Biospecimen CollectionProcedure or surgery
Also called Biological Sample Collection, Biospecimen Collected, Sample Collection, Specimen Collection
Undergo blood sample collection
Bone Marrow AspirationProcedure or surgery
Undergo bone marrow aspiration
Bone Marrow BiopsyProcedure or surgery
Also called Biopsy of Bone Marrow, Biopsy, Bone Marrow
Undergo bone marrow biopsy
Computed TomographyProcedure or surgery
Also called CAT, CAT Scan, Computed Axial Tomography, Computerized Axial Tomography
Undergo CT
LenalidomideDrug
Also called CC 5013, CC-5013, CC5013, CDC 501
Given PO
Pneumococcal Polyvalent VaccineBiological
Also called PCV 23, Pneumococcal 23-valent Polysaccharide Vaccine, Pneumococcal Polysaccharide Vaccine, Pneumococcal Vaccine Polyvalent
Given IM (concurrently or sequentially)
| Study group | Role | What they receive |
|---|---|---|
| Arm A (Concurrent PCV13 and lenalidomide) | Experimental | Patients receive low-dose lenalidomide PO once daily on days 1-28. Treatment repeats every 28 days for at least 24 cycles in the absence of disease progression or unacceptable toxicity. Patients also receive PCV13 IM on day 1 of courses 3 and 5.
Patients may undergo bone marrow biopsy and aspirate and CT during screening and blood sample collection throughout the study. (Blood sample collection discontinued with approval of protocol version 24 dated 3/15/2024) Receives: Procedure: Biospecimen Collection; Procedure: Bone Marrow Aspiration; Procedure: Bone Marrow Biopsy; Procedure: Computed Tomography; Drug: Lenalidomide; Biological: Pneumococcal Polyvalent Vaccine |
| Arm B (Sequential PCV13 and lenalidomide) | Experimental | Patients receive PCV13 IM on days 1 and 78 (cycles 1 and 3). Patients also receive low-dose lenalidomide as in arm 1 beginning on day 1 of course 4. Treatment repeats every 28 days for at least 24 cycles in the absence of disease progression or unacceptable toxicity. Patients may undergo bone marrow biopsy and aspirate and CT during screening and blood sample collection throughout the study. (Blood sample collection discontinued with approval of protocol version 24 dated 3/15/2024) Receives: Procedure: Biospecimen Collection; Procedure: Bone Marrow Aspiration; Procedure: Bone Marrow Biopsy; Procedure: Computed Tomography; Drug: Lenalidomide; Biological: Pneumococcal Polyvalent Vaccine |
What is being measured
The primary outcome is the main question the study is designed to answer.
Proportion of Patients Who Achieve an Antibody Response
Defined as achieving at least a four-fold increase in post-vaccination serotype-specific immunoglobulin G (IgG) titers or serotype-specific IgG concentrations of >= 0.35 ug/mL for 6 of 7 serotypes measured by a standard enzyme linked immunosorbent assay.
Measured: Up to 1 month
Secondary outcomes (32)
Seroconversion Rates
Summarized using descriptive statistics by treatment arm.
Measured: Up to 4 years
Complete Response Rate
95% confidence intervals will be estimated. A designation of complete response (CR) requires all of the following for a period of at least two months from completion of therapy:
- Absence of adenopathy on physical exam.
- No hepatomegaly or splenomegaly on physical exam.
- Absence of constitutional symptoms.
- Normal CBC as exhibited by polymorphonuclear leukocytes ≥ 1500/µL, platelets > 100,000/µL, hemoglobin > 11.0 g/dL (untransfused), and lymphocyte count < 5,000/ µL.
- Bone marrow aspirate and biopsy must be normocellular for age with < 30% of nucleated cells being lymphocytes. Lymphoid nodules must be absent. If the marrow is hypocellular, a repeat determination should be performed in one month.
Measured: At 2 years
Time to First Treatment
Defined by International Workshop on chronic lymphocytic leukemia (CLL) (IWCLL) 2008 criteria. Summarized and explored between treatment arms using Kaplan-Meier methods. Reported as the probability of not starting the next treatment and its 95% CI for each year.
Measured: From study entry to first therapy for progressive CLL, assessed up to 4 years
Overall Survival
Summarized and explored between treatment arms using Kaplan-Meier methods.
Measured: Up to 4 years
Progression-free Survival
Defined by International Workshop on chronic lymphocytic leukemia (CLL) (IWCLL) 2008 criteria. Summarized and explored between treatment arms using Kaplan-Meier methods.
Measured: Time from start of treatment to time of disease progression or death secondary to any cause, assessed up to 2 years
Number of Adverse Events
Summarized by and across treatment arms, along with the type, severity, and perceived attribution to study according to National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) version 5. The rates of severe (grade 3+) toxicity (at least possibly related to treatment) and non-hematologic toxicity will be summarized; assuming the incidence of severe toxicity is binomially distributed, 95% confidence intervals will be calculated. The maximum grade for each type of toxicity will be recorded for each patient, and frequency tables will be reviewed to determine the toxicity patterns. Adverse events occurring in greater than 5% of the participants in each arm will be reported in this outcome measure.
Measured: Up to 4 years
Pharmacokinetic (PK) Parameters of Lenalidomide
PK will be graphically evaluated within and across arms to assess potential patterns and relationships.
Measured: Baseline, days 1 and 2 of course 2 (Arm A) and days 1 and 2 of course 5 (Arm B)
Change in Serum Immunoglobulin
Pharmacodynamic markers will be graphically evaluated within and across arms to assess potential patterns and relationships.
Measured: Baseline up to 4 years
Change in Anti-tumor Antibody Levels
Pharmacodynamic markers will be graphically evaluated within and across arms to assess potential patterns and relationships.
Measured: Baseline up to 4 years
Antibody Titre Levels for Serotype 1
Summarized using descriptive statistics by treatment arm. Changes in serotype-specific markers will be graphically evaluated between the two arms and the nonparametric Mann-Whitney rank sum test will be used to compare the geometric mean concentrations.
Measured: Up to cycle 10 day 1 (each cycle is 28 days)
Antibody Titre Levels for Serotype 2
Summarized using descriptive statistics by treatment arm. Changes in serotype-specific markers will be graphically evaluated between the two arms and the nonparametric Mann-Whitney rank sum test will be used to compare the geometric mean concentrations.
Measured: Up to cycle 10 day 1 (each cycle is 28 days)
Antibody Titre Levels for Serotype 3
Summarized using descriptive statistics by treatment arm. Changes in serotype-specific markers will be graphically evaluated between the two arms and the nonparametric Mann-Whitney rank sum test will be used to compare the geometric mean concentrations.
Measured: Up to cycle 10 day 1 (each cycle is 28 days)
Antibody Titre Levels for Serotype 4
Summarized using descriptive statistics by treatment arm. Changes in serotype-specific markers will be graphically evaluated between the two arms and the nonparametric Mann-Whitney rank sum test will be used to compare the geometric mean concentrations.
Measured: Up to cycle 10 day 1 (each cycle is 28 days)
Antibody Titre Levels for Serotype 5
Summarized using descriptive statistics by treatment arm. Changes in serotype-specific markers will be graphically evaluated between the two arms and the nonparametric Mann-Whitney rank sum test will be used to compare the geometric mean concentrations.
Measured: Up to cycle 10 day 1 (each cycle is 28 days)
Antibody Titre Levels for Serotype 8
Summarized using descriptive statistics by treatment arm. Changes in serotype-specific markers will be graphically evaluated between the two arms and the nonparametric Mann-Whitney rank sum test will be used to compare the geometric mean concentrations.
Measured: Up to cycle 10 day 1 (each cycle is 28 days)
Antibody Titre Levels for Serotype 9N
Summarized using descriptive statistics by treatment arm. Changes in serotype-specific markers will be graphically evaluated between the two arms and the nonparametric Mann-Whitney rank sum test will be used to compare the geometric mean concentrations.
Measured: Up to cycle 10 day 1 (each cycle is 28 days)
Antibody Titre Levels for Serotype 12F
Summarized using descriptive statistics by treatment arm. Changes in serotype-specific markers will be graphically evaluated between the two arms and the nonparametric Mann-Whitney rank sum test will be used to compare the geometric mean concentrations.
Measured: Up to cycle 10 day 1 (each cycle is 28 days)
Antibody Titre Levels for Serotype 14
Summarized using descriptive statistics by treatment arm. Changes in serotype-specific markers will be graphically evaluated between the two arms and the nonparametric Mann-Whitney rank sum test will be used to compare the geometric mean concentrations.
Measured: Up to cycle 10 day 1 (each cycle is 28 days)
Antibody Titre Levels for Serotype 17F
Summarized using descriptive statistics by treatment arm. Changes in serotype-specific markers will be graphically evaluated between the two arms and the nonparametric Mann-Whitney rank sum test will be used to compare the geometric mean concentrations.
Measured: Up to cycle 10 day 1 (each cycle is 28 days)
Antibody Titre Levels for Serotype 19F
Summarized using descriptive statistics by treatment arm. Changes in serotype-specific markers will be graphically evaluated between the two arms and the nonparametric Mann-Whitney rank sum test will be used to compare the geometric mean concentrations.
Measured: Up to cycle 10 day 1 (each cycle is 28 days)
Antibody Titre Levels for Serotype 20
Summarized using descriptive statistics by treatment arm. Changes in serotype-specific markers will be graphically evaluated between the two arms and the nonparametric Mann-Whitney rank sum test will be used to compare the geometric mean concentrations.
Measured: Up to cycle 10 day 1 (each cycle is 28 days)
Antibody Titre Levels for Serotype 22F
Summarized using descriptive statistics by treatment arm. Changes in serotype-specific markers will be graphically evaluated between the two arms and the nonparametric Mann-Whitney rank sum test will be used to compare the geometric mean concentrations.
Measured: Up to cycle 10 day 1 (each cycle is 28 days)
Antibody Titre Levels for Serotype 23F
Summarized using descriptive statistics by treatment arm. Changes in serotype-specific markers will be graphically evaluated between the two arms and the nonparametric Mann-Whitney rank sum test will be used to compare the geometric mean concentrations.
Measured: Up to cycle 10 day 1 (each cycle is 28 days)
Antibody Titre Levels for Serotype 6B
Summarized using descriptive statistics by treatment arm. Changes in serotype-specific markers will be graphically evaluated between the two arms and the nonparametric Mann-Whitney rank sum test will be used to compare the geometric mean concentrations.
Measured: Up to cycle 10 day 1 (each cycle is 28 days)
Antibody Titre Levels for Serotype 10A
Summarized using descriptive statistics by treatment arm. Changes in serotype-specific markers will be graphically evaluated between the two arms and the nonparametric Mann-Whitney rank sum test will be used to compare the geometric mean concentrations.
Measured: Up to cycle 10 day 1 (each cycle is 28 days)
Antibody Titre Levels for Serotype 11A
Summarized using descriptive statistics by treatment arm. Changes in serotype-specific markers will be graphically evaluated between the two arms and the nonparametric Mann-Whitney rank sum test will be used to compare the geometric mean concentrations.
Measured: Up to cycle 10 day 1 (each cycle is 28 days)
Antibody Titre Levels for Serotype 7F
Summarized using descriptive statistics by treatment arm. Changes in serotype-specific markers will be graphically evaluated between the two arms and the nonparametric Mann-Whitney rank sum test will be used to compare the geometric mean concentrations.
Measured: Up to cycle 10 day 1 (each cycle is 28 days)
Antibody Titre Levels for Serotype 15B
Summarized using descriptive statistics by treatment arm. Changes in serotype-specific markers will be graphically evaluated between the two arms and the nonparametric Mann-Whitney rank sum test will be used to compare the geometric mean concentrations.
Measured: Up to cycle 10 day 1 (each cycle is 28 days)
Antibody Titre Levels for Serotype 18C
Summarized using descriptive statistics by treatment arm. Changes in serotype-specific markers will be graphically evaluated between the two arms and the nonparametric Mann-Whitney rank sum test will be used to compare the geometric mean concentrations.
Measured: Up to cycle 10 day 1 (each cycle is 28 days)
Antibody Titre Levels for Serotype 19A
Summarized using descriptive statistics by treatment arm. Changes in serotype-specific markers will be graphically evaluated between the two arms and the nonparametric Mann-Whitney rank sum test will be used to compare the geometric mean concentrations.
Measured: Up to cycle 10 day 1 (each cycle is 28 days)
Antibody Titre Levels for Serotype 9V
Summarized using descriptive statistics by treatment arm. Changes in serotype-specific markers will be graphically evaluated between the two arms and the nonparametric Mann-Whitney rank sum test will be used to compare the geometric mean concentrations.
Measured: Up to cycle 10 day 1 (each cycle is 28 days)
Antibody Titre Levels for Serotype 33F
Summarized using descriptive statistics by treatment arm. Changes in serotype-specific markers will be graphically evaluated between the two arms and the nonparametric Mann-Whitney rank sum test will be used to compare the geometric mean concentrations.
Measured: Up to cycle 10 day 1 (each cycle is 28 days)
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted11 May 2011 (estimated)
- Study start2 Nov 2011
- Primary completion8 Jul 2024
- Study completion6 May 2027 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Other trials for Ann Arbor Stage I Small Lymphocytic LymphomaStudies of the same condition, open and under way.
- More trials run by National Cancer Institute (NCI)The sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 2
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 49 participants (actual)
Sponsor and investigators
- Lead sponsor
- National Cancer Institute (NCI)
- Sponsor type
- US National Institutes of Health
- Responsible party
- Sponsor
- Investigators
- Kerry Rogers, Principal investigator, Ohio State University Comprehensive Cancer Center
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT01351896
- Sponsor's protocol ID
- NCI-2011-02584
- Other IDs
- NCI-2011-02584, CDR0000698438, OSU 10156, 2011C0005, 8834, 8834, N01CM00070, N01CM62207
- Status last verified
- May 2026
- First submitted
- 10 May 2011
- Last updated
- 27 May 2026
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- No
Study at a glance
From the registry record, last updated by the sponsor on 27 May 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Phase II Study of Lenalidomide to Repair Immune Synapse Response and Humoral Immunity in Early-Stage, Asymptomatic Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma (CLL/SLL) With High-Risk Genomic Features
- ClinicalTrials.gov ID
- NCT01351896
- Acronym / sponsor ID
- NCI-2011-02584
- Conditions
- Ann Arbor Stage I Small Lymphocytic Lymphoma, Ann Arbor Stage II Small Lymphocytic Lymphoma, Chronic Lymphocytic Leukemia, Chronic Lymphocytic Leukemia With Unmutated Immunoglobulin Heavy Chain Variable-Region Gene, Small Lymphocytic Lymphoma, Small Lymphocytic Lymphoma With Unmutated Immunoglobulin Heavy Chain Variable-Region Gene
- Phase
- Phase 2
- Study type
- Interventional
- Recruitment status
- Active, not recruiting
- Enrolment
- 49 participants (actual)
- Lead sponsor
- National Cancer Institute (NCI)US National Institutes of Health
- Study start
- 2 Nov 2011 (actual)
- Primary completion
- 8 Jul 2024 (actual)
- Study completion
- 6 May 2027 (estimated)
- First posted
- 11 May 2011 (estimated)
- Results
- Posted 22 Aug 2025
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This phase II trial studies the effect of lenalidomide and vaccine in treating patients with early-stage asymptomatic chronic lymphocytic leukemia or small lymphocytic lymphoma. Lenalidomide may stop the growth of cancer cells by blocking blood flow to the cancer. It may also stimulate the immune system in different ways and stop cancer cells from growing. Vaccines may help the body build an effective immune response to kill cancer cells. Giving lenalidomide together with vaccine therapy may make a stronger immune response and kill more cancer cells.
Detailed description
PRIMARY OBJECTIVE:
- To determine the proportion of early-stage, high-risk chronic lymphocytic leukemia (CLL) patients achieving a response (>= 4-fold increase from baseline and/or antibody concentrations >= 0.35 ug/mL in 6 of 7 type-specific anti-pneumococcal antibody levels) after 2 doses of pneumococcal 13-valent conjugated vaccine (Prevnar 13, PCV13 [pneumococcal polyvalent vaccine]) administered concurrent with versus sequential to low-dose lenalidomide.
SECONDARY OBJECTIVES:
- To determine the complete response (CR) rate after 2 years of lenalidomide therapy.
II. To determine the time to first treatment (TFT), defined as the time from diagnosis to first non-lenalidomide therapy for progressive CLL as described by International Workshop on Chronic Lymphocytic Leukemia (IWCLL) 2008 criteria.
III. To determine the incidence of infection and invasive pneumococcal infections following treatment with the PCV13 vaccine and either concurrent or sequential lenalidomide.
IV. To determine the frequency of humoral and cellular immune response to CLL tumor antigens following treatment with the PCV13 vaccine and either concurrent or sequential lenalidomide.
- To determine the safety and toxicity associated with long-term lenalidomide exposure.
VI. To perform correlative pharmacodynamic and pharmacokinetic studies and correlate these with vaccine/tumor immunologic and disease response.
OUTLINE: Patients are randomized to 1 of 2 treatment arms.
ARM A (concurrent PCV13 and lenalidomide): Patients receive low-dose lenalidomide orally (PO) once daily on days 1-28. Treatment repeats every 28 days for at least 24 cycles in the absence of disease progression or unacceptable toxicity. Patients also receive 13-valent protein-conjugated pneumococcal vaccine (PCV13) intramuscularly (IM) on day 1 of courses 3 and 5.
ARM B (sequential PCV13 and lenalidomide): Patients receive PCV13 IM on days 1 and 78 (cycles 1 and 3). Patients also receive low-dose lenalidomide as in arm 1 beginning on day 1 of cycle 4. Treatment repeats every 28 days for at least 24 cycles in the absence of disease progression or unacceptable toxicity.
Patients may undergo bone marrow biopsy and aspirate and computed tomography (CT) during screening and blood sample collection throughout the study. (Blood sample collection discontinued with approval of protocol version 24 dated 3/15/2024)
After completion of study treatment, patients are followed up for 30 days, every 3 months for 1 year, and then every 6 months thereafter.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Arm A (Concurrent PCV13 and lenalidomide) | Experimental | Procedure: Biospecimen Collection, Procedure: Bone Marrow Aspiration, Procedure: Bone Marrow Biopsy, Procedure: Computed Tomography, Drug: Lenalidomide, Biological: Pneumococcal Polyvalent VaccinePatients receive low-dose lenalidomide PO once daily on days 1-28. Treatment repeats every 28 days for at least 24 cycles in the absence of disease progression or unacceptable toxicity. Patients also receive PCV13 IM on day 1 of courses 3 and 5. Patients may undergo bone marrow biopsy and aspirate and CT during screening and blood sample collection throughout the study. (Blood sample collection discontinued with approval of protocol version 24 dated 3/15/2024) |
| Arm B (Sequential PCV13 and lenalidomide) | Experimental | Procedure: Biospecimen Collection, Procedure: Bone Marrow Aspiration, Procedure: Bone Marrow Biopsy, Procedure: Computed Tomography, Drug: Lenalidomide, Biological: Pneumococcal Polyvalent VaccinePatients receive PCV13 IM on days 1 and 78 (cycles 1 and 3). Patients also receive low-dose lenalidomide as in arm 1 beginning on day 1 of course 4. Treatment repeats every 28 days for at least 24 cycles in the absence of disease progression or unacceptable toxicity. Patients may undergo bone marrow biopsy and aspirate and CT during screening and blood sample collection throughout the study. (Blood sample collection discontinued with approval of protocol version 24 dated 3/15/2024) |
Who may qualify
- Ages
- 18 to 79 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (25 listed)
- Patients must have histologically identified chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL) as defined by the World Health Organization (WHO) classification of hematopoietic neoplasms
- CLL/SLL cells must demonstrate one or more of the following high-risk genomic features:
- Patients cannot meet any of the following consensus criteria for initiating treatment:
- No prior therapy for CLL/SLL, including chemotherapy, radiotherapy, and/or immunotherapy will be allowed
- Age ≥ 18 years and < 80 years (or with justification if older than 80 years due to the higher risk of toxicity in patients older than 80 years). CLL is rare in children and likely represents a different disease process. As a result, children are excluded from this study but may be eligible for future pediatric phase 2 combination trials
Key exclusion criteria (13 listed)
- Patients who have had any treatment for their CLL/SLL, including but not limited to chemotherapy, radiotherapy, or immunotherapy, prior to entering the study
- No corticosteroid use will be permitted within two weeks prior to study, except for maintenance therapy for a non-malignant disease; maintenance therapy dose may not exceed 20 mg/day prednisone or equivalent
- Patients who meet consensus criteria for the treatment of CLL/SLL
- Patients may not be receiving any other investigational agents
- Patients with a recent history (within 6 months of study entry) of deep vein thrombosis (DVT)/pulmonary embolism (PE) are not eligible; patients with a distant history (greater than 6 months before study entry) of venous thromboembolic disease are eligible, but should receive prophylactic aspirin or low molecular weight heparin
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Biospecimen CollectionAlso: Biological Sample Collection, Biospecimen Collected, Sample Collection, Specimen CollectionUndergo blood sample collection | Procedure or surgery | Arm A (Concurrent PCV13 and lenalidomide), Arm B (Sequential PCV13 and lenalidomide) |
| Bone Marrow AspirationUndergo bone marrow aspiration | Procedure or surgery | Arm A (Concurrent PCV13 and lenalidomide), Arm B (Sequential PCV13 and lenalidomide) |
| Bone Marrow BiopsyAlso: Biopsy of Bone Marrow, Biopsy, Bone MarrowUndergo bone marrow biopsy | Procedure or surgery | Arm A (Concurrent PCV13 and lenalidomide), Arm B (Sequential PCV13 and lenalidomide) |
| Computed TomographyAlso: CAT, CAT Scan, Computed Axial Tomography, Computerized Axial TomographyUndergo CT | Procedure or surgery | Arm A (Concurrent PCV13 and lenalidomide), Arm B (Sequential PCV13 and lenalidomide) |
| LenalidomideAlso: CC 5013, CC-5013, CC5013, CDC 501Given PO | Drug | Arm A (Concurrent PCV13 and lenalidomide), Arm B (Sequential PCV13 and lenalidomide) |
| Pneumococcal Polyvalent VaccineAlso: PCV 23, Pneumococcal 23-valent Polysaccharide Vaccine, Pneumococcal Polysaccharide Vaccine, Pneumococcal Vaccine PolyvalentGiven IM (concurrently or sequentially) | Biological | Arm A (Concurrent PCV13 and lenalidomide), Arm B (Sequential PCV13 and lenalidomide) |
Primary outcome
Proportion of Patients Who Achieve an Antibody Response
Time frame: Up to 1 month
Defined as achieving at least a four-fold increase in post-vaccination serotype-specific immunoglobulin G (IgG) titers or serotype-specific IgG concentrations of >= 0.35 ug/mL for 6 of 7 serotypes measured by a standard enzyme linked immunosorbent assay.
32 secondary outcomes
Seroconversion Rates
Time frame: Up to 4 years
Complete Response Rate
Time frame: At 2 years
Time to First Treatment
Time frame: From study entry to first therapy for progressive CLL, assessed up to 4 years
Overall Survival
Time frame: Up to 4 years
Progression-free Survival
Time frame: Time from start of treatment to time of disease progression or death secondary to any cause, assessed up to 2 years
Number of Adverse Events
Time frame: Up to 4 years
Pharmacokinetic (PK) Parameters of Lenalidomide
Time frame: Baseline, days 1 and 2 of course 2 (Arm A) and days 1 and 2 of course 5 (Arm B)
Change in Serum Immunoglobulin
Time frame: Baseline up to 4 years
Change in Anti-tumor Antibody Levels
Time frame: Baseline up to 4 years
Antibody Titre Levels for Serotype 1
Time frame: Up to cycle 10 day 1 (each cycle is 28 days)
Antibody Titre Levels for Serotype 2
Time frame: Up to cycle 10 day 1 (each cycle is 28 days)
Antibody Titre Levels for Serotype 3
Time frame: Up to cycle 10 day 1 (each cycle is 28 days)
Antibody Titre Levels for Serotype 4
Time frame: Up to cycle 10 day 1 (each cycle is 28 days)
Antibody Titre Levels for Serotype 5
Time frame: Up to cycle 10 day 1 (each cycle is 28 days)
Antibody Titre Levels for Serotype 8
Time frame: Up to cycle 10 day 1 (each cycle is 28 days)
Antibody Titre Levels for Serotype 9N
Time frame: Up to cycle 10 day 1 (each cycle is 28 days)
Antibody Titre Levels for Serotype 12F
Time frame: Up to cycle 10 day 1 (each cycle is 28 days)
Antibody Titre Levels for Serotype 14
Time frame: Up to cycle 10 day 1 (each cycle is 28 days)
Antibody Titre Levels for Serotype 17F
Time frame: Up to cycle 10 day 1 (each cycle is 28 days)
Antibody Titre Levels for Serotype 19F
Time frame: Up to cycle 10 day 1 (each cycle is 28 days)
Antibody Titre Levels for Serotype 20
Time frame: Up to cycle 10 day 1 (each cycle is 28 days)
Antibody Titre Levels for Serotype 22F
Time frame: Up to cycle 10 day 1 (each cycle is 28 days)
Antibody Titre Levels for Serotype 23F
Time frame: Up to cycle 10 day 1 (each cycle is 28 days)
Antibody Titre Levels for Serotype 6B
Time frame: Up to cycle 10 day 1 (each cycle is 28 days)
Antibody Titre Levels for Serotype 10A
Time frame: Up to cycle 10 day 1 (each cycle is 28 days)
Antibody Titre Levels for Serotype 11A
Time frame: Up to cycle 10 day 1 (each cycle is 28 days)
Antibody Titre Levels for Serotype 7F
Time frame: Up to cycle 10 day 1 (each cycle is 28 days)
Antibody Titre Levels for Serotype 15B
Time frame: Up to cycle 10 day 1 (each cycle is 28 days)
Antibody Titre Levels for Serotype 18C
Time frame: Up to cycle 10 day 1 (each cycle is 28 days)
Antibody Titre Levels for Serotype 19A
Time frame: Up to cycle 10 day 1 (each cycle is 28 days)
Antibody Titre Levels for Serotype 9V
Time frame: Up to cycle 10 day 1 (each cycle is 28 days)
Antibody Titre Levels for Serotype 33F
Time frame: Up to cycle 10 day 1 (each cycle is 28 days)
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 27 May 2026.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Kerry Rogers principal investigator
Ohio State University Comprehensive Cancer Center
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 2 study testing Biospecimen Collection, Bone Marrow Aspiration and Bone Marrow Biopsy in people with Ann Arbor Stage I Small Lymphocytic Lymphoma and Ann Arbor Stage II Small Lymphocytic Lymphoma, run by National Cancer Institute (NCI) at 1 site in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 25 inclusion and 13 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: under way, not looking for participants, as of the sponsor's last update on 27 May 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
Yes. Results are posted in the registry (first posted 22 Aug 2025). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Proportion of Patients Who Achieve an Antibody Response (time frame: Up to 1 month). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 27 May 2026.