Grade 1 Follicular LymphomaPhase 2NCT03269669
Obinutuzumab With or Without Umbralisib, Lenalidomide, or Combination Chemotherapy in Treating Patients With Relapsed or Refractory Grade I-IIIa Follicular Lymphoma
A Phase 2 study testing Bendamustine Hydrochloride, Biopsy Procedure and Biospecimen Collection in people with Grade 1 Follicular Lymphoma and Grade 2 Follicular Lymphoma, run by National Cancer Institute (NCI) at 429 sites in United States.
Trial summary
This phase II trial studies how well obinutuzumab with or without umbralisib, lenalidomide, or combination chemotherapy work in treating patients with grade I-IIIa follicular lymphoma that has come back (relapsed) or does not respond to treatment (refractory). Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Grade 1 Follicular Lymphoma, Grade 2 Follicular Lymphoma, Grade 3a Follicular Lymphoma
- What is being tested?
- Bendamustine Hydrochloride, Biopsy Procedure and Biospecimen Collection
- Type of treatment
- Injection or infusion, Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 73 participants
- Where
- 429 sitesUnited States
- Study dates
- 23 Jan 2018to 21 Jan 2027
- Phase
- Phase 2
- Are there results?
- Not yet: the study is under way
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 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Patients must have follicular lymphoma (grade I, II or IIIa) confirmed at initial diagnosis and at relapse with identifiable fludeoxyglucose F-18 (FDG) avid disease on PET/CT; patients that have involvement with large cell lymphoma are not eligible
- Patients must have a whole body or limited whole body PET/CT scan performed within 42 days prior to registration
- Patients must have bone marrow biopsy performed within 42 days prior to registration
- Patients must have an indication for therapy as determined by the treating investigator
- All disease must be assessed and documented on the S1608 FDG-PET/CT assessment form
- The intent is to enroll patients with follicular lymphoma (FL) relapsed within 2 years of completing their first course of chemotherapy (CHOP or bendamustine based therapy) + anti-CD20 therapy. Patient is still eligible if he/she received radiation therapy or anti-CD20 therapy prior to chemoimmunotherapy or if maintenance anti-CD20 therapy was administered after chemoimmunotherapy
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- Patients must have either failed to achieve a complete remission, or must have relapsed within 2 years after completing CHOP or bendamustine-containing chemoimmunotherapy (including an anti-CD20 monoclonal antibody), as measured from the last dose of CHOP or bendamustine; relapsed patients must not have received any intervening chemotherapy
- Patients must have received only 1 course of chemotherapy, containing at least 3 cycles of CHOP or bendamustine; (note that no minimum dose of bendamustine is required)
- Patients who received any anti-CD20 antibody therapy prior to CHOP or bendamustine are eligible
- Patients who additionally received any maintenance anti-CD-20 antibody therapy or consolidative radioimmunotherapy within 2 years of the last dose of the CHOP or bendamustine therapy are eligible
- Involved field or involved site radiation is not considered a line of therapy; examples of eligible prior treatment regimens (note this list is not all inclusive):
- 1st line rituximab treatment followed years later by bendamustine rituximab
- Bendamustine rituximab x 4 cycles
- 1st line rituximab treatment, 2nd line ibritumomab tiuxetan, followed by bendamustine bortezomib rituximab x 6 cycles followed by rituximab maintenance
- Bendamustine obinutuzumab x 3 cycles
- CHOP rituximab x 6 cycles followed by rituximab maintenance
- For all forms of systemic therapy, patients must have completed therapy at least 21 days prior to registration; patients must have completed any radioimmunotherapy at least 84 days prior to registration; patients prior treatment related toxicities (except alopecia) must have resolved to grade 1 or less prior to registration
- Patients must have tissue specimens collected prior to registration; patients must be offered participation in biobanking of residual specimens; with patient consent, residuals from the mandatory submission(s) will be banked for future research
- Patients must be >= 18 years of age
- All patients must have a Zubrod performance status of 0, 1 or 2
- Absolute neutrophil count (ANC) >= 1,500/mcL within 28 days prior to registration
- Platelets >= 75,000/mcL within 28 days prior to registration
- Patients must have adequate renal function as documented by a calculated creatinine clearance >= 60 mL/min, within 28 days prior to registration
- Total bilirubin =< 1.5 x institutional upper limit of normal (IULN) (=< 5 x IULN if secondary to lymphoma, Gilbert's syndrome, or medication related [e.g., indinavir, tenofovir, atazanavir]) within 28 days prior to registration
- Direct bilirubin =< 1.5 x IULN (=< 5 x IULN if secondary to lymphoma) within 28 days prior to registration
- Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) =< 2.5 x IULN (=< 5 x IULN secondary to lymphoma) within 28 days prior to registration
- Patients must have an echocardiogram (ECHO) or multigated acquisition (MUGA) scan within 42 days prior to registration with a cardiac ejection fraction >= 45%
- Patients with hepatitis B virus infection must have undetectable hepatitis B virus (HBV) on suppressive therapy and no evidence of HBV-related hepatic damage; patients with hepatitis C virus infection are eligible if complete eradication therapy has been successfully completed, and there is no detectable hepatitis C virus (HVC) or related hepatic damage; patients with known human immunodeficiency virus (HIV) infection are eligible if they meet all of the following criteria in addition to the other protocol eligibility criteria:
- Patient must have no history of acquired immune deficiency syndrome (AIDS)-related complications, other than a history of low CD4+ T-cell count (< 200/mm^3) prior to initiation of combination antiretroviral therapy; on study CD4+ T-cell count may not be informative due to leukemia and should not be used as an exclusion criterion if low
- Patient must be healthy on the basis of HIV disease with high likelihood of near normal life span were it not for the leukemia
- Patient must have serum HIV viral load of < 200 copies/mm^3
- Patient must be on combination antiretroviral therapy with minimal pharmacokinetic interactions with study therapy and minimal overlapping clinical toxicity with protocol therapy; (recommend a regimen of the integrase inhibitor dolutegravir combined with either disoproxil fumarate/emtricitabine or dolutegravir combined with tenofovir alafenamide/emtricitabine)
- Protease inhibitors and once daily formulations containing cobicistat are NOT allowed due to potential pharmacokinetic interactions with leukemia therapy
- Stavudine and zidovudine (AZT) are NOT allowed because of overlapping toxicity with protocol therapy
- Patients must be able and willing to receive prophylaxis with daily aspirin, low molecular weight heparin, factor X inhibitors or warfarin if randomized to lenalidomide; patients unable or unwilling to take any listed prophylaxis are NOT eligible
- No second prior malignancy is allowed except for adequately treated basal (or squamous cell) skin cancer, in situ cervical cancer or other cancer for which the patient has been disease free for three years
- Patients must have a complete history and physical examination within 28 days prior to registration
- 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 and again within 24 hours prior to starting cycle 1 of lenalidomide; further, they must either commit to complete abstinence (true abstinence is acceptable when this is in line with the preferred and usual lifestyle of the subject; periodic abstinence [e.g., calendar, ovulation, symptothermal or post ovulation methods] and withdrawal are not acceptable methods of contraception) 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; while taking lenalidomide, during dose interruptions, and for at least 28 days after the last dose of 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 female who: 1) has achieved menarche at some point; 2) has not undergone a hysterectomy or bilateral oophorectomy; or 3) has not been naturally postmenopausal (amenorrhea following cancer therapy does not rule out childbearing potential) 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 by a trained counselor every 28 days about pregnancy precautions and risks of fetal exposure; NOTE: patients not randomized to receive lenalidomide will not be required to undergo serial pregnancy testing or lenalidomide counseling after registration
- Patients must have lactate dehydrogenase (LDH) and beta-2-microglobulin collected within 28 days prior to registration
- Patients must be informed of the investigational nature of this study and must sign and give written informed consent in accordance with institutional and federal guidelines
- As a part of the Oncology Patient Enrollment Network (OPEN) registration process the treating institution's identity is provided in order to ensure that the current (within 365 days) date of institutional review board approval for this study has been entered in the system
Who cannot join
- Patients must not have clinical evidence of central nervous system involvement by lymphoma since the proposed treatment strategies are not designed to address central nervous system (CNS) involvement adequately; if performed, any laboratory or radiographic tests performed to assess CNS involvement must be negative
- Patients must not have any prior treatment with any PI3K inhibitor, or lenalidomide
Trial locations and contacts
429 sites in 1 country.
300 sites in 1 country
United States300 sites
University of New Mexico Cancer Center
Albuquerque, New Mexico, 87106
Lehigh Valley Hospital-Cedar Crest
Allentown, Pennsylvania, 18103
Kaiser Permanente-Anaheim
Anaheim, California, 92806
Alaska Breast Care and Surgery LLC
Anchorage, Alaska, 99508
Alaska Oncology and Hematology LLC
Anchorage, Alaska, 99508
Alaska Women's Cancer Care
Anchorage, Alaska, 99508
Anchorage Oncology Centre
Anchorage, Alaska, 99508
Katmai Oncology Group
Anchorage, Alaska, 99508
Providence Alaska Medical Center
Anchorage, Alaska, 99508
Trinity Health Saint Joseph Mercy Hospital Ann Arbor
Ann Arbor, Michigan, 48106
University of Michigan Rogel Cancer Center
Ann Arbor, Michigan, 48109
Kaiser Permanente-Deer Valley Medical Center
Antioch, California, 94531
PCR Oncology
Arroyo Grande, California, 93420
Duluth Clinic Ashland
Ashland, Wisconsin, 54806
Northwest Wisconsin Cancer Center
Ashland, Wisconsin, 54806
Emory University Hospital/Winship Cancer Institute
Atlanta, Georgia, 30322
Sutter Auburn Faith Hospital
Auburn, California, 95602
Rocky Mountain Cancer Centers-Aurora
Aurora, Colorado, 80012
The Medical Center of Aurora
Aurora, Colorado, 80012
Kaiser Permanente-Baldwin Park
Baldwin Park, California, 91706
CommonSpirit Saint Joseph Hospital - Bardstown
Bardstown, Kentucky, 40004
Baton Rouge General Medical Center
Baton Rouge, Louisiana, 70806
Hematology/Oncology Clinic PLLC
Baton Rouge, Louisiana, 70809
Bronson Battle Creek
Battle Creek, Michigan, 49017
Nebraska Medicine-Bellevue
Bellevue, Nebraska, 68123
Kaiser Permanente-Bellflower
Bellflower, California, 90706
Sanford Joe Lueken Cancer Center
Bemidji, Minnesota, 56601
Alta Bates Summit Medical Center-Herrick Campus
Berkeley, California, 94704
Billings Clinic Cancer Center
Billings, Montana, 59101
Sanford Bismarck Medical Center
Bismarck, North Dakota, 58501
Illinois CancerCare-Bloomington
Bloomington, Illinois, 61704
Saint Alphonsus Cancer Care Center-Boise
Boise, Idaho, 83706
Saint Luke's Cancer Institute - Boise
Boise, Idaho, 83712
Central Care Cancer Center - Bolivar
Bolivar, Missouri, 65613
Parkland Health Center-Bonne Terre
Bonne Terre, Missouri, 63628
Rocky Mountain Cancer Centers-Boulder
Boulder, Colorado, 80304
Bozeman Health Deaconess Hospital
Bozeman, Montana, 59715
Trinity Health IHA Medical Group Hematology Oncology - Brighton
Brighton, Michigan, 48114
Trinity Health Medical Center - Brighton
Brighton, Michigan, 48114
Henry Ford Cancer Institute-Downriver
Brownstown, Michigan, 48183
Bryn Mawr Hospital
Bryn Mawr, Pennsylvania, 19010
Roswell Park Cancer Institute
Buffalo, New York, 14263
Providence Saint Joseph Medical Center/Disney Family Cancer Center
Burbank, California, 91505
Lahey Clinic
Burlington, Massachusetts, 01805
Fairview Ridges Hospital
Burnsville, Minnesota, 55337
Saint James Community Hospital and Cancer Treatment Center
Butte, Montana, 59701
Illinois CancerCare-Canton
Canton, Illinois, 61520
Trinity Health IHA Medical Group Hematology Oncology - Canton
Canton, Michigan, 48188
Trinity Health Medical Center - Canton
Canton, Michigan, 48188
Mercy Cancer Center - Cape Girardeau
Cape Girardeau, Missouri, 63703
Saint Francis Medical Center
Cape Girardeau, Missouri, 63703
Carson Tahoe Regional Medical Center
Carson City, Nevada, 89703
Illinois CancerCare-Carthage
Carthage, Illinois, 62321
Cancer Center of Kansas - Chanute
Chanute, Kansas, 66720
Medical University of South Carolina
Charleston, South Carolina, 29425
West Virginia University Charleston Division
Charleston, West Virginia, 25304
Carolinas Medical Center/Levine Cancer Institute
Charlotte, North Carolina, 28203
Chelsea Hospital
Chelsea, Michigan, 48118
Trinity Health IHA Medical Group Hematology Oncology - Chelsea Hospital
Chelsea, Michigan, 48118
Northwestern University
Chicago, Illinois, 60611
Rush MD Anderson Cancer Center
Chicago, Illinois, 60612
University of Chicago Comprehensive Cancer Center
Chicago, Illinois, 60637
Marshfield Clinic-Chippewa Center
Chippewa Falls, Wisconsin, 54729
Good Samaritan Hospital - Cincinnati
Cincinnati, Ohio, 45220
TriHealth Cancer Institute-Westside
Cincinnati, Ohio, 45247
TriHealth Cancer Institute-Anderson
Cincinnati, Ohio, 45255
Siteman Cancer Center at Saint Peters Hospital
City of Saint Peters, Missouri, 63376
Clackamas Radiation Oncology Center
Clackamas, Oregon, 97015
Providence Cancer Institute Clackamas Clinic
Clackamas, Oregon, 97015
MetroHealth Medical Center
Cleveland, Ohio, 44109
Southeastern Medical Oncology Center-Clinton
Clinton, North Carolina, 28328
Henry Ford Macomb Hospital-Clinton Township
Clinton Township, Michigan, 48038
Mercy Cancer Center-West Lakes
Clive, Iowa, 50325
UI Health Care Mission Cancer and Blood - West Des Moines Clinic
Clive, Iowa, 50325
Main Line Health Center-Collegeville
Collegeville, Pennsylvania, 19426
Penrose-Saint Francis Healthcare
Colorado Springs, Colorado, 80907
Rocky Mountain Cancer Centers-Penrose
Colorado Springs, Colorado, 80907
Ohio State University Comprehensive Cancer Center
Columbus, Ohio, 43210
Mount Carmel East Hospital
Columbus, Ohio, 43213
Columbus Oncology and Hematology Associates Inc
Columbus, Ohio, 43214
Riverside Methodist Hospital
Columbus, Ohio, 43214
The Mark H Zangmeister Center
Columbus, Ohio, 43219
Mount Carmel Health Center West
Columbus, Ohio, 43222
Mercy Hospital
Coon Rapids, Minnesota, 55433
Bay Area Hospital
Coos Bay, Oregon, 97420
Siteman Cancer Center at West County Hospital
Creve Coeur, Missouri, 63141
Carle at The Riverfront
Danville, Illinois, 61832
Geisinger Medical Center
Danville, Pennsylvania, 17822
Good Samaritan Hospital - Dayton
Dayton, Ohio, 45406
Miami Valley Hospital
Dayton, Ohio, 45409
Miami Valley Hospital North
Dayton, Ohio, 45415
Corewell Health Dearborn Hospital
Dearborn, Michigan, 48124
Henry Ford Medical Center-Fairlane
Dearborn, Michigan, 48126
Cancer Care Specialists of Illinois - Decatur
Decatur, Illinois, 62526
Decatur Memorial Hospital
Decatur, Illinois, 62526
Essentia Health - Deer River Clinic
Deer River, Minnesota, 56636
Denver Health Medical Center
Denver, Colorado, 80204
AdventHealth Porter
Denver, Colorado, 80210
Colorado Blood Cancer Institute
Denver, Colorado, 80218
Presbyterian - Saint Lukes Medical Center - Health One
Denver, Colorado, 80218
Rocky Mountain Cancer Centers-Midtown
Denver, Colorado, 80218
Saint Joseph Hospital - Cancer Centers of Colorado
Denver, Colorado, 80218
Rocky Mountain Cancer Centers-Rose
Denver, Colorado, 80220
Rose Medical Center
Denver, Colorado, 80220
Iowa Methodist Medical Center
Des Moines, Iowa, 50309
UI Health Care Mission Cancer and Blood - Des Moines Clinic
Des Moines, Iowa, 50309
Broadlawns Medical Center
Des Moines, Iowa, 50314
Mercy Medical Center - Des Moines
Des Moines, Iowa, 50314
UI Health Care Mission Cancer and Blood - Laurel Clinic
Des Moines, Iowa, 50314
Iowa Lutheran Hospital
Des Moines, Iowa, 50316
Henry Ford Hospital
Detroit, Michigan, 48202
Henry Ford Health Saint John Hospital
Detroit, Michigan, 48236
Cancer Center of Kansas - Dodge City
Dodge City, Kansas, 67801
City of Hope Comprehensive Cancer Center
Duarte, California, 91010
Kaiser Permanente Dublin
Dublin, California, 94568
Essentia Health Cancer Center
Duluth, Minnesota, 55805
Essentia Health Saint Mary's Medical Center
Duluth, Minnesota, 55805
Miller-Dwan Hospital
Duluth, Minnesota, 55805
Mercy Medical Center
Durango, Colorado, 81301
Henry Ford River District Hospital
East China Township, Michigan, 48054
Marshfield Medical Center-EC Cancer Center
Eau Claire, Wisconsin, 54701
Fairview Southdale Hospital
Edina, Minnesota, 55435
Swedish Cancer Institute-Edmonds
Edmonds, Washington, 98026
Carle Physician Group-Effingham
Effingham, Illinois, 62401
Crossroads Cancer Center
Effingham, Illinois, 62401
Cancer Center of Kansas - El Dorado
El Dorado, Kansas, 67042
Mountain Blue Cancer Care Center - Swedish
Englewood, Colorado, 80113
Swedish Medical Center
Englewood, Colorado, 80113
Illinois CancerCare-Eureka
Eureka, Illinois, 61530
Main Line Health Center-Exton
Exton, Pennsylvania, 19341
Sanford Broadway Medical Center
Fargo, North Dakota, 58122
Sanford Roger Maris Cancer Center
Fargo, North Dakota, 58122
Lake Region Healthcare Corporation-Cancer Care
Fergus Falls, Minnesota, 56537
Blanchard Valley Hospital
Findlay, Ohio, 45840
Genesys Hurley Cancer Institute
Flint, Michigan, 48503
Kaiser Permanente-Fontana
Fontana, California, 92335
UI Healthcare Mission Cancer and Blood - Fort Dodge
Fort Dodge, Iowa, 50501
Parkview Hospital Randallia
Fort Wayne, Indiana, 46805
Parkview Regional Medical Center
Fort Wayne, Indiana, 46845
Kaiser Permanente-Fremont
Fremont, California, 94538
Kaiser Permanente-Fresno
Fresno, California, 93720
Unity Hospital
Fridley, Minnesota, 55432
Saint Luke's Cancer Institute - Fruitland
Fruitland, Idaho, 83619
UF Health Cancer Institute - Gainesville
Gainesville, Florida, 32610
Illinois CancerCare-Galesburg
Galesburg, Illinois, 61401
Northwestern Medicine Cancer Center Delnor
Geneva, Illinois, 60134
Mountain Blue Cancer Care Center
Golden, Colorado, 80401
Southeastern Medical Oncology Center-Goldsboro
Goldsboro, North Carolina, 27534
Wayne Memorial Hospital
Goldsboro, North Carolina, 27534
Nebraska Cancer Specialists/Oncology Hematology West PC
Grand Island, Nebraska, 68803
Saint Mary's Hospital and Regional Medical Center
Grand Junction, Colorado, 81501
Corewell Health Grand Rapids Hospitals - Butterworth Hospital
Grand Rapids, Michigan, 49503
Corewell Health Grand Rapids Hospitals - Helen DeVos Children's Hospital
Grand Rapids, Michigan, 49503
Trinity Health Grand Rapids Hospital
Grand Rapids, Michigan, 49503
Central Care Cancer Center - Great Bend
Great Bend, Kansas, 67530
Benefis Sletten Cancer Institute
Great Falls, Montana, 59405
Banner North Colorado Medical Center
Greeley, Colorado, 80631
Saint Francis Hospital
Greenville, South Carolina, 29601
Saint Francis Cancer Center
Greenville, South Carolina, 29607
Self Regional Healthcare
Greenwood, South Carolina, 29646
Rocky Mountain Cancer Centers-Greenwood Village
Greenwood Village, Colorado, 80111
Henry Ford Saint John Hospital - Academic
Grosse Pointe Woods, Michigan, 48236
Henry Ford Saint John Hospital - Breast
Grosse Pointe Woods, Michigan, 48236
Henry Ford Saint John Hospital - Van Elslander
Grosse Pointe Woods, Michigan, 48236
Kaiser Permanente South Bay
Harbor City, California, 90710
Smilow Cancer Hospital Care Center at Saint Francis
Hartford, Connecticut, 06105
Geisinger Medical Center-Cancer Center Hazleton
Hazleton, Pennsylvania, 18201
Cancer and Blood Specialists-Henderson
Henderson, Nevada, 89052
Comprehensive Cancer Centers of Nevada - Henderson
Henderson, Nevada, 89052
Las Vegas Cancer Center-Henderson
Henderson, Nevada, 89052
Comprehensive Cancer Centers of Nevada-Southeast Henderson
Henderson, Nevada, 89074
Oncology Las Vegas - Henderson
Henderson, Nevada, 89074
Margaret R Pardee Memorial Hospital
Hendersonville, North Carolina, 28791
Essentia Health Hibbing Clinic
Hibbing, Minnesota, 55746
Kaiser Permanente Moanalua Medical Center
Honolulu, Hawaii, 96819
UT MD Anderson Cancer Center
Houston, Texas, 77030
City of Hope Seacliff
Huntington Beach, California, 92648
Cancer Center of Kansas-Independence
Independence, Kansas, 67301
University of Iowa/Holden Comprehensive Cancer Center
Iowa City, Iowa, 52242
City of Hope at Irvine Lennar
Irvine, California, 92618
Kaiser Permanente-Irvine
Irvine, California, 92618
Allegiance Health
Jackson, Michigan, 49201
Baptist MD Anderson Cancer Center
Jacksonville, Florida, 32207
Southeastern Medical Oncology Center-Jacksonville
Jacksonville, North Carolina, 28546
MU Health Care Goldschmidt Cancer Center
Jefferson City, Missouri, 65109
West Michigan Cancer Center
Kalamazoo, Michigan, 49007
Logan Health Medical Center
Kalispell, Montana, 59901
Saint Luke's Hospital of Kansas City
Kansas City, Missouri, 64111
Kansas City Veterans Affairs Medical Center
Kansas City, Missouri, 64128
CHI Health Good Samaritan
Kearney, Nebraska, 68847
Illinois CancerCare-Kewanee Clinic
Kewanee, Illinois, 61443
Cancer Center of Kansas-Kingman
Kingman, Kansas, 67068
Gundersen Lutheran Medical Center
La Crosse, Wisconsin, 54601
Marshfield Medical Center - Ladysmith
Ladysmith, Wisconsin, 54848
Northwestern Medicine Lake Forest Hospital
Lake Forest, Illinois, 60045
Northwell Health/Center for Advanced Medicine
Lake Success, New York, 11042
CommonSpirit Saint Anthony Hospital Cancer Center
Lakewood, Colorado, 80228
Rocky Mountain Cancer Centers-Lakewood
Lakewood, Colorado, 80228
University of Michigan Health - Sparrow Lansing
Lansing, Michigan, 48912
University Medical Center of Southern Nevada
Las Vegas, Nevada, 89102
Cancer and Blood Specialists-Shadow
Las Vegas, Nevada, 89106
Radiation Oncology Centers of Nevada Central
Las Vegas, Nevada, 89106
HealthCare Partners Medical Group Oncology/Hematology-Maryland Parkway
Las Vegas, Nevada, 89109
Sunrise Hospital and Medical Center
Las Vegas, Nevada, 89109
HealthCare Partners Medical Group Oncology/Hematology-San Martin
Las Vegas, Nevada, 89113
Radiation Oncology Centers of Nevada Southeast
Las Vegas, Nevada, 89119
Ann M Wierman MD LTD
Las Vegas, Nevada, 89128
Comprehensive Cancer Centers of Nevada - Northwest
Las Vegas, Nevada, 89128
HealthCare Partners Medical Group Oncology/Hematology-Tenaya
Las Vegas, Nevada, 89128
Oncology Las Vegas - Tenaya
Las Vegas, Nevada, 89128
Alliance for Childhood Diseases/Cure 4 the Kids Foundation
Las Vegas, Nevada, 89135
Comprehensive Cancer Centers of Nevada-Summerlin
Las Vegas, Nevada, 89144
Summerlin Hospital Medical Center
Las Vegas, Nevada, 89144
Las Vegas Cancer Center-Medical Center
Las Vegas, Nevada, 89148-2405
Comprehensive Cancer Centers of Nevada
Las Vegas, Nevada, 89148
HealthCare Partners Medical Group Oncology/Hematology-Centennial Hills
Las Vegas, Nevada, 89149
Comprehensive Cancer Centers of Nevada - Central Valley
Las Vegas, Nevada, 89169
University Cancer Center
Las Vegas, Nevada, 89169
OptumCare Cancer Care at Fort Apache
Las Vegas, Nevada, 89183
Lawrence Memorial Hospital
Lawrence, Kansas, 66044
Dartmouth Hitchcock Medical Center/Dartmouth Cancer Center
Lebanon, New Hampshire, 03756
Geisinger Medical Oncology-Lewisburg
Lewisburg, Pennsylvania, 17837
Cancer Center of Kansas-Liberal
Liberal, Kansas, 67905
Saint Rita's Medical Center
Lima, Ohio, 45801
Rocky Mountain Cancer Centers-Littleton
Littleton, Colorado, 80120
AdventHealth Littleton
Littleton, Colorado, 80122
Trinity Health Saint Mary Mercy Livonia Hospital
Livonia, Michigan, 48154
Loma Linda University Medical Center
Loma Linda, California, 92354
Rocky Mountain Cancer Centers-Sky Ridge
Lone Tree, Colorado, 80124
Sky Ridge Medical Center
Lone Tree, Colorado, 80124
City of Hope at Long Beach Elm
Long Beach, California, 90813
Longmont United Hospital
Longmont, Colorado, 80501
Rocky Mountain Cancer Centers-Longmont
Longmont, Colorado, 80501
PeaceHealth Saint John Medical Center
Longview, Washington, 98632
Kaiser Permanente Los Angeles Medical Center
Los Angeles, California, 90027
Kaiser Permanente West Los Angeles
Los Angeles, California, 90034
Jewish Hospital
Louisville, Kentucky, 40202
Saints Mary and Elizabeth Hospital
Louisville, Kentucky, 40215
UofL Health Medical Center Northeast
Louisville, Kentucky, 40245
Banner North Colorado Medical Center - Loveland Campus
Loveland, Colorado, 80539
Illinois CancerCare-Macomb
Macomb, Illinois, 61455
Henry Ford Saint John Hospital - Macomb Medical
Macomb, Michigan, 48044
Henry Ford Warren Hospital - Breast Macomb
Macomb, Michigan, 48044
University of Wisconsin Carbone Cancer Center - University Hospital
Madison, Wisconsin, 53792
North Shore University Hospital
Manhasset, New York, 11030
Cancer Center of Kansas-Manhattan
Manhattan, Kansas, 66502
Minnesota Oncology Hematology PA-Maplewood
Maplewood, Minnesota, 55109
Saint John's Hospital - Healtheast
Maplewood, Minnesota, 55109
Marietta Memorial Hospital
Marietta, Ohio, 45750
Marshfield Medical Center-Marshfield
Marshfield, Wisconsin, 54449
Carle Physician Group-Mattoon/Charleston
Mattoon, Illinois, 61938
Toledo Clinic Cancer Centers-Maumee
Maumee, Ohio, 43537
Loyola University Medical Center
Maywood, Illinois, 60153
Cancer Center of Kansas - McPherson
McPherson, Kansas, 67460
Riddle Memorial Hospital
Media, Pennsylvania, 19063
Saint Luke's Cancer Institute - Meridian
Meridian, Idaho, 83642
Medical College of Wisconsin
Milwaukee, Wisconsin, 53226
Abbott-Northwestern Hospital
Minneapolis, Minnesota, 55407
Hennepin County Medical Center
Minneapolis, Minnesota, 55415
Health Partners Inc
Minneapolis, Minnesota, 55454
Marshfield Medical Center - Minocqua
Minocqua, Wisconsin, 54548
Saint Patrick Hospital - Community Hospital
Missoula, Montana, 59802
Community Medical Center
Missoula, Montana, 59804
Memorial Medical Center
Modesto, California, 95355
Kaiser Permanente-Modesto
Modesto, California, 95356
Palo Alto Medical Foundation-Camino Division
Mountain View, California, 94040
Palo Alto Medical Foundation-Gynecologic Oncology
Mountain View, California, 94040
Trinity Health Muskegon Hospital
Muskegon, Michigan, 49444
Saint Luke's Cancer Institute - Nampa
Nampa, Idaho, 83687
Smilow Cancer Center/Yale-New Haven Hospital
New Haven, Connecticut, 06510
Yale University
New Haven, Connecticut, 06520
Long Island Jewish Medical Center
New Hyde Park, New York, 11040
Tulane University School of Medicine
New Orleans, Louisiana, 70112
Ochsner Medical Center Jefferson
New Orleans, Louisiana, 70121
Cancer Center of Western Wisconsin
New Richmond, Wisconsin, 54017
NYP/Weill Cornell Medical Center
New York, New York, 10065
Licking Memorial Hospital
Newark, Ohio, 43055
Providence Newberg Medical Center
Newberg, Oregon, 97132
City of Hope Newport Beach
Newport Beach, California, 92660
Cancer Center of Kansas - Newton
Newton, Kansas, 67114
Yale-New Haven Hospital North Haven Medical Center
North Haven, Connecticut, 06473
Henry Ford Medical Center-Columbus
Novi, Michigan, 48377
Cancer Care Center of O'Fallon
O'Fallon, Illinois, 62269
Kaiser Permanente Oakland-Broadway
Oakland, California, 94611
Kaiser Permanente-Oakland
Oakland, California, 94611
University of Oklahoma Health Sciences Center
Oklahoma City, Oklahoma, 73104
Nebraska Medicine-Village Pointe
Omaha, Nebraska, 68118
University of Nebraska Medical Center
Omaha, Nebraska, 68198
Kaiser Permanente-Ontario
Ontario, California, 91761
Providence Willamette Falls Medical Center
Oregon City, Oregon, 97045
Illinois CancerCare-Ottawa Clinic
Ottawa, Illinois, 61350
Palo Alto Medical Foundation Health Care
Palo Alto, California, 94301
VA Palo Alto Health Care System
Palo Alto, California, 94304
Kaiser Permanente - Panorama City
Panorama City, California, 91402
Paoli Memorial Hospital
Paoli, Pennsylvania, 19301
AdventHealth Parker
Parker, Colorado, 80138
Rocky Mountain Cancer Centers-Parker
Parker, Colorado, 80138
Cancer Center of Kansas - Parsons
Parsons, Kansas, 67357
Illinois CancerCare-Pekin
Pekin, Illinois, 61554
Illinois CancerCare-Peoria
Peoria, Illinois, 61615
About this study
Official title: Randomized Phase II Trial in Early Relapsing or Refractory Follicular Lymphoma
This phase II trial studies how well obinutuzumab with or without umbralisib, lenalidomide, or combination chemotherapy work in treating patients with grade I-IIIa follicular lymphoma that has come back (relapsed) or does not respond to treatment (refractory). Immunotherapy with obinutuzumab, may induce changes in body's immune system and may interfere with the ability of tumor cells to grow and spread. Umbralisib may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth. Biological therapies, such as lenalidomide, use substances made from living organisms that may stimulate or suppress the immune system in different ways and stop cancer cells from growing. Chemotherapy drugs, such as cyclophosphamide, doxorubicin, vincristine, prednisone, and bendamustine, work in different ways to stop the growth of cancer cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. It is not yet known whether giving obinutuzumab with or without umbralisib, lenalidomide, or combination chemotherapy will work better in treating patients with grade I-IIIa follicular lymphoma.
Read the detailed description
PRIMARY OBJECTIVE:
- To compare the complete response rate up to 6 cycles after randomization as defined by centrally read positron emission tomography (PET)/computed tomography (CT) (integral biomarker) of 2 targeted therapeutic regimens (obinutuzumab + umbralisib [TGR-1202] or obinutuzumab + lenalidomide) with obinutuzumab + chemotherapy (cyclophosphamide, doxorubicin hydrochloride [doxorubicin], vincristine sulfate [vincristine], and prednisone [CHOP] or bendamustine hydrochloride [bendamustine]) in patients with early relapsing or refractory follicular lymphoma.
SECONDARY OBJECTIVES:
- To validate the prognostic association of the m7-FLIPI model, demonstrating that the population of follicular lymphoma patients who respond poorly to chemoimmunotherapy are enriched for having a high-risk m7-FLIPI score, and that the score is associated with progression-free survival (integrated biomarker). (Primary translational medicine) II. To estimate the 30-month sustained complete response rate (CR30) defined by centrally read PET/CT with each of the regimens in this early relapsing or refractory follicular lymphoma population.
III. To estimate best response up to 12 cycles of therapy, progression free survival, duration of response and overall survival with each of the combinations in early relapsing or refractory follicular lymphoma.
IV. To evaluate the adverse effects of each of the regimens in early relapsing or refractory follicular lymphoma.
- To evaluate the predictive performance of non-invasive genotyping (m7-FLIPI in circulating tumor deoxyribonucleic acid [DNA]) of plasma at study entry relative to standard tumor genotyping (m7-FLIPI) of formalin-fixed paraffin-embedded tumor tissue.
VI. To evaluate the association between the detection of active lymphoma by PET-CT and the detection of circulating tumor DNA in plasma at baseline, after 6 and 12 cycles, and at 30 months after initiation of study therapy.
OUTLINE: Patients are randomized to 1 of 3 arms.
ARM I (CLOSED TO ACCRUAL): Patients receive obinutuzumab intravenously (IV) on day 1 and umbralisib orally (PO) daily on days 1-28. Treatment repeats every 28 days for up to 12 cycles in the absence of disease progression or unacceptable toxicity.
ARM II: Patients receive obinutuzumab IV on day 1 and lenalidomide PO on days 1-21. Treatment repeats every 28 days for up 12 cycles in the absence of disease progression or unacceptable toxicity.
ARM III:
PRIOR BENDAMUSTINE-BASED CHEMOTHERAPY: Patients receive obinutuzumab IV on day 1, cyclophosphamide IV on day 1, doxorubicin IV on day 1, vincristine IV on day 1, and prednisone PO on days 1-5. Treatment with obinutuzumab repeats every 21 or 28 days for up to 12 cycles in the absence of disease progression or unacceptable toxicity. Treatment with combination chemotherapy repeats every 21 days for 6 cycles in the absence of disease progression or unacceptable toxicity.
PRIOR CHOP CHEMOTHERAPY: Patients receive obinutuzumab IV on day 1 and bendamustine IV over 60 minutes on days 1 and 2. Treatment repeats every 28 days for up to 6 or 12 cycles (bendamustine and obinutuzumab, respectively) in the absence of disease progression or unacceptable toxicity.
Patients in all arms undergo biopsy and echocardiogram (ECHO) or multigated acquisition scan (MUGA) during screening, and PET/CT scans and collection of blood throughout the trial.
After completion of study treatment, patients are followed up every 3 months for 2 years and then every 6 months for 3 years.
- Conditions
- Grade 1 Follicular Lymphoma, Grade 2 Follicular Lymphoma, Grade 3a Follicular Lymphoma, Recurrent Follicular Lymphoma, Refractory Follicular Lymphoma
- Being tested
- Bendamustine Hydrochloride, Biopsy Procedure, Biospecimen Collection, Computed Tomography, Cyclophosphamide
- Medical subject headings
- Lymphoma, Follicular
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Bendamustine HydrochlorideDrug
Also called Belrapzo, Bendamustin Hydrochloride, Bendeka, CEP 18083
Given IV
Biopsy ProcedureProcedure or surgery
Also called Biopsy, BIOPSY_TYPE, Bx
Undergo biopsy
Biospecimen CollectionProcedure or surgery
Also called Biological Sample Collection, Biospecimen Collected, Sample Collection, Specimen Collection
Undergo collection of blood
Computed TomographyProcedure or surgery
Also called CAT, CAT Scan, Computed Axial Tomography, Computerized Axial Tomography
Undergo PET/CT scans
CyclophosphamideDrug
Also called (-)-Cyclophosphamide, 2H-1,3,2-Oxazaphosphorine, 2-[bis(2-chloroethyl)amino]tetrahydro-, 2-oxide, monohydrate, Asta B 518, B 518
Given IV
Also called 5,12-Naphthacenedione, 10-[(3-amino-2,3,6-trideoxy-alpha-L-lyxo-hexopyranosyl)oxy]-7,8, 9,10-tetrahydro-6,8,11-trihydroxy-8-(hydroxyacetyl)-1-methoxy-, hydrochloride, (8S-cis)- (9CI), ADM, Adriacin, Adriamycin
Given IV
Echocardiography TestProcedure or surgery
Also called EC, Echocardiography
Undergo ECHO
LenalidomideDrug
Also called CC 5013, CC-5013, CC5013, CDC 501
Given PO
Multigated Acquisition ScanProcedure or surgery
Also called Blood Pool Scan, Equilibrium Radionuclide Angiography, Gated Blood Pool Imaging, Gated Heart Pool Scan
Undergo MUGA
ObinutuzumabBiological
Also called Anti-CD20 Monoclonal Antibody R7159, GA 101, GA-101, GA101
Given IV
Positron Emission TomographyProcedure or surgery
Also called Medical Imaging, Positron Emission Tomography, PET, PET Scan, Positron emission tomography (procedure)
Undergo PET/CT scans
PrednisoneDrug
Also called .delta.1-Cortisone, 1, 2-Dehydrocortisone, Adasone, Cortancyl
Given PO
UmbralisibDrug
Also called 2-((1S)-1-(4-Amino-3-(3-fluoro-4-(1-methylethoxy)phenyl)-1H-pyrazolo(3,4-d)pyrimidin-1-yl)ethyl)-6-fluoro-3-(3-fluorophenyl)-4H-1-benzopyran-4-one, RP-5264, RP5264, TGR 1202
Given PO
Also called Kyocristine, Leurocristine Sulfate, Leurocristine, sulfate, Oncovin
Given IV
| Study group | Role | What they receive |
|---|---|---|
| Arm I (obinutuzumab, umbralisib) | Experimental | CLOSED TO ACCRUAL: Patients receive obinutuzumab IV on day 1 and umbralisib PO daily on days 1-28. Treatment repeats every 28 days for up to 12 cycles in the absence of disease progression or unacceptable toxicity. Patients undergo biopsy and ECHO or MUGA during screening, and PET/CT scans and collection of blood throughout the trial. Receives: Procedure: Biopsy Procedure; Procedure: Biospecimen Collection; Procedure: Computed Tomography; Procedure: Echocardiography Test; Procedure: Multigated Acquisition Scan; Biological: Obinutuzumab; Procedure: Positron Emission Tomography; Drug: Umbralisib |
| Arm II (obinutuzumab, lenalidomide) | Experimental | Patients receive obinutuzumab IV on day 1 and lenalidomide PO on days 1-21. Treatment repeats every 28 days for up to 12 cycles in the absence of disease progression or unacceptable toxicity. Patients undergo biopsy and ECHO or MUGA during screening, and PET/CT scans and collection of blood throughout the trial. Receives: Procedure: Biopsy Procedure; Procedure: Biospecimen Collection; Procedure: Computed Tomography; Procedure: Echocardiography Test; Drug: Lenalidomide; Procedure: Multigated Acquisition Scan; Biological: Obinutuzumab; Procedure: Positron Emission Tomography |
| Arm III (obinutuzumab, combination chemotherapy) | Active comparator | PRIOR BENDAMUSTINE-BASED CHEMOTHERAPY: Patients receive obinutuzumab IV on day 1, cyclophosphamide IV on day 1, doxorubicin IV on day 1, vincristine IV on day 1, and prednisone PO on days 1-5. Treatment with obinutuzumab repeats every 21 or 28 days for up to 12 cycles in the absence of disease progression or unacceptable toxicity. Treatment with combination chemotherapy repeats every 21 days for up to 6 cycles in the absence of disease progression or unacceptable toxicity.
PRIOR CHOP CHEMOTHERAPY: Patients receive obinutuzumab IV on day 1, and bendamustine IV over 1 hour on days 1 and 2. Treatment repeats every 28 days for up to 6 or 12 cycles (bendamustine and obinutuzumab, respectively) in the absence of disease progression or unacceptable toxicity.
Patients undergo biopsy and ECHO or MUGA during screening, and PET/CT scans and collection of blood throughout the trial. Receives: Drug: Bendamustine Hydrochloride; Procedure: Biopsy Procedure; Procedure: Biospecimen Collection; Procedure: Computed Tomography; Drug: Cyclophosphamide; Drug: Doxorubicin Hydrochloride; Procedure: Echocardiography Test; Procedure: Multigated Acquisition Scan; Biological: Obinutuzumab; Procedure: Positron Emission Tomography; Drug: Prednisone; Drug: Vincristine Sulfate |
What is being measured
The primary outcome is the main question the study is designed to answer.
Complete response (CR)
Measured: Up to 6 cycles
Secondary outcomes (8)
Sustained complete response rate (CR30)
Defined by centrally read positron emission tomography (PET)/computed tomography (CT).
Measured: Up to 30 months
Progression-free survival (PFS)
Will be calculated using the method of Kaplan-Meier. 95% confidence for the survival estimates will be constructed using the method of Brookmeyer-Crowley. With 31 eligible patients in each arm, progression free survival at a particular time point, and the 30-month sustained response rate can be estimated to within at least +/- 18% with 95% confidence.
Measured: From date of registration to date of first observation of progressive disease, or death due to any cause, assessed up to 5 years
Duration of response (CR, partial response [PR])
Will be calculated using the method of Kaplan-Meier.
Measured: From date of first documentation of response to treatment (CR, PR) to date of first documentation of progression, or death due to any cause, assessed up to 5 years
Overall survival (OS)
Will be calculated using the method of Kaplan-Meier. 95% confidence for the survival estimates will be constructed using the method of Brookmeyer-Crowley. With 31 eligible patients in each arm, OS at a particular time point, and the 30-month sustained response rate can be estimated to within at least +/- 18% with 95% confidence.
Measured: Up to 5 years
Incidence of adverse events
Assessed by National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE) version 4.0 (version 5.0 will be utilized for serious adverse events reporting only). Toxicity rates can be estimated to within at least +/- 18% with 95% confidence.
Measured: Up to 5 years
Non-invasive genotyping and circulating tumor deoxyribonucleic acid (DNA) assessment
Sensitivity, specificity, positive predictive value, negative predictive value, and kappa coefficient will be used to evaluate the concordance. Will evaluate the association of detection of active lymphoma by positron emission tomography-computed tomography and the detection of circulating tumor DNA in plasma at baseline, after 6 and 12 cycles, and at 30 months after initiation of study therapy. Chi-square test will be used to evaluate the association and odds ratio will be calculated
Measured: Up to 5 years
Active lymphoma and circulating tumor DNA in plasma
The Cox proportional hazards model will be used to assess the association and odds ratio will be calculated.
Measured: From baseline up to 30 months after initiation of treatment
m7-FLIPI model validation
The Cox proportional hazards model will be used to assess the association of the m7-FLIPI with to PFS.
Measured: Up to 5 years
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted1 Sep 2017
- Study start23 Jan 2018
- Primary completion31 Dec 2025
- Study completion21 Jan 2027 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Grade 1 Follicular 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
- 73 participants (actual)
Sponsor and investigators
- Lead sponsor
- National Cancer Institute (NCI)
- Sponsor type
- US National Institutes of Health
- Responsible party
- Sponsor
- Investigators
- Paul M Barr, Principal investigator, SWOG Cancer Research Network
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT03269669
- Sponsor's protocol ID
- NCI-2017-00009
- Other IDs
- NCI-2017-00009, S1608, S1608, U10CA180888
- Status last verified
- Jan 2026
- First submitted
- 30 Aug 2017
- Last updated
- 8 Jul 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
Study at a glance
From the registry record, last updated by the sponsor on 8 Jul 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Randomized Phase II Trial in Early Relapsing or Refractory Follicular Lymphoma
- ClinicalTrials.gov ID
- NCT03269669
- Acronym / sponsor ID
- NCI-2017-00009
- Conditions
- Grade 1 Follicular Lymphoma, Grade 2 Follicular Lymphoma, Grade 3a Follicular Lymphoma, Recurrent Follicular Lymphoma, Refractory Follicular Lymphoma
- Phase
- Phase 2
- Study type
- Interventional
- Recruitment status
- Active, not recruiting
- Enrolment
- 73 participants (actual)
- Lead sponsor
- National Cancer Institute (NCI)US National Institutes of Health
- Study start
- 23 Jan 2018 (actual)
- Primary completion
- 31 Dec 2025 (actual)
- Study completion
- 21 Jan 2027 (estimated)
- First posted
- 1 Sep 2017 (actual)
- Results
- Not posted in the source record
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 how well obinutuzumab with or without umbralisib, lenalidomide, or combination chemotherapy work in treating patients with grade I-IIIa follicular lymphoma that has come back (relapsed) or does not respond to treatment (refractory). Immunotherapy with obinutuzumab, may induce changes in body's immune system and may interfere with the ability of tumor cells to grow and spread. Umbralisib may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth. Biological therapies, such as lenalidomide, use substances made from living organisms that may stimulate or suppress the immune system in different ways and stop cancer cells from growing. Chemotherapy drugs, such as cyclophosphamide, doxorubicin, vincristine, prednisone, and bendamustine, work in different ways to stop the growth of cancer cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. It is not yet known whether giving obinutuzumab with or without umbralisib, lenalidomide, or combination chemotherapy will work better in treating patients with grade I-IIIa follicular lymphoma.
Detailed description
PRIMARY OBJECTIVE:
- To compare the complete response rate up to 6 cycles after randomization as defined by centrally read positron emission tomography (PET)/computed tomography (CT) (integral biomarker) of 2 targeted therapeutic regimens (obinutuzumab + umbralisib [TGR-1202] or obinutuzumab + lenalidomide) with obinutuzumab + chemotherapy (cyclophosphamide, doxorubicin hydrochloride [doxorubicin], vincristine sulfate [vincristine], and prednisone [CHOP] or bendamustine hydrochloride [bendamustine]) in patients with early relapsing or refractory follicular lymphoma.
SECONDARY OBJECTIVES:
- To validate the prognostic association of the m7-FLIPI model, demonstrating that the population of follicular lymphoma patients who respond poorly to chemoimmunotherapy are enriched for having a high-risk m7-FLIPI score, and that the score is associated with progression-free survival (integrated biomarker). (Primary translational medicine) II. To estimate the 30-month sustained complete response rate (CR30) defined by centrally read PET/CT with each of the regimens in this early relapsing or refractory follicular lymphoma population.
III. To estimate best response up to 12 cycles of therapy, progression free survival, duration of response and overall survival with each of the combinations in early relapsing or refractory follicular lymphoma.
IV. To evaluate the adverse effects of each of the regimens in early relapsing or refractory follicular lymphoma.
- To evaluate the predictive performance of non-invasive genotyping (m7-FLIPI in circulating tumor deoxyribonucleic acid [DNA]) of plasma at study entry relative to standard tumor genotyping (m7-FLIPI) of formalin-fixed paraffin-embedded tumor tissue.
VI. To evaluate the association between the detection of active lymphoma by PET-CT and the detection of circulating tumor DNA in plasma at baseline, after 6 and 12 cycles, and at 30 months after initiation of study therapy.
OUTLINE: Patients are randomized to 1 of 3 arms.
ARM I (CLOSED TO ACCRUAL): Patients receive obinutuzumab intravenously (IV) on day 1 and umbralisib orally (PO) daily on days 1-28. Treatment repeats every 28 days for up to 12 cycles in the absence of disease progression or unacceptable toxicity.
ARM II: Patients receive obinutuzumab IV on day 1 and lenalidomide PO on days 1-21. Treatment repeats every 28 days for up 12 cycles in the absence of disease progression or unacceptable toxicity.
ARM III:
PRIOR BENDAMUSTINE-BASED CHEMOTHERAPY: Patients receive obinutuzumab IV on day 1, cyclophosphamide IV on day 1, doxorubicin IV on day 1, vincristine IV on day 1, and prednisone PO on days 1-5. Treatment with obinutuzumab repeats every 21 or 28 days for up to 12 cycles in the absence of disease progression or unacceptable toxicity. Treatment with combination chemotherapy repeats every 21 days for 6 cycles in the absence of disease progression or unacceptable toxicity.
PRIOR CHOP CHEMOTHERAPY: Patients receive obinutuzumab IV on day 1 and bendamustine IV over 60 minutes on days 1 and 2. Treatment repeats every 28 days for up to 6 or 12 cycles (bendamustine and obinutuzumab, respectively) in the absence of disease progression or unacceptable toxicity.
Patients in all arms undergo biopsy and echocardiogram (ECHO) or multigated acquisition scan (MUGA) during screening, and PET/CT scans and collection of blood throughout the trial.
After completion of study treatment, patients are followed up every 3 months for 2 years and then every 6 months for 3 years.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 3
| Arm | Type | Receives |
|---|---|---|
| Arm I (obinutuzumab, umbralisib) | Experimental | Procedure: Biopsy Procedure, Procedure: Biospecimen Collection, Procedure: Computed Tomography, Procedure: Echocardiography Test, Procedure: Multigated Acquisition Scan, Biological: Obinutuzumab, Procedure: Positron Emission Tomography, Drug: UmbralisibCLOSED TO ACCRUAL: Patients receive obinutuzumab IV on day 1 and umbralisib PO daily on days 1-28. Treatment repeats every 28 days for up to 12 cycles in the absence of disease progression or unacceptable toxicity. Patients undergo biopsy and ECHO or MUGA during screening, and PET/CT scans and collection of blood throughout the trial. |
| Arm II (obinutuzumab, lenalidomide) | Experimental | Procedure: Biopsy Procedure, Procedure: Biospecimen Collection, Procedure: Computed Tomography, Procedure: Echocardiography Test, Drug: Lenalidomide, Procedure: Multigated Acquisition Scan, Biological: Obinutuzumab, Procedure: Positron Emission TomographyPatients receive obinutuzumab IV on day 1 and lenalidomide PO on days 1-21. Treatment repeats every 28 days for up to 12 cycles in the absence of disease progression or unacceptable toxicity. Patients undergo biopsy and ECHO or MUGA during screening, and PET/CT scans and collection of blood throughout the trial. |
| Arm III (obinutuzumab, combination chemotherapy) | Active comparator | Drug: Bendamustine Hydrochloride, Procedure: Biopsy Procedure, Procedure: Biospecimen Collection, Procedure: Computed Tomography, Drug: Cyclophosphamide, Drug: Doxorubicin Hydrochloride, Procedure: Echocardiography Test, Procedure: Multigated Acquisition Scan, Biological: Obinutuzumab, Procedure: Positron Emission Tomography, Drug: Prednisone, Drug: Vincristine SulfatePRIOR BENDAMUSTINE-BASED CHEMOTHERAPY: Patients receive obinutuzumab IV on day 1, cyclophosphamide IV on day 1, doxorubicin IV on day 1, vincristine IV on day 1, and prednisone PO on days 1-5. Treatment with obinutuzumab repeats every 21 or 28 days for up to 12 cycles in the absence of disease progression or unacceptable toxicity. Treatment with combination chemotherapy repeats every 21 days for up to 6 cycles in the absence of disease progression or unacceptable toxicity. PRIOR CHOP CHEMOTHERAPY: Patients receive obinutuzumab IV on day 1, and bendamustine IV over 1 hour on days 1 and 2. Treatment repeats every 28 days for up to 6 or 12 cycles (bendamustine and obinutuzumab, respectively) in the absence of disease progression or unacceptable toxicity. Patients undergo biopsy and ECHO or MUGA during screening, and PET/CT scans and collection of blood throughout the trial. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (41 listed)
- Patients must have follicular lymphoma (grade I, II or IIIa) confirmed at initial diagnosis and at relapse with identifiable fludeoxyglucose F-18 (FDG) avid disease on PET/CT; patients that have involvement with large cell lymphoma are not eligible
- Patients must have a whole body or limited whole body PET/CT scan performed within 42 days prior to registration
- Patients must have bone marrow biopsy performed within 42 days prior to registration
- Patients must have an indication for therapy as determined by the treating investigator
- All disease must be assessed and documented on the S1608 FDG-PET/CT assessment form
Key exclusion criteria (2 listed)
- Patients must not have clinical evidence of central nervous system involvement by lymphoma since the proposed treatment strategies are not designed to address central nervous system (CNS) involvement adequately; if performed, any laboratory or radiographic tests performed to assess CNS involvement must be negative
- Patients must not have any prior treatment with any PI3K inhibitor, or lenalidomide
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 |
|---|---|---|
| Bendamustine HydrochlorideAlso: Belrapzo, Bendamustin Hydrochloride, Bendeka, CEP 18083Given IV | Drug | Arm III (obinutuzumab, combination chemotherapy) |
| Biopsy ProcedureAlso: Biopsy, BIOPSY_TYPE, BxUndergo biopsy | Procedure or surgery | Arm I (obinutuzumab, umbralisib), Arm II (obinutuzumab, lenalidomide), Arm III (obinutuzumab, combination chemotherapy) |
| Biospecimen CollectionAlso: Biological Sample Collection, Biospecimen Collected, Sample Collection, Specimen CollectionUndergo collection of blood | Procedure or surgery | Arm I (obinutuzumab, umbralisib), Arm II (obinutuzumab, lenalidomide), Arm III (obinutuzumab, combination chemotherapy) |
| Computed TomographyAlso: CAT, CAT Scan, Computed Axial Tomography, Computerized Axial TomographyUndergo PET/CT scans | Procedure or surgery | Arm I (obinutuzumab, umbralisib), Arm II (obinutuzumab, lenalidomide), Arm III (obinutuzumab, combination chemotherapy) |
| CyclophosphamideAlso: (-)-Cyclophosphamide, 2H-1,3,2-Oxazaphosphorine, 2-[bis(2-chloroethyl)amino]tetrahydro-, 2-oxide, monohydrate, Asta B 518, B 518Given IV | Drug | Arm III (obinutuzumab, combination chemotherapy) |
| Doxorubicin HydrochlorideAlso: 5,12-Naphthacenedione, 10-[(3-amino-2,3,6-trideoxy-alpha-L-lyxo-hexopyranosyl)oxy]-7,8, 9,10-tetrahydro-6,8,11-trihydroxy-8-(hydroxyacetyl)-1-methoxy-, hydrochloride, (8S-cis)- (9CI), ADM, Adriacin, AdriamycinGiven IV | Drug | Arm III (obinutuzumab, combination chemotherapy) |
| Echocardiography TestAlso: EC, EchocardiographyUndergo ECHO | Procedure or surgery | Arm I (obinutuzumab, umbralisib), Arm II (obinutuzumab, lenalidomide), Arm III (obinutuzumab, combination chemotherapy) |
| LenalidomideAlso: CC 5013, CC-5013, CC5013, CDC 501Given PO | Drug | Arm II (obinutuzumab, lenalidomide) |
| Multigated Acquisition ScanAlso: Blood Pool Scan, Equilibrium Radionuclide Angiography, Gated Blood Pool Imaging, Gated Heart Pool ScanUndergo MUGA | Procedure or surgery | Arm I (obinutuzumab, umbralisib), Arm II (obinutuzumab, lenalidomide), Arm III (obinutuzumab, combination chemotherapy) |
| ObinutuzumabAlso: Anti-CD20 Monoclonal Antibody R7159, GA 101, GA-101, GA101Given IV | Biological | Arm I (obinutuzumab, umbralisib), Arm II (obinutuzumab, lenalidomide), Arm III (obinutuzumab, combination chemotherapy) |
| Positron Emission TomographyAlso: Medical Imaging, Positron Emission Tomography, PET, PET Scan, Positron emission tomography (procedure)Undergo PET/CT scans | Procedure or surgery | Arm I (obinutuzumab, umbralisib), Arm II (obinutuzumab, lenalidomide), Arm III (obinutuzumab, combination chemotherapy) |
| PrednisoneAlso: .delta.1-Cortisone, 1, 2-Dehydrocortisone, Adasone, CortancylGiven PO | Drug | Arm III (obinutuzumab, combination chemotherapy) |
| UmbralisibAlso: 2-((1S)-1-(4-Amino-3-(3-fluoro-4-(1-methylethoxy)phenyl)-1H-pyrazolo(3,4-d)pyrimidin-1-yl)ethyl)-6-fluoro-3-(3-fluorophenyl)-4H-1-benzopyran-4-one, RP-5264, RP5264, TGR 1202Given PO | Drug | Arm I (obinutuzumab, umbralisib) |
| Vincristine SulfateAlso: Kyocristine, Leurocristine Sulfate, Leurocristine, sulfate, OncovinGiven IV | Drug | Arm III (obinutuzumab, combination chemotherapy) |
Primary outcome
Complete response (CR)
Time frame: Up to 6 cycles
8 secondary outcomes
Sustained complete response rate (CR30)
Time frame: Up to 30 months
Progression-free survival (PFS)
Time frame: From date of registration to date of first observation of progressive disease, or death due to any cause, assessed up to 5 years
Duration of response (CR, partial response [PR])
Time frame: From date of first documentation of response to treatment (CR, PR) to date of first documentation of progression, or death due to any cause, assessed up to 5 years
Overall survival (OS)
Time frame: Up to 5 years
Incidence of adverse events
Time frame: Up to 5 years
Non-invasive genotyping and circulating tumor deoxyribonucleic acid (DNA) assessment
Time frame: Up to 5 years
Active lymphoma and circulating tumor DNA in plasma
Time frame: From baseline up to 30 months after initiation of treatment
m7-FLIPI model validation
Time frame: Up to 5 years
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 8 Jul 2026.
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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.
Paul M Barr principal investigator
SWOG Cancer Research Network
429 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 2 study testing Bendamustine Hydrochloride, Biopsy Procedure and Biospecimen Collection in people with Grade 1 Follicular Lymphoma and Grade 2 Follicular Lymphoma, run by National Cancer Institute (NCI) at 429 sites 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 41 inclusion and 2 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 8 Jul 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 429 sites 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?
This study is still under way. Results are not available in the source record yet.
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?
Complete response (CR) (time frame: Up to 6 cycles). 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 8 Jul 2026.