LymphomaPhase 1NCT04739813
Venetoclax, Ibrutinib, Prednisone, Obinutuzumab, and Revlimid in Combination With Polatuzumab (ViPOR-P) in Relapsed/Refractory B-cell Lymphoma
A Phase 1 study testing obinutuzumab, prednisone and Revlimid in people with Lymphoma and Non-Hodgkin Lymphoma, run by National Cancer Institute (NCI) at 1 site in United States.
Trial summary
Background: Aggressive B-cell lymphomas can be cured but people with disease that resists treatment or that returns after treatment have poor outcomes with standard therapies. Indolent B-cell lymphomas are generally incurable with standard therapy and treatment is aimed at controlling symptoms and achieving a durable… Read more about this study
- Who is it for?
- Ages 18 to 120 years
- Conditions the study is for
- Lymphoma, Non-Hodgkin Lymphoma, Diffuse Large B-Cell Lymphoma
- What is being tested?
- obinutuzumab, prednisone and Revlimid
- Type of treatment
- Pill or oral medicine, Injection or infusion
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 34 participants
- Where
- 1 siteUnited States
- Study dates
- 9 Jul 2021to 18 Jun 2031
- Phase
- Phase 1
- 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 to 120 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Patients must have histologically or cytologically confirmed B-cell lymphoma confirmed by the Laboratory of Pathology, NCI, as follows:
- Cohorts 1 and 2:
- Aggressive B-cell lymphoma: includes DLBCL and subtypes, transformed lymphoma, Burkitt lymphoma, as well as high-grade B-cell lymphoma with MYC and/or BCL2 and/or BCL6 rearrangement(s).
- Indolent B-cell lymphoma: with the following exceptions:
- MCL is excluded given increased risk of tumor lysis syndrome (TLS) with venetoclax compared to other non-Hodgkin lymphomas and need for venetoclax ramp-up, dose-escalation.
- CLL/SLL is excluded given alternative dosing of FDA-approved venetoclax for relapsed CLL/SLL and increased risk of TLS with CLL/SLL compared to other non-Hodgkin lymphomas.
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- Cohort 3:
- -Non-GCB DLBCL: includes DLBCL NOS and subtypes, transformed lymphoma, THRLBCL, as well as high-grade B-cell lymphoma with MYC and/or BCL6 rearrangement(s).
- NOTE: Patients with known active CNS lymphoma are not eligible.
- Relapsed and/or refractory disease after at least 1 prior treatment regimen, as follows:
- Aggressive B-cell lymphoma: relapsed after and/or refractory to at least 1 prior anthracycline-containing regimen
- Indolent B-cell lymphoma: relapsed after and/or refractory to at least 1 prior anti- CD20 antibody-containing regimen.
- Patients must have evaluable disease by clinical exam (i.e., palpable lymphadenopathy, measurable skin lesions, etc.), laboratory assessment (i.e., lymphoma involvement of bone marrow or peripheral blood by morphology, cytology or flow cytometry), and/or imaging (measurable lymph nodes or masses on CT or MRI and/or evaluable FDG-avid lesions on PET).
- NOTE: Lesions that have been irradiated cannot be included in the tumor assessment unless unequivocal tumor progression has been documented in these lesions after radiation therapy.
- -Age >=18 years
- NOTE: Because no dosing or adverse event data are currently available on the use of polatuzumab in combination with venetoclax, ibrutinib, obinutuzumab, prednisone and Revlimid(R) in patients <18 years of age, children are excluded from this study, but will be eligible for future pediatric trials.
- ECOG performance status <=2.
- Adequate organ and marrow function as defined below unless dysfunction is secondary to lymphoma:
- absolute neutrophil count* >=1,000/mcL
- hemoglobin* >=8 g/dL
- Platelets >=75,000/mcL
- INR <=1.5 X institutional upper limit of normal (ULN) for patients not receiving therapeutic anticoagulation
- PTT/aPTT <=1.5 X institutional ULN normal except if, in the opinion of the investigator, the aPTT is elevated because of a positive Lupus Anticoagulant, or a significant bleeding risk has been ruled out in the absence of a positive Lupus Anticoagulant
- total bilirubin <=1.5 X institutional ULN (or <=3 X institutional ULN for patients with documented Gilberts syndrome identified by an isolated unconjugated hyperbilirubinemia in the absence of other signs of liver dysfunction and/or UGT1A1 mutational testing)
- AST(SGOT)/ALT(SGPT) <=3 X institutional ULN
- Serum creatinine <=2.0 mg/dL OR
- Creatinine clearance >=30 mL/min/1.73 m2 for patients with creatinine levels above 2 mg/dL
- NOTE: Cr Cl will be calculated with the use of the 24-hour creatinine clearance or eGRF in the clinical lab
- RBC transfusions and use of G-CSF will be allowed in order to meet eligibility parameters.
- Immune-modulating drugs (IMiDs) including Revlimid(R) are known to be teratogenic and potential embryo-fetal harm can be seen with use of polatuzumab, venetoclax and ibrutinib. The effects of obinutuzumab on the developing human fetus is unknown. For these reasons, individuals of child-bearing potential and individuals able to father a child must agree to use adequate contraception as described below.
- For individuals of childbearing potential:
- Agreement to remain abstinent (refrain from heterosexual intercourse) or use a contraceptive method with a failure rate of < 1% per year as outlined below.
- Agreement to refrain from donating eggs during timelines specified below.
- Individuals of childbearing potential (ICBP) 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 prescribing Revlimid(R) for Cycle 1 (prescriptions must be filled within 7 days as required by Revlimid REMSTM) and 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 she starts taking Revlimid(R) ICBP must also agree to ongoing pregnancy testing.
- An individual is considered to be of childbearing potential if that person is post-menarcheal, has not reached a postmenopausal state (>= 12 continuous months of amenorrhea with no identified cause other than menopause), and has not undergone surgical sterilization (removal of ovaries and/or uterus).
- Examples of contraceptive methods with a failure rate of < 1% per year include bilateral tubal ligation, male sterilization, hormonal contraceptives that inhibit ovulation, hormone-releasing intrauterine devices, and copper intrauterine devices.
- The reliability of sexual abstinence should be evaluated in relation to the duration of the clinical trial and the preferred and usual lifestyle of the patient. Periodic abstinence (e.g., calendar, ovulation, symptothermal, or post-ovulation methods) and withdrawal are not acceptable methods of contraception.
- For individuals able to father a child:
- Agreement to remain abstinent (refrain from heterosexual intercourse) or use contraceptive measures, and agreement to refrain from donating sperm, as defined below:
- With partners of childbearing potential, individuals able to father a child must remain abstinent or use a condom plus an additional contraceptive method that together result in a failure rate of < 1% per year as noted below. Individuals must refrain from donating sperm during this same period.
- With pregnant partners, individuals must remain abstinent or use a condom as noted below to avoid exposing the embryo.
- The reliability of sexual abstinence should be evaluated in relation to the duration of the clinical trial and the preferred and usual lifestyle of the patient. Periodic abstinence (e.g., calendar, ovulation, symptothermal, or post-ovulation methods) and withdrawal are not acceptable methods of contraception.
- Contraception Requirements
- Time frame/Study Drug (Pre-Treatment/During Treatment) - Individuals of childbearing potential (Time frame prior to/during dosing) / Individuals able to father a child (Time frame prior to/during dosing):
- ---All drugs; Begins 28 days prior to treatment; Begins on day 1
- Time frame/Study Drug (Post-Treatment) - Individuals of childbearing potential (Time frame after the last dose) / Individuals able to father a child (Time frame after the last dose):
- Venetoclax - 90 days / 90 days
- Ibrutinib - 3 months / 3 months
- Obinutuzumab - 18 months / 6 months
- Revlimid(R) - 28 days / 28 days
- Polatuzumab - 3 months / 5 months
- All study participants must be registered into the mandatory Revlimid REMSTM program and be willing and able to comply with the requirements of Revlimid REMSTM. NOTE: Individuals of reproductive potential must adhere to the scheduled pregnancy testing as required in the Revlimid REMSTM program.
- Ability of subject to understand and the willingness to sign a written informed consent document.
Who cannot join
- The following restrictions apply to current or prior anti-cancer treatment, prior to the first dose of study drug:
- Patients who are actively receiving any other investigational agents.
- Any chemotherapy or anti-cancer antibodies within 2 weeks. NOTE: Short courses of corticosteroids or palliative XRT prior to enrollment are permitted within the 2- week washout period.
- Radio- or toxin-immunoconjugates within 10 weeks.
- Previous treatment with more than one of the study agents (i.e., polatuzumab, venetoclax, ibrutinib, or Revlimid(R)), excluding prior prednisone or anti-CD20 antibody treatment.
- Prior allogeneic stem cell (or other organ) transplant within 6 months or any evidence of active graft-versus-host disease or requirement for immunosuppressants within 28 days.
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- Not recovered (i.e., <= Grade 1 or baseline) from adverse events due to previously administered anti-cancer treatment, surgery, or procedure. NOTE: Exceptions to this include events not considered to place the subject at unacceptable risk of participation in the opinion of the PI (e.g., alopecia).
- Patients requiring the use of warfarin are excluded because of potential drug-drug interactions that may potentially increase the exposure of warfarin.
- Patients requiring the following agents to the first dose of venetoclax or ibrutinib are excluded, as noted:
- Strong CYP3A inhibitors within 7 days
- Strong CYP3A inducers within 7 days
- NOTE: Moderate CYP3A inhibitors and inducers should be used with caution and an alternative medication used, whenever possible.
- Uncontrolled intercurrent illness including, but not limited to the following that may limit interpretation of results or that could increase risk to the patient at the discretion of the investigator:
- Symptomatic congestive heart failure, unstable angina pectoris, or uncontrolled cardiac arrhythmia
- Uncontrolled and/or symptomatic thyroid disease
- Known active bacterial, viral, fungal, mycobacterial, parasitic, or other infection (excluding fungal infections of nail beds) at study enrollment, or any major episode of infection requiring treatment with IV antibiotics or hospitalization (relating to the completion of the course of antibiotics) within 2 weeks prior to Cycle 1, Day 1;
- Clinically significant history of liver disease, including viral or other hepatitis, current alcohol abuse, or cirrhosis; as well as active infection with HBV or HCV:
- Patients who are positive for HCV antibody must be negative for HCV by polymerase chain reaction (PCR) to be eligible for study participation
- Patients with occult or prior HBV infection (defined as positive hepatitis B surface antigen (HBsAg) or positive hepatitis B core antibody (HBcAb) and with negative HBsAg) may be included if HBV DNA is undetectable (i.e., none detected in copies/mL or IU/mL). These patients must be willing to undergo HBV DNA testing during treatment and in surveillance for at least 12 months after completion of study therapy.
- Malabsorption syndrome or other condition that precludes enteral route of administration
- Psychiatric illness/social situations that would limit compliance with study requirements
- Pregnant individuals, or individuals who intend to become pregnant during the study, are excluded from this study because Revlimid(R) has known teratogenic effects and polatuzumab, venetoclax, ibrutinib and obinutuzumab are agents 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 these agents, nursing should be discontinued if the individual is treated on study.
- HIV-positive patients are ineligible because of the potential for pharmacokinetic interactions with venetoclax, ibrutinib and Revlimid(R) and combination antiretroviral therapy. In addition, these patients are at increased risk of lethal infections when treated with marrow-suppressive therapy. Appropriate studies will be undertaken in patients receiving combination antiretroviral therapy when indicated.
- Evidence of active tumor lysis syndrome based on laboratory assessment
- History of recent major surgery within 6 weeks prior to the start of Cycle 1, Day 1 other than for diagnosis
- History of other active malignancy that could affect compliance with the protocol or interpretation of results
- Patients with a history of curatively treated basal or squamous cell carcinoma or stage 1 melanoma of the skin as well as any in situ carcinoma are eligible.
- Patients with a malignancy that has been treated with curative intent will also be eligible. Individuals in documented remission who are not receiving active treatment prior to enrollment may be included at the discretion of the investigator.
- Known allergy to both xanthine oxidase inhibitors and rasburicase; or, known hypersensitivity to any of the study drugs
Trial locations and contacts
1 site in 1 country.
United States1 site
National Institutes of Health Clinical Center
Bethesda, Maryland, 20892
About this study
Official title: Phase 1 Study of Venetoclax, Ibrutinib, Prednisone, Obinutuzumab, and Revlimid in Combination With Polatuzumab (ViPOR-P) in Relapsed/Refractory B-cell Lymphoma
Background:
Aggressive B-cell lymphomas can be cured but people with disease that resists treatment or that returns after treatment have poor outcomes with standard therapies. Indolent B-cell lymphomas are generally incurable with standard therapy and treatment is aimed at controlling symptoms and achieving a durable remissions. Researchers want to see if a combination of drugs can help patients with both aggressive and indolent B-cell lymphomas.
Read more
Objective:
To learn if it is safe and effective to give polatuzumab along with venetoclax, ibrutinib, prednisone, obinutuzumab, and lenalidomide to people with certain B-cell lymphomas.
Eligibility:
Adults ages 18 and older with relapsed and/or refractory B-cell lymphoma who have had at least one prior cancer treatment.
Design:
Participants will be screened with:
Medical history
Physical exam
Assessment of how they do their daily activities
Blood and urine tests
Heart function test
Tissue biopsy (if needed)
Body imaging scans (may get a contrast agent through an intravenous (IV) catheter)
Participants will have a bone marrow aspiration and/or biopsy. A needle will be put into the hipbone. Bone marrow will be removed.
Participants may give blood, tissue, saliva, or cheek swab samples. They may have optional biopsies.
Screening tests will be repeated during the study.
Treatment will be given for up to 6 cycles. Each cycle lasts 21 days.
Participants will take venetoclax and prednisone tablets by mouth. They will take ibrutinib and lenalidomide capsules by mouth. They will get obinutuzumab and polatuzumab by IV infusion. They will keep a medicine diary.
Participants will visit the clinic 30 days after treatment ends. They will have follow-up visits for 5 years. If needed, they can visit their local doctor instead. They may be contacted by phone, mail, etc., for the rest of their life....
Read the detailed description
Background:
- Combination chemotherapy with rituximab has been the mainstay of treatment for CD20-positive B-cell lymphomas.
- Significant advances have been made in curing aggressive B-cell lymphomas with chemoimmunotherapy, but indolent lymphomas and relapsed/refractory aggressive lymphomas remain mostly incurable with chemotherapy alone.
- Targeted therapies, aimed at disrupting key survival pathways in lymphoid malignancies, are emerging and showing significant activity in non-Hodgkin lymphoma (NHL) in both the relapsed and first-line settings.
- Mechanistically based combinations of targeted agents are likely to benefit patients who cannot tolerate or who relapse after or are refractory to standard chemoimmunotherapy.
- ViPOR-P targets major survival pathways in B-cell lymphomas including BCL-2 (apoptosis); BTK (B-cell receptor signaling and NF-kB); Cereblon (NF-kB) and CD20 with additional genotoxic stress from the anti-mitotic antibody-drug conjugate targeting CD79b, polatuzumab.
Objectives:
- To determine the maximum tolerated dose (MTD) and the safety and toxicity profile of polatuzumab and venetoclax in combination with ibrutinib, prednisone, obinutuzumab and Revlimid (lenalidomide) (ViPOR-P) in relapsed/refractory B-cell lymphomas
- To determine the complete response (CR) rate of ViPOR-P in relapsed/refractory non-GCB
DLBCL
Eligibility:
- Individuals >= 18 years of age
- ECOG performance status of <= 2
- Histologically or cytologically confirmed relapsed and/or refractory B-cell lymphoma, excluding mantle cell lymphoma (MCL) and chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL)
- Adequate organ function unless dysfunction secondary to lymphoma
Design:
- Open-label, single-center, non-randomized phase 1 study
- Standard 3 + 3 design will be used to determine the MTD of polatuzumab and venetoclax in combination with ibrutinib, prednisone, obinutuzumab and Revlimid (lenalidomide) (ViPOR-P) in relapsed/refractory B-cell lymphomas
- A small expansion cohort will be treated at the MTD for a further analysis of safety and preliminary activity.
- An expansion cohort of 32 patients (including 27 new patients + 5 patients already enrolled at DL3/MTD) with non-GCB DLBCL will be treated at the MTD to determine the CR rate to ViPOR-P of this aggressive lymphoma subtype.
- Maximum 6 cycles of combination targeted therapy every 21 days.
- To explore all dose levels in the phase 1 study and to assess the CR rate in non-GCB
DLBCL patients in a dose expansion at the MTD as well as to allow for the possibility of a few screen failures and inevaluable subjects, the accrual ceiling will be set at 55 patients.
- Being tested
- obinutuzumab, prednisone, Revlimid, Polatuzumab, ibrutinib
- Keywords
- Monoclonal Antibody, Dose Finding
- Medical subject headings
- Lymphoma, Lymphoma, Non-Hodgkin, Lymphoma, Large B-Cell, Diffuse, Burkitt Lymphoma
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
obinutuzumabBiological
administered intravenously, days 1 and 2, at a dose of 1000 mg; every 21 days for up to 6 cycles, or until disease progression or unacceptable toxicity
prednisoneDrug
administered orally, days 1-7, at a dose of 100 mg; every 21 days for up to 6 cycles, or until disease progression or unacceptable toxicity
RevlimidDrug
administered orally, days 1 and 14, at a dose of 15 mg; every 21 days for up to 6 cycles, or until disease progression or unacceptable toxicity
PolatuzumabBiological
administered intravenously, on day 2, at varying doses of 1.4-1.8 mg/kg (based upon assigned dose level); every 21 days for up to 6 cycles, or until disease progression or unacceptable toxicity
ibrutinibDrug
administered orally, days 1-14, at a dose of 560 mg; every 21 days for up to 6 cycles, or until disease progression or unacceptable toxicity
venetoclaxDrug
administered orally, days 2-14, at a dose of 800 mg; every 21 days for up to 6 cycles, or until disease progression or unacceptable toxicity
| Study group | Role | What they receive |
|---|---|---|
| Arm 1: Dose Escalation | Experimental | Venetoclax (PO) 800mg at escalating doses (2 dose levels) on days 2-14, ibrutinib (PO) 560mg on days 1-14, prednisone (PO) 100mg on days 1-7, obinutuzumab 1000mg (IV) on days 1 and 2, lenalidomide (PO) 15mg on days 1-14, and polatuzumab (IV) at escalating doses (2 dose levels) on day 2 of each 21-day cycle (maximum 6 cycles) to determine MTD of polatuzumab and venetoclax Receives: Biological: obinutuzumab; Drug: prednisone; Drug: Revlimid; Biological: Polatuzumab; Drug: ibrutinib; Drug: venetoclax |
| Arm 2: Dose Expansion | Experimental | Venetoclax (PO) at the MTD days 2-14, ibrutinib (PO) 560mg on days 1-14, prednisone (PO) 100mg on days 1-7, obinutuzumab 1000mg (IV) on days 1 and 2, lenalidomide (PO) 15mg on days 1-14, and polatuzumab (IV) at the MTD of each 21-day cycle (maximum 6 cycles) Receives: Biological: obinutuzumab; Drug: prednisone; Drug: Revlimid; Biological: Polatuzumab; Drug: ibrutinib; Drug: venetoclax |
What is being measured
The primary outcome is the main question the study is designed to answer.
Number and grade of adverse events
Number and grade of adverse events
Measured: 21 days
Complete response (CR) rate
Response rate based on Lugano Classification Response Criteria
Measured: every 42 days for 3 assessments (e.g., every 2 cycles) and/or end of treatment
Secondary outcomes (6)
Overall Response Rate (ORR)
time measurement criteria are met for CR or PR (whichever is first recorded) until the first date that recurrent or progressive disease is objectively documented or death, assessed every 3-6months
Measured: time measurement criteria are met for CR or PR (whichever is first recorded) until the first date that recurrent or progressive disease is objectively documented or death, assessed every 3-6months
Duration of Response (DOR)
For ORR-time measurement criteria are met for CR or PR (whichever is first recorded) until the first date that recurrent or progressive disease is objectively documented or death, assessed every 3-6months, For CR-time measurement criteria are met for CR or PR (whichever is first recorded) until the first date that recurrent or progressive disease is objectively documented or death, assessed every 3-6months
Measured: For ORR-time measurement criteria are met for CR or PR (whichever is first recorded) until the first date that recurrent or progressive disease is objectively documented or death, assessed every 3-6months, For CR-time measurement criteria are met for CR
Progression-free survival (PFS)
time from date of study enrollment until time of disease relapse, disease progression, or death, whichever occurs first, assessed every 3-6 months
Measured: time from date of study enrollment until time of disease relapse, disease progression, or death, whichever occurs first, assessed every 3-6 months
Event-free survival (EFS)
time from the date of study enrollment until time of disease relapse, disease progression, alternative therapy for lymphoma given (such as radiation), or death, whichever occurs first, assessed every 3-6 months
Measured: time from the date of study enrollment until time of disease relapse, disease progression, alternative therapy for lymphoma given (such as radiation), or death, whichever occurs first, assessed every 3-6 months
Overall survival (OS)
time from the date of study enrollment until death from any cause, assessed every 3-6 months
Measured: time from the date of study enrollment until death from any cause, assessed every 3-6 months
Complete response (CR) rate
time measurement criteria are met for CR until the first date that progressive disease is objectively documented or death, assessed every 3-6months
Measured: time measurement criteria are met for CR until the first date that progressive disease is objectively documented or death, assessed every 3-6months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted5 Feb 2021
- Study start9 Jul 2021
- Primary completion7 May 2026
- Study completion18 Jun 2031 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for 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 1
- Primary purpose
- Treatment
- Allocation
- Non-randomised
- Intervention model
- Sequential
- Masking
- None (open label)
- Enrolment
- 34 participants (actual)
Sponsor and investigators
- Lead sponsor
- National Cancer Institute (NCI)
- Sponsor type
- US National Institutes of Health
- Responsible party
- Sponsor
- Investigators
- Christopher J Melani, M.D., Principal investigator, National Cancer Institute (NCI)
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT04739813
- Sponsor's protocol ID
- 210014
- Other IDs
- 21-C-0014
- Status last verified
- 28 May 2026
- First submitted
- 4 Feb 2021
- Last updated
- 1 Jun 2026
- Results posted
- No
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
- Individual data sharing
- Yes: All IPD recorded in the medical record will be shared with intramural investigators upon request. @@@@@@@@@@@@In addition, all large scale genomic sequencing data will be shared with subscribers to dbGaP. @@@@@@@@@@@@All collected IPD will be shared with collaborators under the terms of collaborative agreements.
Study at a glance
From the registry record, last updated by the sponsor on 1 Jun 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Phase 1 Study of Venetoclax, Ibrutinib, Prednisone, Obinutuzumab, and Revlimid in Combination With Polatuzumab (ViPOR-P) in Relapsed/Refractory B-cell Lymphoma
- ClinicalTrials.gov ID
- NCT04739813
- Acronym / sponsor ID
- 210014
- Keywords
- Monoclonal Antibody, Dose Finding
- Phase
- Phase 1
- Study type
- Interventional
- Recruitment status
- Active, not recruiting
- Enrolment
- 34 participants (actual)
- Lead sponsor
- National Cancer Institute (NCI)US National Institutes of Health
- Study start
- 9 Jul 2021 (actual)
- Primary completion
- 7 May 2026 (actual)
- Study completion
- 18 Jun 2031 (estimated)
- First posted
- 5 Feb 2021 (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.
Background:
Aggressive B-cell lymphomas can be cured but people with disease that resists treatment or that returns after treatment have poor outcomes with standard therapies. Indolent B-cell lymphomas are generally incurable with standard therapy and treatment is aimed at controlling symptoms and achieving a durable remissions. Researchers want to see if a combination of drugs can help patients with both aggressive and indolent B-cell lymphomas.
Objective:
To learn if it is safe and effective to give polatuzumab along with venetoclax, ibrutinib, prednisone, obinutuzumab, and lenalidomide to people with certain B-cell lymphomas.
Eligibility:
Adults ages 18 and older with relapsed and/or refractory B-cell lymphoma who have had at least one prior cancer treatment.
Design:
Participants will be screened with:
Medical history
Physical exam
Assessment of how they do their daily activities
Blood and urine tests
Heart function test
Tissue biopsy (if needed)
Body imaging scans (may get a contrast agent through an intravenous (IV) catheter)
Participants will have a bone marrow aspiration and/or biopsy. A needle will be put into the hipbone. Bone marrow will be removed.
Participants may give blood, tissue, saliva, or cheek swab samples. They may have optional biopsies.
Screening tests will be repeated during the study.
Treatment will be given for up to 6 cycles. Each cycle lasts 21 days.
Participants will take venetoclax and prednisone tablets by mouth. They will take ibrutinib and lenalidomide capsules by mouth. They will get obinutuzumab and polatuzumab by IV infusion. They will keep a medicine diary.
Participants will visit the clinic 30 days after treatment ends. They will have follow-up visits for 5 years. If needed, they can visit their local doctor instead. They may be contacted by phone, mail, etc., for the rest of their life....
Detailed description
Background:
- Combination chemotherapy with rituximab has been the mainstay of treatment for CD20-positive B-cell lymphomas.
- Significant advances have been made in curing aggressive B-cell lymphomas with chemoimmunotherapy, but indolent lymphomas and relapsed/refractory aggressive lymphomas remain mostly incurable with chemotherapy alone.
- Targeted therapies, aimed at disrupting key survival pathways in lymphoid malignancies, are emerging and showing significant activity in non-Hodgkin lymphoma (NHL) in both the relapsed and first-line settings.
- Mechanistically based combinations of targeted agents are likely to benefit patients who cannot tolerate or who relapse after or are refractory to standard chemoimmunotherapy.
- ViPOR-P targets major survival pathways in B-cell lymphomas including BCL-2 (apoptosis); BTK (B-cell receptor signaling and NF-kB); Cereblon (NF-kB) and CD20 with additional genotoxic stress from the anti-mitotic antibody-drug conjugate targeting CD79b, polatuzumab.
Objectives:
- To determine the maximum tolerated dose (MTD) and the safety and toxicity profile of polatuzumab and venetoclax in combination with ibrutinib, prednisone, obinutuzumab and Revlimid (lenalidomide) (ViPOR-P) in relapsed/refractory B-cell lymphomas
- To determine the complete response (CR) rate of ViPOR-P in relapsed/refractory non-GCB
DLBCL
Eligibility:
- Individuals >= 18 years of age
- ECOG performance status of <= 2
- Histologically or cytologically confirmed relapsed and/or refractory B-cell lymphoma, excluding mantle cell lymphoma (MCL) and chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL)
- Adequate organ function unless dysfunction secondary to lymphoma
Design:
- Open-label, single-center, non-randomized phase 1 study
- Standard 3 + 3 design will be used to determine the MTD of polatuzumab and venetoclax in combination with ibrutinib, prednisone, obinutuzumab and Revlimid (lenalidomide) (ViPOR-P) in relapsed/refractory B-cell lymphomas
- A small expansion cohort will be treated at the MTD for a further analysis of safety and preliminary activity.
- An expansion cohort of 32 patients (including 27 new patients + 5 patients already enrolled at DL3/MTD) with non-GCB DLBCL will be treated at the MTD to determine the CR rate to ViPOR-P of this aggressive lymphoma subtype.
- Maximum 6 cycles of combination targeted therapy every 21 days.
- To explore all dose levels in the phase 1 study and to assess the CR rate in non-GCB
DLBCL patients in a dose expansion at the MTD as well as to allow for the possibility of a few screen failures and inevaluable subjects, the accrual ceiling will be set at 55 patients.
Study design
- Primary purpose
- Treatment
- Allocation
- Non-randomised
- Intervention model
- Sequential
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Arm 1: Dose Escalation | Experimental | Biological: obinutuzumab, Drug: prednisone, Drug: Revlimid, Biological: Polatuzumab, Drug: ibrutinib, Drug: venetoclaxVenetoclax (PO) 800mg at escalating doses (2 dose levels) on days 2-14, ibrutinib (PO) 560mg on days 1-14, prednisone (PO) 100mg on days 1-7, obinutuzumab 1000mg (IV) on days 1 and 2, lenalidomide (PO) 15mg on days 1-14, and polatuzumab (IV) at escalating doses (2 dose levels) on day 2 of each 21-day cycle (maximum 6 cycles) to determine MTD of polatuzumab and venetoclax |
| Arm 2: Dose Expansion | Experimental | Biological: obinutuzumab, Drug: prednisone, Drug: Revlimid, Biological: Polatuzumab, Drug: ibrutinib, Drug: venetoclaxVenetoclax (PO) at the MTD days 2-14, ibrutinib (PO) 560mg on days 1-14, prednisone (PO) 100mg on days 1-7, obinutuzumab 1000mg (IV) on days 1 and 2, lenalidomide (PO) 15mg on days 1-14, and polatuzumab (IV) at the MTD of each 21-day cycle (maximum 6 cycles) |
Who may qualify
- Ages
- 18 to 120 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (53 listed)
- Patients must have histologically or cytologically confirmed B-cell lymphoma confirmed by the Laboratory of Pathology, NCI, as follows:
- Aggressive B-cell lymphoma: includes DLBCL and subtypes, transformed lymphoma, Burkitt lymphoma, as well as high-grade B-cell lymphoma with MYC and/or BCL2 and/or BCL6 rearrangement(s).
- Indolent B-cell lymphoma: with the following exceptions:
- -Non-GCB DLBCL: includes DLBCL NOS and subtypes, transformed lymphoma, THRLBCL, as well as high-grade B-cell lymphoma with MYC and/or BCL6 rearrangement(s).
- NOTE: Patients with known active CNS lymphoma are not eligible.
Key exclusion criteria (29 listed)
- The following restrictions apply to current or prior anti-cancer treatment, prior to the first dose of study drug:
- Patients requiring the use of warfarin are excluded because of potential drug-drug interactions that may potentially increase the exposure of warfarin.
- Patients requiring the following agents to the first dose of venetoclax or ibrutinib are excluded, as noted:
- NOTE: Moderate CYP3A inhibitors and inducers should be used with caution and an alternative medication used, whenever possible.
- Uncontrolled intercurrent illness including, but not limited to the following that may limit interpretation of results or that could increase risk to the patient at the discretion of the investigator:
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 |
|---|---|---|
| obinutuzumabadministered intravenously, days 1 and 2, at a dose of 1000 mg; every 21 days for up to 6 cycles, or until disease progression or unacceptable toxicity | Biological | Arm 1: Dose Escalation, Arm 2: Dose Expansion |
| prednisoneadministered orally, days 1-7, at a dose of 100 mg; every 21 days for up to 6 cycles, or until disease progression or unacceptable toxicity | Drug | Arm 1: Dose Escalation, Arm 2: Dose Expansion |
| Revlimidadministered orally, days 1 and 14, at a dose of 15 mg; every 21 days for up to 6 cycles, or until disease progression or unacceptable toxicity | Drug | Arm 1: Dose Escalation, Arm 2: Dose Expansion |
| Polatuzumabadministered intravenously, on day 2, at varying doses of 1.4-1.8 mg/kg (based upon assigned dose level); every 21 days for up to 6 cycles, or until disease progression or unacceptable toxicity | Biological | Arm 1: Dose Escalation, Arm 2: Dose Expansion |
| ibrutinibadministered orally, days 1-14, at a dose of 560 mg; every 21 days for up to 6 cycles, or until disease progression or unacceptable toxicity | Drug | Arm 1: Dose Escalation, Arm 2: Dose Expansion |
| venetoclaxadministered orally, days 2-14, at a dose of 800 mg; every 21 days for up to 6 cycles, or until disease progression or unacceptable toxicity | Drug | Arm 1: Dose Escalation, Arm 2: Dose Expansion |
Primary outcome
Number and grade of adverse events
Time frame: 21 days
Number and grade of adverse events
Complete response (CR) rate
Time frame: every 42 days for 3 assessments (e.g., every 2 cycles) and/or end of treatment
Response rate based on Lugano Classification Response Criteria
6 secondary outcomes
Overall Response Rate (ORR)
Time frame: time measurement criteria are met for CR or PR (whichever is first recorded) until the first date that recurrent or progressive disease is objectively documented or death, assessed every 3-6months
Duration of Response (DOR)
Time frame: For ORR-time measurement criteria are met for CR or PR (whichever is first recorded) until the first date that recurrent or progressive disease is objectively documented or death, assessed every 3-6months, For CR-time measurement criteria are met for CR
Progression-free survival (PFS)
Time frame: time from date of study enrollment until time of disease relapse, disease progression, or death, whichever occurs first, assessed every 3-6 months
Event-free survival (EFS)
Time frame: time from the date of study enrollment until time of disease relapse, disease progression, alternative therapy for lymphoma given (such as radiation), or death, whichever occurs first, assessed every 3-6 months
Overall survival (OS)
Time frame: time from the date of study enrollment until death from any cause, assessed every 3-6 months
Complete response (CR) rate
Time frame: time measurement criteria are met for CR until the first date that progressive disease is objectively documented or death, assessed every 3-6months
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 1 Jun 2026.
- NIH Clinical Center Detailed Web PageLink provided by the sponsor.
- Individual participant dataSharing planned: Yes. All IPD recorded in the medical record will be shared with intramural investigators upon request. @@@@@@@@@@@@In addition, all large scale genomic sequencing data will be shared with subscribers to dbGaP. @@@@@@@@@@@@All collected IPD will be shared with collaborators under the terms of collaborative agreements.
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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.
Christopher J Melani, M.D. principal investigator
National Cancer Institute (NCI)
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 1 study testing obinutuzumab, prednisone and Revlimid in people with Lymphoma and Non-Hodgkin 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 53 inclusion and 29 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 1 Jun 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 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.
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?
Number and grade of adverse events (time frame: 21 days). The study lists 2 primary outcomes in all. 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 1 Jun 2026.