MC230813 A Study of Golcadomide with Rituximab prior to CAR-T with Relapsed or Primary Refractory Aggressive B-cell Non-Hodgkin Lymphoma (NHL)

Overview

About this study

The purpose of this study is to evaluate efficacy as measured by the disease control rate (CMR, PMR, and NMR) by Lugano 2014 PET-CT based assessment after 2 cycles of therapy.

Participation eligibility

Participant eligibility includes age, gender, type and stage of disease, and previous treatments or health concerns. Guidelines differ from study to study, and identify who can or cannot participate. There is no guarantee that every individual who qualifies and wants to participate in a trial will be enrolled. Contact the study team to discuss study eligibility and potential participation.

Inclusion Criteria:

  • Age ≥18 years
  • Confirmed pathology diagnosis according to 2016 WHO classification including patients with diseases listed below with relapsed, progressive and/or refractory disease (Cheson et al. 2014) following treatment with one or two prior lines of standard therapy, no more than two lines of therapy are permitted:
    • Diffuse large B-cell lymphoma NOS including:
      • Transformed lymphoma
      • Germinal center B-cell type
      • Activated B-cell type
    • High-grade B-cell lymphoma (HGBCL), NOS
    • High grade B-cell lymphoma with MYC and BCL2 translocation
    • Primary mediastinal (thymic) large B-cell lymphoma
    • Grade 3B follicular lymphoma
    • T-cell/histiocyte-rich large B-cell lymphoma
    • Large B-cell lymphoma with IRF4 rearrangement
    • Primary cutaneous DLBCL, leg type
    • EBV positive DLBCL, NOS
    • DLBCL associated with chronic inflammation
    • Intravascular large B-cell lymphoma
    • ALK positive large B-cell lymphoma
      NOTE: Richters Transformation patients are excluded
  • Measurable disease by PET-CT with at least one lymph node or other type of lesion that has a size >1.5 cm in the transverse diameter, as defined by Lugano classification. NOTE: Tumor lesions in a previously irradiated area are not considered measurable disease; Disease that is measurable by physical examination only is not eligible.
  • Patient is potentially eligible for CAR-T therapy as determined by treating physician. 
  • ECOG Performance Status (PS) 0, 1, or 2.
  • The following laboratory values obtained ≤14 days prior to registration:
    • Hemoglobin >7.0 g/dL
    • Absolute neutrophil count (ANC) ≥1000/mcL; growth factor support allowed at physician discretion.
    • Platelet count ≥75,000/mcL
    • Total bilirubin ≤1.5 x ULN; if total bilirubin is >1.5 ULN, direct bilirubin must be normal.
    • Alanine aminotransferase (ALT) and aspartate transaminase (AST)
    • ≤2.5 x ULN (≤5 x ULN if there is evidence of parenchymal liver involvement with lymphoma)
    • Calculated creatinine clearance ≥45 ml/min using the Cockcroft-Gault formula.
  • Have 2 negative pregnancy tests as verified by the Investigator prior to starting CC-99282: · a negative serum pregnancy test (sensitivity of at least 25 mIU/mL) at Screening (between 10 to 14 days prior to Cycle 1 Day 1) · a negative serum or urine pregnancy test (Investigator’s discretion) within 24 hours prior to Cycle 1 Day 1 of study treatment.
  • Provide written informed consent.
  • Willing to return to enrolling institution for follow-up (during the Active Monitoring Phase of the study).
  • Subjects must agree not to donate blood while receiving golcadomide, during dose interruptions and for ≥28 days following the last dose of golcadomide.

Exclusion Criteria:

  • Any of the following because this study involves an investigational agent that has known genotoxic, mutagenic, and teratogenic effects:
    • Pregnant persons
    • Nursing persons
  • Persons of childbearing potential (and persons able to father a child) who are unwilling to employ adequate contraception.  Persons of childbearing potential (PCBP) unwilling to use two reliable forms of contraception simultaneously or to practice 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 contact during the following time periods related to this study:  For ≥28 days before starting treatment, during treatment and dose interruptions, and for ≥28 days after the last dose of golcadomide.
    • Examples of highly effective methods of contraception:
      • Intrauterine device (IUD)
      • Hormonal (birth control pills, injections, implants, levonorgestrel-releasing intrauterine system [IUS], medroxyprogesterone acetate depot injections, ovulation inhibitory
      • Progesterone-only pills [e.g., desogestrel])
      • Tubal ligation
      • Partner’s vasectomy
    • Examples of additional effective methods:
      • Male condom
      • Diaphragm
      • Cervical Cap
    • Persons who can father a child unwilling to practice 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.) or unwilling to use a condom during sexual contact with a pregnant person or a PCBP during treatment and dose interruptions, and for >28 days following the last dose of golcadomide, even if they have undergone a successful vasectomy.  Persons who can father a child and are unwilling to refrain from donating semen or sperm while receiving golcadomide, during dose interruptions, or for ≥28 days following the last dose of golcadomide.
  • Life expectancy <3 months
  • Any of the following prior therapies:
    • Any prior CAR-T or other T-cell targeting treatment (approved or investigational) ≤4 weeks prior to Registration.
    • Any prior systemic anti-cancer treatment (approved or investigational)
      ≤5 half-lives or 4 weeks prior to Registration, whichever is shorter.
      • Exception: Monoclonal and bispecific antibodies is acceptable.
    • Prior therapy with golcadomide ≤4 weeks prior to Registration.
    • Prior autologous SCT ≤3 months prior to Registration. If subject had autologous SCT >3 months prior to the start of Registration, any
      treatment-related toxicity is unresolved (Grade >1).
    • Major surgery ≤3 weeks prior to registration
    • Chemotherapy ≤2 weeks prior to registration
    • Concomitant radiation therapy; local palliative radiotherapy is permitted
  • Co-morbid systemic illnesses or other severe concurrent disease or cancer which, in the judgment of the investigator, would make the patient inappropriate for entry into this study or interfere significantly with the proper assessment of safety and toxicity of the prescribed regimens.
  • Impaired cardiac function or clinically significant cardiac diseases including, but not limited to:
    • Symptomatic congestive heart failure
    • History of myocardial infarction ≤6 months, or congestive heart failure requiring use of ongoing maintenance therapy for life-threatening ventricular arrhythmias
    • Unstable angina pectoris
    • Cardiac arrhythmia
  • Uncontrolled intercurrent non-cardiac illness including, but not limited to:
    • Ongoing or active infection
    • Psychiatric illness/social situations
    • Dyspnea at rest due to complications of advanced malignancy or other disease that requires continuous oxygen therapy (such as interstitial lung disease or COPD).
    • Any other conditions that would limit compliance with study requirements.
  • Subject had prior allogeneic SCT with either standard or reduced intensity conditioning ≤6 months prior to Registration. If subject had prior allogeneic SCT >6 months prior to Registration, any treatment-related toxicity is unresolved (Grade >1).
  • Immunocompromised patients and patients known to be HIV positive and currently receiving antiretroviral therapy, as there is currently no safety data in HIV positive patients.
  • Subject has known chronic active hepatitis B or C virus (HBV/HCV) infection. Exception: Patients with HBV and an undetectable viral load who are on suppressive therapy and/or those with HCV and an undetectable viral load are allowed.
  • Concurrent administration of strong or moderate CYP3A4/5 inhibitors and inducers within 14 days or 5 half-lives, whichever is longer before the study treatment administration.
  • Receiving any other investigational agent which would be considered as a treatment for lymphoma. Exception: Corticosteroids are allowed.
  • Active second malignancy requiring treatment that would interfere with the assessment of the response of the primary cancer or interpretation of the safety of this protocol therapy.
  • History of deep venous thrombosis/embolism, threatening thromboembolism or known thrombophilia. Patients with a history of DVT/PE or thrombophilia may still participate if they are willing to be on full anticoagulation during treatment. Full anticoagulation is defined as Warfarin, factor X inhibitors, or low molecular weight heparin at therapeutic doses. The rationale for this requirement is that golcadomide therapy is associated with an increased risk of thrombosis.  Patients with no history of DVT/PE or thrombophilia are not required to take anticoagulation and/or anti-platelet prophylaxis. NOTE: If a patient develops a thrombotic event, they must be able and willing to receive anticoagulation therapy with aspirin 81-325 mg daily prophylaxis, low molecular weight heparin, factor X inhibitors or Warfarin. This is due to an increased risk of thrombosis in patients treated with golcadomide without prophylaxis.
  • Live COVID-19 vaccine administered ≤28 days prior to Registration.

Note: Other protocol defined Inclusion/Exclusion Criteria may apply.

Eligibility last updated 02/03/2025. Questions regarding updates should be directed to the study team contact.

Participating Mayo Clinic locations

Study statuses change often. Please contact the study team for the most up-to-date information regarding possible participation.

Mayo Clinic Location Status Contact

Rochester, Minn.

Mayo Clinic principal investigator

Grzegorz Nowakowski, M.D.

Contact us for the latest status

Contact information:

Cancer Center Clinical Trials Referral Office

(855) 776-0015

Eau Claire, Wis.

Mayo Clinic principal investigator

Eyad Al-Hattab, M.D.

Contact us for the latest status

Contact information:

Cancer Center Clinical Trials Referral Office

(855) 776-0015

Jacksonville, Fla.

Mayo Clinic principal investigator

Muhamad Alhaj Moustafa, M.D., M.S.

Contact us for the latest status

Contact information:

Cancer Center Clinical Trials Referral Office

(855) 776-0015

La Crosse, Wis.

Mayo Clinic principal investigator

Scott Okuno, M.D.

Contact us for the latest status

Contact information:

Cancer Center Clinical Trials Referral Office

(855) 776-0015

Mankato, Minn.

Mayo Clinic principal investigator

Amrit Singh, M.B.B.S.

Contact us for the latest status

Contact information:

Cancer Center Clinical Trials Referral Office

(855) 776-0015

Albert Lea, Minn.

Mayo Clinic principal investigator

Mina Hanna, M.D.

Contact us for the latest status

Contact information:

Cancer Center Clinical Trials Referral Office

(855) 776-0015

Scottsdale/Phoenix, Ariz.

Mayo Clinic principal investigator

Javier Munoz, M.D., M.B.A.

Contact us for the latest status

Contact information:

Cancer Center Clinical Trials Referral Office

(855) 776-0015

More information

Publications

Publications are currently not available
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CLS-20579778

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