A Phase 1 interventional study of Biospecimen Collection and Bone Marrow Aspiration in Recurrent Diffuse Large B-Cell Lymphoma, Recurrent Follicular Lymphoma and Recurrent Lymphoplasmacytic Lymphoma, sponsored by National Cancer Institute (NCI). Active, not recruiting at 3 sites in 2 countries. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-05-13.
Sponsored by National Cancer Institute (NCI) · Phase 1, Interventional, and Treatment
This phase I trial studies the side effects and best dose of lenalidomide and ibrutinib in treating patients with B-cell non-Hodgkin lymphoma that has returned (relapsed) or not responded to treatment (refractory). Lenalidomide helps shrink or slow the growth of non-Hodgkin lymphoma. Ibrutinib may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth. Giving lenalidomide with ibrutinib may work better in treating non-Hodgkin lymphoma than giving either drug alone.
PRIMARY OBJECTIVES:
I. To determine the dose limiting toxicity (DLT) and maximum tolerated dose (MTD) of the combination of lenalidomide and ibrutinib in patients with relapsed and refractory B-cell non-Hodgkin's lymphoma (NHL).
II. To define the qualitative and quantitative toxicities of the combination of lenalidomide and ibrutinib.
SECONDARY OBJECTIVES:
I. To describe the overall objective response rate to the combination of lenalidomide and ibrutinib in patients with relapsed or refractory B-cell NHL.
II. To describe the response duration and two-year progression free survival (PFS) in patients with B-cell NHL receiving lenalidomide and ibrutinib.
III. To characterize the pharmacokinetics of the combination of lenalidomide and ibrutinib in patients with relapsed or refractory B-cell NHL.
IV. To identify associations of genetic polymorphisms in drug metabolizing enzymes, transporters or target genes with pharmacokinetics, pharmacodynamics, and clinical outcomes.
V. To monitor the effects of combined therapy with ibrutinib and lenalidomide on B- T-, and natural killer (NK)-cell subsets by flow cytometry and quantitative immunoglobulin levels.
VI. To explore the effects of the combination of ibrutinib and lenalidomide on pharmacodynamic markers including T helper cell, type 1 (TH1) and T helper cell, type 2 (TH2) cytokines, ex vivo NK cell cytotoxicity, serum micro ribonucleic acids (RNAs), plasma metabolites, and levels of Bruton's tyrosine kinase occupancy and other selected kinases.
VII. To explore the relationship between pretreatment pathologic prognostic features and overall objective response.
OUTLINE: This is a dose-escalation study.
Patients receive lenalidomide orally (PO) on days 1-21 and ibrutinib PO on days 1-28 (days 2-28 of cycle 1). Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients also undergo blood sample collection and CT or PET/CT throughout the study. Patients may undergo bone marrow biopsy and aspiration and MRI as clinically indicated.
After completion of study treatment, patients are followed up for 4 weeks and then every 6 months thereafter.
1,389 studies on the registry are indexed under Lymphoma, Large B-Cell, Diffuse; 349 are open to participants now.
This study's enrollment of 39 is below the median of 47 across 1,185 interventional studies indexed under Lymphoma, Large B-Cell, Diffuse.
Browse Lymphoma, Large B-Cell, Diffuse studies →National Cancer Institute (NCI) is the lead sponsor of 3,506 studies on the registry; 334 are open to participants now.
Of its 402 completed or terminated interventional studies of FDA-regulated products, 365 (91%) have results posted.
Counted across the registry records on this site, refreshed daily.
Exclusion Criteria:
Patients receive lenalidomide PO on days 1-21 and ibrutinib PO on days 1-28 (days 2-28 of cycle 1). Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients also undergo blood sample collection and CT or PET/CT throughout the study. Patients may undergo bone marrow biopsy and aspiration and MRI as clinically indicated.
Procedure: Biospecimen Collection · Procedure: Bone Marrow Aspiration · Procedure: Bone Marrow Biopsy · Procedure: Computed Tomography · Drug: Ibrutinib · Drug: Lenalidomide · Procedure: Magnetic Resonance Imaging · Procedure: Positron Emission Tomography
Undergo blood sample collection
Also known as: Biological Sample Collection, Biospecimen Collected, Sample Collection, Specimen Collection
Undergo bone marrow aspiration
Undergo bone marrow biopsy
Also known as: Biopsy of Bone Marrow, Biopsy, Bone Marrow
Undergo CT and/or PET/CT
Also known as: CAT, CAT Scan, Computed Axial Tomography, Computerized Axial Tomography, Computerized axial tomography (procedure), Computerized Tomography, Computerized Tomography (CT) scan, CT, CT Scan, Diagnostic CAT Scan, Diagnostic CAT Scan Service Type, tomography
Given PO
Also known as: BTK Inhibitor PCI-32765, CRA 032765, CRA-032765, CRA032765, Imbruvica, PCI 32765, PCI-32765, PCI32765
Given PO
Also known as: CC 5013, CC-5013, CC5013, CDC 501, Revlimid
Undergo MRI
Also known as: Magnetic Resonance, Magnetic Resonance Imaging (MRI), Magnetic resonance imaging (procedure), Magnetic Resonance Imaging Scan, Medical Imaging, Magnetic Resonance / Nuclear Magnetic Resonance, MR, MR Imaging, MRI, MRI Scan, MRIs, NMR Imaging, NMRI, Nuclear Magnetic Resonance Imaging, sMRI, Structural MRI
Undergo PET/CT
Also known as: Medical Imaging, Positron Emission Tomography, PET, PET Scan, Positron emission tomography (procedure), Positron Emission Tomography Scan, Positron-Emission Tomography, PT
Maximum tolerated dose (MTD)
Defined as the highest safely tolerated dose where at most one patient experiences dose limiting toxicity (DLT) with the next higher dose having at least 2 patients who experience DLT.
Time frame: 28 days
Incidence of toxicity according to the National Cancer Institute Common Terminology Criteria for Adverse Events version 5.0 criteria
Worst grade toxicities will be recorded for each patient and summarized using frequency tables. Tolerability of the regimen is assessed by summarizing the number of patients who required dose modifications and/or dose delays. In addition, the proportion of patients who go off treatment due to adverse reactions or even those who refuse further treatment for lesser toxicities that inhibit their willingness to continue participation on the trial will be counted.
Time frame: Up to 2 years
Number of patients responding to treatment
Responses will be summarized with simple descriptive statistics, delineating complete responses from lesser responses and stable disease or progressive disease according to the International Harmonization Project Lymphoma Response Criteria and the Response Criteria for Waldenstrom's Macroglobulinemia.
Time frame: Up to 2 years
Degree of response
Responses will be summarized with simple descriptive statistics, delineating complete responses from lesser responses and stable disease or progressive disease according to the International Harmonization Project Lymphoma Response Criteria and the Response Criteria for Waldenstrom's Macroglobulinemia.
Time frame: Up to 2 years
Duration of overall response
Summarized with simple descriptive statistics.
Time frame: From the time measurement criteria are met for complete response or partial response (whichever is first recorded) until the first date that recurrent or progressive disease is objectively documented, assessed up to 2 years
Duration of stable disease
Summarized with simple descriptive statistics.
Time frame: From the start of the treatment until the criteria for progression are met, assessed up to 2 years
Progression free survival (PFS)
Summarized with simple descriptive statistics.
Time frame: Duration of time from the start of treatment to the time of measured progression or death, assessed up to 2 years
Pharmacokinetic interactions between lenalidomide and ibrutinib
Confidence intervals will be presented as the primary method of analysis.
Time frame: Baseline and on days 1, 2, and 22 of course 1
Single gene polymorphisms, such as those in genes coding for relevant drug metabolizing enzymes, receptors and transporters
Pharmacogenetic analyses will be conducted to identify single gene polymorphisms and their effects on drug response. Confidence intervals will be presented as the primary method of analysis.
Time frame: Baseline and on day 1 of course 1
Ki67 staining
Potential relationships with response will be explored using graphical analyses and quantitative summaries. Confidence intervals will be presented as the primary method of analysis.
Time frame: Baseline
Change in pharmacodynamic markers including TH1 and TH2 cytokines, ex vivo NK cell cytotoxicity, serum microRNAs, plasma metabolites, and levels of Bruton's tyrosine kinase occupancy and other selected kinases
Standard paired statistical tests, parametric and nonparametric, will be used to compare baseline with treatment values, and repeated measures analysis of variance will be used to analyze data collected serially over time, recognizing the inherent limitations due to the sample size. Hence, graphical analyses will also be used, including box plots and individual time plots to help identify potential patterns, provide important insights into mechanism, and gather essential preliminary data.
Time frame: Baseline, on days 1 and 8 of course 1, and day 1 of courses 2 and 3
Changes in B- T-, and NK- cell subsets
Standard paired statistical tests, parametric and nonparametric, will be used to compare baseline with treatment values, and repeated measures analysis of variance will be used to analyze data collected serially over time, recognizing the inherent limitations due to the sample size. Hence, graphical analyses will also be used, including box plots and individual time plots to help identify potential patterns, provide important insights into mechanism, and gather essential preliminary data.
Time frame: Baseline and on day 1 of courses 1, 3, 6, and 12
Changes in quantitative immunoglobulin levels
Standard paired statistical tests, parametric and nonparametric, will be used to compare baseline with treatment values, and repeated measures analysis of variance will be used to analyze data collected serially over time, recognizing the inherent limitations due to the sample size. Hence, graphical analyses will also be used, including box plots and individual time plots to help identify potential patterns, provide important insights into mechanism, and gather essential preliminary data.
Time frame: Baseline and on day 1 of courses 1, 3, 6, and 12
This study is active, not recruiting, as verified in May 2026. You cannot join it, but the record below documents what was studied.
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Lymphoma, Large B-Cell, Diffuse→
National Cancer Institute (NCI)