ClinicalTrials.gg
RecruitingNCT05389423Updated Aug 25, 2026

Pomalidomide and Dose-Adjusted EPOCH +/- Rituximab for HIV-Associated Lymphomas

A Phase 1 interventional study of Vincristine and Prednisone in Diffuse Large Cell Lymphoma, Non-Hodgkin Lymphoma and Burkitt Lymphoma, sponsored by National Cancer Institute (NCI). Recruiting at 1 site in United States. Open to participants aged 18 Years to 120 Years. Per ClinicalTrials.gov, last updated 2026-08-25.

Primary conditionPlasmablastic LymphomaRegistry: Lymphoma, Large B-Cell, DiffuseReclassifiedWhy we changed it
Registry
Lymphoma, Large B-Cell, Diffuse — the first condition term the registry derived for this study.
ClinicalTrials.gg
Plasmablastic Lymphoma
Why
  1. The study's listed conditions name Plasmablastic Lymphoma, a narrower term within Lymphoma, Large B-Cell, Diffuse.
Confidence
High: the new condition is named in the study's own listed conditions. Of 351 hand-checked studies reclassified this way, 68% were exactly right and 84% in the right disease family; the registry's first term was right for 5% (measured 2026-10-21). How we classify →
Wrong?
Tell us the study's main condition →

Sponsored by National Cancer Institute (NCI) · Phase 1, Interventional, and Treatment

From the registry’s dates

  • Started Jun 2023; still recruiting 3 years 4 months later.
Phase
Phase 1
Study type
Interventional
Enrollment
25
Allocation
Non-randomized
Ages
18 Years to 120 Years
Sex
All
01

Study summary

Background:

Non-Hodgkin lymphoma (NHL) is the most common cancer among people living with HIV in the United States. People with HIV are up to 17 times more likely to get NHL than people who do not have HIV. The disease may also be different in these two groups. More study is needed for treating

people with both HIV and NHL.

Objective:

To test a study drug (pomalidomide) in combination with chemotherapy with or without another drug (rituximab) in people with HIV-associated NHL.

Eligibility:

Adults aged 18 years or older diagnosed with HIV-associated B-cell NHL with high-risk features.

Design:

Individuals will undergo screening. They will have a physical exam. They will have blood and urine tests and tests of heart function. They may have imaging scans. Researchers will review tissue samples of individual s tumors. In some cases, a new biopsy may be needed.

Individuals will receive up to 6 cycles of treatment.

The first cycle is 26 days: Individuals will take pomalidomide by mouth for 10 days. After 5 days they will start receiving chemotherapy drugs through a tube attached to a needle placed in a vein (IV). Some participants will receive rituximab on day 5. All individuals will receive a second set of IV drugs that will last for 4 days (96 hours). They will receive another IV drug after the previous treatment is complete.

The remaining cycles are each 21 days. Individuals will take pomalidomide by mouth for the first 10 days. Other chemotherapy treatments will also be repeated starting on day 1 of each cycle.

Screening tests will be repeated at study visits.

Follow-up visits will continue for 4 years....

Read the detailed description

Background:

  • Non-Hodgkin lymphoma (NHL) is the most common cancer among people living with human immunodeficiency virus (HIV) (PLWH) in the United States. Even in the modern era of antiretroviral therapy (ART), PLWH have an 11- to 17-fold higher risk of NHL than the general population due in part to CD4+ T-cell lymphopenia but also immune dysregulation and exhaustion from chronic viral antigen stimulation.
  • The most common NHL subtypes are diffuse large cell lymphoma (DLBCL) and Burkitt lymphoma (BL), that are much more frequently associated with the oncogenic virus Epstein Barr virus (EBV) in PLWH, which portends a poorer prognosis, than in the general population.
  • Plasmablastic lymphoma (PBL) is a rare CD20 negative B cell lymphoma associated with EBV almost exclusively seen in PLWH.
  • Although these subtypes of lymphoma occur in the general population, their presentation and pathogenesis may be different - meaning there may be different therapeutic targets and strategies to consider in HIV-associated lymphomas necessitating clinical trials targeted to this underserved population of patients.
  • Lenalidomide, a 2nd generation immunomodulatory drug, has shown safety and improved survival in combination with chemotherapy in advanced stage DLBCL in one of two randomized trials.
  • Pomalidomide, a 3rd generation immunomodulatory agent, has activity in primary central nervous system (CNS) lymphoma demonstrating its activity in both NHL and CNS involvement, which is more common in PLWH and NHL. In a number of parameters, it is more potent than lenalidomide.
  • Pomalidomide has shown to increase natural killer (NK) and T-cell activation and reverse T-cell senescence in addition to increasing CD4+ T-cell count in PLWH and cancer. It can also enhance expression of surface immune markers in vitro in cell lines from EBV-induced tumors.
  • Dose-adjusted etoposide, prednisone, vincristine, cyclophosphamide, and doxorubicin (DA-EPOCH) along with rituximab (DA-EPOCH-R) is an anthracycline-based regimen that has been shown to be safe and effective in PLWH and in the most common subtypes of NHL seen in PLWH, DLBCL and BL.

Objective:

-Determine the safety and maximum tolerated dose (MTD) of the combination of pomalidomide and dose-adjusted EPOCH +/ rituximab (DA-EPOCH-RP) in participants with enrolled subtypes of HIV-associated lymphomas

Eligibility:

  • Adult participants >= 18 years with pathology-confirmed HIV-associated B-cell non-Hodgkin lymphoma with high-risk features, excluding primary CNS lymphoma
  • Positive HIV1/2 serology

Design:

  • This is a phase 1 study of DA-EPOCH-RP in participants with HIV-associated B-cell non-Hodgkin lymphoma. Only participants with CD20+ HIV-associated B-cell non-Hodgkin lymphoma will receive Rituximab.
  • This is a dose escalation study to evaluate pomalidomide in combination with modified DA-EPOCH-R to determine safety and tolerability. Dosing will begin at dose level 1, 3 mg of pomalidomide and proceed to dose escalation or de-escalation to doses 4 mg or 2 mg depending on dose-limiting toxicities.
  • Participants will be prescribed ART.
  • In this phase I study, up to 12 evaluable participants will be accrued in the escalation phase (3-6 participants per level) and up to 6 evaluable participants will be accrued in the expansion phase to be treated at MTD.
02

Conditions studied

  • Diffuse Large Cell Lymphoma
  • Non-Hodgkin Lymphoma
  • Burkitt Lymphoma
  • Plasmablastic Lymphoma
  • B-Cell Neoplasm

Keywords

  • Non-Hodgkin Lymphoma
  • Epstein Barr Virus
  • Plasmablastic Lymphoma
  • Chemotherapy
  • Immune Modulatory
03

In context

Plasmablastic Lymphoma Reclassified

18 studies on the registry are indexed under Plasmablastic Lymphoma; 11 are open to participants now.

This study's planned enrollment of 25 is below the median of 28 across 16 interventional studies indexed under Plasmablastic Lymphoma.

Browse Plasmablastic Lymphoma studies →

Lead sponsor

National Cancer Institute (NCI) is the lead sponsor of 3,556 studies on the registry; 336 are open to participants now.

Of its 411 completed or terminated interventional studies of FDA-regulated products, 373 (91%) have results posted.

Compared within Plasmablastic Lymphoma, this study's primary condition as ClinicalTrials.gg classifies it; the registry's first condition term is Lymphoma, Large B-Cell, Diffuse. The counts are of registry records indexed under each term, refreshed daily. How we classify →

04

Who can participate

Ages eligible
18 Years to 120 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • or cytologically confirmed B-cell NHL confirmed by the Laboratory of Pathology (LP), NCI, with one or more of the following features:

    • /CSF involvement
    • High-risk for CNS relapse per CNS-IPI (score 4-6)
    • Plasmablastic histology
    • Gamma herpesvirus positive tumor
    • Presence of KS
  • Measurable or evaluable lymphoma.
  • Positive HIV1/2 serology.
  • Individuals may not have received prior curative-intent chemotherapy for lymphoma. Individuals who have received prior treatment as a bridge to curative-intent therapy will be considered per Protocol Chair discretion if >= 2 weeks since administration. given for any reason or rituximab given for multicentric Castleman disease may be given any time prior to treatment start.
  • Age >=18 years
  • performance status (ECOG-PS) \<=4
  • Individuals of (IOCBP) must have a negative serum or urine pregnancy test with a sensitivity of at least 25 mIU/mL within 2 weeks prior to and again within 1 day before starting the study drugs and must either commit to continued abstinence from penetrative vaginal intercourse or begin TWO acceptable methods of , one highly effective method and one additional effective method AT THE SAME TIME, at least 28 days before the participant starts taking pomalidomide and for 12 months after the last dose of combined chemotherapy.
  • Individuals able to father a child must agree to use an effective method of contraception (barrier, surgical sterilization, abstinence) for the duration of the study treatment and up to six (6) months after the last dose of the study drug(s). We also will recommend individuals able to father a child with IOCBP partners to ask the partners to be on an effective birth control (hormonal, intrauterine device (IUD), surgical sterilization). Individuals able to father a child must not freeze or donate sperm within the same period.
  • All individuals must agree to be registered into the mandatory POMALYST REMS(R)TM program and be willing and able to comply with the requirements of the POMALYST REMS(R)TM program.
  • Able to take aspirin 81mg orally daily or another substitute thromboprophylaxis.
  • Adequate organ and marrow function as defined below unless abnormalities are attributed to lymphoma or as determined by investigator:

    • >=1,000/mcL
    • >=75,000/mcL
    • total \<=1.5 X institutional (individuals with history of Gilbert disease are eligible if total bilirubin \<= 5 mg/dL with \<80% unconjugated bilirubin)
    • (AST) / alanine transaminase (ALT) \<=3 X institutional upper limit of normal
    • >=60 mL/min/1.73 m\^2 for individuals with creatinine levels above institutional normal.
  • virus (HBV) infection must be on suppressive antiviral therapy.
  • Willingness to take and adhere to ART (individuals are not required to be on any specific regimen of ART).
  • Individuals must understand and sign a written document.

Exclusion criteria

EXCLUSION CRITERIA:

  • Individuals may not receive agents on other clinical trials.
  • Requirement of any of the agents listed as prohibited thearapies.
  • History of allergic reactions attributed to compounds of similar chemical or biologic composition to pomalidomide or other agents used in study.
  • Parenchymal brain involvement with lymphoma.
  • less than 40% by echocardiography (ECHO)
  • CTCAEv5.0 Grade 3-4 neuropathy
  • History of malignant tumors other than KS or KSHV-associated multicentric Castleman Disease, (MCD), unless:

    • In complete remission for >= 1 year from the time response was first documented; or,
    • Completely resected basal cell carcinoma; or,
    • In situ squamous cell carcinoma of the cervix or anus; or,
    • Prior or concurrent has a natural history or treatment which does not have the potential to interfere with the safety or efficacy assessment of the investigational regimen per Protocol Chair discretion.
  • Known drug-related, inherited, or acquired procoagulant disorder including prothrombin gene mutation 20210, antithrombin III deficiency, protein C deficiency, protein S deficiency and antiphospholipid syndrome but not including heterozygosity for the Factor V Leiden mutation or the presence of a lupus anticoagulant in the absence of other criteria for the antiphospholipid syndrome.
  • Symptomatic congestive heart failure
  • Unstable angina pectoris, symptomatic cardiac arrhythmia, or cardiac arrhythmia requiring medical treatment.
  • Uncontrolled intercurrent illness or participants considered to be of poor medical health due to a serious, uncontrolled medical disorder, non-malignant systemic disease or active uncontrolled infection (excluding lymphoma or ) as documented in prior records or suggested by medical history, physical examination or standard clinical assessments such as imaging and laboratory studies.
  • Pregnant or nursing individuals (if lactating, must agree not to nurse while taking pomalidomide).
Terms in these criteria, in plain language(18)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Histologically or cytologically confirmed

The diagnosis was confirmed by looking at a sample under a microscope: tissue from a biopsy or surgery (histology), or cells from a fluid or needle sample (cytology).

Your pathology report is the document that shows this.

Leptomeningeal disease

Cancer that has spread to the leptomeninges, the thin layers covering the brain and spinal cord, and the fluid between them. It is not the same as brain metastases.

Criteria often treat it separately, and many studies leave it out even where treated brain metastases are allowed.

Corticosteroids (steroids)

Anti-inflammatory medicines such as prednisone, prednisolone and dexamethasone — not the anabolic steroids used for muscle.

Studies differ in what they allow: check which steroid medicines, routes (tablets, injections, creams, inhalers, eye drops) and doses this study accepts.

ECOG performance status

A scale of how much an illness limits everyday activity. For people being assessed to join a study, scores run from 0 (fully active) to 4; lower is more active.

0
Fully active, no restrictions.
1
Limited in strenuous activity, but walking and able to do light work, such as housework or office work.
2
Walking and able to look after yourself, but unable to work; up and about more than half of waking hours.
3
Able to look after yourself only in part; in bed or a chair more than half of waking hours.
4
Unable to look after yourself at all; in bed or a chair all day.

Studies most often ask for 0–1 or 0–2. Your doctor gives the score; the WHO scale uses the same steps. The full scale also has 5, which records death.

Childbearing potential

Able to become pregnant: from the first period until menopause, unless permanently unable to through surgery (removal of the womb, or of both ovaries or both fallopian tubes).

Criteria for people of childbearing potential usually ask for a negative pregnancy test and for contraception during the study and for a time after it.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

HIV

The human immunodeficiency virus, which weakens the immune system.

Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.

Absolute neutrophil count (ANC)

The number of neutrophils, white blood cells that help fight infection, in a given amount of blood. Too few raises the risk of infection.

It is a count, not a percentage of the white cells. Limits are written in units that mean the same: ≥ 1.5 × 10⁹/L is ≥ 1,500 per mm³ (µL). Each lab has its own reference range.

Platelets

Blood cells that help blood clot. Too few raises the risk of bleeding and bruising. A usual adult range is about 150–400 × 10⁹/L (150,000–400,000 per µL); each lab has its own reference range.

Bilirubin

A yellow substance made when red blood cells are broken down, which the liver clears. A high level can mean a problem with the liver or the bile ducts.

Criteria often allow more for people with Gilbert’s syndrome, a harmless inherited condition that raises bilirubin.

ULN (upper limit of normal)

The top of the normal range for a blood test, as set by the laboratory that runs it. Each lab prints its own range next to your result.

“≤ 2.5 × ULN” means the result can be up to two and a half times that top value.

ALT and AST (liver enzymes)

Two enzymes measured in a routine blood test of the liver. Higher levels can mean the liver is under strain or damaged. SGPT and SGOT are older names for ALT and AST.

Criteria usually give a limit as a multiple of the upper limit of normal (ULN), often higher when cancer has spread to the liver.

Creatinine clearance (CrCl)

How quickly the kidneys clear creatinine, a waste product, from the blood. A study may estimate it from a blood test with age, weight and sex (often by the Cockcroft–Gault formula), or measure it using blood and urine collected over a set time. Given in mL/min; higher is better.

Hepatitis B tests

Hepatitis B is a virus that infects the liver. These are separate tests: HBsAg positive usually means a current infection (a recent vaccination can briefly cause it too); total anti-HBc (HBcAb) positive means an infection now or in the past; HBV DNA measures how much virus is in the blood.

Some studies accept a past infection if HBV DNA is undetectable, sometimes with antiviral medicine during the study. Check what this study allows.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Investigational drug or device

A drug or device being studied in a clinical trial.

It may be new, or already approved and being studied for another use, dose or form. Criteria often leave out people who took part in another study of one within a recent period, commonly 30 days or five half-lives.

LVEF (left ventricular ejection fraction)

The share of blood the heart’s main pumping chamber (the left ventricle) pushes out with each beat, measured by an echocardiogram (heart ultrasound) or a MUGA scan. About 50–70% is normal.

Cancer (malignancy)

Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.

Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.

05

Study design

Phase
Phase 1
Primary purpose
Treatment
Allocation
Non-randomized
Intervention model
Sequential assignment
Masking
None (open label)
Enrollment
25 participants (estimated)

Study arms

  • Experimental
    1/Dose Escalation

    Pomalidomide (escalating doses) + Prednisone, Etoposide, Doxorubicin, Vincristin

    Drug: Vincristine · Drug: Prednisone · Drug: Doxorubicin · Drug: Etoposide · Drug: Pomalidomide · Drug: Cyclophosphamide · Drug: Rituximab

  • Experimental
    2/Dose Expansion

    Pomalidomide (at the MTD) + Prednisone, Etoposide, Doxorubicin, Vincristine and

    Drug: Vincristine · Drug: Prednisone · Drug: Doxorubicin · Drug: Etoposide · Drug: Pomalidomide · Drug: Cyclophosphamide · Drug: Rituximab

Interventions

  • 0.4 mg/m2/day administered by CIVI on days 1 to 4

  • 60 mg/m2/day administered orally on days 1 to 5

  • 10 mg/m2/day administered by CIVI on days 1 to 4

  • 50 mg/m2/day administered by CIVI on days 1 to 4

  • An initial dose of 3mg administered orally for 10 days in all cycles. In cycle 1, it will start 5 days before DA-EPOCH; in cycles 2-6, it will start on day 1. Administered at an MTD dose for the expansion phase.

  • 750 mg/m2 administered IV on day 5

  • 375 mg/m2 administered IV on day 1 (only for CD20+ tumors)

06

What researchers measure

Primary outcomes

  1. safety and tolerability

    The fraction of individuals with toxicity noted at each dose level will be reported by grade and type of toxicity identified. Maximum tolerated dose will also be reported.

    Time frame: 6 cycles of treatment, or until confirmed progression, unacceptable toxicity or trial withdrawal

Secondary outcomes

  1. progression-free survival

    duration of time from the start of the treatment until time of disease relapse from PR, disease progression, or death, whichever occurs first

    Time frame: every 3 weeks for the first 6 cycles, every 3 months for the rest of the first year, then every 6 months for 4 years (5 years total).

  2. preliminary estimates of response

    Percentage of individuals with the best overall response of CR or PR to therapy

    Time frame: every 3 weeks for the first 6 cycles, every 3 months for the rest of the first year, then every 6 months for 4 years (5 years total).

07

Study locations

1 of 1 sites recruiting
  • National Institutes of Health Clinical Center
    Bethesda, Maryland 20892, United States
    Recruiting
    • For more information at the NIH Clinical Center contact National Cancer Institute Referral Office · Contact888-624-1937
08

References and documents

Individual participant data

Plan to share: Yes — All IPD recorded in the medical record will be shared with intramural investigators upon request.

Supporting information: Study protocol, Statistical analysis plan, Informed consent form

Time frame: Clinical data available during the study and indefinitely.

Access criteria: Clinical data will be made available via subscription to BTRIS and with the permission of the study PI.

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reached

Started Jun 2023 (actual). Primary completion is estimated for Jun 2028, 59 months after the start.

How these figures are worked out, and which studies are left out of them.

Registered
May 21, 2022
First posted
May 25, 2022
StartActual
Jun 27, 2023
Primary completionEst.
Jun 1, 2028
CompletionEst.
Jun 1, 2032
Last update
Aug 25, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Aug 25, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT05389423
Responsible party
Sponsor
First posted
May 25, 2022
Start date
Jun 27, 2023
Primary completion
Jun 1, 2028 (estimated)
Completion
Jun 1, 2032 (estimated)
Last update
Aug 25, 2026

Study contacts

Irene B Ekwede, R.N.
Contact
ekwedeib@mail.nih.gov
(240) 760-6126
Ramya M Ramaswami, M.D.
Contact
ramya.ramaswami@nih.gov
(240) 506-1088
Ramya M Ramaswami, M.D.
principal investigator · National Cancer Institute (NCI)

Oversight

FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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Studies of the drugs tested here: Pomalidomide · Rituximab

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