ClinicalTrials.gg
RecruitingNCT05907759Updated Oct 16, 2026

Daratumumab for Relapsed/Refractory Primary Effusion Lymphoma, Plasmablastic Lymphoma, and Multicentric Castleman Disease

A Phase 2 interventional study of Daratumumab SC in Lymphoma, Primary Effusion, 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 2026-10-16.

Sponsored by National Cancer Institute (NCI) · Phase 2, Interventional, and Treatment

From the registry’s dates

  • Started Jul 2024; still recruiting 2 years 4 months later.
Updated Sep 25, 2026Enrollment updatedEligibility revisedGo to Updates ↓
Phase
Phase 2
Study type
Interventional
Enrollment
40
Allocation
Not applicable
Ages
18 Years to 120 Years
Sex
All
01

Study summary

Background:

Primary effusion lymphoma (PEL), plasmablastic lymphoma (PBL), and Multicentric Castleman Disease (MCD) are aggressive forms of cancer that affects cells in the immune system and lymph nodes. How they develop is not well understood, and these diseases do not respond well to standard treatments for other types of lymphomas.

Objective:

To test a drug treatment (daratumumab SC) in people with PEL, PBL, or MCD.

Eligibility:

People aged 18 and older with PEL, PBL, or MCD who must have failed to respond to therapy or they must be unable to receive standard treatment for the disease.

Design:

Participants will be screened. They will have a physical exam with blood tests. They will have imaging scans and tests of their heart and lung function. They may need to have a biopsy: tissue or fluid will be collected. They will have an eye exam.

Daratumumab SC is given as an injection into the fat under the skin in the abdomen. This takes 3 to 5 minutes. Participants will receive the treatment once a week for 8 weeks; then every 2 weeks for 16 weeks; then every 4 weeks for up to 24 months.

Participants will have other tests during the study period. These may include lumbar punctures: A needle will be inserted between the bones of the spine to draw some fluid from the area around the spinal cord. Participants may also have a thoracentesis: A needle or plastic tube will be inserted into the space around the lungs to withdraw fluid. Participants will have more imaging scans and blood tests.

Follow-up visits will continue after treatment ends. Participants will be in the study for up to 5 years.

Read the detailed description

Background

  • Primary effusion lymphoma (PEL) is an aggressive B-cell lymphoma caused by the Kaposi sarcoma herpesvirus (KSHV) with clinicopathologic and molecular profiles distinct from other HIV-related lymphomas.
  • Plasmablastic lymphoma (PBL) is an aggressive B-cell lymphoma frequently caused by Epstein-Barr virus (EBV) with frequent extranodal presentations involving the bones and gastrointestinal tract.
  • Immunophenotypically, PEL and PBL are post-germinal center B cell neoplasms expressing surface markers consistent with plasmacytic differentiation, such as CD45, CD38, CD138, MUM-1, and IRF4, similar to that of multiple myeloma (MM).
  • Outcomes for PEL and PBL treated with front-line combination chemotherapy are inferior to those of other HIV-associated lymphomas, and second-line cytotoxic chemotherapy is often ineffective, and profound immunosuppression often prevents this approach.
  • In the second-line setting, chemotherapy-sparing treatments that do not contribute to further immune suppression may be more effective. In addition, patients with PEL often have concurrent KS, which can be severely exacerbated by immune suppression and contributes to mortality in PEL.
  • Kaposi sarcoma herpesvirus-associated multicentric Castleman disease (KSHV-MCD) is a rare lymphoproliferative disorder that develops predominantly in people with HIV with inflammatory symptoms associated with high levels of interleukin-6 (IL-6), KSHV-encoded viral IL-6 (vIL-6), and other cytokines.
  • The pathologic hallmark of KSHV-MCD is the presence of KSHV-infected Lambda-restricted plasmablasts in the mantle zones of lymph nodes which stain brightly for CD45 and CD38 and negative for CD20.
  • KSHV-MCD is generally treated with the anti-CD20 monoclonal antibody, rituximab, with the goal to rapidly improve symptoms and eliminate reservoirs of KSHV-infected plasmablasts.
  • Concurrent Kaposi sarcoma is often exacerbated by or develops during rituximab therapy and contributes to morbidity in KSHV-MCD.
  • Daratumumab is a human monoclonal antibody that binds to a unique region on CD38 and induces killing of CD38-expressing cells via antibody-dependent cell-mediated cytotoxicity (ADCC), complement-dependent cytotoxicity (CDC), and apoptosis.
  • Daratumumab also depletes immunosuppressive non-plasma cells that express CD38 thereby reducing local immunosuppression and stimulating an increase in T-helper cells, cytotoxic T cells, T-cell functional response, and T-cell receptor (TCR) clonality in the tumor microenvironment.

Objective

-To evaluate the partial response (PR) plus complete response (CR) rate (further referred to as the overall response rate [ORR]) of daratumumab SC in participants with relapsed/refractory PEL or PBL and/or symptomatic KSHV-MCD or who are ineligible for front-line chemotherapy

Eligibility

  • Age >=18 years
  • Participants with pathologically confirmed relapsed and/or refractory PEL, including extracavitary variant and KSHV-associated large cell lymphoma, PBL, or ineligible for front line chemotherapy
  • Participants with PEL or PBL must have:

    • Measurable or assessable disease
    • Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) 0-3
    • Received first-line curative-intent therapy for PEL or PBL, unless such therapy is contraindicated
  • Participants with KSHV-MCD must have:

    • ECOG PS 0-2 or 3 if secondary to PEL or PBL/MCD
    • At least one clinical symptom and at least one laboratory abnormality attributable to KSHV-MCD

Design

  • This is a Phase 2 study to evaluate the response rate of daratumumab SC in participants with relapsed/refractory PEL or PBL, and/or symptomatic KSHV-MCD.
  • The study will accrue up to 12 evaluable participants with PEL or PBL and up to 12 evaluable participants with KSHV-MCD.
  • For participants with relapsed/refractory PEL or PBL, daratumumab SC will be administered subcutaneously (SC) as 1800 mg/30,000 units weekly for a total of 8 weeks followed by every 2 weeks for a total of 16 weeks followed by every 4 weeks for up to 96 weeks in the absence of off-treatment criteria. Participants who are deriving benefit from therapy and exhibit disease worsening without meeting the criteria for progression may resume therapy every two weeks for up to 96 weeks.
  • Participants with relapsed/refractory PEL or PBL who are benefiting from treatment but show progression in effusions or CSF may continue therapy for up to an additional 3 months.
  • For participants with symptomatic KSHV-MCD, daratumumab SC will be administered SC as 1800 mg/30,000 units weekly for 8 weeks. If response assessment indicates progressive or stable disease, daratumumab SC will be given every 2 weeks for up to 24 weeks (6 months).
02

Conditions studied

  • Lymphoma, Primary Effusion

Keywords

  • Multicentric Castleman Disease
  • Non-Hodgkin Lymphoma
  • Kaposi Sarcoma Herpesvirus
  • HIV
  • CD38
  • B cell lymphoproliferative diseases
03

In context

Multi-centric Castleman's Disease

24 studies on the registry are indexed under Multi-centric Castleman's Disease; 6 are open to participants now.

This study's planned enrollment of 40 is above the median of 34 across 16 interventional studies indexed under Multi-centric Castleman's Disease.

Browse Multi-centric Castleman's Disease 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.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

The criteria were revised on the registry on Sep 25, 2026. See what changed

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

  • Participants with confirmed primary effusion lymphoma (PEL) including extracavitary and KSHV-associated large cell lymphoma variants, plasmablastic lymphoma (PBL), and/or KSHV-associated multicentric Castleman disease (MCD) that has , and/or is refractory after frontline chemotherapy, or who are ineligible for front-line chemotherapy
  • Age >= 18 years.
  • Any status
  • Participants with HIV must be receiving or will initiate an effective combination antiretroviral therapy (ART) regimen and must have an undetectable HIV VL which is defined as \<200 copies/mL.
  • Participants with PEL or PBL must meet the following criteria:

    • Must have measurable or assessable lymphoma
    • performance status (PS) 0-2 or 3 if secondary to PEL or PBL
    • Adequate hematological and renal functions as defined below:

      • (Hgb) > 7 g/dL
      • (CrCl) >= 15 mL/min/1.73 m\^2
    • Must have received curative-intent therapy (anthracycline-containing chemotherapy) for PEL or PBL, unless such therapy is due to infection that precludes combination chemotherapy (such as progressive multifocal leukoencephalopathy) or if there is a contraindication to receiving CHOP or EPOCH (such as multi-organ failure).
  • Participants with KSHV-MCD must meet the following criteria:

    • ECOG performance status (PS) 0-2 or 3 if secondary to MCD
    • Adequate hematological and renal functions as defined below:

      • Hemoglobin (Hgb) > 7 g/dL
      • Creatinine clearance (CrCl) >= 15 mL/min/1.73 m\^2
    • At least one clinical symptom attributed to KSHV-MCD

      • Fever (>38 degrees Celsius)
      • Fatigue
      • Gastrointestinal symptoms
      • Respiratory/sinus symptoms
      • Rash
    • At least one laboratory abnormality attributed to KSHV-MCD

      • Anemia (Hgb [men] \< 12.5 g/dL, Hgb [women] \< 11 g/dL)
      • Thrombocytopenia (\< 150 K/microL)
      • Hypoalbuminemia (\< 3.4 g/dL)
      • Hyponatremia (\< 135 mmol/L)
      • Elevated C-reactive protein (CRP) (> 3 mg/L)
  • For participants with evidence of chronic virus (HBV) infection, participants must be on suppressive therapy with an undetectable VL.
  • Participants who are seropositive for virus (HCV)are eligible only in the setting of a sustained virologic response [SVR], defined as aviremia, at least 12 weeks after completion of antiviral therapy.
  • Participants that have received agents on other clinical trials must have had a of 2 weeks or 5 drug half-lives, whichever is longer.
  • Women of (WOCBP) must agree to use an effective (dual) form of (barrier, surgical sterilization, abstinence) prior to study entry and for the duration of study participation and for 3 months after the last dose of study drug. WOCBP must refrain from egg donations during the study and for 3 months after the last dose of daratumumab.
  • Men must agree to use an effective method of contraception (barrier, surgical sterilization, abstinence) for the duration of the study treatment and up to 3 months after the last dose of the study drug(s). We also will recommend men with female partners of childbearing potential to ask female partners to be on an effective birth control (hormonal, intrauterine device [IUD], surgical sterilization).
  • Breastfeeding participants must be willing to discontinue breastfeeding from study treatment initiation through 3 months after the last dose of the study drug.
  • Participants must understand and sign a written document.

Exclusion criteria

EXCLUSION CRITERIA:

  • Participants who have had anticancer treatment within the last 2 weeks unless the cancer treatment is for a whose natural history or treatment does not have the potential to interfere with the safety or efficacy assessment of the regimen are eligible for this trial, such as local treatment for carcinoma in situ or hormonal therapy for prostate or breast carcinoma. Toxicity related to prior therapies other than hair loss and neuropathy must have resolved to grade 1.
  • KS requiring urgent treatment with cytotoxic chemotherapy.
  • (total) > 1.5 times the ; (AST) and/or alanine aminotransferase (ALT) > 3 times the upper limit of normal (ULN);

EXCEPTIONS:

  • Total bilirubin >= 5 mg/dL in participants with Gilbert's syndrome as defined by > 80% unconjugated
  • If the elevated total bilirubin or AST/ALT are due to ART or lymphoma

    • ANC \< 1000/mm\^3 and \< 75,000/mm\^3 unless related to lymphoma and/or KSHV-MCD or prior therapy.
    • Life-threatening or organ-threatening manifestations of KSHV-MCD.
    • cardiac disease, including:
  • Myocardial infarction within 6 months of randomization, or an unstable or uncontrolled disease/condition related to or affecting cardiac function (e.g., unstable angina, congestive heart failure, Class IIIIV).
  • Uncontrolled cardiac arrhythmia

    • (COPD) with a (FEV1) \< 50% of predicted normal.
    • Moderate or severe persistent asthma within the past 2 years, or uncontrolled asthma of any classification. Note that participants who currently have controlled intermittent asthma or controlled mild persistent asthma are allowed to participate in the study.
    • Pregnant people as evaluated by a positive serum or urine beta-human chorionic gonadotropin (Beta-hCG) test
    • Participants with severe uncontrolled intercurrent illness, evaluated by history, physical exam and chemistry panel. Participants with severe intercurrent illnesses attributed to lymphoma may be eligible per PI s or designee s discretion.
Terms in these criteria, in plain language(24)

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.

Relapsed and refractory

Relapsed: the illness came back after treatment had worked. Refractory: it did not respond to treatment, or stopped responding while still on it.

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.

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.

Hemoglobin (Hb)

The protein in red blood cells that carries oxygen. A low level is anaemia, which can cause tiredness and breathlessness. Measured in g/dL or g/L (9 g/dL is 90 g/L).

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.

Line of therapy

A line of therapy is one course of treatment, which may combine several drugs. First-line is the first course given; second-line follows when that stops working or is not tolerated.

“Two prior lines” means two courses that count separately under the study’s rules — not simply two drugs. Ask the study team if you are unsure how yours are counted.

Contraindication

A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.

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.

Hepatitis C tests

Hepatitis C is a virus that infects the liver. An HCV antibody test can stay positive after an infection has cleared (and is occasionally positive without one); an HCV RNA test shows whether the virus is there now.

After treatment, hepatitis C counts as cured when HCV RNA is still undetectable 12 weeks or more after the treatment ended. Studies often accept people cured this way.

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.

Washout period

A planned gap after a treatment, so that its effects can lessen before the study treatment or a study assessment. Ask the study team and the doctor who prescribed it before changing any medicine.

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.

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.

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.

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.

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.

Clinically significant

Judged by the study doctor to matter for your health or for the study. It is a doctor’s decision, so ask the study team if you are unsure whether something counts.

NYHA class (heart failure)

The New York Heart Association’s four classes of how much heart failure limits physical activity.

I
No limits: ordinary activity causes no undue tiredness or breathlessness.
II
Slight limits: comfortable at rest, ordinary activity causes symptoms.
III
Marked limits: comfortable at rest, less than ordinary activity causes symptoms.
IV
Symptoms even at rest; any activity makes them worse.

Studies set their own limit — many outside heart failure leave out class III–IV, while heart failure studies may ask for a particular class. Check the class this study names.

COPD

Chronic obstructive pulmonary disease: long-term lung disease that makes it hard to breathe out, including emphysema and chronic bronchitis.

FEV1

From a breathing test (spirometry): how much air you can blow out in the first second. Often given as a percentage of what is expected for your age, height and sex.

05

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
40 participants (estimated)

Study arms

  • Experimental
    Arm 1

    Treatment with daratumumab SC

    Drug: Daratumumab SC

Interventions

  • Daratumumab SC (daratumumab and hyaluronidase) is administered subcutaneously (SC) as 1800 mg/30,000 units weekly for a total of 8 weeks followed by every 2 weeks for a total of 16 weeks followed by every 4 weeks for up to 96 weeks

06

What researchers measure

Primary outcomes

  1. Overall response rate (ORR)

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

    Time frame: at 9 and 17 weeks, and every 12 weeks from week 25 to the end of therapy

Secondary outcomes

  1. Safety of daratumumab

    Adverse events (AEs) will be reported by type and grade of toxicity

    Time frame: From first dose through 30 days after the end of treatment

07

Study locations

1 of 1 sites recruiting
  • National Institutes of Health Clinical Center
    Bethesda, Maryland 20892, United States
    Recruiting
    • National Cancer Institute Referral Office · Contact888-624-1937
08

References and documents

Individual participant data

Plan to share: Yes — All collected IPD will be shared

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

Time frame: Data from this study may be requested from other researchers at least 1 year after the completion of the primary endpoint.

Access criteria: Data from this study may be requested by contacting the PI.

09

Timeline

3 registry updates since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reached

Started Jul 2024 (actual). Primary completion is estimated for Aug 2034, 120 months after the start.

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

Registered
Jun 15, 2023
First posted
Jun 18, 2023
StartActual
Jul 10, 2024
Primary completionEst.
Aug 1, 2034
CompletionEst.
Dec 1, 2035
Last update
Oct 16, 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.
Enrollment
28→40
Sep 25, 2026
Eligibility
1 exclusion criterion edited
What changed in the criteria
Exclusion criteria
  • EditedNo lifeLife-threatening or organ-threatening manifestations of KSHV-MCD.
Sep 25, 2026
Show all 3 updates
  1. Oct 16, 2026
    Minor edits only
    + 1 other change: verification date
  2. Oct 13, 2026
    Minor edits only
    + 1 other change: verification date
  3. Sep 25, 2026
    Enrollment 28→40
    Eligibility 1 exclusion criterion edited
    What changed in the criteria
    Exclusion criteria
    • EditedNo lifeLife-threatening or organ-threatening manifestations of KSHV-MCD.
    + 2 other changes: description and arm descriptions

From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗

10

Registry details

Key details

Study ID
NCT05907759
Responsible party
Sponsor
First posted
Jun 18, 2023
Start date
Jul 10, 2024
Primary completion
Aug 1, 2034 (estimated)
Completion
Dec 1, 2035 (estimated)
Last update
Oct 16, 2026

Study contacts

Anaida Widell
Contact
anaida.widell@nih.gov
(240) 760-6074
Robert Yarchoan, M.D.
Contact
robert.yarchoan@nih.gov
(240) 760-6075
Robert Yarchoan, 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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