Lenalidomide in Relapsed or Refractory Primary-cutaneous Large B-cell Lymphoma Leg-type : Multicentre Prospective Phase II Single Arm Trial of the French Study Group of Cutaneous Lymphoma (REV-LEG)

May 11, 2026 updated by: University Hospital, Bordeaux

A Multicentre Prospective Phase II Single Arm Trial Evaluating the Benefit of Therapy With Lenalidomide (Revlimid®) in Relapsed or Refractory Primary-cutaneous Large B-cell Lymphoma (Leg-type) After First Line Treatment by Chemotherapy Plus Rituximab for the French Study Group of Cutaneous Lymphoma (GFELC)

In spite of high initial response rate after a first line treatment by R-polychemotherapy, cutaneous but also extra-cutaneous recurrences occur after 2 years in about half of the patients with PCBCL-LT. Thereafter there is no consensus concerning patients care: radiotherapy has only a palliative effect, advanced age often limits using more aggressive chemotherapies and no treatment has demonstrated a prolonged efficacy in these relapsing cases. Therefore new alternatives therapeutic options are needed. Lenalidomide has an antineoplastic pro-apoptotic effect but also immunomodulatory, and antiangiogenic properties. Preliminary results suggest its efficacy in relapsing or refractory diffuse large B-cells lymphomas, especially of nongerminal cells phenotype. By analogy with these results, lenalidomide appears as an attractive candidate in PCLBCL-LT, more specially as it has a manageable toxicity even in advanced age patients.

If the lenalidomide efficacy is confirmed in relapsing PCLBCL-LT, this will plead its evaluation as maintenance therapy after R-chemotherapy in order to avoid recurrences.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

To assess benefit and safety of lenalidomide in patients with refractory or relapsing primary cutaneous large B-cell lymphoma leg type (PCBCL-LT) after a first line treatment by Rituximab and polychemotherapy. The primary endpoint is overall response rate (complete response and partial response) at 6 months. Response will be assessed according to clinical and isotopic criteria.

Optional biological study:

A biological collection (skin and blood samples) will be established. Predictive biological markers of response or of aggressiveness and resistance to the treatment will be investigated on the skin biopsies by phenotypic and genetic analyses. The recent discovery of BLIMP1 inactivation or deletion at 6q21 in activated B-cell like type of diffuse large B-cell systemic lymphoma points to the need of both a global genetic analysis by Array-CGH with Single Nucleotide Polymorphism study and a specific investigations of the status of genes such as CDKN2A, BCL2, BCL6 and BLIMP1 by FISH analysis and/or gene dosage. Xenograft will be performed from skin biopsies in order to develop animal models for PCLBCL-LT.

Lenalidomide stimulates NK cells immunity and enhances anti-tumor responses. It also seems to modify the phenotype of NK cells through a decrease of the expression of Killer cell Immunoglobulin-like Receptors and NKp46. The expression of the NK receptors on blood cells will be analyzed in order to evidence modifications of the phenotypical and functional changes under treatment, and to search for a correlation with the clinical response to the treatment.

Study Type

Interventional

Enrollment (Actual)

19

Phase

  • Phase 2

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • France
      • Amiens, France, 80054
        • CHU Amiens, Hôpital Sud
      • Besançon, France, 25030
        • CHU Besançon, Hôpital Saint-Jacques
      • Bobigny, France, 93009
        • AP-HP Hôpital Avicenne
      • Boulogne-Billancourt, France, 92104
        • AP-HP Hôpital Ambroise Paré
      • Clermont-Ferrand, France, 63003
        • CHU de Clermont-Ferrand, Estaing
      • Créteil, France, 94010
        • AP-HP Hopital Henri Mondor
      • Dijon, France, 21079
        • CHU de Dijon, Le Bocage
      • Grenoble, France, 38043
        • Chu de Grenoble
      • Lille, France, 59037
        • CHU de Lille Hôpital Claude Huriez
      • Lyon, France, 69373
        • Centre léon bérard
      • Marseille, France, 13915
        • AP-HM Hopital Nord
      • Montpellier, France, 34295
        • CHRU de Montpellier Hôpital Saint-Eloi
      • Nantes, France, 44093
        • CHU de Nantes, Hôtel Dieu
      • Nice, France, 06202
        • CHU de Nice Groupe hospitalier l'Archet
      • Paris, France, 75970
        • AP-HP Hopital Tenon
      • Paris, France, 75475
        • AP-HP- Hôpital Saint Louis
      • Paris, France, 75679
        • AP-HP Groupe hospitalier Cochin
      • Paris, France, 75877
        • AP-HP Groupe hospitalier Bichat - Claude Bernard
      • Pessac, France, 33604
        • CHU de Bordeaux Hôpital du Haut Lévèque
      • Pierre-Bénite, France, 69450
        • CHU Lyon Sud
      • Reims, France, 51092
        • CHU de Reims, Hôpital Robert Debré
      • Rouen, France, 76031
        • CHU de Rouen, Hôpital Charles Nicolle
      • Toulouse, France, 31059
        • CHU de Toulouse Hôpital Larrey
      • Tours, France, 37044
        • CHU de Tours- Hôpital Trousseau

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Biopsy-proven Primary cutaneous large B-cell lymphoma leg-type
  • Clinically measurable skin involvement (T1-T3) or skin and nodal (N1-N3) involvement measurable by PET-CT, corresponding to :

Relapse after initial complete response (CR) after R-polychemotherapy Or Partial response or stable disease after R-polychemotherapy

  • Age > 18 years
  • Life expectancy > 3 months
  • WHO performance status 0-2
  • Skin biopsy performed at the inclusion on a skin tumor : new tumor in case of relapsing PCLBCL-LT or initial skin tumor refractory to the previous treatment
  • Signed informed consent for clinical and biological analyses. The Lenalidomide Information Sheet will be given to each patient receiving lenalidomide study therapy. The patient must read this document prior to starting lenalidomide study treatment and each time they receive a new supply of study drug.
  • Social security cover
  • Conditions of global RPP have to be fulfilled by all the patients
  • The Lenalidomide Education and Counseling Guidance Document must be completed and signed by either a trained counselor or the Investigator at the participating clinical center prior to each dispensing of lenalidomide study treatment. A copy of this document must be maintained in the patient records.

Exclusion Criteria:

  • Central nervous system involvement (cerebral CT scan is performed at the inclusion)
  • One or more of the biological abnormalities :

Neutrophil count < 1,500/mm3 ; Platelet count < 60,000/mm3 ; Transaminases > 5 x upper limit of normal ; Total bilirubin > 2.0 mg/dl (34 µmol/L)/ conjugated bilirubin>0.8 mg/dL, except of haemolytic anemia ; Creatinine clearance < 50 mL /min ( measured or calculated according to the method of Cockcroft-Gault)

  • Pregnant or lactating females, potentially childbearing females defined by sexually mature female who: 1) has not undergone a hysterectomy (the surgical removal of the uterus) or bilateral oophorectomy (the surgical removal of both ovaries) or 2) has not been naturally postmenopausal (amenorrhea following cancer therapy does not rule out childbearing potential) for at least 24 consecutive months (i.e., has had menses at any time during the preceding 24 consecutive months.
  • Patients should not receive steroids continuously except for prednisone for tumoral flare treatment
  • Uncontrolled infectious and thromboembolic diseases
  • Subjects not willing to take deep venous thrombosis prophylaxis
  • Prior history of malignancies unless the subject has been free of the disease for ≥5 years. Exceptions include basal cell skin carcinoma, carcinoma in situ of the cervix or of the breast
  • Any serious medical condition, laboratory abnormality, or psychiatric illness that would prevent the subject from signing the informed consent form
  • Known seropositive for or active viral infection with HIV, Hepatitis B and C virus.
  • Uncontrolled intercurrent illness including, but not limited to ongoing or active infection requiring parenteral antibiotics, uncontrolled diabetes mellitus as defined by the investigator
  • Chronic symptomatic congestive heart failure (III or IV of the NYHA Classification for Heart Disease)
  • Unstable angina pectoris, angioplasty or myocardial infarctions within 6 months
  • Clinically significant cardiac arrhythmia that is symptomatic or requires treatment, or asymptomatic sustained ventricular tachycardia.
  • Prior ≥ Grade 3 allergic reaction/hypersensitivity or desquamative rash while taking thalidomide
  • Any standard or experimental anti-cancer drug therapy or radiation within 3 weeks of the initiation of study drug therapy.
  • Participation in another clinical trial

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Lenalidomide treatment
Drug: Lenalidomide
Patient orally treated with lenalidomide 25 mg daily for 21 days with 7 days rest of a 28 days cycle.Treatment maintained for 12 months unless progression

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Overall response rate (complete response CR and partial response PR) at 6 months
Time Frame: 6 months after study treatment start
Response will be assessed according to clinical and isotopic criteria.
6 months after study treatment start

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Overall response rate (complete response CR and partial response PR) at 12 months
Time Frame: 12 months after study treatment start
Response will be assessed according to clinical and isotopic criteria.
12 months after study treatment start
Duration of response
Time Frame: Every 6 months
Time between the first PR and progression
Every 6 months
Progression-free survival
Time Frame: Every 6 months
Time between the beginning of the treatment by lenalidomide and progression or death
Every 6 months
Overall survival and disease specific survival
Time Frame: Evrey 6 months
Evrey 6 months
Safety : description of adverse events occured including grade based on CTCAE v4.0
Time Frame: Monthly during treatment duration (up to 12 months)
Monthly during treatment duration (up to 12 months)
Quality of life
Time Frame: Every 2 months during treatment duration (up to 12 month)
Every 2 months during treatment duration (up to 12 month)

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

University Hospital, Bordeaux

Investigators

  • Principal Investigator: Marie BEYLOT-BARRY, MD-PhD, University Hospital, Bordeaux
  • Study Chair: Eric FRISON, MD, Unité de Soutien Méthodologique à la Recherche clinique et épidémiologique; University Hospital, Bordeaux

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

July 1, 2012

Primary Completion (Actual)

March 1, 2015

Study Completion (Actual)

August 1, 2015

Study Registration Dates

First Submitted

March 12, 2012

First Submitted That Met QC Criteria

March 15, 2012

First Posted (Estimated)

March 16, 2012

Study Record Updates

Last Update Posted (Actual)

May 14, 2026

Last Update Submitted That Met QC Criteria

May 11, 2026

Last Verified

September 1, 2016

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • CHUBX 2011/28
  • 2011-003716-23 (EudraCT Number)

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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