Study of Lenalidomide Maintenance Versus Placebo in Responding Elderly Patients With DLBCL and Treated With R-CHOP
Study of Lenalidomide Maintenance Versus Placebo in Responding Elderly Patients With DLBCL and Treated With R-CHOP
This study is designed as a phase III, randomized, double-blind, placebo-controlled trial to
 explore the effect of maintenance therapy with lenalidomide versus placebo on
 progression-free survival (PFS) in patients treated with R-CHOP responding to induction
 therapy

 For the primary efficacy variable, PFS, an improvement in median PFS from 38.6 months for
 Treatment Arm B to 54 months for Treatment Arm A (corresponding to a 2-year PFS of 65% vs
 73.6%), is considered clinically relevant.
Patients should have received at least 6 and up to 8 cycles of the R-CHOP 14 or R-CHOP 21
 regimen or 6 R-CHOP-14 or -21 completed by 2 Rituximab alone in accordance to local
 preferences.

 Patients can be registered to participate in the study at two time points:

 -  At time of initial diagnosis and study enrolment (signature of informed consent) before
 the first cycle of treatment with R-CHOP.

 -  At randomization (signature of informed consent) after treatment in first line with
 R-CHOP and have reached at least PR or CR.

 Evaluation of the response to R-CHOP must be in accordance with Revised Response Criteria for
 Malignant Lymphoma(2007).

 Stratification: Before randomization, the patients will be stratified according to the
 country and the response to R-CHOP (PR vs CR).

 Randomization: Patients in CR/PR after R-CHOP will be randomized to maintenance therapy with
 lenalidomide or placebo.
Ages Eligible for Study: Between 60 and 80 years old

 Genders Eligible for Study: Both

 Accepts Healthy Volunteers: No

 Inclusion Criteria:

 For patients registered at the time of initial diagnosis

 -  Patient with histologically proven CD20+ diffuse large B cel LYMPHOMA (DLBCL) 5WHO
 classification 2008) including clinical subtypes (primitive mediastinal,
 intravascular, etc.). Patients with De Novo Transformed DLBCL from low grade lymphoma
 (Follicular, other..) may also be included. Patients with DLBCL associated with some
 small cell infiltration in bone marrow may also be included Or CD20+ B-cell lymphoma
 with intermediate features between DLBCL and Burkitt or with intermediate features
 between DLBCL and classical Hodgkin lymphoma Or CD20+ Follicular lymphoma grade 3B Or
 CD20+ Aggressive B-cell lymphoma unclassifiable

 -  previous untreated with chemo- or radiotherapy

 For patients registered after response evaluation to first line treatment with R-CHOP:

 -  Patient with histologically proven CD20+ diffuse large B cell LYMPHOMA (DLBCL) 5WHO
 classification 2008) including clinical subtypes (primitive mediastinal,
 intravascular, etc.). Patients with De Novo Transformed DLBCL from low grade lymphoma
 (Follicular, other..) may also be included. Patients with DLBCL associated with some
 small cell infiltration in bone marrow may also be included Or CD20+ B-cell lymphoma
 with intermediate features between DLBCL and Burkitt or with intermediate features
 between DLBCL and classical Hodgkin lymphoma Or CD20+ Follicular lymphoma grade 3B Or
 CD20+ Aggressive B-cell lymphoma unclassifiable

 -  Have reached a CR or PR after first line treatment with at least 6 cycles of R-CHOP 14
 regimens and up to 8 cycles of R-CHOP21

 -  Previously untreated with Radiotherapy

 For all patients:

 -  aged from 60 to 80 years at time of registration

 -  Ann Arbor stages II-IV at time of initial diagnosis

 -  aaIPI> 1 at time of initial diagnosis

 -  ECOG performance status 0-2

 -  Minimum life expectancy of 3 months

 -  Following laboratory values at screening:

 -  ANC≥ 1000.10^6/L and Platelets≥60000.10^6/L

 -  AST<5*ULN, ALT<5*ULN, Total Bilirubin<1,5*ULN

 -  Creatinine clearance>30mL/min

 -  Women are are using effective contraception, are not pregnant and agree not to become
 pregnant during participation in the trial and after end of study. Men agree not to
 father a child during participation in the trial and during the 12 months thereafter.

 -  Having previously signed a written informed consent form

 Exclusion Criteria:

 -  Any other histological type of Lymphoma, Burkitt included.

 -  Any history of treated or non treated small B-cell lymphoma

 -  Central nervous system or meningeal involvement by lymphoma

 -  Contraindication to any drug contained in the chemotherapy regimen Myocardial
 infarction during last 3 months or unstable coronary disease or uncontrolled chronic
 symptomatic congestive heart insufficiency NYHA III-IV

 -  Uncontrolled hypertension

 -  Uncontrolled diabetes mellitus as defined by the investigator

 -  Active systemic infection requiring treatment

 -  previously known HIV positive serology

 -  Active hepatitis B or C

 -  Prior history of malignancies other than lymphoma within 3 years

 -  Serious medical or psychiatric illness