Trial Outcomes & Findings for Rituximab and Pembrolizumab With or Without Lenalidomide in Treating Patients With Relapsed Follicular Lymphoma and Diffuse Large B-Cell Lymphoma (NCT NCT02446457)

NCT ID: NCT02446457

Last Updated: 2026-03-09

Results Overview

To determine the overall response rate (ORR) in subjects with relapsed follicular lymphoma (FL) treated with Rituximab plus pembrolizumab therapy. II. To determine the ORR in subjects with relapsed/refractory FL and relapsed/refractory diffuse large B-Cell lymphoma (DLBCL) who failed chimeric antigen receptor (CAR) T cell therapy and rea treated with rituximab in combination with pembrolizumab and lenalidomide (Cohort 2)

Recruitment status

ACTIVE_NOT_RECRUITING

Study phase

PHASE2

Target enrollment

53 participants

Primary outcome timeframe

Approximately 1 year and 6 months

Results posted on

2026-03-09

Participant Flow

Participant milestones

Participant milestones
Measure
Cohort 1
Rituxan Plus Pembrolizumab
Cohort 2
Rituxan Plus Pembro Plus Lenalidomide
Overall Study
STARTED
30
14
Overall Study
COMPLETED
10
3
Overall Study
NOT COMPLETED
20
11

Reasons for withdrawal

Reasons for withdrawal
Measure
Cohort 1
Rituxan Plus Pembrolizumab
Cohort 2
Rituxan Plus Pembro Plus Lenalidomide
Overall Study
Adverse Event
6
1
Overall Study
Death
0
2
Overall Study
Withdrawal by Subject
0
1
Overall Study
Relocation
1
0
Overall Study
Progression of Disease
13
7

Baseline Characteristics

Rituximab and Pembrolizumab With or Without Lenalidomide in Treating Patients With Relapsed Follicular Lymphoma and Diffuse Large B-Cell Lymphoma

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Cohort 1
n=30 Participants
Rituxan Plus Pembrolizumab
Cohort 2
n=14 Participants
Rituxan Plus Pembro Plus Lenalidomide
Total
n=44 Participants
Total of all reporting groups
Age, Categorical
<=18 years
0 Participants
n=68 Participants
0 Participants
n=69 Participants
0 Participants
n=137 Participants
Age, Categorical
Between 18 and 65 years
30 Participants
n=68 Participants
12 Participants
n=69 Participants
42 Participants
n=137 Participants
Age, Categorical
>=65 years
0 Participants
n=68 Participants
2 Participants
n=69 Participants
2 Participants
n=137 Participants
Sex: Female, Male
Female
13 Participants
n=68 Participants
5 Participants
n=69 Participants
18 Participants
n=137 Participants
Sex: Female, Male
Male
17 Participants
n=68 Participants
9 Participants
n=69 Participants
26 Participants
n=137 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
1 Participants
n=68 Participants
2 Participants
n=69 Participants
3 Participants
n=137 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
29 Participants
n=68 Participants
12 Participants
n=69 Participants
41 Participants
n=137 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=68 Participants
0 Participants
n=69 Participants
0 Participants
n=137 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=68 Participants
0 Participants
n=69 Participants
0 Participants
n=137 Participants
Race (NIH/OMB)
Asian
0 Participants
n=68 Participants
1 Participants
n=69 Participants
1 Participants
n=137 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=68 Participants
0 Participants
n=69 Participants
0 Participants
n=137 Participants
Race (NIH/OMB)
Black or African American
1 Participants
n=68 Participants
0 Participants
n=69 Participants
1 Participants
n=137 Participants
Race (NIH/OMB)
White
29 Participants
n=68 Participants
11 Participants
n=69 Participants
40 Participants
n=137 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=68 Participants
0 Participants
n=69 Participants
0 Participants
n=137 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=68 Participants
2 Participants
n=69 Participants
2 Participants
n=137 Participants
Region of Enrollment
United States
30 participants
n=68 Participants
14 participants
n=69 Participants
44 participants
n=137 Participants

PRIMARY outcome

Timeframe: Approximately 1 year and 6 months

To determine the overall response rate (ORR) in subjects with relapsed follicular lymphoma (FL) treated with Rituximab plus pembrolizumab therapy. II. To determine the ORR in subjects with relapsed/refractory FL and relapsed/refractory diffuse large B-Cell lymphoma (DLBCL) who failed chimeric antigen receptor (CAR) T cell therapy and rea treated with rituximab in combination with pembrolizumab and lenalidomide (Cohort 2)

Outcome measures

Outcome measures
Measure
Cohort I (Rituximab, Pembrolizumab)
n=30 Participants
Patients receive rituximab IV over 4-8 hours on days 1, 8, 15, and 22. Patients also receive pembrolizumab IV over 1 hour on day 2 every 3 weeks for up to 16 cycles (1 year) in the absence of disease progression or unacceptable toxicity. Laboratory Biomarker Analysis: Correlative studies Pembrolizumab: Given IV Rituximab: Given IV
Cohort II (Rituximab, Pembrolizumab, Lenalidomide)
n=14 Participants
Patients receive rituximab IV over 4-8 hours on days 1, 8 and 15 of cycle 1, and day 1 of cycle 2. Patients also receive pembrolizumab IV over 1 hour on day 2 every 3 weeks for up to 2 years, and lenalidomide PO on days 1-14 every 3 weeks for up to 12 cycles in the absence of disease progression or unacceptable toxicity. Laboratory Biomarker Analysis: Correlative studies Lenalidomide: Given PO Pembrolizumab: Given IV Rituximab: Given IV
Overall Response Rate (Complete + Partial Responses)
Complete Response (CR)
15 Participants
5 Participants
Overall Response Rate (Complete + Partial Responses)
Partial Response (PR)
5 Participants
0 Participants
Overall Response Rate (Complete + Partial Responses)
Not Evaluable
0 Participants
2 Participants
Overall Response Rate (Complete + Partial Responses)
Progressive Disease (PD)
0 Participants
7 Participants

SECONDARY outcome

Timeframe: Up to 30 days after the completion of study treatment

Will be graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events version 4.0. Toxicity will be monitored simultaneously using the Bayesian stopping boundaries calculated based on beta-binomial distributions. Toxicity defined as any grade 3 or 4 non-hematologic toxicity that in the opinion of the principal investigator is at least possibly related to study treatment. Toxicity evaluation will be based on the incidence of severity and type of adverse events (including physical and laboratory). Frequency tables will be used to summarize categorical variables. Logistic regression will be utilized to assess the effect of patient prognostic factors on the toxicity rate.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: Up to 2 years after completion of study treatment

Logistic regression will be utilized to assess the effect of patient prognostic factors on the response rate.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: Up to 2 years after completion of study treatment

The PFS will be compared between patients relapsing =\< 1 year vs \> 1 year after last prior therapy. The distribution of time-to-event endpoints will be estimated using the method of Kaplan and Meier. Comparison of time-to-event endpoints by important subgroups will be made using the log-rank test. Cox proportional hazard regression will be employed for multivariate analysis on time-to-event outcomes.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: Up to 2 years after completion of study treatment

The distribution of time-to-event endpoints will be estimated using the method of Kaplan and Meier. Comparison of time-to-event endpoints by important subgroups will be made using the log-rank test. Cox proportional hazard regression will be employed for multivariate analysis on time-to-event outcomes.

Outcome measures

Outcome data not reported

Adverse Events

Cohort I (Rituximab, Pembrolizumab)

Serious events: 7 serious events
Other events: 30 other events
Deaths: 0 deaths

Cohort II (Rituximab, Pembrolizumab, Lenalidomide)

Serious events: 6 serious events
Other events: 14 other events
Deaths: 2 deaths

Serious adverse events

Serious adverse events
Measure
Cohort I (Rituximab, Pembrolizumab)
n=30 participants at risk
Patients receive rituximab IV over 4-8 hours on days 1, 8, 15, and 22. Patients also receive pembrolizumab IV over 1 hour on day 2 every 3 weeks for up to 16 cycles (1 year) in the absence of disease progression or unacceptable toxicity. Laboratory Biomarker Analysis: Correlative studies Pembrolizumab: Given IV Rituximab: Given IV
Cohort II (Rituximab, Pembrolizumab, Lenalidomide)
n=14 participants at risk
Patients receive rituximab IV over 4-8 hours on days 1, 8 and 15 of cycle 1, and day 1 of cycle 2. Patients also receive pembrolizumab IV over 1 hour on day 2 every 3 weeks for up to 2 years, and lenalidomide PO on days 1-14 every 3 weeks for up to 12 cycles in the absence of disease progression or unacceptable toxicity. Laboratory Biomarker Analysis: Correlative studies Lenalidomide: Given PO Pembrolizumab: Given IV Rituximab: Given IV
Infections and infestations
Meningits
3.3%
1/30 • Approximately 1 year and 6 months
0.00%
0/14 • Approximately 1 year and 6 months
Gastrointestinal disorders
Nausea/ Headache
3.3%
1/30 • Approximately 1 year and 6 months
0.00%
0/14 • Approximately 1 year and 6 months
Gastrointestinal disorders
Vomiting
3.3%
1/30 • Approximately 1 year and 6 months
0.00%
0/14 • Approximately 1 year and 6 months
Skin and subcutaneous tissue disorders
Atrial Flutter
3.3%
1/30 • Approximately 1 year and 6 months
0.00%
0/14 • Approximately 1 year and 6 months
Nervous system disorders
Hyperglycemia
3.3%
1/30 • Approximately 1 year and 6 months
7.1%
1/14 • Approximately 1 year and 6 months
Nervous system disorders
Neoplasams
3.3%
1/30 • Approximately 1 year and 6 months
0.00%
0/14 • Approximately 1 year and 6 months
Blood and lymphatic system disorders
Alainine Aminotransferase Increased
3.3%
1/30 • Approximately 1 year and 6 months
0.00%
0/14 • Approximately 1 year and 6 months
General disorders
Fever
3.3%
1/30 • Approximately 1 year and 6 months
14.3%
2/14 • Approximately 1 year and 6 months
Skin and subcutaneous tissue disorders
Rash
3.3%
1/30 • Approximately 1 year and 6 months
0.00%
0/14 • Approximately 1 year and 6 months
Gastrointestinal disorders
Abdominal Pain
3.3%
1/30 • Approximately 1 year and 6 months
0.00%
0/14 • Approximately 1 year and 6 months
Gastrointestinal disorders
Diarrhea
3.3%
1/30 • Approximately 1 year and 6 months
0.00%
0/14 • Approximately 1 year and 6 months
Blood and lymphatic system disorders
Febrile Neutropenia (Neutropenia Fever)
0.00%
0/30 • Approximately 1 year and 6 months
21.4%
3/14 • Approximately 1 year and 6 months
Respiratory, thoracic and mediastinal disorders
Respiratory Failire
0.00%
0/30 • Approximately 1 year and 6 months
7.1%
1/14 • Approximately 1 year and 6 months
Respiratory, thoracic and mediastinal disorders
Pneumonitis
0.00%
0/30 • Approximately 1 year and 6 months
7.1%
1/14 • Approximately 1 year and 6 months
Vascular disorders
Pulmonary Embolism
0.00%
0/30 • Approximately 1 year and 6 months
7.1%
1/14 • Approximately 1 year and 6 months
Respiratory, thoracic and mediastinal disorders
Hypoxia/ Lung Infection
0.00%
0/30 • Approximately 1 year and 6 months
7.1%
1/14 • Approximately 1 year and 6 months
Infections and infestations
Lung Infection
0.00%
0/30 • Approximately 1 year and 6 months
7.1%
1/14 • Approximately 1 year and 6 months
Respiratory, thoracic and mediastinal disorders
Pneumonia
0.00%
0/30 • Approximately 1 year and 6 months
7.1%
1/14 • Approximately 1 year and 6 months

Other adverse events

Other adverse events
Measure
Cohort I (Rituximab, Pembrolizumab)
n=30 participants at risk
Patients receive rituximab IV over 4-8 hours on days 1, 8, 15, and 22. Patients also receive pembrolizumab IV over 1 hour on day 2 every 3 weeks for up to 16 cycles (1 year) in the absence of disease progression or unacceptable toxicity. Laboratory Biomarker Analysis: Correlative studies Pembrolizumab: Given IV Rituximab: Given IV
Cohort II (Rituximab, Pembrolizumab, Lenalidomide)
n=14 participants at risk
Patients receive rituximab IV over 4-8 hours on days 1, 8 and 15 of cycle 1, and day 1 of cycle 2. Patients also receive pembrolizumab IV over 1 hour on day 2 every 3 weeks for up to 2 years, and lenalidomide PO on days 1-14 every 3 weeks for up to 12 cycles in the absence of disease progression or unacceptable toxicity. Laboratory Biomarker Analysis: Correlative studies Lenalidomide: Given PO Pembrolizumab: Given IV Rituximab: Given IV
General disorders
Eye Pain
26.7%
8/30 • Approximately 1 year and 6 months
0.00%
0/14 • Approximately 1 year and 6 months
Gastrointestinal disorders
Constipation
3.3%
1/30 • Approximately 1 year and 6 months
21.4%
3/14 • Approximately 1 year and 6 months
General disorders
Fever
6.7%
2/30 • Approximately 1 year and 6 months
14.3%
2/14 • Approximately 1 year and 6 months
Gastrointestinal disorders
Abdominal Pain
6.7%
2/30 • Approximately 1 year and 6 months
0.00%
0/14 • Approximately 1 year and 6 months
General disorders
Eye Disorders
6.7%
2/30 • Approximately 1 year and 6 months
0.00%
0/14 • Approximately 1 year and 6 months
General disorders
Blurred Vision
16.7%
5/30 • Approximately 1 year and 6 months
0.00%
0/14 • Approximately 1 year and 6 months
Respiratory, thoracic and mediastinal disorders
Chest Pain
3.3%
1/30 • Approximately 1 year and 6 months
0.00%
0/14 • Approximately 1 year and 6 months
Respiratory, thoracic and mediastinal disorders
Productive Cough
3.3%
1/30 • Approximately 1 year and 6 months
0.00%
0/14 • Approximately 1 year and 6 months
Blood and lymphatic system disorders
White Blood Cound Decrease
10.0%
3/30 • Approximately 1 year and 6 months
28.6%
4/14 • Approximately 1 year and 6 months
General disorders
Edema Limbs
3.3%
1/30 • Approximately 1 year and 6 months
0.00%
0/14 • Approximately 1 year and 6 months
Metabolism and nutrition disorders
Hyperglycemia
6.7%
2/30 • Approximately 1 year and 6 months
7.1%
1/14 • Approximately 1 year and 6 months
Metabolism and nutrition disorders
Hyperkalemia
6.7%
2/30 • Approximately 1 year and 6 months
0.00%
0/14 • Approximately 1 year and 6 months
Musculoskeletal and connective tissue disorders
Arthralgia
3.3%
1/30 • Approximately 1 year and 6 months
7.1%
1/14 • Approximately 1 year and 6 months
General disorders
Left Shoulder Pain
0.00%
0/30 • Approximately 1 year and 6 months
7.1%
1/14 • Approximately 1 year and 6 months
General disorders
Ankle Pain
0.00%
0/30 • Approximately 1 year and 6 months
7.1%
1/14 • Approximately 1 year and 6 months
Skin and subcutaneous tissue disorders
Palpulopustialar Rash
0.00%
0/30 • Approximately 1 year and 6 months
7.1%
1/14 • Approximately 1 year and 6 months
Skin and subcutaneous tissue disorders
Pruritus
0.00%
0/30 • Approximately 1 year and 6 months
7.1%
1/14 • Approximately 1 year and 6 months
Blood and lymphatic system disorders
Creatinine Increase
0.00%
0/30 • Approximately 1 year and 6 months
7.1%
1/14 • Approximately 1 year and 6 months
Blood and lymphatic system disorders
Decrease Total Protein
0.00%
0/30 • Approximately 1 year and 6 months
7.1%
1/14 • Approximately 1 year and 6 months
Investigations
Sinus Bradycardia
0.00%
0/30 • Approximately 1 year and 6 months
7.1%
1/14 • Approximately 1 year and 6 months
General disorders
Hyponatremia
0.00%
0/30 • Approximately 1 year and 6 months
7.1%
1/14 • Approximately 1 year and 6 months
Investigations
Alkaline Phosphatase Increase
0.00%
0/30 • Approximately 1 year and 6 months
7.1%
1/14 • Approximately 1 year and 6 months
Metabolism and nutrition disorders
Hyperuricemia
0.00%
0/30 • Approximately 1 year and 6 months
14.3%
2/14 • Approximately 1 year and 6 months
Metabolism and nutrition disorders
Hypomagnesemia
0.00%
0/30 • Approximately 1 year and 6 months
7.1%
1/14 • Approximately 1 year and 6 months
Metabolism and nutrition disorders
hypoalbuminemia
0.00%
0/30 • Approximately 1 year and 6 months
7.1%
1/14 • Approximately 1 year and 6 months
Investigations
INR Increased
0.00%
0/30 • Approximately 1 year and 6 months
7.1%
1/14 • Approximately 1 year and 6 months
Investigations
Activated partial thromboplastin time prolonged
0.00%
0/30 • Approximately 1 year and 6 months
7.1%
1/14 • Approximately 1 year and 6 months
Blood and lymphatic system disorders
AST Increased
0.00%
0/30 • Approximately 1 year and 6 months
35.7%
5/14 • Approximately 1 year and 6 months
Musculoskeletal and connective tissue disorders
Pain in Extremity
0.00%
0/30 • Approximately 1 year and 6 months
7.1%
1/14 • Approximately 1 year and 6 months
Blood and lymphatic system disorders
Peripheal Sensory Neuropathy
0.00%
0/30 • Approximately 1 year and 6 months
21.4%
3/14 • Approximately 1 year and 6 months
General disorders
Localized Edema
0.00%
0/30 • Approximately 1 year and 6 months
7.1%
1/14 • Approximately 1 year and 6 months
General disorders
Sore Throat
0.00%
0/30 • Approximately 1 year and 6 months
7.1%
1/14 • Approximately 1 year and 6 months
Respiratory, thoracic and mediastinal disorders
Nasal Congestion
0.00%
0/30 • Approximately 1 year and 6 months
7.1%
1/14 • Approximately 1 year and 6 months
Blood and lymphatic system disorders
Blood Lymphatic System Disorder
0.00%
0/30 • Approximately 1 year and 6 months
7.1%
1/14 • Approximately 1 year and 6 months
Nervous system disorders
Joint Stiffness
0.00%
0/30 • Approximately 1 year and 6 months
7.1%
1/14 • Approximately 1 year and 6 months
Blood and lymphatic system disorders
Increased TSH
0.00%
0/30 • Approximately 1 year and 6 months
7.1%
1/14 • Approximately 1 year and 6 months
Blood and lymphatic system disorders
Decreased IGG
0.00%
0/30 • Approximately 1 year and 6 months
7.1%
1/14 • Approximately 1 year and 6 months
Respiratory, thoracic and mediastinal disorders
Respiratory Failure
0.00%
0/30 • Approximately 1 year and 6 months
7.1%
1/14 • Approximately 1 year and 6 months
Infections and infestations
Urinary Tract Infection
0.00%
0/30 • Approximately 1 year and 6 months
7.1%
1/14 • Approximately 1 year and 6 months
General disorders
Hyperthyroidism
0.00%
0/30 • Approximately 1 year and 6 months
14.3%
2/14 • Approximately 1 year and 6 months
Respiratory, thoracic and mediastinal disorders
Hypoxia
0.00%
0/30 • Approximately 1 year and 6 months
7.1%
1/14 • Approximately 1 year and 6 months
Respiratory, thoracic and mediastinal disorders
Pneumonitis
6.7%
2/30 • Approximately 1 year and 6 months
0.00%
0/14 • Approximately 1 year and 6 months
General disorders
Hypocalcemia
0.00%
0/30 • Approximately 1 year and 6 months
7.1%
1/14 • Approximately 1 year and 6 months
Gastrointestinal disorders
Diarrhea
26.7%
8/30 • Approximately 1 year and 6 months
21.4%
3/14 • Approximately 1 year and 6 months
Gastrointestinal disorders
Liver Enzymes Abnormalaties
40.0%
12/30 • Approximately 1 year and 6 months
0.00%
0/14 • Approximately 1 year and 6 months
Gastrointestinal disorders
Oral Mucositis
10.0%
3/30 • Approximately 1 year and 6 months
0.00%
0/14 • Approximately 1 year and 6 months
Skin and subcutaneous tissue disorders
Rash
23.3%
7/30 • Approximately 1 year and 6 months
0.00%
0/14 • Approximately 1 year and 6 months
Blood and lymphatic system disorders
Lymphocyte Count Decreased
33.3%
10/30 • Approximately 1 year and 6 months
0.00%
0/14 • Approximately 1 year and 6 months
Gastrointestinal disorders
Gastritis/ Esophagitis
3.3%
1/30 • Approximately 1 year and 6 months
0.00%
0/14 • Approximately 1 year and 6 months
Nervous system disorders
Headache
3.3%
1/30 • Approximately 1 year and 6 months
7.1%
1/14 • Approximately 1 year and 6 months
Musculoskeletal and connective tissue disorders
Myalgia
20.0%
6/30 • Approximately 1 year and 6 months
7.1%
1/14 • Approximately 1 year and 6 months
Respiratory, thoracic and mediastinal disorders
Dyspnea/ Wheezing
13.3%
4/30 • Approximately 1 year and 6 months
28.6%
4/14 • Approximately 1 year and 6 months
Blood and lymphatic system disorders
Hyperkalemia
6.7%
2/30 • Approximately 1 year and 6 months
0.00%
0/14 • Approximately 1 year and 6 months
Blood and lymphatic system disorders
Hyperglycemia
6.7%
2/30 • Approximately 1 year and 6 months
0.00%
0/14 • Approximately 1 year and 6 months
Blood and lymphatic system disorders
White Blood Count Decrease
16.7%
5/30 • Approximately 1 year and 6 months
0.00%
0/14 • Approximately 1 year and 6 months
Nervous system disorders
Fatigue
36.7%
11/30 • Approximately 1 year and 6 months
14.3%
2/14 • Approximately 1 year and 6 months
Gastrointestinal disorders
Nausea/ Vomitting
3.3%
1/30 • Approximately 1 year and 6 months
28.6%
4/14 • Approximately 1 year and 6 months
Infections and infestations
Menugitis
3.3%
1/30 • Approximately 1 year and 6 months
0.00%
0/14 • Approximately 1 year and 6 months
Nervous system disorders
Dizziness
3.3%
1/30 • Approximately 1 year and 6 months
0.00%
0/14 • Approximately 1 year and 6 months
Vascular disorders
Hypertension
10.0%
3/30 • Approximately 1 year and 6 months
7.1%
1/14 • Approximately 1 year and 6 months
General disorders
Infusion Related Reaction
6.7%
2/30 • Approximately 1 year and 6 months
0.00%
0/14 • Approximately 1 year and 6 months
General disorders
Watering Eyes
26.7%
8/30 • Approximately 1 year and 6 months
0.00%
0/14 • Approximately 1 year and 6 months
General disorders
Irritated Eyes
3.3%
1/30 • Approximately 1 year and 6 months
0.00%
0/14 • Approximately 1 year and 6 months
Respiratory, thoracic and mediastinal disorders
Cough
20.0%
6/30 • Approximately 1 year and 6 months
14.3%
2/14 • Approximately 1 year and 6 months

Additional Information

Ranjit Nair, MD

The University of Texas MD Anderson Cancer Center

Phone: (281) 787-7904

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place