The goal of this clinical research study is to learn if CC-5013 (lenalidomide) can help to
control myelofibrosis. The safety of lenalidomide in the treatment of myelofibrosis will
also be studied.
Lenalidomide blocks the activity of a substance in the blood called tumor necrosis factor
alpha. Tumor necrosis factor alpha is a substance that is believed to prevent new blood
cells from forming in the bone marrow. Lenalidomide is also believed to help the body's
immune system fight diseases.
Before treatment starts, you will have a complete physical exam, including blood (about 3
teaspoonfuls) and urine tests. A bone marrow sample will be taken. To collect a bone marrow
sample, an area of the hip or chest bone is numbed with anesthetic and a small amount of
bone marrow is withdrawn through a large needle. An ECG (test to measure the electrical
activity of the heart) may be performed.
Women who are able to have children must have a negative pregnancy test [blood (about 1
teaspoon) or urine]. These pregnancy tests must occur within 10 - 14 days and again within
24 hours before the start of lenalidomide. Women who are able to have children with regular
or no menstruation must have a pregnancy test weekly for the first 28 days and then every 28
days while on therapy (including breaks in therapy); when they stop taking lenalidomide and
at Day 28 after the last dose of lenalidomide. Females with irregular menstruation must
have a pregnancy test weekly for the first 28 days and then every 14 days while on therapy
(including breaks in therapy), when they stop taking lenalidomide and at Day 14 and Day 28
after the last dose of lenalidomide.
You are considered to be a woman who is able to have children if you are a sexually mature
female who: 1) has not undergone a hysterectomy or bilateral oophorectomy; or 2) has not
been naturally postmenopausal for at least 24 consecutive months (i.e., has had menses at
any time in the preceding 24 consecutive months).
You will take 2 lenalidomide capsules by mouth daily. You should swallow lenalidomide
capsules whole with water at the same time each day. Do not break, chew or open the
capsules. If you miss a dose of lenalidomide, take it as soon as you remember on the same
day. If you miss taking your dose for the entire day, take your regular dose the next
scheduled day (do NOT take double your regular dose to make up for the missed dose).
If your platelet count is less than 100,000 at the time of study enrollment, the dose will
be one capsule daily. The dose may be decreased depending on side effects. The dose may be
increased if needed to better control the disease. This will be decided cycle by cycle.
During treatment, you will give blood samples (about 1 tablespoon each) about every week.
The tests may be repeated more frequently to check for side effects. You will need to
return to M. D. Anderson monthly for the first 3 months, then at least every 3 months
afterwards (while on the study) in order to be evaluated for response and tolerance to
lenalidomide. Only one 28-day cycle of lenalidomide may be given to you for each cycle per
You may continue to receive this therapy as long as there are no severe side effects or
worsening of the disease. You will be asked to keep diaries documenting when you take the
capsules. You will also need to return empty medication bottles at each visit. If you have
had 4 to 6 months of treatment without any evidence of benefit, you may be taken off the
This is an investigational study. Lenalidomide is a new drug related to the drug called
thalidomide. Lenalidomide is approved by the Food and Drug Administration (FDA) for the
treatment of specific types of myelodysplastic syndrome (MDS) and in combination with
dexamethasone for patients with multiple myeloma (MM) who have received at least 1 prior
therapy. MDS and MM are cancers of the blood. It is currently being tested in a variety of
cancer conditions. In this case it is considered investigational. Up to 41 participants may
take part in this study. All will be enrolled at M. D. Anderson.
- Diagnosis of myelofibrosis or Philadelphia negative myeloproliferative disorder with
myelofibrosis requiring therapy.
- Disease-free of prior malignancies for greater than or equal to 2 years with
exception of basal cell, squamous cell carcinoma of the skin, or carcinoma "in situ"
of the cervix or breast.
- Eastern Cooperative Oncology Group (ECOG) performance status 0 to 3.
- Total bilirubin less than or equal to 3.0 mg/dL (unless due to tumor) and serum
creatinine less than or equal to 3.0 mg/dL (unless due to tumor).
- Females of childbearing potential (FCBP)† must have a negative serum or urine
pregnancy test with a sensitivity of at least 50 mIU/mL within 10 - 14 days prior to
and again within 24 hours of starting lenalidomide and must either commit to
continued abstinence from heterosexual intercourse or begin TWO acceptable methods of
birth control, one highly effective method and one additional effective method AT THE
SAME TIME, at least 4 weeks before she starts taking lenalidomide. FCBP must also
agree to ongoing pregnancy testing.
- continued from above.....Men must agree to use a condom during sexual contact with a
female of child bearing potential even if they have had a successful vasectomy. All
patients must be counseled at a minimum of every 28 days about pregnancy precautions
and risks of fetal exposure.
- continued from above.....† A female of childbearing potential is a sexually mature
woman who: 1) has not undergone a hysterectomy or bilateral oophorectomy; or 2) has
not been naturally postmenopausal for at least 24 consecutive months (i.e., has had
menses at any time in the preceding 24 consecutive months).
- Signed informed consent.
- Use of any other experimental drug or therapy within 28 days of therapy, except in
cases with rapidly progressive disease and/or recovery from all toxicity from
previous therapy (does not apply to growth factors).
- Platelet count less than 30,000.
- Known prior clinically relevant hypersensitivity reaction or desquamating rash with
- Prior therapy with CC-5013.
- Pregnancy, suspected pregnancy or breast feeding females.